733 - Culturally Adapted Early Language Intervention to Promote Neurodevelopment in Vulnerable Low Birth Weight Infants in Ethiopia

Publication Number: 733.4504

Ashley Darcy Mahoney, George Washington School of Nursing, Washington, DC, United States; Jennifer L. Stapel-Wax, Emory University School of Medicine, Atlanta, GA, United States; Selambizu G. Hailu, Addis Ababa University, Addis Ababa, Adis Abeba, Ethiopia; Susan Brasher, Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, United States; Amy Becklenberg, Loyola University Chicago Marcella Niehoff School of Nursing, Decatur, GA, United States; Rachel Hall-Clifford, Emory University, Atlanta, GA, United States; Meseret S. Yibrehu, Dekalb public health, Grayson, GA, United States; John Nutting. Cranmer, Emory University, Atlanta, GA, United States; Abebe Gebremariam. Gobezayehu, Emory University, Grayson, GA, United States

Background: Developmental disabilities (DD), including neurodevelopmental disabilities (NDD), affect approximately 52.9 million children under five globally. Ethiopia ranks among the top ten countries for high DD and NDD prevalence, with small and vulnerable newborns (SVN), including low birth weight (LBW) and preterm infants, at increased risk. Early language interactions significantly impact cognitive and language development, making targeted interventions essential.

Objective: The “Talk With Me Baby” (TWMB) program, a language promotion initiative developed in the U.S., was adapted for the Ethiopian context to promote neurodevelopment in LBW infants. TWMB-Ethiopia (TWMB-E) was implemented in collaboration with the Ethiopian Ministry of Health (MOH) and the national Saving Little Lives (SLL) consortium to address developmental challenges in SVN.

Design/Methods: TWMB-E was co-designed using a phased, iterative approach in partnership with Ethiopian healthcare and academic institutions. Phase 1 involved training 15 NICU nurses at Tikur Anbessa Hospital, followed by focus groups to refine the curriculum. Feedback was incorporated from six newborn care experts and MOH advisors. In Phase 2, the adapted curriculum was introduced to 10 additional NICU nurses at referral hospitals. Nurses practiced TWMB-E techniques over 30 days and provided feedback on feasibility and cultural relevance. Training included multimodal formats such as Amharic-language videos, hands-on sessions, and culturally adapted instructional materials, with qualitative focus groups guiding continuous refinement

Results: Key themes emerged: (1) Limited initial provider-infant communication, (2) Inconsistent parental engagement norms, (3) New skills acquired through TWMB-E, (4) Positive perceptions of TWMB-E’s integration despite logistical challenges, and (5) Strong appreciation for the multimedia training structure. Findings highlight TWMB-E’s alignment with Ethiopia’s early childhood development policies, enabling a sustainable scaling pathway.

Conclusion(s): TWMB-E established feasibility, acceptability, and scalability in Ethiopian NICU settings, emphasizing early language as “nutrition” for brain development. Sustainable implementation will be supported through (1) SLL consortium collaboration, (2) engagement with Addis Ababa University faculty, (3) MOH guidance, and (4) real-world testing in referral hospitals. This project provides a scalable model for early language intervention in low- and middle-income contexts, offering insights to support neurodevelopmental outcomes in vulnerable infants globally.

Parent and Nurse Instructional Materials
Visual materials created to guide parents and nurses on language interaction techniques, emphasizing culturally relevant language "nutrition" strategies that enhance infant brain development.

Amharic Language Training Videos
Educational videos in Amharic, designed to instruct healthcare providers and parents on the importance of early language exposure and practical ways to engage with infants.

Culturally Adapted Visual Guides
Illustrated guides in Amharic that convey key developmental messages and provide step-by-step instructions, supporting the integration of TWMB principles into neonatal care practices in Ethiopia.