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25,000 children are born preterm in Australia each year. ReadyStepGrow is a non-profit organisation providing therapeutic programs to families of children born preterm from nursery discharge to school commencement.

33 percent

of parents of babies born preterm ( <32 weeks) struggle with depression and anxiety 1

85 percent

of preterm children are born ( <32 weeks) and have increased risk of developmental and school-related problems2

50 percent

of preterm children ( <32 weeks) develop intellectual, educational and/or behavioural problems3

38 percent

of babies born ( <30 weeks) have oromotor difficulties indicating surveillance and support transitioning to solids 4

44 percent

preterm children ( <32 weeks) showed vulnerabilities in multiple domains of school readiness5

Background

Because of the multifaceted risk factors associated with prematurity and evidence that social and environmental factors play a major role in outcomes, ReadyStepGrow (RSG) has developed a comprehensive program that focuses both on parent well-being and child development.

Method

Delivered by a team of therapists, all of whom specialise in development of preterm children with expertise as follows:

  • Paediatric Dietician (nutrition and health promotion)
  • Speech Pathologist (early communication and feeding development)
  • Occupational Therapist (emotional regulation and fine-motor development)
  • Early Years Educator (school readiness and working memory intervention)

The program incorporates a broad range of evidenced-based practises to empower parents by providing:

  1. Education & activities to assist areas of known neurodevelopmental risk
  2. Reinforcement of positive influence of parenting & parent well-being on child outcomes

Program Development

  • Attracting the friendly and enthusiastic multidisciplinary team has been crucial to the program's success
  • Each program builds upon the foundations set in earlier sessions
  • Tiny Premmies 0 - 6m+ | Baby Prems 6 - 18m+ | Tiny Toddlers 16 - 24m+
  • Toddlers 2y - 3y+ | Pre-Kindy 3 - 4y+
  • Program costs subsidised by more than 75% thanks to generous donors
  • Medicare rebates may apply and families encouraged to talk with their GP

Results

Program participation has steadily increased since 2013. Retention of families in the program is over 85%. Parent feedback shows:

33 percent
33 percent
33 percent

Case Presentation

Sia has been in the RSG program for the last 4 years.

History

  • Born at 30 weeks weighing 1276 grams
  • Head ultrasound at 32 weeks showed grade 3 bilateral IVHs
  • One septic episode
  • Discharge at 8 weeks
  • 3 weeks later readmitted to ICU with bacterial meningitis
  • MRI showed decreased white matter
  • Sia was diagnosed with cerebral palsy at 6 months

Andrea’s own words follow

“My mission was to do everything I could to give Sia the best possible outcome. Knowledge became my power and that’s when I came across RSG - it was like everything I dreamed of right before my eyes."
Figure 1. RSG Pre-Kindy; Sia (front) and Matilda (back) use magnetic tiles on vertical surface (upper body gross motor + fine motor task)

RSG has

  • Healed emotional wounds by learning strategies to deal with stress and anxiety.
  • Made me feel more confident when parenting a prem.
  •   Allowed Sia, who had terrible separation anxiety, to slowly gain confidence.

Today, all Sia's therapists agree

  • Her brain has created new pathways and found new ways to do things.
  • Her legs are only very mildly affected.
  • She has perfect hearing, eye sight and symmetry in her hands

We can only put this down to early intervention, RSG and one amazing brain. I feel so privileged that we have been involved with such a ground breaking program for which we will be eternally grateful.” Andrea Chand

Conclusions

ReadyStepGrow increases parent confidence and improves parent well-being

Separation anxiety is reduced in children attending the program

Next phase is to extend this unique program beyond metropolitan Melbourne

  1. Pace, C, 2016. Evolution of Depression and Anxiety Symptoms in Parents of Very Preterm Infants During the Newborn Period. JAMA Pediatrics, 170/9, 863-870
  2. Potijk, M, 2012. Higher rates of behavioural and emotional problems at preschool age in children born moderately preterm. Archives of Disease in Childhood, 97, 112-117.
  3. Colditz, P, 2015. Prem Baby Triple P: a randomised controlled trial of enhanced parenting capacity to improve developmental outcomes in preterm infants. BMC Pediatrics, 15
  4. Sanchez, K, 2016. Oromotor Feeding in Children Born Before 30 Weeks' Gestation and Term-Born Peers at 12 Months' Corrected Age . The Journal of Pediatrics, (early online)
  5. Roberts, G, 2011. High Rates of School Readiness Difficulties at 5 Years of Age in Very Preterm Infants Compared with Term Controls. Journal Developmental Behavioural Pediatrics 32:117–124

View and download the PDF version here!

Testimonials

  • Aimie

    support for premature children Paediatric Occupational Therapist "I found the work you are doing to support premature children and their families, so inspiring. From Read More
  • Andrea

    Sia born at 30 weeks Sia was born in her 30th week. The hospital did everything they could to stop her but she had a Read More
  • Asha & Maya's story

    Asha & Maya's story ReadyStepGrow "helped reduce my girl's separation anxiety and their need to be physically with me all the time, it increased Read More
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