Evaluation of the effectiveness of early intervention methods in newborns who have suffered hypoxic-ischemic CNS damage

  • I. V. Halactionova Vinnytsia Regional Children's Clinical Hospital, Vinnytsia, Ukraine
  • O. I. Iziumets National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • N. D. Korolova National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • K. V. Zhuk National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • V. Y. Angelska National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Keywords: early intervention, newborns, hypoxic-ischemic encephalopathy, assessment of psychomotor development, rehabilitation of young children, effectiveness.

Abstract

Timely diagnosis of cerebral disorders both in the prenatal period and in the early neonatal period, as well as early rehabilitation treatment is the basis for the prevention of childhood disability. To this end, the so-called Early Intervention System is being introduced in Ukraine. The effectiveness of early intervention techniques directly depends on timely diagnosis and correctly chosen intervention tactics. Given the high neuroplasticity of the developing brain, it is advisable to start the elements of neurodevelopmental therapy from infancy. The aim of the work is to evaluate the effectiveness of methods of early intervention in children of the first 3 months of life who have suffered hypoxic-ischemic CNS damage in the neonatal period, by assessing the main indicators of psycho-motor development. 101 children who were treated in the neonatal pathology department due to hypoxic-ischemic CNS damage and did not have concomitant somatic pathology were examined. The children were in the ward for rehabilitation. To assess the effectiveness of comprehensive rehabilitation in young children, it is advisable to use adapted for Ukraine scale of Munich functional developmental diagnostics, which allows to assess the child's development in all major areas, its harmony and effectiveness of rehabilitation measures during the first 3 years of life. Statistical processing of the obtained results should be performed in the license package "Statistica 6.1 for Windows". Timely diagnosis of cerebral disorders both in the prenatal period and in the early neonatal period, as well as early rehabilitation treatment is the basis for the prevention of childhood disability. Given the high neuroplasticity of the developing brain, it is advisable to start the elements of neurodevelopmental therapy from infancy. The effectiveness of the methods recommended for use depends on timely diagnosis and correctly chosen intervention tactics. Assessment of the effectiveness of care for children at risk of deviant psychomotor development should be based on the application of the criteria and scales recommended by international expert groups, which are adapted in our country. Signs of full-fledged early intervention in the region are: perinatal diagnosis of congenital pathology, timely provision of medical and rehabilitation, social and special pedagogical services to children aged 0 to 3 years and their families. In order to achieve the set goals, in our opinion, the priority measures should be steps to implement the national protocol for care for children with perinatal CNS injuries, approval and implementation in Ukraine of the modern International Classification of Functioning, Life and Health Restrictions, providing medical care, rehabilitation and social services for young children.

Downloads

Download data is not yet available.

References

[1] Aikardi, Z. H., Martin, B., Kristofer, G. Turko, K. S., Gerasimov, A. P., Barashkova, S. V., ... & Skoromets, A. A. (2013). Заболевания нервной системы у детей [Diseases of the nervous system in children]. М.: Издательство Панфилова; БИНОМ Лаборатория знаний – М.: Panfilov Publishing House; BINOM Knowledge Laboratory.
[2] Badheka, R., Barad, N. K., & Sankhla, C. S. (2018). Pediatric movement disorders. Neurology India, 66(7), 59-67. doi: 10.4103/0028-3886.226447
[3] Barashnev, Iu. I. (1997). Компенсация нарушенных функций ЦНС и значение стимулирующей терапии при перинатальных повреждениях головного мозга новорожденных [Compensation of impaired central nervous system functions and the importance of stimulating therapy in perinatal brain damage in newborns]. Российский вестник перинатологии и педиатрии – Russian Bulletin of Perinatology and Pediatrics, (6), 7-13.
[4] Berezhnyi, V. V. (2013). Педіатрія: національний підручник [Pediatrics: a national textbook]. Київ: б, (2013) – Kyiv: b, (2013).
[5] Busl, K. M., & Greer, D. M. (2010). Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. NeuroRehabilitation, 26(1), 5-13. doi: 10.3233/NRE-2010-0531
[6] Ciuraj, M., Kieszczyńska, K., Doroniewicz, I., & Lipowicz, A. (2019, June). Subjective and Objective Assessment of Developmental Dysfunction in Children Aged 0–3 Years–Comparative Study. In International Conference on Information Technologies in Biomedicine (pp. 382-391). Springer, Cham. doi: 10.1007/978-3-030-23762-2_34
[7] Clinical Practice Guideline: Report of the Recommendations. (2006). Motor Disorders, Assessment and Intervention for Young Children (Age 0–3 Years). New York State Department of Health, P.O. Box 2000, Albany, New York 12220.
[8] Cowan, F., Rutherford, M., Groenendaal, F., Eken, P., Mercuri, E., Bydder, G. M., ... & de Vries, L. S. (2003). Origin and timing of brain lesions in term infants with neonatal encephalopathy. The Lancet, 361(9359), 736-742. doi: 10.1016/S0140-6736(03)12658-X
[9] Detsyk, O. Z., & Melnyk, R. M. (2017). Вплив появи важкохворої дитини на соціальний статус її родини [The influence of the appearance of a seriously ill child on the social status of her family]. Україна. Здоров'я нації – Ukraine. The health of the nation, (1), 16-21.
[10] Dobrova-Krol, N. (2014). Раннее вмешательство: ключевые аспекты и международный опыт [Early intervention: key aspects and international experience]. URL:http://www.unicef.org/ukraine/ukr/Early_Intervention_Concept_RUS. pdf (date of the application: 1.05. 2018).
[11] Gajewska, E., Sobieska, M., & Samborski, W. (2006). Correlates between Munich Functional Development Diagnostics and postural reactivity findings based on seven provovoked postural reactions modus Vojta during the first period of child's life. In Annales Academiae Medicae Stetinensis (Vol. 52, No. 3, pp. 67-70). PMID: 17385350
[12] Guzzetta, A., D’acunto, M. G., Carotenuto, M., Berardi, N., Bancale, A., Biagioni, E., ... & Cioni, G. (2011). The effects of preterm infant massage on brain electrical activity. Developmental Medicine & Child Neurology, 53, 46-51. doi: 10.1111/j.1469-8749.2011.04065.x
[13] Hackworth, N. J., Berthelsen, D., Matthews, J., Westrupp, E. M., Cann, W., Ukoumunne, O. C., ... & Nicholson, J. M. (2017). Impact of a brief group intervention to enhance parenting and the home learning environment for children aged 6–36 months: A cluster randomised controlled trial. Prevention Science, 18(3), 337-349. doi: 10.1007/s11121-017-0753-9
[14] Hadders‐Algra, M., Boxum, A. G., Hielkema, T., & Hamer, E. G. (2017). Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review. Developmental Medicine & Child Neurology, 59(3), 246-258. doi: 10.1111/dmcn.13331
[15] Hutchon, B., Gibbs, D., Harniess, P., Jary, S., Crossley, S. L., Moffat, J. V., ... & Basu, A. P. (2019). Early intervention programmes for infants at high risk of atypical neurodevelopmental outcome. Developmental Medicine & Child Neurology, 61(12), 1362-1367. doi: 10.1111/dmcn.14187
[16] Johnston, M. V., Fatemi, A., Wilson, M. A., & Northington, F. (2011). Treatment advances in neonatal neuroprotection and neurointensive care. The Lancet Neurology, 10(4), 372-382. doi: 10.1016/S1474-4422(11)70016-3
[17] Koy, A., Lin, J. P., Sanger, T. D., Marks, W. A., Mink, J. W., & Timmermann, L. (2016). Advances in management of movement disorders in children. The Lancet Neurology, 15(7), 719-735. doi: 10.1016/S1474-4422(16)00132-0
[18] Landsem, I. P., Handegård, B. H., Ulvund, S. E., Kaaresen, P. I., & Rønning, J. A. (2015). Early intervention influences positively quality of life as reported by prematurely born children at age nine and their parents; a randomized clinical trial. Health and quality of life outcomes, 13(1), 1-11. doi: 10.1186/s12955-015-0221-9
[19] Liu, J., Li, J., & Gu, M. (2007). The correlation between myocardial function and cerebral hemodynamics in term infants with hypoxic-ischemic encephalopathy. Journal of tropical pediatrics, 53(1), 44-48. doi: 10.1093/tropej/fml053
[20] Martyniuk, V. Yu. (2016). Основи соціальної педіатрії. Навчально-методичний посібник: у 2-х т [Fundamentals of social pediatrics. Training manual: in 2 volumes]. К.: ФОП Верес О.І. – К.: FOP Veres O.I.
[21] Ministry of Health of Ukraine. (2008). Про затвердження Клінічного протоколу медичного догляду за здоровою дитиною віком до 3-х років [On approval of the Clinical Protocol of medical care for a healthy child under 3 years of age]. Нормативно-директивні документи МОЗ України. Наказ № 149 від 20.03.2008 – Regulatory documents of the Ministry of Health of Ukraine. Order № 149 of 20.03.2008.
[22] Ministry of Health of Ukraine. (2013). Про затвердження клінічних настанов та Уніфікованого клінічного протоколу медичної допомоги та медичної реабілітації «Церебральний параліч та інші органічні ураження головного мозку у дітей, які супроводжуються руховими порушеннями» [About the statement of clinical instructions and the Unified clinical protocol of medical care and medical rehabilitation "Cerebral palsy and other organic defeats of a brain at children which are followed by motor disturbances"]. Нормативно-директивні документи МОЗ України. Наказ № 286 від 09.04.2013 – Regulatory documents of the Ministry of Health of Ukraine. Order № 286 of 09.04.2013.
[23] Morgan, C., Novak, I., Dale, R. C., Guzzetta, A., & Badawi, N. (2016). Single blind randomised controlled trial of GAME (Goals Activity Motor Enrichment) in infants at high risk of cerebral palsy. Research in Developmental Disabilities, 55, 256-267. doi: 10.1016/j.ridd.2016.04.005
[24] Richter, L. M., Daelmans, B., Lombardi, J., Heymann, J., Boo, F. L., Behrman, J. R., ... & Lancet Early Childhood Development Series Steering Committee. (2017). Investing in the foundation of sustainable development: pathways to scale up for early childhood development. The Lancet, 389(10064), 103-118. doi: 10.1016/S0140-6736(16)31698-1
[25] Spittle, A., & Treyvaud, K. (2016). The role of early developmental intervention to influence neurobehavioral outcomes of children born preterm. In Seminars in perinatology (Vol. 40, No 8, pp. 542-548). WB Saunders. doi: 10.1053/j.semperi.2016.09.006
[26] Spittle, A., Orton, J., Anderson, P. J., Boyd, R., & Doyle, L. W. (2015). Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database of Systematic Reviews, (11), CD005495. doi: 10.1002/14651858.CD005495.pub4
[27] United Nations Office on Drugs and Crime’s. (2017). Compilation of Evidence-Based Family Skills Training Programmes. URL: https://www.issup.net/knowledge-share/publications/2017-08/compilation-evidence-based-family-skills-training-programmes (date of the application: 10.10. 2019).
[28] Voronenko, Yu. V., Hoida, N. H., & Moiseienko, R. O. (2015). Cучасні аспекти розвитку системи медико-соціальних послуг для уразливих груп дітей в Україні [Modern aspects of the development of the system of medical and social services for vulnerable groups of children in Ukraine]. Український медичний часопис – Ukrainian medical journal, (1), 14-18.
Published
2021-11-27
How to Cite
Halactionova, I. V., Iziumets, O. I., Korolova, N. D., Zhuk, K. V., & Angelska , V. Y. (2021). Evaluation of the effectiveness of early intervention methods in newborns who have suffered hypoxic-ischemic CNS damage. Biomedical and Biosocial Anthropology, (40), 60-65. https://doi.org/10.31393/bba40-2020-10