Interventions for Executive Function in High-Risk Infants and Toddlers
This review summarizes the current state of evidence regarding interventions for executive function in high-risk infants and toddlers. Currently, there is a paucity of data in this area, with the interventions that have been studied highly variable in their content, dosage, target, and results. Self-regulation is the executive function construct targeted the most, with mixed results. The few studies that report later child outcomes in prekindergarten/school-aged children are encouraging, overall indicating improved cognition and behavior in the children of parents who received a parenting style intervention. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Andrea F. Duncan Source Type: research
Efficacy of Therapist Supported Interventions from the Neonatal Intensive Care Unit to Home
Infants born preterm or with complicated medical conditions requiring care in the neonatal intensive care unit (NICU) are at high risk for long-term developmental disabilities. The transition from NICU to early intervention/outpatient settings results in a disruptive gap in a therapeutic intervention during a period of maximal neuroplasticity and development. This meta-review evaluated evidence from existing systematic reviews regarding therapeutic interventions that start in the NICU and continue at home with the goal of improving developmental outcomes for infants at high risk for cerebral palsy. We also evaluated the im...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Dana B. McCarty, Lisa Letzkus, Elaine Attridge, Stacey C. Dusing Source Type: research
Intensive Multidisciplinary Feeding Intervention for High-Risk Infants
Infants born premature or other medical complex infants are at high risk for developing long-term feeding problems that extends beyond infancy. Intensive multidisciplinary feeding intervention (IMFI) represents the standard of care for children with chronic and severe feeding issues, with a profession team that should involve, at a minimum, psychology, medicine, nutrition, and feeding skill expertise. IMFI seems to hold benefit for preterm and medically complex infants; however, there remains a need to develop and investigate new therapeutic pathways to reduce the number of patients who likely require this level of care. (...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: William G. Sharp Source Type: research
Using Telemedicine to Overcome Barriers to Neurodevelopmental Care from the Neonatal Intensive Care Unit to School Entry
Dedicated Neonatal Intensive Care Unit (NICU) follow-up programs are recommended for ongoing surveillance for infants at high-risk for future neurodevelopmental impairment (NDI). Systemic, socioeconomic, and psychosocial barriers remain for referrals and the continued neurodevelopmental follow-up of high-risk infants. Telemedicine can help overcome these barriers. Telemedicine allows standardization of evaluations, increased referral rates, and reduced time to follow-up as well as increased therapy engagement. Telemedicine can expand neurodevelopmental surveillance and support all NICU graduates, facilitating the early ide...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Darrah N. Haffner, Sarah L. Bauer Huang Source Type: research
Neonatal Opioid Withdrawal Syndrome
Infants and children with prenatal opioid exposure generally have development within the normal range; however, they seem to be at risk for behavioral problems and for lower scores on cognitive, language, and motor assessments than children without prenatal opioid exposure. It is as of yet unclear whether prenatal opioid exposure itself causes issues with development and behavior, or whether it is simply correlated, due to other confounding factors. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Kristen L. Benninger, Jennifer M. McAllister, Stephanie L. Merhar Source Type: research
Parenting Style Interventions in Parents of Preterm and High-Risk Infants
This review highlights the current state of evidence on interventions whose primary purpose is to change parenting style in parents of preterm, and other-high risk, infants. To date, interventions for parents of preterm infants are heterogeneous with variability in intervention timing, measured outcomes, program components, and cost. Most interventions target parental responsivity/sensitivity. Most reported outcomes are short-term, measured at age less than 2 years. The few studies that report later child outcomes in prekindergarten/school-aged children are encouraging, overall indicating improved cognition and behavior ...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Mary Lauren Neel Source Type: research
A Comparison of the Clinical Presentation of Preterm Birth and Autism Spectrum Disorder
Premature infants and infants later diagnosed with autism spectrum disorder (ASD) share many commonalities in clinical presentations. However, prematurity and ASD also have differences in clinical presentation. These overlapping phenotypes can lead to misdiagnoses of ASD or missing a diagnosis of ASD in preterm infants. We document these commonalities and differences in various developmental domains with the hope of aiding in the accurate early detection of ASD and timely intervention implementation in children born premature. Given the degree of similarities in presentation, evidence-based interventions designed specifica...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Adriana I. Mendez, Hannah Tokish, Emma McQueen, Shivaang Chawla, Ami Klin, Nathalie L. Maitre, Cheryl Klaiman Source Type: research
Interventions for Motor Disorders in High-Risk Neonates
Early childhood affords rapid brain development and advancement of the motor system. In High-Risk Infant Follow-Up programs, watchful waiting and monitoring of infants at high risk is shifting toward active surveillance and early diagnosis, followed by immediate targeted very early interventions. Infants with delayed motor skills benefit from developmental care, NIDCAP, and generic or specific motor training. Infants with cerebral palsy benefit from enrichment, targeted skills interventions, and task-specific motor training at high intensity. Infants with degenerative conditions benefit from enrichment but also require acc...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Lynda McNamara, Catherine Morgan, Iona Novak Source Type: research
Beyond Survival
Low- and middle-income countries account for the greatest burden of preterm birth globally; however, there is limited understanding of neurodevelopmental outcomes of survivors within these resource-constrained settings. To accelerate progress, current priorities are to generate more high-quality data; engage with diverse local stakeholders including families of infants born preterm to identify neurodevelopmental outcomes meaningful to them within their contexts; and develop sustainable, scalable, high-quality models of neonatal follow-up, codesigned with local stakeholders, addressing the unique needs of low- and middle-in...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Samudragupta Bora Source Type: research
High-Risk Infant Follow-Up After NICU Discharge
Preterm infants are at heightened risk for chronic health problems and developmental delays compared with term-born peers. High-risk infant follow-up programs provide surveillance and support for problems that may emerge during infancy and early childhood. Although considered standard of care, program structure, content, and timing are highly variable. Families face challenges accessing recommended follow-up services. Here, the authors review common models of high-risk infant follow-up, describe novel approaches, and outline considerations for improving the quality, value, and equity of follow-up care. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Jonathan S. Litt, Deborah E. Campbell Source Type: research
Implementation of Early Detection and Intervention for Cerebral Palsy in High-Risk Infant Follow-Up Programs
Early detection and intervention for cerebral palsy is best practice for all high-risk infants according to international guidelines, consensus statements and research-supported evidence. It allows support for families and optimization of developmental trajectories into adulthood. All phases of implementation of CP early detection can be found across the world in high-risk infant follow-up programs, demonstrating feasibility and acceptability through standardized implementation science. The largest clinical network for CP early detection and intervention in the world has now sustained an average age at detection less than ...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Nathalie L. Maitre, Diane Damiano, Rachel Byrne Source Type: research
The Future of High-Risk Infant Follow-Up
As this issue of Clinics in Perinatology illustrates, a profound shift has occurred in the driving purpose of high-risk infant follow-up (HRIF) over the past 5 years. As a result, HRIF has evolved from primarily providing an ethical compass, concerned surveillance and documentation of outcomes, to developing novel models of care, considering new high-risk populations, settings, and psychosocial factors, and incorporating active, targeted interventions to improve outcomes. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Nathalie L. Maitre, Andrea F. Duncan Source Type: research
Hypoxic-Ischemic Encephalopathy
Neonatal hypoxic-ischemic encephalopathy (HIE) is a leading cause of death and neurodevelopmental impairment in neonates. Therapeutic hypothermia (TH) is the only established effective therapy and randomized trials affirm that TH reduces death and disability in moderate-to-severe HIE. Traditionally, infants with mild HIE were excluded from these trials due to the perceived low risk for impairment. Recently, multiple studies suggest that infants with untreated mild HIE may be at significant risk of abnormal neurodevelopmental outcomes. This review will focus on the changing landscape of TH, the spectrum of HIE presentations...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Athina Pappas, Gina Milano, Lina F. Chalak Source Type: research
Health Care Disparities in High-Risk Neonates
Long-standing health disparities in maternal reproductive health, infant morbidity and mortality, and long-term developmental outcomes are rooted in a foundation of structural racism. Social determinants of health profoundly affect reproductive health outcomes of Black and Hispanic women disproportionately; they have higher rates of death during pregnancy and preterm birth. Their infants are also more likely to be cared for in poorer quality neonatal intensive care units (NICUs), receive poorer quality of NICU care, and are less likely to be referred to an appropriate high-risk NICU follow-up program. Interventions that mi...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Yvette R. Johnson, Charleta Guillory, Sonia Imaizumi Source Type: research
Nothing Matters More Than the Long-Term Outcomes of High-Risk Newborns
It has been 5 years since the last issue of the Clinics in Perinatology devoted to long-term follow-up of high-risk newborns was published. In that issue edited by Drs Adams-Chapman and DeMauro, we discussed how predicting long-term outcomes of high-risk newborns is singularly challenging.1 In fact, no other area of medicine faces a prognostic challenge of this magnitude, where developmental and neurologic indicators in the first year or two of life are expected to shed light on potential outcomes decades later. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Lucky Jain Tags: Foreword Source Type: research
