Short term effect of SAFE early intervention approach in infants born preterm in Turkey: a randomised controlled single blinded study

Apaydın U. , Yıldız R., Yıldız A., Soysal Acar A. Ş. , Gücüyener K., Elbasan B.

AACPDM 75th Annual Meeting, 6 - 09 October 2021, pp.72-73

  • Publication Type: Conference Paper / Summary Text
  • Page Numbers: pp.72-73


Background an d Obj ective(s): Early physiotherapy intervention for
infants born preterm is beneficial for improving neurodevelopmental outcomes, but there is no evidence based early physiotherapy intervention specific to our infants born preterm and
appropriate to the cultural and social structure of our country. In
this study, we developed the SAFE early intervention approach,
which is a family collaborative early intervention approach based
on sensory strategies, activity-based motor training and environmental enrichment. The name of the early intervention approach
was composed of initials of these basic principles and was determined as SAFE early intervention approach (S: Sensory Strategies,
A: Activity Based Motor Training, F: Family Collaboration, E:
Environmental Enrichment). Therefore, our aim was to examine
the short term effects of this approach on sensory, motor, cognitive and language development in infants born preterm.
S tudy D esi gn: Prospective, assessor-blinded, randomised, controlled trial.
S tudy Parti c i pan ts & Set t in g: Infants born <34 weeks and their
caregivers living in Ankara, Turkey.
Materi als/ Me th od s: Of 36 eligible infants with corrected age 910
months, 24 were randomised to neurodevelopmental treatment
(NDT) based home programme (
n=12) and SAFE early intervention programme (n=12). Infants in both groups before the treatment and after 10 weeks of the treatment were assessed by Bayley
Scales of Infant and Toddler Development III (Bayley III),
Hammersmith Infants Neurological Examination (HINE), Test
of Sensory Functions in Infants (TSFI), Canadian Occupational
Performance Measure (COPM), Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS). The 
mental health of the parents was evaluated as using the Depression, Anxiety, Stress Scale Short Form (DASS-SF). All assessments were applied by blinded raters.

Resu lts: Before the treatment, the Bayley III cognitive total score
and language total score of the control group were significantly
higher than SAFE group (
p<0.05). There was no difference
between the groups before the treatment in terms of HINE,
p>0.05). After the
treatment, a significant difference was observed between the
groups in favor of the SAFE group in terms of Bayley III cognitive and language development scores, TSFI, and AHEMD-IS
score (
p<0.05). It was observed that, the SAFE early intervention
approach improved cognitive, language, sensory development
scores. At the same time, better environmental enrichment was
achieved in the SAFE early intervention group.
Conc l us ions/S igni fica nce: This study showed that the SAFE early
intervention approach, composed of sensory strategies and activity-based motor training principles, can be used effectively in the
natural home environments of infants born preterm with the
active participation of their families. Creating an enriched home
environment and acting in cooperation with the family have an
important role in early intervention and rehabilitation practices. It
was thought that, by extending these principles to infants born
preterm at risk in our country, treatment costs could be reduced
and they would contribute significantly to the national health