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Each year in the United States, 250,000 infants are born too soon,
weighing too little. For these low birth weight, premature infants,
the future is uncertain, since they are at risk for a variety of
serious medical and developmental problems--including behavioral
and learning disorders that may have damaging effects for the rest
of their lives. The extent to which a comprehensive early
intervention program could improve or prevent these adverse
outcomes was examined in the Infant Health and Development Program,
a randomized controlled trial involving almost 1,000 infants in
eight cities in the United States. This book describes in detail
the program, its research methodology, the progress of the program,
and the results of the clinical trial.
The program was administered by an interdisciplinary team composed
of physicians, biostatisticians, child development specialists, and
researchers from several disciplines. It was instituted upon the
discharge of the infants from the neonatal nursery and was
maintained for three years. One-third of the infants were randomly
assigned to an intervention group, the remainder to a follow-up
group. Infants in both groups received pediatric care and community
referral services, but only those in the intervention group
participated in a program that included extensive home visits,
attendance at a child development center, and group meetings for
parents.
The results of the program proved to be clinically important; at
age three, the children in the intervention group had significantly
higher IQ scores, greater cognitive development, and fewer
behavioral problems. The implications of the findings for public
policy are equally important, for there is increasing interest in
the prevention, early detection, and management of developmental
disabilities in children, as evidenced by such legislation as the
Education for All Children Act. Strategies to minimize the problems
of low birth weight children, with their potential for long-term
savings through the prevention of disabilities and their attendant
costs, could have significant repercussions in such governmental
areas as medical care, education, and social welfare.
Down syndrome is one of the most commonly occurring developmental
disorders and it is now possible to conceptualize and define
opportunities for neurocognitive rehabilitation for those with the
condition. This book describes how early cognitive intervention in
children with Down syndrome can be carried out, and can reduce, or
compensate for, the major deficits characteristic of the condition.
This comprehensive account relates the neurocognitive approach to
the major therapeutic endeavors in the neighboring fields of
neurogenetics, experimental environmental enrichment, molecular
genetics, pharmacology, pediatrics and cardiology for infants with
Down syndrome. Neurocognitive Rehabilitation of Down Syndrome
provides the guidance required to establish effective
rehabilitation programs, and is essential reading for developmental
clinicians, pediatricians, neuropsychologists and other health
professionals.
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