Project Title:	Facilitating Attentiveness in Preterm Infants by Massage Therapy
Principal Investigator/Program Director:	Tiffany Field, Ph.D.
Other Investigators and Departments (or other Universities, if applicable):	Miguel Diego, Ph.D.
Community Based Organization-Collaborator (if applicable)	NA
Funding Source (e.g., NICHD, NCI, Dept of Education, Children’s Trust):	NCCAM
Annual Direct Costs:	$200,000
Annual Facility and Administration Costs (F&A) and Rate, (e.g., 53%, 10%):	53%
Total Project Award (Combined Direct and F&A Costs):	$607,123
Dates of Award (if pending, indicated Pending):	Pending
Lay Abstract (in space below): Please be concise (space below will word wrap and expand)	Please include: (a) Specific Aims, Objectives, and/or Hypotheses of the study; (b) Participants (disease or disability, age, gender, child, family, etc), (c) Project type (eg., descriptive study, service demonstration project, case study, ethnographic study, clinical trial); (d) Brief description of methods and procedures; and (e) anticipated outcomes/benefits
Preterm infants have notable cognitive delays as late as school-age. These delays have been predicted by less attentiveness on a focused attention task as early as seven months, highlighting the need for early interventions to enhance attentiveness in preterm infants. Although massage therapy has been primarily used to increase weight gain in preterm infants, it has also been noted to have short-term effects on the attentiveness of preterm infants at the neonatal stage, suggesting that massage may be an effective intervention for infant attentiveness. This may happen via massage increasing vagal activity (which is notably related to attentiveness) and decreasing arousal (cortisol levels). Preterm neonates are known to have not only less attentiveness but also lower vagal activity and higher cortisol levels. The purpose of the proposed study is to determine whether massage therapy can enhance attentiveness during early infancy, which would, in turn, be expected to reduce cognitive delays at school-age. In addition we hope to determine whether any of the earlier variables being assessed in this study could predict to the 7 month focused attention task so that infants could be identified for earlier interventions to prevent cognitive delays. In the proposed study, 120 preterm neonates would be randomly assigned to a massage therapy or to a simple hands-on, touch/attention control group (N=60 per group). Before and after a 10-day period of massage therapy (20 minutes per day) the groups would be compared on their attentiveness on the Brazelton Orientation Scale, their vagal activity and cortisol levels. Then they would be followed to 4 months and to 7 months and assessed again on their vagal activity, their cortisol levels and their performance on the focused attention task that has been noted to predict school-age cognitive delays. We would hypothesize that the massaged infants would have 1) higher Brazelton Orientation Scale scores, higher vagal activity and lower cortisol levels at the end of the treatment period; and 2) better performance on the focused attention task, higher vagal activity and lower cortisol levels at the 4 and 7-month periods. The relationships between massage, vagal activity, cortisol and the focused attention task at 4 and 7 months would be explored using a regression analysis with focused attention task performance at 7 months as the criterion variable to determine whether focused attention at 7 months could be predicted by any of the earlier assessment variables.
Abstracts and/or Publications Resulting from the Project: