***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The Infant Health and Development Program is a r and omized clinical trial to test the efficacy of educational and family support services and pediatric follow-up , offered during the first 3 years of life , in reducing the incidence of developmental delay in low birth weight preterm infants at eight clinical sites ( N = 985 ) . It was hypothesized that larger intervention effects would be found for the domains in which low birth weight preterm infants are known to have problems , specifically visual-motor and spatial skills and receptive language skills . These analyses explore the effects of the Infant Health and Development Program on different domains of cognitive functioning . Cognitive domains are identified by means of factor analysis of the intelligence tests used at 12 , 24 , and 36 months ( Bayley Scales of Infant Development ( including the Mental and Motor scales ) at 12 and 24 months ; the Stanford-Binet , Peabody Picture Vocabulary Test , and Beery Test of Visual Motor Intergration at 36 months ) . Our results reveal that , although intervention benefits accrue across cognitive domains at 24 and 36 months , gains are most pronounced for receptive language and visual-motor and spatial skills At a corrected age of 3 months , 80 low birth-weight infants were assigned to normal or at-risk groups on the basis of a neurodevelopmental assessment scale . Both groups were further divided into intervention and non-intervention sub-groups ( 20 infants in each ) . Intervention consisted of monthly hospital-based neurodevelopmental therapy in addition to a home exercise programme . Infants were re-assessed by a physiotherapist at 6 , 9 , and 12 months , and were tested at 12 months by an independent psychologist blinded for infant group . Mean birthweight and gestational age were similar for normal and at-risk groups . At-risk infants had higher mean neurodevelopmental scores throughout the study period and lower 1-year development quotients ( DQ ) than normals . In neither normal nor at-risk groups did neurodevelopmental therapy alter the pattern of development or the outcome OBJECTIVE To determine whether the Infant Behavioral Assessment and Intervention Program ( IBAIP ) , design ed to support and enhance infants ' self-regulatory competence , improved developmental and neurobehavioral outcomes in very low birth weight ( VLBW ) infants . STUDY DESIGN We r and omized 86 infants to 1 intervention before discharge and to 6 to 8 home interventions until 6 months corrected age , and 90 control infants received st and ard care .  Developmental and behavioral outcomes were evaluated at 6 months corrected age with the Bayley Scales of Infant Development-II ( BSID-II ) . Neurobehavioral functioning was evaluated with the  Infant Behavioral Assessment ( IBA ) at baseline and at 6 months corrected age . RESULTS Despite r and omization , some differences in neonatal characteristics were found between the intervention and control infants . After adjustment , intervention effects of 7.2 points ( + /- st and ard error 3.1 ) on the Mental Developmental Index and 6.4 + /- 2.4 points on the Psychomotor Developmental Index favored the intervention infants . The Behavioral Rating Scale of the BSID-II ( P = .000 ) and the  IBA  ( more approach [ P = .003 ] and less stress [ P = .001 ] over time ) also favored the intervention infants . CONCLUSIONS The IBAIP improved the mental , motor , and behavioral outcomes  of VLBW infants at 6 months corrected age Aims : To test the effectiveness of a home based developmental education intervention in improving outcome at 5 years for very preterm infants . Methods : The Avon Premature Infant Project ( APIP ) is a r and omised controlled trial in which the parents of 284 babies born <33 weeks gestational age received a developmental education programme , a social support intervention , or st and ard care .  A term reference population was also recruited . This study reports outcomes at 5 years ( mean age 58 months 15 days ) for 187 ( 66 % ) of these children without disability . Outcomes were assessed using the British Ability Scales II for cognitive development , the Movement ABC for motor impairment , and the Child Behavior Checklist for behavioural problems . Results : Preterm infants showed poorer cognitive performance than their term peers . Mean ( SD ) general conceptual ability ( GCA ) scores were : Portage 99.2 ( 15.7 ) ; parent adviser 100.3 ( 14.8 ) ; preterm control 101.1 ( 15.0 ) ; term reference 107.2 ( 13.4 ) . There were no significant differences between preterm groups in GCA scores indicating no effect of either intervention . Similarly , there was no significant effect of intervention on behavioural or motor outcomes . Further analyses , in which outcome data were adjusted for social factors , did not reveal any differences between the three preterm groups or by subgroups classified by a range of perinatal variables . Conclusion : The small advantage shown at 2 years of age is no longer detectable at 5 years . These results question the effectiveness of early intervention in enhancing cognitive , behavioural , and motor function at 5 years OBJECTIVE . To assess whether improvements in cognitive and behavioral development seen in preschool educational programs persist , we compared those in a multisite r and omized trial of such a program over the first 3 years of life ( INT ) to those with follow-up only ( FUO ) at 18 months of age . METHODS . This was a prospect i ve follow-up of the Infant Health and Development Program at 8 sites heterogeneous for sociodemographic characteristics . Originally 985 children were r and omized to the INT ( n = 377 ) or FUO ( n = 608 ) groups within 2 birth weight strata : heavier low birth weight ( HLBW ; 2001–2499 g ) and lighter low birth weight ( LLBW ; ≤2000 g ) . Primary outcome measures were the Peabody Picture Vocabulary Test ( PPVT-III ) , reading and mathematics subscales of the Woodcock-Johnson Tests of Achievement , youth self-report on the Total Behavior Problem Index , and high-risk behaviors on the Youth Risk Behavior Surveillance System ( YRBSS ) . Secondary outcomes included Weschler full-scale IQ , caregiver report on the Total Behavior Problem Index , and caregiver and youth self-reported physical health using the Medical Outcome Study measure . Assessors were masked as to study status . RESULTS . We assessed 636 youths at 18 years ( 64.6 % of the 985 , 72 % of whom had not died or refused at prior assessment s ) . After adjusting for cohort attrition , differences favoring the INT group were seen on the Woodcock-Johnson Tests of Achievement in math ( 5.1 points ) , YRBSS ( −0.7 points ) , and the PPVT-III ( 3.8 points ) in the HLBW youth . In the LLBW youth , the Woodcock-Johnson Tests of Achievement in reading was higher in the FUO than INT group ( 4.2 ) . CONCLUSIONS . The findings in the HLBW INT group provide support for preschool education to make long-term changes in a diverse group of children who are at developmental risk . The lack of observable benefit in the LLBW group raises questions about the biological and educational factors that foster or inhibit sustained effects of early educational intervention A r and omised controlled trial was conducted to evaluate the effect of a motor developmental program in improving motor performance in Thai infants born preterm . Eighty-four preterm born infants were r and omly assigned to either a control or intervention group . Additionally , 27 low-risk preterm infants were included forming a comparative group for this study . From term equivalent age to four months adjusted age , all infants had their motor performance assessed monthly with the Test of Infant Motor Performance by one of the physiotherapist research assistants blind to group assignment and infants ' adjusted age . In addition , the intervention infants received a developmental program at each monthly visit . Motor performance for each group plotted against age revealed linear trends of progression . The intervention group showed the greatest improvement . Two-way repeated measures ANOVA revealed significant differences across age and among groups . Scheffé comparisons indicated that the mean differences between each pair of the three groups were significant and supported the finding of greater improvement of the intervention infants over the control group . Thus the results suggest that the intervention program is likely to have beneficial effects when offered to a similar population of preterm born infants A prospect i ve , r and omized , controlled trial was conducted to assess the effects of early physical therapy on infants at risk for neurologic sequelae and to evaluate the impact of such early treatment on the prevention or minimization of future h and icaps . A cohort of 134 infants who had received care in two Montreal inborn neonatal intensive care units was identified prospect ively . Infants were stratified according to prognosis and birth weight and were r and omly assigned to either an experimental or control group . Babies assigned to the experimental group received early physical therapy , whereas those allocated to the control group received conventional follow-up care . Outcome measures were administered by independent evaluators at 12 months and included measures of neurologic status , motor and overall development , and physical growth . No statistically significant differences on any of the measured outcomes at 12 months were found between the experimental and control groups . Infants weighing less than 750 g at birth , regardless of group assignment , consistently demonstrated significant delays in their growth and development when compared with their heavier peers . The early physical therapy program investigated in this study was not efficacious in altering the pattern of motor development in those high-risk infants participating in the trial Mothers of low-birthweight babies born at the Medical Center Hospital of Vermont during a 21-month period were r and omly assigned to experimental ( N = 34 ) and control ( N = 40 ) groups . Forty-one normal-birthweight controls were also recruited . Experimental mothers received an 11-session intervention program which emphasized maternal sensitivity and responsiveness to infant social signals . This paper analyzes the impact of the program , by 6 months , on maternal adaptation and psychopathology , and on infant cognitive development and temperament BACKGROUND Preterm infants are at increased risk of cognitive , motor and behavioral problems . Different intervention programs have been design ed in an attempt to improve outcome , but the results are conflicting . OBJECTIVE To examine the effects of an early intervention program on cognitive , motor and behavioral problems and parenting stress among low birth weight children at 2 years corrected age . METHODS A r and omized controlled trial was conducted including infants with a birth weight < 2000 g treated at the University Hospital of North Norway , to examine the effects of a  modified version of the Mother-Infant Transaction Program on cognitive , motor and behavioral outcomes and parenting stress . The children were assessed with the Bayley Scales of Infant Development and the Child Behavior Checklist/2 - 3 ( CBCL ) and the Parenting Stress Index were administered to the parents at 2 years corrected age . RESULTS Sixty-nine children in the intervention group and 67 in the control group were assessed at 2 years . There were no differences between the groups in cognitive or motor outcomes . The intervention group scored consistently lower on all CBCL syndrome scales , but no difference was significant . The mothers in the intervention group reported significantly lower parental stress in both child and parent domain , whereas the fathers reported lower stress in child domain compared to the control group . CONCLUSION This early intervention program does not improve cognitive , motor or behavioral outcomes at 2 years . There was a significant reduction in parenting stress reported by both mothers and fathers in the intervention group The outcome of an early intervention program for low-birthweight ( LBW ) infants was examined in this study . The intervention consisted of 11 sessions , beginning during the final week of hospitalization and extending into the home over a 3-month period . The program aim ed to facilitate maternal adjustment to the care of a LBW infant , and , indirectly , to enhance the child 's development .  Neonates weighing less than 2,200 grams and under 37 weeks gestational age were r and omly assigned to experimental or control conditions . A full-term , normal birthweight ( NBW ) group served as a second control . 6-month analyses of dyads who completed all assessment s over a 4-year period ( N 's = 25 LBW experimental , 29 LBW control , and 28 NBW infant-mother dyads ) showed that the experimental group mothers reported significantly greater self-confidence and satisfaction with mothering , as well as more favorable perception of infant temperament than LBW control group mothers . A progressive divergence between the LBW experimental and LBW control children on cognitive scores culminated in significant group differences on the McCarthy GCI at ages 36 and 48 months , when the LBW experimental group caught up to the NBW group . Possible explanations for the observed delay in the emergence of intervention effects on cognitive development and the mediating role of favorable mother-infant transactional patterns are discussed in light of recent evidence from the literature AIM To test the effectiveness of a home based developmental education programme in very preterm children . METHODS A r and omised controlled trial was conducted of developmental or social support intervention , started at discharge for up to 2 years , in 309 consecutive survivors of 32 weeks gestation or less , born to mothers resident in greater Bristol between December 1990 and July 1993 . Home visits were made by research nurses trained in either Portage ( a developmental education programme ) or in nondirectional counselling ( parent adviser scheme ) . Interventions were also provided to appropriate primary care and community support for disability . Griffiths Mental Development Scales were used to assess outcome at 2 years . RESULTS Mean ( SEM ) Griffiths quotients ( GQ ) were : Portage 96.8 ( 1.6 ) ; parent adviser 95.9 ( 1.6 ) ; preterm control 92 
    Output:
    
Early intervention had little effect on motor outcome at infant or school age , and there was no study reporting motor outcome at preschool age .
INTERPRETATION Current evidence suggests that the benefits of developmental intervention postdischarge are restricted to short-term gains in cognitive outcome