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EARLY Intervention in Parent-professional Cooperation in Cerebral Palsy

Not Applicable
Recruiting
Conditions
Cerebral Palsy
Interventions
Other: PRECOP program
Registration Number
NCT06180291
Lead Sponsor
Hospices Civils de Lyon
Brief Summary

Cerebral Palsy (CP) is the most common motor disability in children. It is due to damage that occurs during brain development in the fetus or infant. Early treatment (before 2 years) will allow the child to promote brain plasticity to compensate for the effects of the lesion and reduce the severity of CP. The goals of early intervention are to increase motor, cognitive and communication skills, prevent complications and provide parental support. Most authors agree to recognize the benefit of early care by emphasizing home intervention programs with active parental participation. To date, no recommendations exist in France for the management of cerebral palsy in children under the age of two. It is therefore necessary to conduct scientific studies in this population.

Based on published international studies, the PRECOP program (PREcoce intervention in parent-professional COoperation in Cerebral Palsy) consists of individualized care adapted to the specific needs of each child, from the arrival of the infant at home, by a multidisciplinary team during the child's first two years.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
66
Inclusion Criteria
  • New born presenting on transfontanellar ultrasound and confirmed on brain MRI (magnetic resonance imaging) at least one of the following brain lesions at high risk of cerebral palsy :

    • Stage 3 intraventricular hemorrhage, requiring at least 2 subtractive lumbar punctures and/or the establishment of a ventriculoperitoneal bypass
    • Stage 4 intraventricular hemorrhage
    • Periventricular leukomalacia : extensive unilateral or bilateral
    • Sequelae of perinatal anoxo-ischemic encephalopathy
    • Extensive neonatal stroke
  • Less than 3 months old (corrected age in case of prematurity)

  • Hospitalized in neonatology or hospitalized in pediatric intensive care unit or within two months following return home (follow-up visit after initial hospitalization)

  • Affiliate to social security

  • Parental or legal representative consent to participate in the study (free and informed written consent)

Exclusion Criteria
  • Children who have had an Antenatal Diagnosis of a pathology causing fear of the onset of developmental delay
  • Children presenting with a congenital pathology with neonatal revelation, whether of metabolic, genetic or malformative origin
  • Palliative care offered by the neonatology team (LATA: Limitation and Discontinuation of Active Therapeutics)
  • Children participating simultaneously in another screening and early care program (excluding the COCON program (Soins préCOces et COordonnés du Nouveau-né vulnérable))

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention groupPRECOP programPRECOP group: screening and early treatment. CAMSP (Centre d'Action Médico-Sociale Précoce) orientation upon discharge from neonatology for immediate follow-up according to PRECOP protocol: early multidisciplinary care, with targeted objectives according to the child's needs.
Primary Outcome Measures
NameTimeMethod
Score of the Total Motor Index at PDMS-3 scale (Peabody Developmental Motor Scales).24 months

Score of the Total Motor Index at PDMS-3 scale (Peabody Developmental Motor Scales).The Total Motor Index results from the combination of Gross Motor Index and Fine Motor Index scores at PDMS-3. The functional impact of cerebral palsy at 2 years is assessed by the PDMS-3 at 24 months of age will be estimated in each of the two groups by a mean value with a 95% confidence interval.

Secondary Outcome Measures
NameTimeMethod
Early relational problems24 months

Early relational problems will be detected by Modified Checklist for Autism in Toddlers (M CHAT)

Development of Production Language in French (DLPF) questionnaire24 months

The development of communication and language will be assessed through the Development of Production Language in French (DLPF) questionnaire

Motor development24 months

The assessment of motor development will be completed by taking the Global Functional Motor Assessment (EMFG) Scale ranging from 0 to 3, with 3 being the best.

Cognitive development24 months

Cognitive development will be measured by the Ages and Stages Questionnaire (ASQ)

Nutritional development24 months

Nutritional development will be assessed by the Montreal Children's Hospital (MCH) Eating Scale Scale ranging from 1 to 7, with the best score depending on each item.

Parental adherencethrough study completion, an average of 42 months

Parental adherence to the recommendations given in the PRECOP program evaluated according to the number of sessions not carried out or canceled by the parents.

Parental stress24 months

Parental stress will be measured at 24 months of the child by the Parental Stress Scale (ESP for "Echelle de Stress Parental" in french).

Scale ranging from 1 to 5, with the best score depending on each item.

Implemented intervention and fidelity to the planned intervention at the center levelthrough study completion, an average of 42 months

Number of professionals trained and profile of professionals, human, material and organizational resources mobilized.

Intervention implemented and fidelity to the planned intervention at the patient levelthrough study completion, an average of 42 months

Number of components of the intervention received, compliance with the frequency of interventions and deadlines in relation to the course planned to achieve the child's objectives.

Program transferability using PIET model: Population, Intervention, Environment, Transferthrough study completion, an average of 42 months

Assessing whether PRECOP programm can be transferred from the "primary context" (the context of the intervention as it was performed in the original study) to the "target context" (the context that the intervention is aimed at being performed in) using PIET model : Population, Intervention, Environment, Transfer.

Cost ratio impact12, 24 and 36 months

Differential cost ratio resulting from the PRECOP strategy compared to the management of the control group.

Acceptability of the interventionthrough study completion, an average of 42 months

Acceptability from the parents' and professionals point of view, assessed by a questionnaire constructed for the study.

Annual cost impact12, 24 and 36 months

Average annual cost of support for the financier depending on the pricing methods.

Budgetary impact12, 24 and 36 months

Estimating annual net budget up to 3 years according to trial data, literature and expert opinion.

Trial Locations

Locations (8)

CH de Annecy

🇫🇷

Annecy, France

Service de Réanimation et médecine néonatale

🇫🇷

Chambery, France

Service de Réanimation Néonatale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon

🇫🇷

Lyon, France

Service de néonatologie et de réanimation néonatale, Hôpital Femme Mère Enfant, Hospices Civils de Lyon

🇫🇷

Lyon, France

Service de néonatologie et de réanimation néonatale, CHU Saint-ELOI

🇫🇷

Montpellier, France

Service de néonatologie et de réanimation néonatale, Hôpital Universitaire Carémeau

🇫🇷

Nîmes, France

Service de réanimation pédiatrique, Hôpital des enfants

🇫🇷

Toulouse, France

Service de néonatologie, Hôpital des enfants

🇫🇷

Toulouse, France

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