Individualized Developmental Care in the Neonatal Intensive Care Nursery

Advances in medical care have improved the success of medical interventions in treating high-risk and premature infants, but long-term developmental outcomes are less positive. The neonatal intensive care unit (NICU) setting influences infant brain development and organization, as well as the parent-infant relationship. One advanced-practice role for a speech-language pathologist (SLP) is that of a newborn developmental specialist (NDS). The NDS working in the NICU understands the influence of medical, environmental, and caregiving interactions on the neurologic and neurobehavioral organization of the infant. The NICU setting advanced practice skills are grounded in an individualized, developmentally supportive care model, such as the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Neurodevelopmental assessment focuses on the competence of the infant. The developmental assessment and intervention strategies are individualized to support the infant's own goal strivings. In this framework, interactions with infants become modified to increase competence and organization. The SLP working in the NICU is in a unique position to facilitate communication between the infant and the parent, as well as between the infant and professional caregivers. The SLP can help the parent interpret and respond appropriately to the infant's communication by focusing on non-verbal stress and stability cues, and by planning all interactions with a goal of co-regulation. Interactions with infants and families in this Model in the NICU have beneficial lifelong implications.