EI SMART

Hutchon B, Gibbs D, Harniess P, Jary S, Crossley SL, Moffat JV, Basu N, Basu AP. Early intervention programmes for infants at high risk of atypical neurodevelopmental outcome. Dev Med Child Neurol. 2019 Mar 4

"We propose ‘early intervention: sensorimotor development, attention and regulation, relationships, and therapist support’ (EI SMART) as a clinical reasoning framework, derived from consensus clinical expertise in partnership with parents and supported by current evidence. The framework was developed to encourage practitioners working with infants born preterm and other high-risk infants to work collaboratively with parents with the aim of optimizing and making manageable, early interventional support for infants and their families, as well as identifying their own professional development requirements. Articulating the components enables therapists to support their consideration of the interplay of these elements and how they may impact an infant’s development and the parent-infant relationship, which will underpin the planning and delivery of their specific therapeutic intervention. As such, EI SMART can promote a multidisciplinary, team-working ethos with the knowledge, skills, and attitudes to undertake appropriate assessments and work with parents to identify and address the needs of the child and family in a tailored programme

Core components of the EI SMART programme.

"We consider the following as core components: (1) Actively involving, educating, and empowering parents in biopsychosocial aspects of their infant’s care; (2) Supporting a consistent and responsive parent–infant relationship; (3) Recognizing, supporting, and promoting the infant’s self-regulatory behaviours; (4) Scaffolding the infant’s next developmental cognitive, motor, sensory, and communication steps to stimulate and elicit active participation; (5) Modifying the infant’s environment to ensure the infant remains challenged and able to participate in a wide variety of self-initiated, self-produced motor activities in a variety of conditions; and (6) Promoting parental well-being."

How the EI-SMART framework differs from other framework

The EI-SSMART website provides further information about the different components of the programme, which highlight differences with other EI frameworks. 

1 There is no mention of encouragement of communication as a core component of the programme. This differs from the Small Step framework which emphasizes this aspect of development.

2 The use of "specific handling skills that provide physical support where necessary to facilitate activity and/or modify unhelpful activity, reducing support as the required activity is produced and ultimately initiated and led by the baby. "  EI-Smart website 

It can be assumed that he inclusion of "special handling skills"  refers to Neurodevelopmental Therapy (NDT).