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Updated: Jun 7, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A model of neurodevelopmental risk and protection for preterm infants
Rita H Pickler1, Jacqueline M McGrath, Barbara A Reyna
1Department of Family and Community Health Nursing, School of Nursing, VCU Health System, Richmond, Virginia 23298, USA. rpickler@vcu.edu
Insights
This model explains how neuroprotection interventions in the neonatal intensive care unit (NICU) can improve long-term outcomes for very preterm infants. Understanding these neurodevelopmental risks and protective factors is key to better infant care.
Area of Science:
- Neuroscience
- Developmental Psychology
- Neonatology
Background:
- Infants born before 30 weeks gestation face significant neurodevelopmental challenges.
- Neonatal intensive care unit (NICU) environments can pose risks to brain development.
- Understanding the interplay of risks and protective factors is crucial for infant outcomes.
Purpose of the Study:
- Introduce a model of neurodevelopmental risk and protection.
- Explain relationships between biobehavioral risks, environmental risks, and caregiving.
- Identify factors influencing neurobehavioral and cognitive outcomes in infants.
Main Methods:
- Conceptual model development.
- Literature review on neurodevelopmental risk and protection.
- Analysis of factors affecting vulnerable infant populations.
Main Results:
- The proposed model integrates biobehavioral and environmental risks with caregiving behaviors.
- Neuroprotection interventions during the neonatal period show potential for positive long-term effects.
- The model highlights the importance of NICU-based interventions for very preterm infants.
Conclusions:
- Interventions focused on neuroprotection in the NICU can positively impact long-term developmental trajectories.
- Further research is needed to understand NICU interventions' impact on long-term outcomes.
- Guiding NICU caregiving practices requires a better understanding of these complex relationships.
Abstract:
The purpose of this article is to introduce a model of neurodevelopmental risk and protection that may explain some of the relationships among biobehavioral risks, environmental risks, and caregiving behaviors that potentially contribute to neurobehavioral and cognitive outcomes. Infants born before 30 weeks of gestation have the poorest developmental prognosis of all infants. These infants have lengthy hospitalization periods in the neonatal intensive care unit (NICU,) an environment that is not always supportive of brain development and long-term developmental needs. The model supports the premise that interventions focused on neuroprotection during the neonatal period have the potential to positively affect long-term developmental outcomes for vulnerable very preterm infants. Finding ways to better understand the complex relationships among NICU-based interventions and long-term outcomes are important to guiding caregiving practices in the NICU.
