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- Baraldi, Erika, 1982-
(författare)
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Specialpedagogik riktad till extremt för tidigt födda barn
- 2021
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Ingår i: Specialpedagogik för lärare. - Stockholm : Natur och kultur. - 9789127827318 ; , s. 340-364
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Mer än en av tjugo elever är födda för tidigt och ett fåtal av dem föddes redan efter cirka halva graviditetstiden, de extremt för tidigt födda barnen. De här barnen har ofta varit svårt sjuka i livets början och en del av dem har varit nära att inte överleva sin ettårsdag. Det här kapitlet handlar om de här barnen och deras faniljer; hur skolans personal kan bli en viktig resurs att bidra till dessa barns utveckling och lärande, som de första personerna utanför familjen och medicinsk personal som gör skillnad för en helt ny grupp barn: de nya överlevarna som de kallats av nyföddhetsläkaren Hugo Lagercrantz. Hur kan förskolmiljön och pedagogiken i skolan anpasas så att det passar också de 5-6% elever som är för tidigt födda? I det här kapitlet presenterar vi forskning om hjärnans utveckling, för tidigt födda barn och autentiska fallexempel.
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| 2. |
- Baraldi, Erika, 1982-
(författare)
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An Interaction-Based Early Intervention During the First Year of Life : Targeting Infants Born Extremely Preterm and Their Parents
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The first thousand days from conception are crucial for future learning and development throughout life. During the infant year, several sensitive periods for sensorimotor, cognitive and social development coincide, making the period particularly suitable for early intervention (EI). From a special educational perspective, the social and physical environment of a child may either support or hinder future growth. Optimal early learning environments include environmental enrichment, reduced toxic stress and strengths-based support of parent-child interaction.Being born extremely preterm (EPT <28 gestational weeks) is a biological risk factor, increasing the risk for future disability, academic difficulties and social challenges. The parents are also negatively affected by prematurity. Sweden offers highly specialized neonatal care from 22 GW, resulting in a new population of surviving children.The aim of this thesis is to evaluate an interaction-based and strengths-based EI for infants born EPT and their parents in a Swedish context. The Stockholm Preterm Interaction-Based Intervention (SPIBI) consists of 10 home visits led by a trained interventionist during the first year at home, focusing on parent-child interaction, family strengths and reduction of toxic stress. The control group received an extended treatment as usual follow-up program (TAU+). The thesis has a mixed methods design and includes three studies.Study I presents the protocol, including a description of the planning, formulation, theoretical background, theory of change, interventionist training, recruitment, randomization and implementation of the SPIBI. Study II reports the primary outcome of the RCT (N=130, intervention=66 vs. controls=64) and their parents regarding parent-child interaction as measured with the Emotional Availability Scale (EAS) at 12 months corrected age (CA). The EAS consists of the six dimensions: sensitivity, structuring, non-intrusiveness, non-hostility, child responsiveness and child involvement. No significant effect of the EAS at 12 months CA related to the SPIBI was found. In the secondary analysis, analysis of covariances for all EAS dimensions were tested with predefined medical, social, and psychological moderators. The model with the best fit was one for the EAS dimension child involvement (adj R2=.463). A significant effect modifier shows that the SPIBI enhances child involvement in families where the mothers rate themselves as depressed at discharge (F(1, 65)=5.499, p=.023).The parental experience during the first year at home with or without the SPIBI was qualitatively analyzed and reported in Study III (n=17). The results showed that child-related medical concerns were still present a year post-discharge, and that the premature birth experience still affected the parental inner state and family dynamics. Parents in the intervention group (n=8) also pointed out the security the knowledgeable interventionists gave them, while some parents described the SPIBI as important but not necessary.Overall, this thesis adds to the understanding of the first year at home with a child born EPT. An interaction-based intervention in the home environment is feasible in Sweden. It is possible to unite different professions in an EI in a special educational context. The tested intervention does not affect the emotional availability at 1 year CA, but findings from secondary analyses prompt further research on specific subgroups, particularly families with depressed mothers.
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| 3. |
- Baraldi, Erika, 1982-, et al.
(författare)
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Clinical Protocol & Research Process of Stockholm Preterm Interaction-Based Intervention, SPIBI
- 2019
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Ingår i: Pediatric Research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 86:Suppl., s. 54-55
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundExtremely preterm (EPT) born children are at increased risk of cognitive and neurodevelopmental impairment, neuropsychiatric disorders and academic difficulties. Parents of EPT born children are extra vulnerable for anxiety, posttraumatic stress disorder and depression and the parent-child interaction is negatively affected by prematurity. There is some evidence that early interventions have beneficial effects on neurocognitive and motor outcomes (Spittle A et al 2015). Based on a previous intervention (Verkerk G et al 2012) and adjusted to the Swedish context with 480 days paid parental leave, we created a post–discharge intervention, SPIBI, for families of EPT born children.MethodThe aim of (SPIBI) is to improve the quality of the parent-child interaction, child development and parental mental health in families with EPT born children. . SPIBI is a randomized controlled beginning at discharge and lasting until the child is 12 months corrected age. The trial design is a two arm randomized trial with four recruiting sites in Stockholm. Intervention group (target, n=65) receives 10 visits and two telephone calls from a trained interventionist and the control group (target n=65) receives treatment as usual plus an extended follow-up program. The SPIBI-team has recruited and trained 6 multi-professional and NICU-experienced interventionists. The training takes one year (0.2 of full time) and the content was both theoretical and practical, including pilot-cases. ResultSPIBI is an ongoing research project, beginning the 1st of September 2018 and planning to end recruitment the 31st of August 2020 and finishing the home-visits in August 2021. By the end of April 2019, 33 eligible infants had been identified within the four neonatal units in Stockholm; of which 26 children approved and 7 children declined participation. At this stage, three children have dropped out of the study, because of severe social challenges and child death. Identified challenges have been social and medical vulnerability of the EPT-families, finding the optimal multi-professional balance of motoric, psychological, pedagogical and medical kernels of the intervention, ethical considerations when to ask families for participation, lack of long-term discharge-planning of the neonatal units and large geographical spread of NICUs as well as families.ConclusionIn conclusion, the protocol seem to be feasible and appreciated by parents in the target group. With regard to the small recruitment base, trials of this kind needs a long inclusion time. Since EPT-children and their parents displays a wide scope of difficulties and challenges, multi-professional cooperation is preferable, placing high demands of sensitivity, professional respect and time for long collaborative processes.
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| 4. |
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| 5. |
- Baraldi, Erika, 1982-
(författare)
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Hva lærer bør vite om prematurfødte : Hva jeg skulle ønske at alle lærer fikk vite om sine prematurfødte elever
- 2021
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Ingår i: Prematurposten Norge. ; 2021:1, s. 6-9
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Alt begynner med barna. Barna som har overlevd sin for tidlige fødsel, og deres ofte emosjonelt berørte pårørende, som har våket over kuvøsen. At barna overlever er et bevis på helsevesenets enorme framgang innen nyfødtmedisin, et tegn på internasjonalt samarbeid, dyktige forskere og flinke klinikker. Men, historien slutter ikke der. For etter tiden på sykehuset kommer det noe annet.Om et ekstremt for tidlig født barn tilbringer 100 dager på sykehus, så er det ingenting mot de nærmere 2000 grunnskoledagene som barnet senere skal gjennom. Med andre ord, skolen trenger å utvikle seg i samme takt som helsevesenet når det gjelder de for tidlig fødte elevene – for barnas skyld, for foreldrenes skyld og for pedagogenes skyld.
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| 6. |
- Baraldi, Erika, 1982-, et al.
(författare)
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Innovative multiprofessional early intervention aiming at improving development of prematurely born children
- 2024
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Abstract: Extremely preterm born children and their parents is a vulnerable group with a high risk of developmental delays, academic challenges and parental mental health difficulties. Previously interventions have been medical focusing of increasing survival, but recently post-discharge interventions improving long-term development have been presented. This abstract concerns a novel multiprofroessional intervention, Stockholm Preterm Interaction-Based Intervention (SPIBI) aiming at consolidation of expertise from educational, behavioral and medical fields in benefit of the child development and family well-being. Rationale and purpose: SPIBIs purpose is to enhance the parent-child interaction, child cognitive and motor development, child preschool social participation and parental mental health in families with extreme preterm born infants.Description of methods, results, or modes of inquiry: In a novel RCT a strengths-based post-discharge intervention targeting extreme preterm born (EPT= born before 28 gestational weeks) infants and their parents is being tested. 130 EPT born children and their parents have been randomly allocated to an intervention group receiving 10 home visits during the first year at home, or a control group receiving treatment as usual with an extended follow-up program. The novel intervention is named Stockholm Preterm Interaction-Based Intervention (SPIBI).Innovation: The field of long-term development of extremely born infants is innovative in itself, since the field consist of a severely vulnerable population on the verge of viability, who did not survive twenty years ago. The innovation in SPIBI is its consolidation of practical knowledge as well as research concerning the challenges of extreme prematurity from a medical (brain developmental), special educational (preschool behavioral), physiotherapeutic (motor), psychological (parent-child-interactional and cognitive) perspective. Working together will benefit the child and family as a whole, since extreme prematurity is a nuanced field with implications for several aspects of development. Despite this, previous international research from the field is almost always unidisciplinary.Implications for policy or practice: The outcome will influence practice at a regional and possible national level, concerning how a low cost early intervention may improve several outcomes and reduce challenges for a group of children with a high risk of developmental delays.Relationship to principles of diversity, equity, and inclusion: The extreme preterm born population often has double challenges, both concerning developmental delays and socioeconomic hardships, both internationally and in a Swedish context. Giving this vulnerable population initial extra support is ultimately a question of equity, increasing the chance of participating in fully inclusive learning environments ahead.Methods used to encourage audience engagement When presenting the poster, these 3 questions will be continuously discussed with researchers passing by:1. What do parents to medically fragile infants who have been balancing on the verge of death, need when the family comes back home from the hospital?2. What are the key elements of multidisciplinary and multiprofessional co-operation between medicine, psychology and special education?3. What may be the different needs of different groups of families with extreme preterm born children, regarding socioeconomic background, severity of prematurity and migration statues?
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| 7. |
- Baraldi, Erika, 1982-, et al.
(författare)
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Insights Gained from Stockholm Preterm Interaction-Based Intervention - A Critical View
- 2022
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Konferensbidrag (refereegranskat)abstract
- SPIBI is a strength-based early intervention targeting parent-child interaction amongst extremely preterm born infants, currently tested in an RCT in Sweden. Of 130 infants, 72% have reached 12 months of age. Based on interviews with 17 parents’ and 6 intervention providers we identified SPIBI strengths and shortcomings. SPIBI seems feasible, is possible to integrate it into home-visiting practice and is appreciated by parents. Identified challenges are geographical distance; recruitment obstacles including Covid-19, leading to longer-term implementation; service-provider fatigue; and social adversities amongst some eligible participants requiring ethical considerations. Future improvements include: reconsidering inclusion criteria, increasing use of e-health, and exploring the possibility of a tiered approach.
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| 8. |
- Baraldi, Erika, 1982-, et al.
(författare)
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Parent–child interaction after home-visiting intervention for children born extremely preterm–A randomised clinical trial
- 2024
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Ingår i: Acta Paediatrica. - 0803-5253 .- 1651-2227. ; 00, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To determine whether a strength- based home-visiting program enhances par-ent–child interaction during the first year at home for children born extremely pre-term (gestational age < 28). Methods: A randomised controlled trial of 130 infants born extremely preterm 2018–2021 in Stockholm, allocated to either the Stockholm preterm interaction-based in-tervention (SPIBI) (n = 66) or an extended follow-up program (n = 64). The interventiongroup received ten home visits during the first year by a trained interventionist follow-ing SPIBI guidelines: an interaction- based intervention supporting sensitive parentalresponses to infants' signals. The primary outcome of emotional availability was as-sessed at 12 months corrected age (CA) using the emotional availability scales (EAS). Results: At 1-year CA, data were collected from 115/130 (89%) of the includedchildren. There were no significant group differences in emotional availability at12 months CA. A secondary analysis showed an effect modifier in families with moth-ers self-rated as depressed at discharge, with the outcome favouring intervention inthe EAS dimension of child involvement. Conclusion: The SPIBI had no significant main effect on emotional availability at12 months CA. Children of self-reported depressed mothers displayed superior in-volvement behaviour in the intervention group, prompting further research on riskgroups and potential modifications of post-discharge interventions.
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| 9. |
- Baraldi, Erika, 1982-, et al.
(författare)
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The development of a post-discharge intervention program in Sweden for extremely preterm infants and their caregivers, through home visits during their first year of life
- 2019
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Konferensbidrag (refereegranskat)abstract
- Sweden has a proactive neonatal intensive care, saving children born from gestation week 22, with a 90% survival rate in the extremely preterm (EPT) group. With increased survival rates, the long-term outcome of the EPT children has gained much research interest. Recent studies indicate that 1/3 of the EPT-children in Sweden show moderate to severe neurodevelopmental deficits when beginning school. An interdisciplinary research team has designed an intervention for EPT infants and their caregivers in their home-environment after hospital discharge and throughout the first year of life. The aim of the ongoing randomized controlled trial is to study intervention effects on the children’s cognitive, motor and psychosocial function, the parental mental health and the infant-parent interaction. This paper present the intervention’s theory of change, the validity considerations, and an overview of the syllabus of the training given to the interdisciplinary team of six clinicians who serve as interventionists.
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