Developmental Care Research Articles

Neonatal Neurocardiac Care: Strategies to Optimize Neurodevelopmental Outcomes in Congenital Heart Disease.

Neonatal Neurocardiac Care: Strategies to Optimize Neurodevelopmental Outcomes in Congenital Heart Disease.

Strengthening Parental Capabilities: Examining the Role of Interdisciplinary Support in Enhancing Parental Well-Being and Capabilities in Developmental Disability Care

Purpose: The purpose of this study was to explore parents’ lived experiences raising children with developmental disabilities (DDs), examine their emotional and physical challenges, and investigate the role of interdisciplinary support in strengthening parental capabilities. Materials and Methods: A qualitative descriptive study was conducted using two focus groups (n = 23 parents). Data were analyzed using Braun and Clarke’s six-step thematic analysis. Results: Five major themes emerged: (1) acceptance and emotional journey, (2) healthcare system navigation challenges, (3) educational and community integration barriers, (4) the development of coping strategies and support systems, and (5) resilience and positive growth. Parents reported significant emotional challenges but demonstrated remarkable resilience when supported by comprehensive care systems. Conclusions: The findings highlight the need for integrated support systems that address both the practical and emotional needs of parents raising children with DDs. Healthcare providers and community stakeholders must work collaboratively to create more inclusive and supportive environments for these families.

Developmental Care in the Early Years in Pediatric Intensive Care Patients as a Strategy to Mitigate Pediatric Post-Intensive-Care Syndrome: A Narrative Review.

Survivors after pediatric critical care often have adverse sequelae in domains of cognition, executive function, attention, memory, visual-spatial skills, language, motor function, behavior, and emotional functioning, the post-intensive-care syndrome pediatric (PICS-p). The time from birth to approximately age 2 years is a period of rapid structural and functional brain development. The fundamental structural and functional architecture of the brain is in place by the second year of life. This narrative review focuses on how we, in the pediatric intensive care unit (PICU), can work towards maximizing each patient's full potential despite adverse experiences during hospitalization. In part I, concepts relevant to understanding the effects of hospitalization in PICU on brain development are clarified, including concepts of toxic stress and trauma, sensitive periods and cascades, experience-expectant neural plasticity in the early years, and resilience and buffering of adversity focused on relational care. In part II, evidence is presented that these concepts are important because they describe the effects of early childhood adversity that are pervasive on physical health, cognitive, and emotional outcomes throughout the lifespan. Evidence is presented to show that intervention to improve these outcomes can be effective. In part III, the concepts and evidence are synthesized by focusing on the opportunity before us, what we must and can do better while patients are in the PICU, in order to improve their long-term lifelong outcomes. We present evidence to argue that we in pediatric critical care must take a public-health approach to address the key environmental conditions necessary for optimal early childhood development and hence facilitate children's ability to thrive. Future research must aim to determine what works best and what does not work in the PICU. Early childhood investments to improve lifelong outcomes have great potential to help patients and reduce the growing burden of healthcare costs.

Perspectives on Implementing European Newborn Health Standards: Insights From Parent Representatives and Healthcare Professionals.

To address disparities in the care for preterm infants, the European Standards of Care for Newborn Health were developed in a co-creation process. The aim of this study was to provide an overview of their implementation state based on the perspectives of parent representatives and healthcare professionals (HCPs), including implementation barriers and facilitators. Online questionnaires were developed and pre-tested to assess validity/usability. Representatives of parent organisations and healthcare societies participated. Data were analysed using descriptive and qualitative content analyses. Overall, 23 parent representatives and 76 HCPs from 24 countries participated. Regarding implementation gaps, parents mentioned Follow-up care (14/23) and NICU design (13/23). HCPs selected Infant- and family-centred developmental care (34/76), also being considered as the most urgent priority by both groups (16/23; 34/76). Medical care and Birth and transfer were seen as implementation successes by both groups (parents: 14/23 & 11/23; HCPs: 46/76 & 50/76). Most frequently mentioned barriers included missing resources and inadequate infrastructure. Information dissemination, interdisciplinary collaboration and training opportunities were considered facilitators. The implementation state varied across topics, with parents and HCPs being frequently of the same opinion. Strengthening collaboration among stakeholders could provide an opportunity to improve future implementation efforts.

Newborn Behavioral Observation (NBO) at different stages of the perinatal journey

Newborn Behavioral Observation (NBO) at different stages of the perinatal journey

Loss to Follow-up and Developmental Delay in the Neonatal High-Risk Infant Follow-up Clinic.

Neonatal follow-up (NFU) clinics provide developmental assessments for infants at high risk for developmental delays. Disparities in NFU attendance and loss to follow-up (LTF) are well documented, but it is not known whether patients who are LTF have different developmental outcomes. The population of patients LTF from the NFU clinic is assumed to be homogenous, but we hypothesize there is a subpopulation of patients LTF who are receiving developmental care elsewhere. Our objective was to compare the baseline characteristics and developmental outcomes of infants who completed follow-up, infants who were LTF but seen by others in the community, and infants who were LTF but not seen by others (true LTF).Retrospective cohort study at a regional specialty center, including 262 patients referred to the NFU clinic who were born between 2014 and 2017, with a 24-month total follow-up period, such that assessment of all follow-up outcomes (NFU clinic attendance outcome, and clinician assessed developmental delay) was complete prior to March 2020. Multivariable logistic regression was used to model the odds of developmental delay, true LTF, and referral to developmental services at initial hospital discharge.Of 262 patients, 86 (33%) were LTF from the NFU clinic. Of these, 55 (64%) had developmental assessments by other providers. Of those LTFs from NFU but seen by other providers, the prevalence of clinician-assessed developmental delay at 24 months was 67%, compared with 45% of those who completed the NFU clinic (p < 0.001). Social risk factors (younger mothers, late or no prenatal care, maternal smoking, or referral for a social reason) were associated with higher odds of true LTF, but no different odds of referral to developmental services at hospital discharge.A majority of patients LTF from the NFU clinic had developmental assessments by others (64%). Social risk factors were associated with true LTF and missed developmental assessments. · Sixty-four percent of patients with LTF had developmental assessments by other providers.. · Social risk factors were associated with higher odds of true LTF.. · Infants with social risk factors were not referred to developmental services early..

Impact of Interventions From a Secondary Home-Based Palliative Care Unit on Caregiver Burden in Kerala, India.

Caregivers in low- and middle-income countries (LMICs) experience severe caregiver burden manifested as physical, emotional, developmental, social, and financial strain. The burden experienced by caregivers becomes severe in the case of patients in need of secondary palliative care since the care recipients are completely dependent on caregivers for activities of daily living (ADLs) and instrumental activities of daily living (iADLs) and require advanced nursing care and symptom management. The paper examines the interventions implemented by the best-performing secondary home-based palliative care (HBPC) unitin Kerala, focusing on the provision of caregiving services and resources, and evaluates their impact on perceived caregiver burden. Using in-depth interviews, qualitative data on aspects of caregiver burden and the impact ofintervention by the HBPC unit were collected from 10 caregivers selected purposively to reflect the heterogeneity of the caregiver population. A multidimensional tool, the Caregiver Burden Scale (CBS), was developed to measure the impact of the HBPC unit on caregiver burden. A sample of 36 caregivers was selected using proportional random sampling from among the caregivers of 93 patients registered at the HBPC unit in 2021.Quantitative data on palliative care services provided by the secondary palliative care unit, activities of the HBPC unit, frequencyand duration of home care visits, particulars of caregivers, and details of caregiving services and resources were collected and analyzed. Additionally, the device CBS was also administered to the selected sample of caregivers. The domains of caregiver burden impacted by the HBPC unitare found to be time burden, emotional burden, physical burden, social burden, developmental burden, coping up burden, and quality care burden. Of all these domains, notable impact is seen in the developmental and quality care domains. This impact resulted from the HBPC unittargeting the health of caregivers, supporting caregiving services, and providing caregiving resources. The HBPC unit cared for caregivers' physical and emotional well-being and enabled them to maintain social relationships. In addition, medication management, advanced nursing care, and support for ADLs were provided during home care visits. The team, by coordinating with the local self-government (LSG) and other institutions, provided caregiving resources, including care facilities and caregiving education. The experience of the intervention of the best-performing secondary home-based palliative care team in Kerala depicts that aholistic interventionin the form of provision of caregiving servicesand caregiving resources from the palliative team can have a positive impact on the various domains of caregiver burden.

Longitudinal outcomes in Noonan syndrome.

Longitudinal outcomes in Noonan syndrome.

Simulated Heat Waves Affect Cell Fate and Fitness in the Social Amoeba Dictyostelium discoideum

The effects of heatwaves at organism and population levels have been widely investigated; however, little is known about how they affect the development of cell populations and the fitness of the resulting organism. Disruptions caused by heatwaves are especially critical during early developmental stages in organisms lacking parental developmental protection or care. Here we use the social amoeba Dictyostelium discoideum, a soil microbe with a life cycle that transitions between single-cell and multicellular stages. D. discoideum thrives optimally at 22 °C and elevated temperatures impair (27 °C) or completely arrest (30 °C) growth, development, and spore yield. We established a simulated heatwave model in which vegetative cells were exposed to 27 °C for 3 days and studied the effects on the expression of early and cell type specific developmental genes using real-time quantitative PCR. A single heatwave severely impaired the expression of cyclic AMP-dependent early developmental gene markers (carA, acaA, pkaR, gtaC, tgrC1, and csaA) as well as that of prespore markers (cotB and spiA), while the expression of the prestalk marker ecmA was less affected. When mixed with heat-stressed cells, reporter cells expressing β-galactosidase grown at 22 °C preferentially occupy the spore mass of the fruiting body. Chimera assays of wild-type and reporter cells grown at optimal temperature or subjected to a heatwave confirmed a decreased fitness (contribution to chimeric fruiting bodies). We conclude that exposure of unprotected organisms at the single cell stage to a single heatwave has the potential to negatively impact their ability to cope with environmental extremes.

Proprioceptive developmental care and parental mental health

Proprioceptive developmental care and parental mental health

Neuropsychology's Role in Multidisciplinary Follow-Up Care of Neurologically Complex Infants and Toddlers.

Neuropsychology's Role in Multidisciplinary Follow-Up Care of Neurologically Complex Infants and Toddlers.

Assessment of pain and support for parents in the neonatal unit

Assessment of pain and support for parents in the neonatal unit

The Impact of Pacifiers and Positioning on Pain Management in Neonates: Meta-Analysis.

The Impact of Pacifiers and Positioning on Pain Management in Neonates: Meta-Analysis.

"This is the best ward round I have ever been a part of": Implementing Developmental Care Ward Rounds in A Tertiary Neonatal Unit in The UK.

"This is the best ward round I have ever been a part of": Implementing Developmental Care Ward Rounds in A Tertiary Neonatal Unit in The UK.

Using Social Network Analysis to Understand the Effect of Developmental Care Education

Using Social Network Analysis to Understand the Effect of Developmental Care Education

The Impact of a Developmental Care Skin-To-Skin Quality Improvement Project as Part of our Process of Becoming A NIDCAP Certified Unit.

The Impact of a Developmental Care Skin-To-Skin Quality Improvement Project as Part of our Process of Becoming A NIDCAP Certified Unit.

Enhancing Neurodevelopmental Outcomes in Preterm Infants Through the Sensory Development Care Map.

Background/Objectives: Preterm infants are at a high risk of neurodevelopmental impairments due to immature brain development and the stressors of the neonatal intensive care unit (NICU) environment. To improve outcomes, incorporating a neuropromotion strategy by promoting nurturing encounters (NEs) is essential. Methods: In this 48-bed tertiary perinatal care center, an informal survey showed that staff lacked consistent knowledge about sensory neurodevelopment, while parents expressed a need for clearer guidance. This paper describes the development and implementation of the Sensory Developmental Care Map (SDCM) as part of a larger quality-improvement initiative. The SDCM is an educational tool designed to guide NICU staff and families in providing neuroprotective and neuropromotive care, based on the infant's gestational age (GA). The SDCM was created by integrating evidence on sensory development across GAs and providing practical strategies to promote positive sensory input while protecting the developing brain. The map visually indicates when to protect or stimulate each sense, offering clear, developmentally appropriate guidance. Printed and digital versions of the map were made accessible to families and staff, with bedside copies and a poster displayed in the unit. Results: A post-implementation evaluation is ongoing, but preliminary feedback suggests that the SDCM improved the family understanding of sensory developmental care. The SDCM serves as a valuable resource for promoting appropriate sensory input for preterm infants and further enhancing developmentally supportive care within the NICU.

Neonatal intensive care: outcomes and long-term developmental implications for preterm infants

Neonatal Intensive Care Units (NICUs) offer preterm infants’ life-saving medical interventions to help them survive complications related to prematurity. Preterm infants still face major obstacles in terms of long-term developmental outcomes, even though the immediate results of NICU care, such as survival rates and the avoidance of acute morbidity, have improved over time. This abstract explores the intricate connection between NICU care and preterm infants' long-term development and health, with a particular emphasis on cognitive, motor, and social-emotional outcomes. According to studies, preterm babies especially those born at extremely low birth weights—are more likely to experience behavioral issues, learning disabilities, and neurodevelopmental delays as they get older. However, improvements in NICU procedures, including better nutritional interventions, developmental care, and respiratory support, have improved overall prognosis. Long-term developmental obstacles still exist despite these advancements, calling for constant observation and early intervention techniques. This article examines current studies on the results of preterm infants treated in the intensive care unit (NICU), focusing on the long-term health consequences and the significance of early therapeutic interventions in reducing developmental risks. To improve the quality of life and developmental paths of preterm infants, it emphasizes the necessity of ongoing innovation in neonatal care as well as extensive follow-up services.

“Effectiveness of a Multimodal Teaching Program on Nurses” Knowledge Acquisition, Practice, and Perception of Neurodevelopmental Supportive Care in NICU: A Non-randomized Controlled Trial

Introduction Developmental supportive care (DSC) gradually gaining recognition and adoption in NICUs. This study aimed to assess the effectiveness of a multimodal teaching program (MMTP) on nurses’ knowledge acquisition, practices, and perception of neurodevelopmental supportive care (NDSC). Methods A non-randomized controlled trial with a one-group pre-test–post-test design was employed to evaluate the efficacy of MMTP on NDSC among the 55 nurses working in the NICU. Pre and post-assessment followed by one-month follow-up data was collected using a self-administered questionnaire for knowledge, an observation checklist for practice assessment and a Likert scale to assess the perception. Results This study findings showed that the mean (SD) score at pre-test, post-test-I and II were 12.18 (3.15), 17.2 (1.04) and 19.1 (1.82), respectively; MD (95% CI) between pre-test and post-test-I = 5.06 (3.84-6.27), P = .001 and MD (95% CI) between pre-test and post-test-II = 6.90 (5.78-8.09), P = .001. After the MMTP, 90%-100% of nurses exhibited adequate practice skills in NDSC, with 81.6% of participants reporting a positive perception toward it. Conclusion The MMTP effectively improved and sustained nurses’ knowledge and practices regarding NDSC.

Development of a web-based individualized supportive developmental care (Web-DevCare) program for newborns, evaluation of content quality and usability

Development of a web-based individualized supportive developmental care (Web-DevCare) program for newborns, evaluation of content quality and usability