Premature infants are at risk for abnormal sensory development due to brain immaturity at birth and atypical early sensory experiences in the Neonatal Intensive Care Unit. This altered sensory development can have downstream effects on other more complex developmental processes. There are currently no interventions that address rehabilitation of sensory function in the neonatal period. This study is a randomized controlled trial of preterm infants enrolled at 32–36 weeks postmenstrual age to either standard care or standard care plus multisensory intervention in order to study the effect of multisensory intervention as compared to standard care alone. The study population will consist of 100 preterm infants in each group (total n = 200). Both groups will receive standard care, consisting of non-contingent recorded parent’s voice and skin-to-skin by parent. The multisensory group will also receive contemporaneous holding and light pressure containment for tactile stimulation, playing of the mother’s voice contingent on the infant’s pacifier sucking for auditory stimulation, exposure to a parent-scented cloth for olfactory stimulation, and exposure to carefully regulated therapist breathing that is mindful and responsive to the child’s condition for vestibular stimulation. The primary outcome is a brain-based measure of multisensory processing, measured using time locked-EEG. Secondary outcomes include sensory adaptation, tactile processing, speech sound differentiation, motor and language function, measured at one and two years corrected gestational age. This is the first randomized controlled trial of a multisensory intervention using brain-based measurements in order to explain the causal effects of the multisensory intervention on neural processing changes to mediate neurodevelopmental outcomes in former preterm infants. In addition to contributing a critical link in our understanding of these processes, the protocolized multisensory intervention in this study is therapist administered, parent supported and leverages simple technology. Thus, this multisensory intervention has the potential to be widely implemented in various NICU settings, with the opportunity to potentially improve neurodevelopment of premature infants. NIH Clinical Trials ( clinicaltrials.gov ): NCT03232931 . Registered July 2017.

Multisensory processes include the capacity to combine information from the different senses, often improving stimulus representations and behavior. The extent to which multisensory processes are an innate capacity or instead require experience with environmental stimuli remains debated. We addressed this knowledge gap by studying multisensory processes in prematurely born and full-term infants. We recorded 128-channel event-related potentials (ERPs) from a cohort of 55 full-term and 61 preterm neonates (at an equivalent gestational age) in response to auditory, somatosensory, and combined auditory-somatosensory multisensory stimuli. Data were analyzed within an electrical neuroimaging framework, involving unsupervised topographic clustering of the ERP data. Multisensory processing in full-term infants was characterized by a simple linear summation of responses to auditory and somatosensory stimuli alone, which furthermore shared common ERP topographic features. We refer to the ERP topography observed in full-term infants as “typical infantile processing” (TIP). In stark contrast, preterm infants exhibited non-linear responses and topographies less-often characterized by TIP; there were distinct patterns of ERP topographies to multisensory and summed unisensory conditions. We further observed that the better TIP characterized an infant’s ERPs, independently of prematurity, the more typical was the score on theInfant/Toddler Sensory Profile(ITSP) at 12 months of age and the less likely was the child to the show internalizing tendencies at 24 months of age. Collectively, these results highlight striking differences in the brain’s responses to multisensory stimuli in children born prematurely; differences that relate to later sensory and internalizing functions.

The aims of this study were to identify the aspects of school readiness that best distinguish very preterm (VPT) preschoolers from full-term (FT) controls, determine the extent to which readiness problems in the VPT group reflected global cognitive weaknesses or more specific deficits, and identify distinct profiles of readiness problems. Fifty-three VPT (gestational age ≤ 30 weeks) 4-year-olds were compared to 38 FT (gestational age ≥ 37 weeks) controls on measures of global cognitive ability, executive function, motor skills, early literacy and numeracy, and psychosocial functioning. Latent class analysis (LCA) was also conducted to identify individual readiness profiles. The VPT group had the most pronounced difficulties on tests of spatial and nonverbal cognitive abilities, executive function, motor skills, phonological processing, and numeracy. The VPT group also had sex-related difficulties in processing speed, social functioning, and emotion regulation. These differences were evident in analyses of both continuous scores and rates of deficits. The VPT group’s difficulties in motor skills, and VPT females’ difficulties in social functioning and emotion regulation, were evident even when controlling for global cognitive ability. LCA suggested four profiles of readiness, with the majority of the VPT group assigned to profiles characterized by relative weaknesses in either cognitive abilities or psychosocial functioning or by more global readiness problems. The findings support the need to evaluate multiple aspects of school readiness in VPT preschoolers and inform efforts to design more targeted early educational interventions.