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Updated: Sep 19, 2025

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

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Looking beyond diagnoses to functioning: using the F words and personalizing care in neonatology

Emilie Thivierge1, Thuy Mai Luu2, Peter Rosenbaum3

  • 1CHU Sainte-Justine Research Center, Montréal, Canada.

Seminars in Perinatology
|June 19, 2025
PubMed

Insights

Neonatal follow-up for extremely preterm infants needs better communication. Shifting from medical terms to family-centered "F-words" like Functioning and Future improves care for high-risk babies.

Area of Science:

  • Neonatal Medicine
  • Developmental Pediatrics
  • Family-Centered Care

Background:

  • Extreme prematurity poses risks for mortality and morbidities.
  • Current neonatal follow-up often focuses on medical diagnoses, not family-important outcomes.
  • Discrepancies exist between parents and clinicians regarding the definition of severe outcomes.

Purpose of the Study:

  • To recommend a shift in communication strategies for parents of preterm infants during NICU hospitalization.
  • To promote a growth and development-centered approach over a deficit-based model.
  • To integrate family-important outcomes into neonatal follow-up using the WHO's biopsychosocial framework.

Main Methods:

  • Review of current neonatal follow-up practices and parent-clinician communication.
  • Analysis of the limitations of medicalized, deficit-based outcome assessments.
  • Proposal for a communication framework based on the World Health Organization's 'F-words' for child development.

Main Results:

  • Parents desire balanced information focusing on functioning rather than solely medical diagnoses.
  • Existing neonatal follow-up often neglects crucial functional domains important to families.
  • The 'F-words' (Functioning, Family, Fitness, Fun, Friends, Future) offer a comprehensive biopsychosocial approach.

Conclusions:

  • Communication with parents of preterm infants should transition from medicalized, deficit-focused discussions to a growth and development perspective.
  • Adopting the 'F-words' framework enhances the evaluation of family-important outcomes.
  • This approach supports improved care, research, and quality initiatives in neonatal follow-up.

Keywords:
Clinical ethicsCommunicationDevelopmental pediatricsDisabilityDisability paradoxF-wordsFamily-centeted careNICU, NeonatologyNeonatal follow-upNeonatal outcomesPalliative carePatient important outcomePrematurityPrenatal consultations

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