Audrey E. Kane

Objective: To determine the scope of feeding therapy for preterm infants in the NICU and medical and sociodemographic factors related to feeding therapy referral and service provision. Study design: Retrospective study of infants born p < 0.001). In addition, infants with greater medical complexity, who required oxygen at 36 weeks, who had a history of mechanical ventilation, and who had a higher postmenstrual age at discharge were more likely to be referred to feeding therapy (all p < 0.001). Conclusion: While medical factors relate to feeding therapy referrals, there are other complex person and system factors that determine feeding therapy referral and service provision.

Date Presented 03/21/24 Emotions around the neonatal intensive care unit (NICU) experience and transition home were explored. Fear was expressed equally for NICU and home, and happiness was discussed twice as often for home experiences. Professionals need to consider parent emotions during this period. Primary Author and Speaker: Audrey Kane Contributing Authors: Christine M. Spence, Corri Stuyvenberg, Rachel Gaston, Jennifer Burnsed, Karen D. Hendricks-Muñoz, Richard D. Stevenson, Stacey Dusing

Understanding the type and frequency of current neonatal intensive care unit (NICU) therapy services and predictors of referral for therapy services is a crucial first step to supporting positive long-term outcomes in very preterm infants. This study enrolled 83 very preterm infants (<32 weeks, gestational age mean 26.5 ± 2.0 weeks; 38 male) from a longitudinal clinical trial. Race, neonatal medical index, neuroimaging, and frequency of therapy sessions were extracted from medical records. The Test of Infant Motor Performance and the General Movement Assessment were administered. Average weekly sessions of occupational therapy, physical therapy, and speech therapy were significantly different by type, but the magnitude and direction of the difference depended upon the discharge week. Infants at high risk for cerebral palsy based on their baseline General Movements Assessment scores received more therapy sessions than infants at low risk for cerebral palsy. Baseline General Movements Assessment was related to the mean number of occupational therapy sessions but not physical therapy or speech therapy sessions. Neonatal Medical Index scores and Test of Infant Motor Performance scores were not predictive of combined therapy services. Medical and developmental risk factors, as well as outcomes from therapy assessments, should be the basis for referral for therapy services in the neonatal intensive care unit.

Families (n = 12) with infants born at <29 weeks gestation shared their experiences while in the NICU and transitioning home. Parents were interviewed 6–8 weeks after NICU discharge, including some during the acute phase of the COVID-19 pandemic. Findings regarding the parent experience in the NICU were focused around challenges navigating parent-infant separation, social isolation, communication difficulties, limited knowledge of preterm infants, mental health challenges. Parents also discussed supports that were present and supports they wished were present, as well as the impact of COVID-19 on their experiences. In the transition to home, primary experiences included the sudden nature of the transition, anxiety around discharge preparation, and the loss of the support from nursing staff. During the first few weeks at home, parents expressed joy and anxiety, particularly around feeding. The COVID-19 pandemic limited emotional, informational, and physical support to parents and resulted in limited mutual support from other parents of infants in the NICU. Parents of preterm infants in the NICU present with multiple stressors, rendering attending to parental mental health crucial. NICU staff need to address logistical barriers and familial priorities impacting communication and parent-infant bonding. Providing multiple opportunities for communication, participating in caretaking activities, and meeting other families can be important sources of support and knowledge for parents of very preterm infants.

This study evaluated whether caregiver-provided learning opportunities moderated the effect of START-Play physical therapy intervention on the cognitive skills of young children with neuromotor del...

Date Presented 04/05/19 For infants with mild motor impairments, parent-provided cognitive opportunities during play continue to increase after mobility is achieved, in contrast to those with severe motor impairment, where cognitive opportunities decrease, as gross motor abilities remain stable. This analysis of two infants demonstrates this difference and will be confirmed in the analysis of 90 children with mild, moderate, and severe impairment. These findings have implications for early-intervention service providers. Primary Author and Speaker: Audrey Kane Additional Authors and Speakers: Stacey Dusing Contributing Authors: Emily Marcinowski, Lin-Ya Hsu