Odochi Nwabara1, Cynthia Rogers2, Terrie Inder3, Roberta Pineda1,4. 1. a Program in Occupational Therapy , Washington University , St Louis , Missouri , USA. 2. b Department of Psychiatry , Washington University , St. Louis , Missouri , USA. 3. c Department of Pediatric Newborn Medicine , Brigham and Women's Hospital , Boston , Massachusetts , USA. 4. d Department of Pediatrics , Washington University , St. Louis , Missouri , USA.
Abstract
AIMS: To (1) characterize early therapy services for preterm infants in the first two years of life, and (2) define factors related to accessing early therapy services. METHODS: Therapy utilization after discharge from the neonatal intensive care unit (NICU) was tracked in 57 infants born ≤30 weeks gestation from 2007 to 2010. Participants returned for developmental testing at two years. Factors related to early therapy utilization were explored. RESULTS: Fifty-two (91%) infants received a referral for therapy at NICU discharge but only 44 (77%) received at least one type of therapy during the first two years of life. Infants who received early therapy services were more likely to have more days on ventilation (p =.005), have single mothers (p =.047), and exhibit abnormal neurobehavior at term equivalent age (p =.03). On average, infants first received occupational therapy at a mean age of 5.1 ± 4.6 months with a median of 2.6 (1.3-9.0), physical therapy at a mean age of 4.3 ± 4.1 months with a median of 3.7 (0.1-5.5), and speech-language pathology services at a mean age of 14.0 ± 6.1 months with a median of 15.0 (11.3-17.7) months corrected age. Of the 13 children who did not receive any therapy in the first two years after NICU discharge, seven (53%) had a developmental delay at an age of two years. CONCLUSIONS: In spite of high referral rates for therapy services, there is a delay in therapy activation following NICU discharge, and some infants who warrant services do not obtain them.
AIMS: To (1) characterize early therapy services for preterm infants in the first two years of life, and (2) define factors related to accessing early therapy services. METHODS: Therapy utilization after discharge from the neonatal intensive care unit (NICU) was tracked in 57 infants born ≤30 weeks gestation from 2007 to 2010. Participants returned for developmental testing at two years. Factors related to early therapy utilization were explored. RESULTS: Fifty-two (91%) infants received a referral for therapy at NICU discharge but only 44 (77%) received at least one type of therapy during the first two years of life. Infants who received early therapy services were more likely to have more days on ventilation (p =.005), have single mothers (p =.047), and exhibit abnormal neurobehavior at term equivalent age (p =.03). On average, infants first received occupational therapy at a mean age of 5.1 ± 4.6 months with a median of 2.6 (1.3-9.0), physical therapy at a mean age of 4.3 ± 4.1 months with a median of 3.7 (0.1-5.5), and speech-language pathology services at a mean age of 14.0 ± 6.1 months with a median of 15.0 (11.3-17.7) months corrected age. Of the 13 children who did not receive any therapy in the first two years after NICU discharge, seven (53%) had a developmental delay at an age of two years. CONCLUSIONS: In spite of high referral rates for therapy services, there is a delay in therapy activation following NICU discharge, and some infants who warrant services do not obtain them.
Entities:
Keywords:
Developmental delay; early intervention; occupational therapy; physical therapy; prematurity; speech language pathology
Authors: Per Ivar Kaaresen; John A Rønning; Jorunn Tunby; Solveig Marianne Nordhov; Stein Erik Ulvund; Lauritz B Dahl Journal: Early Hum Dev Date: 2007-08-14 Impact factor: 2.079