Challenges and limitations of evaluating the efficacy of music intervention for preterm infants: auditory development, methodological heterogeneity, medical complexity, parental involvement and environmental barriers

Despite growing interest in music therapy (MT) as a supportive intervention in neonatal intensive care units (NICUs), strong evidence for its long-term efficacy remains scarce. This perspective article explores the multifaceted challenges of implementing and evaluating MT in NICUs, particularly for preterm infants. These challenges include (1) limited understanding of premature auditory development, (2) environmental acoustics, (3) methodological inconsistencies in MT delivery, and the complex medical (4) and psychosocial (5) context of the NICU. Further compounding this issue is the underappreciation of parental involvement and the perception of MT among healthcare professionals. Addressing these gaps is essential for establishing standardized, effective MT protocols tailored to this vulnerable population.