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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering

Sounding Relation: Use of music microanalysis to explore parental contributions to premature infant regulation in the neonatal context

Alternative title: Sounding Relation: Bruk av musikalsk mikroanalyse å utforske foreldres bidrag til premature spedbarns regulering

Awarded: NOK 11.7 mill.

By virtue of their voices, parents possess inherent resources that can help support their premature infants’ well-being during and after intensive care hospitalization. Premature birth presents various challenges for both infants and parents. Premature infants need time to mature and have more subtle communication cues that other newborns. Parents experience stress and worry in their daily experience of the neonatal intensive care unit, and face challenges when getting to know their infant and forming a bond. Research suggests that parents can learn how to musically support their infants during this vulnerable time, but we lack a nuanced understanding of how parents make such contributions. In collaboration with a music therapist, parents can learn how to adjust their singing and speaking voices to match infant signals in the moment. This tailored musical interaction can then help both infants and parents calm down, in a way that we hope contributes to infant development and parental well-being. In this project, we will carefully study moment-to-moment interactions that take place between parents and infants who engage in music therapy while hospitalized following preterm birth. Our aim is to understand how parents contribute to the musical stabilization of their infants in the neonatal intensive care context. We will use detailed analysis of video and audiorecordings from music therapy sessions to achieve our aims. Such analysis will help us identify what parents, infants, music therapists and staff do that help or hamper parent-infant regulation. We will explore whether parents who learn such techniques through music therapy have infants who demonstrate better socio-emotional development when they get older. We will create tips and recommendations for parents and health personnel based on our findings.

Background: Meta-analyses of music therapy for premature infants demonstrate beneficial short-term outcomes for infants and parents, but we lack knowledge about mechanisms involved. Early parent-infant mutual regulation helps develop infant capacity for self-regulation, which supports better neurodevelopmental outcomes. Given rapid shifts in premature infant behavior state, it is necessary to study parent-infant interactions using microanalysis. Objectives: We will microanalytically explore moments when parent-led, infant-directed singing leads to infant regulation in neonatal intensive care, to identify micro interactions that foster mutual regulation in this stressful sensory environment. We will determine if engagement in resource-oriented music therapy that uses parent-led, infant-directed singing predicts longer-term social-emotional development. Methods: This mixed methods study will use music microanalysis of music therapy videos taken from a multi-nation clinical trial to identify patterns of regulation and dysregulation in parent-infant interactions. The findings of the microanalysis will serve as a foundation for interdisciplinary exploration of the phenomenon from a socioecological perspective to understand how music-based parent-infant mutual regulation contributes to health promotion. We will conduct process-outcome analysis (via regression analysis) to determine if engagement in music therapy predicts longer-term social-emotional development in preterm infants. We will translate our synthesized findings into evidence-based recommendations for clinical practice and competency building among parents and healthcare staff. Discussion: Grounded in user needs (parents of premature infants) and informed by user-based and interdisciplinary perspectives, this study addresses two critical gaps in knowledge: understanding the mechanisms by which parents use music therapy to regulate their premature infants, and evaluating longer-term effects of music therapy.

Funding scheme:

BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering