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Updated: Jun 10, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Is the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) effective for preterm infants with
H Als1, F H Duffy, G B McAnulty
1Department of Psychiatry, Children's Hospital Boston, Boston, MA 02115 USA. heidelise.als@childrens.harvard.edu
Insights
The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) improved neurobehavioral and cognitive outcomes in preterm infants with intrauterine growth restriction (IUGR). This intervention shows promise for vulnerable newborns.
Area of Science:
- Neonatal care
- Developmental neuroscience
- Perinatal medicine
Background:
- Preterm infants with severe intrauterine growth restriction (IUGR) face significant neurodevelopmental challenges.
- Early neurobehavioral and electrophysiological functioning are critical indicators of long-term outcomes in this population.
- The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is a specialized care approach designed to support vulnerable infants.
Purpose of the Study:
- To evaluate the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) in preterm infants diagnosed with severe intrauterine growth restriction (IUGR).
- To assess the impact of NIDCAP on neurobehavioral and electrophysiological development in this high-risk infant cohort.
Main Methods:
- A randomized controlled trial involving 30 preterm infants (28-33 weeks gestational age) with severe IUGR.
- Infants were assigned to either standard care (control) or NIDCAP (experimental) groups.
- Neurobehavioral assessments and electroencephalography (EEG) were conducted at 2 weeks corrected age, with neurobehavioral and health assessments repeated at 9 months corrected age.
Main Results:
- Both groups were comparable in health and anthropometrics at all assessment points.
- At 2 weeks corrected age, the NIDCAP group demonstrated significantly improved autonomic, motor, and self-regulation functioning, with enhanced motility and response thresholds.
- The NIDCAP group also exhibited reduced EEG connectivity in adjacent brain regions and showed significantly better mental performance at 9 months corrected age.
Conclusions:
- This study provides the first evidence demonstrating the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) for preterm infants experiencing severe intrauterine growth restriction (IUGR).
- NIDCAP intervention positively influences neurobehavioral and cognitive development in this vulnerable population.
Objective:
This study investigates the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on neurobehavioral and electrophysiological functioning of preterm infants with severe intrauterine growth restriction (IUGR).
Study Design:
Thirty IUGR infants, 28 to 33 weeks gestational age, randomized to standard care (control/C=18), or NIDCAP (experimental/E=12), were assessed at 2 weeks corrected age (2wCA) and 9 months corrected age (9mCA) in regard to health, anthropometrics, and neurobehavior, and additionally at 2wCA in regard to electrophysiology (EEG).
Result:
The two groups were comparable in health and anthropometrics at 2wCA and 9mCA. The E-group at 2wCA showed significantly better autonomic, motor, and self-regulation functioning, improved motility, intensity and response thresholds, and reduced EEG connectivity among several adjacent brain regions. At 9mCA, the E-group showed significantly better mental performance.
Conclusion:
This is the first study to show NIDCAP effectiveness for IUGR preterm infants.
