A comprehensive occupational therapy intervention in Pierre robin sequence in NICU level-III: A case study

Abstract

Background: Pierre Robin Sequence (PRS) is a rare congenital condition characterized by micrognathia, glossoptosis, and upper airway obstruction, often associated with feeding difficulties and respiratory compromise. Early occupational therapy intervention may support feeding, airway management, and neurodevelopmental regulation in neonates with PRS.Objective: To describe the role of early in promoting oral feeding, airway stability, sensory regulation, and caregiver support in a neonate with PRS.Methods: A single-case study was conducted in a Level III NICU in Mumbai. A term neonate with PRS was assessed using standardized tools, including the Infant Positioning Assessment Tool, Preterm Oral Feeding Readiness Assessment Scale, Infant-Driven Feeding Readiness Scale, Infant Sensory Profile-2, and Parental Stress Scale. Interventions included therapeutic positioning, sensory modulation, oral motor stimulation, and caregiver education within a multidisciplinary framework.Results: Post-intervention, the infant demonstrated improved oral feeding skills, oxygen saturation, and behavioral organization. IPAT scores improved from 4.5 to 12.0 and POFRAS from 5.0 to 16.0, indicating enhanced positioning, oral motor control, and feeding readiness. Infant-Driven Feeding Readiness increased from 1.0 to 4.0. Sensory hyper-responsiveness reduced, with Infant Sensory Profile-2 scores decreasing from 65 to 50. Parental Stress Scale scores reduced from 78.5 to 61.0, and the infant successfully transitioned to partial oral feeding.Conclusion: Early occupational therapy intervention can significantly enhance feeding outcomes, airway stability, neurobehavioral regulation, and family-centered care in neonates with Pierre Robin Sequence (PRS). This case study highlights the effectiveness of early, structured occupational therapy interventions targeting positioning, airway support, feeding readiness, sensory modulation, and oral motor skills in improving feeding performance, physiological stability, self-regulation, and oral motor function. These findings underscore the importance of early occupational therapy involvement as part of a multidisciplinary approach to optimize developmental outcomes in infants with PRS.