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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Published on: August 25, 2014

School Age Effects of the Newborn Individualized Developmental Care and Assessment Program for Medically Low-Risk

Gloria McAnulty1, Frank H Duffy, Sandra Kosta

  • 1Department of Psychiatry, Neurology, Harvard Medical School and Boston Children's Hospital, 320 Longwood Avenue, Boston, Massachusetts 02115.

Journal of Clinical Neonatology
|August 17, 2013
PubMed

Insights

The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) improved school-age outcomes for moderately preterm infants. NIDCAP care led to better neurodevelopment, brain function, and brain structure compared to standard care.

Area of Science:

  • Neonatal care
  • Developmental pediatrics
  • Neuroscience

Background:

  • Moderately preterm infants (29-33 weeks gestational age) often experience neuro-cognitive deficits and behavioral problems by school age.
  • Even low-risk preterm children exhibit poorer outcomes than their full-term peers.
  • Identifying interventions to mitigate these long-term effects is crucial.

Purpose of the Study:

  • To evaluate the school-age outcomes of moderately preterm infants receiving the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) versus standard care.
  • To assess neuropsychological function, neuro-electrophysiological measures, and brain structure at school age.
  • To determine if NIDCAP intervention improves developmental trajectories in this population.

Main Methods:

  • A randomized trial comparing NIDCAP to standard care in the Neonatal Intensive Care Unit for moderately preterm infants (29-33 weeks GA).
  • Follow-up evaluation at 8 years corrected age included neuropsychological testing, EEG spectral coherence, and diffusion tensor MRI.
  • Original sample of 30 infants, with 23 (15 NIDCAP, 8 standard care) assessed at follow-up.

Main Results:

  • Children who received NIDCAP intervention demonstrated significantly better performance on the Kaufman Assessment Battery for Children-Second Edition (KABC-II).
  • NIDCAP group showed trends towards better scores on the Rey-Osterrieth Complex Figure Test and exhibited more mature brain connectivities and fiber tracts.
  • Newborn neurobehavioral assessments accurately predicted later neuropsychological functioning at 8 years corrected age.

Conclusions:

  • The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) intervention positively impacts moderately preterm infants.
  • NIDCAP care is associated with improved neuropsychological function, neuro-electrophysiological measures, and brain structure at school age.
  • Early NIDCAP intervention offers a promising approach to enhance long-term outcomes for preterm children.
Abstract

Keywords:
Diffusion tensor magnetic resonance imagingelectroencephalogramneuropsychological functionnewborn individualized developmental care and assessment programprematurityschool-agespectral coherence

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