Authors
- Khodagholi Zahra
- Orlova Olga S. Doctor of Education Sciences
- Ilenko Lidia I. Dr. Med. Sc, Professor
Annotation
The importance of parental involvement in speech therapy habilitation for preterm infants in the neonatal intensive care unit (NICU) stems from advances in modern
medicine that have increased survival rates of preterm newborns. Premature birth involves physiological immaturity, difficulties with sucking and swallowing, vulnerability
of the nervous system, and delays in speech development, requiring a specialised approach to habilitation. Speech therapists, as key members of the interdisciplinary team, address sucking and swallowing disorders, maintain communication between parents and child, and prevent future speech and swallowing issues.
Premature birth affects the entire family: parents, especially mothers, often experience stress, depression, and feelings of incompetence in caring for their baby. This article explores the role of active parental involvement in NICU care within speech therapy habilitation to improve feeding and speech development. The study employs an analytical-theoretical approach based on domestic and international sources examining parental involvement, speech therapist-parent interaction, and impacts on oral feeding skills and communication development. Findings demonstrate that active parental involvement, particularly by mothers, improves oral feeding skills, accelerates transition from tube to independent feeding, strengthens emotional bonding, and reduces stress. Speech therapists equip parents with knowledge and skills through step-by-step training. With regular supervision, parents effectively implement recommendations. These findings possess scientific and practical significance, aiding speech therapists, neonatologists, and nurses in developing structured, family-centred care and habilitation protocols for preterm infants.
How to link insert
Khodagholi, Z. ., Orlova, O. S. & Ilenko, L. I. (2025). PARENTAL INVOLVEMENT IN SPEECH AND LANGUAGE ABILITATION OF PRETERM INFANTS IN THE NEONATAL INTENSIVE CARE UNIT Bulletin of the Moscow City Pedagogical University. Series "Pedagogy and Psychology", 19 (4), 139. https://doi.org/10.24412/2076-9121-2025-4-139-163
References
1.
1. Ohuma, E. O., Moller, A.-B., Bradley, E., Chakwera, S., Hussain-Alkhateeb, L., Lewin, A., Okwaraji, Y. B., Mahanani, W. R., Johansson, E. W., Lavin, T., Fernandez, D. E., Domínguez, G. G., de Costa, A., Cresswell, J. A., Krasevec, J., Lawn, J. E., Blencowe, H., Requejo, J., & Moran, A. C. (2023). National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis. The Lancet, 402(10409), 1261–1271.
https://doi.org/10.1016/S0140-6736(23)00878-4
2.
2. Kryuchkova, T. A. (2021). Risk factors for speech development delay in early childhood and preschool-aged children. Russian Pediatric Journal, 24(5), 323–327. (In Russ). https://doi.org/10.1016/j.jped.2023.09.004
3.
3. Rachmawati, E. Z. K., Wahyuni, L. K., Dewi, D. J., Hsu, W.-C., Tamin, S., Yunizaf, R., Prihartono, J., & Iskandar, R. A. T. P. (2024). Risk and predictive factors of oral feeding skills disorder in preterm infants. An observational study using flexible endoscopic evaluation of swallowing. Pediatrics & Neonatology. https://doi.org/10.1016/j.pedneo.2024.04.010
4.
4. Ionio, C., Lista, G., Mascheroni, E., Olivari, M. G., Confalonieri, E., Mastrangelo, M., Brazzoduro, V., Balestriero, M. A., Banfi, A., Bonanomi, A., Bova, S., Castoldi, F., Colombo, C., Introvini, P., & Scelsa B. (2017). Premature birth: complexities and difficulties in building the mother-child relationship. Journal of reproductive and infant psychology, 35(5), 509–523. https://doi.org/10.1080/02646838.2017.1383977
5.
5. Neri, E., Giovagnoli, S., Genova, F., Benassi, M., Stella, M., & Agostini, F. (2020). Reciprocal influence of depressive symptoms between mothers and fathers during the first postpartum year: A comparison among full-term, very low, and extremely low birth weight infants. Frontiers in Psychiatry, 11, 578264. https://doi.org/10.3389/fpsyt.2020.578264
6.
6. Als, H. (1986). A synactive model of neonatal behavioral organization: framework for the assessment of neurobehavioral development in the premature infant and for support of infants and parents in the neonatal intensive care environment. Physical & Occupational Therapy in Pediatrics, 6(3-4), 3–53. https://doi.org/10.1080/J006v06n03_02
7.
7. Larsson, J., Nyborg, L., & Psouni, E. (2022). The role of family function and triadic interaction on preterm child development — A systematic review. Children, 9(11), 1695. https://doi.org/10.3390/children9111695
8.
8. Korja, R., Latva, R., & Lehtonen, L. (2012). The effects of preterm birth on mother-infant interaction and attachment during the infant’s first two years. Acta obstetricia et gynecologica Scandinavica, 91(2), 164–173. https://doi.org/10.1111/j.1600-0412.2011.01304.x
9.
9. Wolf, L. S., & Glass, R. P. (1992). Feeding and Swallowing Disorders in Infancy: Assessment and Management. Therapy Skill Builders. https://lccn.loc.gov/92223083
10.
10. Dietrich, L., Gong, A., Gelfond, J., & Blanco, C. (2024). Oral feeding trajectories and neurodevelopmental outcomes at 12 and 24 month follow-up for preterm infants. Journal of neonatal-perinatal medicine, 17(1), 21–30. https://doi.org/10.3233/NPM-230088
11.
11. Baranov, A. A., Namazova-Baranova, L. S., Belyaeva, I. A., Yatsyk, G. V., Bombardirova, E. P., Zainiddinova, R. S., & Smirnov, I. E. (2014). The stage II neonatal hospital “Mother and Child” as a medical and organizational technology for improving the system of medical care for newborns. Russian Pediatric Journal, 17(6), 16–22. (In Russ). https://www.elibrary.ru/item.asp?id=22592236
12.
12. Baldoni, F., Ancora, G., & Latour, J. M. (2021). Being the father of a preterm-born child: contemporary research and recommendations for NICU staff. Frontiers in pediatrics, 9, 724992. https://doi.org/10.3389/fped.2021.724992
13.
13. Lazarev, V., Budunov, Ch., & Avksentyeva, M. (2021). Therapeutic and socio-economic aspects of parent-child costay in the intensive care unit. Anesthesiology and Resuscitation, (6), 91–99. (In Russ.). https://elibrary.ru/item.asp?id=47228827
14.
14. Andrushchenko, N., Mukhamedrakhimov, R., & Kryukov, E. (2024). Emotional state of mothers of premature newborns with intraventricular brain hemorrhages in the neonatal intensive care unit. Consultative Psychology and Psychotherapy, 32(2), 31–47. (In Russ). https://doi.org/10.17759/cpp.2024320202
15.
15. Séassau, A., Munos, P., Gire, C., Tosello, B., & Carchon, I. (2023). Neonatal care unit interventions on preterm development. Children, 10(6), 999. https://doi.org/10.3390/children10060999
16.
16. Edney, S. K., & McHugh, G. (2023). Parental participation in NICU-based occupational therapy, physiotherapy, and speech and language therapy: a qualitative study. Advances in Neonatal Care, 23(3), 246–253. https://doi.org/10.1097/ANC.0000000000000830
17.
17. Horner, S., Benbrook, K., Hoffman, M., & Libutti, L. (2023). Implementing guidelines for nicu parent presence: effects on parent and infant stress. The Journal of Perinatal & Neonatal Nursing, 10, 1097. https://doi.org/10.1097/JPN.0000000000000776
18.
18. Deepika, S. R., & Rahman, J. (2020). Patient and family centered care: practices in pediatrics. International Journal of Nursing Education, 12(4), 43–47. https://doi.org/10.37506/ijone.v12i4.11215
19.
19. Hodgson, C. R., Mehra, R., & Franck, L. S. (2025). Infant and Family Outcomes and Experiences Related to Family-Centered Care Interventions in the NICU: A Systematic Review. Children, 12(3), 290. https://doi.org/10.3390/children12030290
20.
20. Dusing, S. C., Murray, T., & Stern, M. (2008). Parent preferences for motor development education in the neonatal intensive care unit. Pediatric Physical Therapy, 20(4), 363–368. https://doi.org/10.1097/PEP.0b013e31818add5d
21.
21. Jiang, M., Zhang, Q., Zhang, W., He, W., Huang, K., Peng, G., Huang, J., & Zhao, M. (2020). Effect of parenting training on neurobehavioral development of infants. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, e924457-1. https://doi.org/10.12659/MSM.924457
22.
22. Hsu, H. C., & Jeng, S. F. (2013). Differential effects of still‐face interaction on mothers of term and preterm infants. Infant Mental Health Journal, 34(4), 267–279. https://doi.org/10.1002/imhj.21386
23.
23. Muller-Nix, C., Forcada-Guex, M., Pierrehumbert, B., Jaunin, L., Borghini, A., & Ansermet, F. (2004). Prematurity, maternal stress and mother – child interactions. Early human development, 79(2), 145–158. https://doi.org/10.1016/j.earlhumdev.2004.05.002
24.
24. Fitzallen, G. C., Kirby, J. N., Taylor, H. G., Liley, H. G., & Bora, S. (2024). Evaluating multidimensional facets of the maternal experience after preterm birth. Journal of Perinatology, 44(5), 635–642. https://doi.org/10.1038/s41372-024- 01865-y
25.
25. Cristobal, C. D., Bonillo, P. A, Galera, M. R., Casado, B. M., & Parron, C. T. (2022). Effects of kangaroo mother care in the NICU on the physiological stress parameters of premature infants: a meta-analysis of RCTs. International journal of environmental research and public health, 19(1), 583. https://doi.org/10.3390/ijerph19010583
26.
26. Han, Z., Li, X., Hu, F., & Yang, J. (2025). Meta-analysis of the Impact of Kangaroo Care on Physical Growth and Neurobehavioral Development in Premature Infants. Advances in Neonatal Care, 25(2), 162–172. https://doi.org/10.1097/ANC.0000000000001254
27.
27. Rostami, F. F., Soleimani, F., Norouzi, M., Hatamizadeh, N., Mokhtarinouri, J., & Poshtmashhadi, M. (2020). Preterm infant neurodevelopmental care training program and mother-infant attachment. International Journal of Womens Health and Reproduction Sciences, 8(2), 192 –197. https://doi.org/10.15296/ijwhr.2020.30
28.
28. Yue, W., Han, X., Luo, J., Zeng, Z., & Yang, M. (2021). Effect of music therapy on preterm infants in neonatal intensive care unit: Systematic review and meta‐analysis of randomized controlled trials. Journal of Advanced Nursing, 77(2), 635–652. https://doi.org/10.1111/jan.14630
29.
29. Koreti, M., & Gharde, P. M. (2022). A narrative review of kangaroo mother care (KMC) and its effects on and benefits for low birth weight (LBW) babies. Cureus, 14(11). https://doi.org/10.7759/cureus.31948
30.
30. Shchukina, E. G., & Solovyova, S. L. (2008). Self-organization of the “mother – child” system under stress. World of psychology, 4, 112–120. (In Russ.). https://elibrary.ru/item.asp?id=11708143/
31.
31. Yilmaz, F., Küçükoğlu, S., Aytekin Özdemir, A., Oğul, T., & Aşki, N. (2020). The Effect of Kangaroo Mother Care, Provided in the Early Postpartum Period, on the Breastfeeding Self-Efficacy Level of Mothers and the Perceived Insufficient Milk Supply. The Journal of Perinatal & Neonatal Nursing, 34(1). https://doi.org/10.1097/JPN.0000000000000434
32.
32. Naderifar, E., Tarameshlu, M., Salehi, R., Ghelichi, L., Bordbar, A., Moradi, N., & Lessen Knoll, B. (2024). A Single-Subject Study to Consider the Premature Infant Oral Motor Intervention Combined with Kinesio-Tape in Premature Infants with Feeding Problems. Med J Islam Republic of Iran, 38, 38. https://doi.org/10.47176/mjiri.38.38
33.
33. Sasmal, S., Shetty, A. P., & Saha, B. (2020). Effect of prefeeding oromotor stimulation on preterm infants: a systematic review. Int J Health Sci Res, 10(12), 93–104. ISSN: 2249–9571. https://www.researchgate.net/profile/SuvashriSasmal/publication/346808378_Effect_of_Prefeeding_Oromotor_Stimulation_on_Pret erm_Infants_A_Systematic_Review/links/5ff1be2a92851c13fee32 32a/Effect-of-Prefeeding-Oromotor-Stimulation-on-Preterm-Infants-A-Systematic-Review.pdf
34.
34. Kamity, R., Kapavarapu, P. K., & Chandel, A. (2021). Feeding Problems and Long-Term Outcomes in Preterm Infants — A Systematic Approach to Evaluation and Management. Children (Basel), 8(12). https://doi.org/10.3390/children8121158
35.
35. Barlow, S. M., Jegatheesan, P., Weiss, S., Govindaswami, B., Wang, J., Lee, J, Oder, A., & Song, D. (2014). Amplitude-integrated EEG and range-EEG modulation associated with pneumatic orocutaneous stimulation in preterm infants. J Perinatol, 34(3), 213–219. https://doi.org/10.1038/jp.2013.150
36.
36. Orlova, O. S., & Khodagholi, Z. (2024). Oral motor stimulation in speech therapy practice and its impact on the neurodevelopment of premature infants. Special Education, 4(76), 94–110. (In Russ.). https://www.elibrary.ru/item.asp?id=80301656
37.
37. Jaywant, S. S., Dandavate, P. S., & Kale, J. S. (2020). Premature Infant Oral Motor Intervention (PIOMI) with and Without Massage Therapy on Social Emotional Development in Preterm Infants. The Indian Journal of Occupational Therapy, 52(3). https://doi.org/10.4103/ijoth.ijoth_13_20
38.
38. Øberg, G. K., Ustad, T., Jørgensen, L., Kaaresen, P. I., Labori, C., & Girolami, G. L. (2019). Parents’ perceptions of administering a motor intervention with their preterm infant in the NICU. European Journal of Physiotherapy, 21(3), 134–141. https://doi.org/10.1080/21679169.2018.1503718
39.
39. Majoli, M., De Angelis, L. C., Panella, M., Calevo, M. G., Serveli, S., Knoll, B. L., & Ramenghi, L. A. (2023). Parent-administered oral stimulation in preterm infants: a randomized, controlled, open-label pilot study. American Journal of Perinatology, 40(8), 845–850. https://doi.org/10.1055/s-0041-1731452
40.
40. Woodson, R., Drinkwin, J., & Hamilton, C. (1985). Effects of nonnutritive sucking on state and activity: term-preterm comparisons. Infant Behavior and Development, 8(4), 435–441. https://doi.org/10.1016/0163-6383(85)90007-4
41.
41. Foster, J. P., Psaila, K., & Patterson, T. (2016). Non-nutritive sucking for increasing physiologic stability and nutrition in preterm infants. Cochrane Database Syst Rev, 10(10), Cd001071. https://doi.org/10.1002/14651858.CD001071.pub3
42.
42. Curtis, M. D., McIntosh, N., Ventura, V., & Brooke, O. (1986). Effect of nonnutritive sucking on nutrient retention in preterm infants. The Journal of Pediatrics, 109(5), 888–890. https://doi.org/10.1016/S0022-3476(86)80720-X
43.
43. Asadollahpour, F., Yadegari, F., Soleimani, F., & Khalesi, N. (2015). The Effects of Non-Nutritive Sucking and Pre-Feeding Oral Stimulation on Time to Achieve Independent Oral Feeding for Preterm Infants. Iran J Pediatr, 25(3), e809. https://doi.org/10.5812/ijp.25(3)2015.809
44.
44. Shaki, F., Aziznejadroshan, P., Rad, Z. A., Chehrazi, M., & Arzani, A. (2022). Comparison of the effect of two methods of sucking on pacifier and mother’s finger on oral feeding behavior in preterm infants: a randomized clinical trial. BMC pediatrics, 22(1), 292. https://doi.org/10.1186/s12887-022-03352-9
45.
45. Mohammadi Pirkashani, L., Mansori, K., Babaei, H., & Rahmani, P. (2018). The effect of non-nutritive sucking on mother’s finger on feeding tolerance and attainment of independent oral feeding in preterm infants: a randomized trial. International Journal of Pediatrics, 6(12), 8715–8725. https://doi.org/10.22038/ijp.2018.33045.2919
46.
46. Laleh, S. S., Mirghafourvand, M., İnal, S., & Karaahmet, A. Y. (2025). More Than a Sense: The Sense of Smell and Its Reflection in Mother and Baby: A Comprehensive Review. Journal of Evaluation in Clinical Practice, 31(1), e14284. https://doi.org/10.1111/jep.14284
47.
47. Doucet, S., Soussignan, R., Sagot, P., & Schaal, B. (2007). The “smellscape” of mother’s breast: effects of odor masking and selective unmasking on neonatal arousal, oral, and visual responses. Developmental Psychobiology, 49(2), 129–138. https://doi.org/10.1002/dev.20210
48.
48. Porter, R. H., Makin, J. W., Davis, L. B., & Christensen, K. M. (1992). Breast-fed infants respond to olfactory cues from their own mother and unfamiliar lactating females. Infant Behavior and Development, 15(1), 85–93. https://doi.org/10.1016/0163-6383(92)90008-T
49.
49. Sullivan, R. M., & Toubas, P. (1998). Clinical usefulness of maternal odor in newborns: soothing and feeding preparatory responses. Neonatology, 74(6),402–408. https://doi.org/10.1159/000014061
50.
50. Khodagholi, Z., Zarifian, T., Soleimani, F., Khoshnood Shariati, M., & Bakhshi, E. (2018).The Effect of Non-Nutritive Sucking and Maternal Milk Odor on the Independent Oral Feeding in Preterm Infants. Iran J Child Neurol, 12(4), 55–64. https://doi.org/10.22037/ijcn.v12i4.16438
51.
51. Le, Q, Zheng, S-H., Zhang, L., Wu, L-F., Zhou, F-J., Kang, M., & Lu, C-H. (2022). Effects of oral stimulation with breast milk in preterm infants oral feeding: a randomized clinical trial. Journal of Perinatal Medicine, 50(4), 486–492. https://doi.org/10.1515/jpm-2020-0282
52.
52. Shahbazi, F., Fattahi-Darghlou, M., Moslehi, S., Dabiri-Golchin, M., & Shahbazi, M. (2025). Effect of music therapy on behavioral and physiological neonatal outcomes: A systematic review and dose-response meta-analysis. PloS one, 20(1), e0316674. https://doi.org/10.1371/journal.pone.0316674
53.
53. Chorna, O. D., Slaughter, J. C., Wang, L., Stark, A. R., & Maitre, N. L. (2014). A pacifier-activated music player with mother’s voice improves oral feeding in preterm infants. Pediatrics, 133(3), 462–468. https://doi.org/10.1542/peds.2013-2547
54.
54. Standley, J. M. (2003). The effect of music-reinforced nonnutritive sucking on feeding rate of premature infants. Journal of Pediatric Nursing, 18(3), 169–173. https://doi.org/10.1053/jpdn.2003.34
55.
55. Shin, H.-J., Park, J., Oh, H.-K., & Kim, N. (2022). Comparison of effects of Mothers’ and Mozart’s lullabies on physiological responses, feeding volume, and body weight of premature infants in NICU. Frontiers in Public Health, 10, 870740. https://doi.org/10.3389/fpubh.2022.870740
56.
56. Lazarev, M. L. (2023a). The use of a controlled sensory-developmental environment to optimize breastfeeding in low birth weight infants. Educational Management: Theory and Practice, 13(10-2), 88–94. (In Russ.). https://doi.org/10.25726/e5121-2522-9552-n
57.
57. Lazarev, M. L. (2023b). Optimization of child development during the prenatal period of ontogenesis using the musical method ”Sonatal”. Educational Management: Theory and Practice, 13(10-1), 147–153. (In Russ.). https://doi.org/10.25726/w7549-5643-2668-o
58.
58. Cajiao-Nieto, J., Torres-Giménez, A., Merelles-Tormo, A., & Botet-Mussons, F. (2021). Paternal symptoms of anxiety and depression in the first month after childbirth: A comparison between fathers of full term and preterm infants. Journal of Affective Disorders, 282, 517–526. https://doi.org/10.1016/j.jad.2020.12.175
59.
59. Gibbs, D., Harniess, P., & Crossley, S-L. (2019). The constant by our side — Mothers’ experiences of early intervention therapy services for infants with emerging signs of complex neurodevelopmental difficulties. Infants & Young Children, 32(4), 255–269.
https://doi.org/10.1097/IYC.0000000000000149
60.
60. Polunina, N., Keshishyan, E., Dubovich, E., & Sakharova, E. (2011). Socio-psychological profile of parents with preterm children having severe forms of retinopathy. General Medicine, 3, 66–70. (In Russ.). https://www.elibrary.ru/item.asp?id=17072557