Browsing by Author "Gucuyener, Kivilcim"
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Article Effects of Safe Early Intervention Approach in the First Months of Life in Infants at Risk: A Randomized Controlled Study(Wiley, 2025) Yildiz, Ayse; Yildiz, Ramazan; Apaydin, Umut; Efkere, Pelin Atalan; Gucuyener, Kivilcim; Hirfanoglu, Ibrahim Murat; Elbasan, BulentBackground: This study aimed to examine the effects of the SAFE early intervention approach (Sensory strategies, Activity-based motor training, Family collaboration, and Environmental Enrichment), developed for at-risk infants, on motor, cognitive, language development, and sensory processing skills in the first 3 months of life. Methods: Twenty-six infants with a corrected age of 42 weeks were included in the study, and the infants were randomly distributed to the treatment and control groups. The SAFE early intervention approach was applied to 14 infants in the treatment group, and the Neurodevelopmental Treatment-based home programme was applied to 12 infants in the control group. All infants included in the study were evaluated at the corrected 42nd week before the intervention and at the corrected 12th week after the intervention by an evaluator blinded to the treatment. Bayley Scales of Infant and Toddler Development III (Bayley-III) to evaluate cognitive and motor development; Test of Infant Motor Performance (TIMP) to evaluate neuromotor development; Infant/Toddler Sensory Profile 2 (ITSP 2) to assess sensory processing t was used. The Infant/Toddler HOME Inventory was used to evaluate the home environment. Results: The interaction effects (time x group) revealed significant advantages for the SAFE early intervention group, evidenced by higher scores in the Bayley-III motor composite, TIMP elicited and HOME total assessments (p 0.05). The main effect for time was significant in all parameters (p < 0.05). Similarly, the main impact for groups was substantial in all evaluation parameters except the Bayley-III language composite score and TIMP observed score (p < 0.05). The interaction effects (time x group) demonstrated significant differences in favour of the SAFE early intervention group for the general processing score, auditory processing score, tactile processing score and total score of the ITSP 2 (p < 0.05). Conclusions: The SAFE early intervention approach enhanced motor and sensory outcomes and provided a more enriched home environment than the NDT-based home programme. It was concluded that neurodevelopmental improvement will be achieved with the SAFE early intervention approach in the early period in at-risk infants.Article Long-Term Neurodevelopmental Outcomes of the Safe Early Intervention in Infants at Risk: A Randomised Controlled Trial(Wiley, 2025) Yildiz, Ramazan; Yildiz, Ayse; Apaydin, Umut; Efkere, Pelin Atalan; Gucuyener, Kivilcim; Hirfanoglu, Ibrahim Murat; Elbasan, BulentBackground Early intervention for infants at risk of cerebral palsy (CP) plays a critical role in improving neurodevelopmental outcomes. Recently, approaches emphasising infant active participation and family collaboration have shown greater effectiveness compared to traditional methods.Aims This study aimed to evaluate the effects of the SAFE early intervention approach on cognitive, language, and motor development in infants at risk for CP, in comparison to conventional neurodevelopmental treatment (NDT) practices.Methods In this randomised controlled trial, 46 infants were assigned to either the SAFE intervention group (n = 23) or the control group receiving NDT-based care (n = 23). The intervention lasted for 3 months, with developmental assessments conducted at 6 and 12 months using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).Results Significant improvements were observed in motor and language composite scores in the SAFE group between baseline (T1) and the 3-month follow-up (T2), while cognitive scores showed a non-significant increase. Compared to the control group, the SAFE group demonstrated significantly higher scores across all Bayley-III domains at T2. However, the time x group interaction was significant in favour of the SAFE group for motor scores, while cognitive scores favoured the control group. No significant interaction was observed for language scores. Over time, both groups showed developmental progress in various domains, with the SAFE group exhibiting significant motor gains from T1 to T3. The control group showed significant cognitive improvements from T1 and T2 to T3.Conclusions The SAFE early intervention model appears to be a feasible and effective approach for infants at risk for CP, especially before a formal diagnosis is made. Its focus on active infant participation, family engagement, and enriched environments supports improved motor development outcomes.Article Using the Center of Pressure Movement Analysis in Evaluating Spontaneous Movements in Infants: A Comparative Study with General Movements Assessment(BMC, 2023) Celik, Halil Ibrahim; Yildiz, Ayse; Yildiz, Ramazan; Mutlu, Akmer; Soylu, Ruhi; Gucuyener, Kivilcim; Elbasan, BulentBackground: Researchers have attempted to automate the spontaneous movement assessment and have sought quantitative and objective methods over the past decade. The purpose of the study was to present a quantitative assessment method of spontaneous movement using center-of-pressure (COP) movement analysis.Methods: A total of 101 infants were included in the study. The infants were placed in the supine position on the force plate with the cranial-caudal orientation. In this position, the recording of video and COP movement data were made simultaneously for 3 min. Video recordings were used to observe global and detailed general movement assessment (GMA), and COP time series data were used to obtain quantitative movement parameters.Results: According to the global GMA, 13 infants displayed absent fidgety movements (FMs) and 88 infants displayed normal FMs. The binary logistic regression model indicated significant association between global GMA and COP movement parameters (chi-square = 20.817, p < 0.001). The sensitivity, specificity, and overall accuracy of this model were 85% (95% CI: 55-98), 83% (95% CI: 73-90), and 83% (95% CI: 74-90), respectively. The multiple linear regression model showed a significant association between detailed GMA (motor optimality score-revised/MOS-R) and COP movement parameters (F = 10.349, p < 0.001). The MOS-R total score was predicted with a standard error of approximately 1.8 points (6%).Conclusions: The present study demonstrated the possible avenues for using COP movement analysis to objectively detect the absent FMs and MOS-R total score in clinical settings. Although the method presented in this study requires further validation, it may complement observational GMA and be clinically useful for infant screening purposes, particularly in clinical settings where access to expertise in observational GMA is not available.

