Les programmes d'intervention pour les enfants prématurés et leur impact sur le développement: Et trop et pas assez

Abstract

This paper critically reviews the literature on intervention programs applied to premature infants during the first weeks of life and their impact on the child's later development. In light of the findings that both interventions that call for reducing stimulation and those that advocate increasing stimulation report gains in similar doamains (e.g., increased weight gain, earlier hospital discharge, better cognitive development in the first weeks of life), the paper examines potential mechanisms that may mediate these improvements. It is suggested that the various intervention programs operate on the same neuro-developmental systeminfant state - and increase the level of organization in this system, thereby promoting the premature infant's orientation to his/her surrounding. Mother-infant skin-to-skin contact (Kangaroo Care, KC) is discussed as an intervention that buffers overwhelming stimulation on the one hand, and provides necessary tactile, olfactory, rythmic-proprioceptive input within the mother-infant attachment relationship on the other hand. Finally, results from our recent large-scale study on the effects of the KC intervention demonstrate positive gains in infants' cognitive, self-regulatory, attentional, and exploratory capacities, as well as improvement in maternal sensitivity and infant social behavior.