en Pediatrics Protocol Protocol <strong>Background</strong>: Motor control in infancy begins with feeding and swallowing, which can affect later cognitive, language, social-communication, and motor development. Feeding disorders in preterm infants increase the risk of developmental delays. The premature infant oral motor intervention (PIOMI) is a structured method developed to enhance oral feeding in preterm infants, but its effects on swallowing muscle activity and long-term developmental outcomes remain unclear.&nbsp;<br> <strong>Objectives</strong>: This study provides a protocol for a randomized controlled trial (RCT) that will evaluate the impact of PIOMI on swallowing muscle activity and developmental outcomes in preterm infants with feeding disorders.&nbsp;<br> <strong>Methods</strong>: This is a protocol for a single-blind RCT with a pre-test/post-test/follow-up design, with the participation of 60 preterm infants with feeding disorders from the neonatal intensive care unit (NICU) of a medical center in Babol, Iran. They will be randomly allocated to the PIOMI and control groups. The PIOMI group will receive daily oral-motor intervention for seven days along with routine care, while the control group will receive only routine care. Swallowing muscle activity will be assessed using surface electromyography (sEMG) pre- and post-intervention. Developmental outcomes, including cognitive, receptive/expressive language, social-communication, and motor skills, will be evaluated at 3 and 6 months post-intervention using the Newsha development scale, the ages and stages questionnaire, third edition (ASQ-3), and the Bayley scales of infant and toddler development, third edition (Bayley-III).<br> <strong>Results</strong>: Recruitment began in April 2025, and the intervention and follow-up are expected to conclude in December 2025. The results of data analysis will be ready by summer 2026.<br> <strong>Conclusions</strong>: We assume that PIOMI may enhance developmental outcomes, support independent oral feeding, and improve long-term developmental outcomes in preterm infants. Findings of the RCT are expected to inform clinical practice and standards of NICU care. Preterm Infant, Feeding disorder, Oral-motor intervention, Premature infant oral motor intervention (PIOMI), Developmental outcomes 309 318 http://jpr.mazums.ac.ir/browse.php?a_code=A-10-1182-2&slc_lang=en&sid=1 Shamim Ghazi Shamimghazi1997@gmail.com 100319475328460013982 100319475328460013982 No Department of Speech Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Zahra Sadeghi zah.sadeghi@uswr.ac.ir 100319475328460013983 100319475328460013983 Yes Department of Speech Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Farin Soleimani soleimani_farin@yahoo.com 100319475328460013984 100319475328460013984 No Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Brenda Lessen Knoll bknoll@iwu.edu 100319475328460013985 100319475328460013985 No Department of Nursing, Illinois Wesleyan University, Bloomington, United States of America. Akbar Darui ak.darouie@uswr.ac.ir 100319475328460013986 100319475328460013986 No Department of Speech Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Iraj Abdollahi ir.abdollahi@uswr.ac.ir 100319475328460013987 0009-0005-6600-8288 No Department of Physiotherapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Enayatollah Bakhshi bakhshi@razi.tums.ac.ir 100319475328460013988 100319475328460013988 No Department of Biostatistics and Epidemiology, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.