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Updated: May 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 Pickier1, Jacqueline M McGrath, Barbara A Reyna
1Department of Family and Community Health Nursing, School of Nursing (Drs Pickler and McGrath), VCU Health System (Mss Reyna, Lewis, and Cone), Department of Adult Health and Nursing Systems, School of Nursing (Dr McCain), Department of Biostatics, School of Medicine (Dr Best), Department of Biomedical Engineering, School of Engineering (Dr Wetzel), and Virginia Commonwealth University (Drs Pickler, McGrath, McCain, Wetzel, and Best), Richmond, Virginia.
Insights
Neuroprotection interventions in the neonatal intensive care unit (NICU) can improve long-term outcomes for very preterm infants. Understanding these interventions is key to optimizing neurodevelopmental care.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Neonatology
Context:
- Infants born before 30 weeks gestation face significant neurodevelopmental challenges.
- The neonatal intensive care unit (NICU) environment presents risks to infant brain development.
- Long-term developmental outcomes for very preterm infants are a critical concern.
Purpose:
- Introduce a model of neurodevelopmental risk and protection.
- Explain relationships between biobehavioral/environmental risks and caregiving.
- Guide NICU caregiving practices through better understanding of interventions.
Summary:
- A neurodevelopmental risk and protection model is proposed.
- The model links various risks and caregiving behaviors to neurobehavioral outcomes.
- It highlights the potential of neonatal neuroprotection for vulnerable infants.
Impact:
- Interventions during the neonatal period can positively influence long-term development.
- Understanding NICU interventions is crucial for improving care for very preterm infants.
- This model can inform strategies for enhanced neuroprotection and developmental support.
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.
