Music Therapy in Infancy and Neurodevelopmental Outcomes in Preterm Children

This secondary analysis of the LongSTEP randomized clinical trial compares cognitive, language, and motor scores at the 24-month follow-up among preterm infants receiving a music therapy intervention that included parent-led, infant-directed singing vs those receiving standard care.


eAppendix. Standardization procedures of neurodevelopmental assessment with the Bayley Scales of Infant and Toddler Development, 3 rd edition (BISD-III)
The standardization procedures prior to assessments were adjusted to the assessors' level of experience.Those with no prior experience with BSID-III assessments (Poland) took part in five standardization exercises along with a video recording of an assessment evaluated by a project senior psychologist.In the standardization procedures, the assessors administered the test with a child at approximately 24 months while the other assessor observed and double scored.The assessors were ready to start with assessments for the LongSTEP study when an inter-rater agreement >0.9 was reached in the standardization exercises and the video was approved by the project senior psychologists.Assessors with experience in BSID-III assessments (Argentina, Israel, Colombia and Norway) did not take part in these standardization procedures.

eTable 1. Infant baseline characteristics of those followed-up versus lost to follow-up
Abbreviations: SD, standard deviation; GA, gestational age; PMA, post-menstrual age; IVH, intraventricular hemorrhage 1 IVH was diagnosed by cranial ultrasound and graded according to Papile et al. 1 2 From two-sided Z-test;

eFigure 2 .eFigure 3 .
Estimates of intervention effects on the Bayley Scales of Infant and Toddler Development, 3 rd edition (BISD-III) Language Composite score by selected clinical/demographic predictors Note.Graphical display of the estimates in the model presented in eTable 4. Effects of music interventions on the Bayley Scales of Infant and Toddler Development, 3 rd edition (BISD-III) at 24 months across studies a) Language Composite b) Motor composite c) Cognitive Composite Note: We present random-effects meta-analyses because of high clinical heterogeneity between interventions.Lejeune et al. 2 used music listening to recorded music without a music therapist (tracks were created by a nurse); Haslbeck et al. 3 used creative MT where the music therapist led the intervention; Bieleninik et al (present study) used parent-led, infant-directed singing predominantly led by the parent.End Study Heterogeneity: I 2 = 0%,  2 = 0, p = 0.77 Test for subgroup differences:  2 2 = 1.76, df = 2 (p = 0.41)

Weight at enrollment (grams), mean (sd)
3From two-sided t-test; 4 From chi square test

eTable 2. Completers by country and intervention group
Standard care Standard care; MTSC, Music therapy Standard care; SCMT, Standard care Music therapy; MTMT, Music therapy Music therapy; ARG, Argentina; COL, Colombia; ISR, Israel; NOR, Norway; POL, Poland Note.Showing completers (valid BSID-III Language Composite Score), totals, and percentage of completers by country and intervention group.No significant association of completers between country and intervention group was found (Fisher's Exact Test for Count Data, p = 0.468).

Clinical and demographic predictors of the Bayley Scales of Infant and Toddler Development, 3 rd edition (BISD-III) Language Composite score Language Composite
Based on a linear mixed-effects model with site as random effects.Effects of oxygen supplementation were also explored by country (Colombia versus others).Oxygen supplementation was very common at the Colombian site because its high altitude.It did not predict scores there, thus masking an even larger effect when Colombia was removed (not shown).

Estimates of clinical and demographic predictors of the Bayley Scales of Infant and Toddler Development, 3 rd edition (BISD-III) Language Composite score
Note.Graphical display of the estimates in the model presented in eTable 3. eTable 4.

Sensitivity analysis: Estimates of intervention effects on the Bayley Scales of Infant and Toddler Development, 3 rd edition (BISD-III) Language Composite score using multiple imputation Language Composite
Abbreviations: MTSC, Music therapy Standard care; SCMT, Standard care Music therapy; MTMT, Music therapy Music therapy Note.Pooled summary of linear mixed-effects models from 5 complete datasets generated with multiple imputation (R package mice, using predictive mean matching for continuous variables and logistic regression for binary variables; including selected clinical/demographic variables, site, intervention group, and all outcomes in the imputation).

discharge Intervention during NICU and post−disc harge Random effects model
© 2024 Bieleninik Ł et al.JAMA Network Open of intervention post-discharge refers to 6 months in Bieleninik et al.Effects of intervention during NICU and post−discharge refers to music therapist provided 3 times weekly in NICU and 7 sessions post-NICU across 6 months in Bieleninik et al.