Commentary on "Supporting Play Exploration and Early Developmental Intervention from NICU to Home: A Feasibility Study".

Abstract

“How could I apply this information?” This feasibility study suggests Supporting Play Exploration and Early Development Intervention (SPEEDI) may bridge the gap in services between hospital discharge and early intervention (EI) and help families implement developmentally appropriate play and routines. Parents of infants born premature are interested and capable of implementing SPEEDI at home and want more support—both in the neonatal intensive care unit (NICU) and at home after the infant is discharged. Neonatal intensive care unit teams should consider implementing SPEEDI to help parents interpret their infants' cues and readiness for interaction, and to establish routines that include developmentally appropriate play. Therapists should prioritize and increase parents' involvement in the NICU and consider visiting the family at home after discharge to improve parent confidence and to answer questions. Supporting Play Exploration and Early Development Intervention is likely more essential in communities where EI services are delayed post-NICU discharge. For example, in some communities, delays in EI services might include not regularly referring families to EI, monitoring at-risk infants until a delay is identified, or a lack of available providers. Other barriers depending on where the family lives include challenges with scheduling the initial EI evaluation and differences in referral, intake, and eligibility procedures. “What should I be mindful about in applying this information?” Neonatal intensive care unit teams who choose to use SPEEDI should be mindful that this was a feasibility study with a small sample of infants born premature from 1 urban NICU, so it cannot be generalized to all infants. For example, infants born at term, infants with multiple special health care needs requiring extensive care postdischarge, or infants born premature in a suburban area might have different results. Determining whether SPEEDI leads to better outcomes for infants across sites and family demographics is an important next step. The SPEEDI program was developed to address barriers to initiation of services post-NICU discharge; therefore, stakeholders must also examine access to EI services in communities where barriers exist. Tricia Catalino, PT, DSc, PCS Touro University Nevada Henderson, Nevada Amanda Arevalo, PT, DSc, PCS Amanda Arevalo Physical Therapy PC Berwyn, Illinois