Current Trends in Neonatal Therapy Practice

This study aimed to describe contemporary neonatal therapy practice in the neonatal intensive care unit (NICU).

This Institutional Review Board (IRB)-approved research, conducted in 2024, surveyed occupational therapists (OTs), physical therapists (PTs), and speech-language pathologists (SLPs) who worked in the NICU within the past 5 years.

There were 1,095 clinicians from 728 hospitals who responded: 459 (42%) OTs, 328 (30%) PTs, and 308 (28%) SLPs. Among respondents, 517 (55%) practiced in Level III NICUs, 385 (41%) in Level IV NICUs, and 48 (5%) in Level II units. Additionally, 581 (62%) were Certified Neonatal Therapists (CNTs). Most respondents reported the presence of OTs (765, 95%), SLPs (697, 86%), and PTs (691, 85%) in their NICU, and 723 (81%) had standing therapy orders. Most (513; 58%) reported having all three disciplines in their NICU. Common neurobehavioral assessments included the Test of Infant Motor Performance, General Movement Assessment, Infant Positioning Assessment Tool, and Hammersmith Neonatal Neurological Assessment. Frequently used feeding assessments were the Early Feeding Skills Assessment, Neonatal Eating Outcome Assessment, and Neonatal Oral Motor Assessment Scale. Therapists commonly treated infants requiring ventilatory support, supported skin-to-skin care, facilitated breastfeeding transitions, and worked with extremely low birth weight, late preterm, and substance-exposed infants. Regarding care philosophy, 211 (62%) reported using the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, 123 (36%) Trauma-Informed Care, 97 (28%) the Newborn Individualized Developmental Care and Assessment program (NIDCAP), 95 (28%) Neonatal Integrative Developmental Care Model, and 68 (20%) Family Integrated Care. Over the past 5 years, therapists described shifts toward evidence-based practice, stronger interdisciplinary collaboration, development of structured small-baby team approaches, and implementation of interventions such as the SENSE and Infant-Driven Feeding programs.

There is greater integration of neonatal therapists to identify developmental risks and provide targeted interventions in the NICU.

· Neonatal therapy is increasingly specialized, with more CNTs.. · There are rapid changes occurring in neonatal therapy practice.. · Neonatal therapists have increased use of standardized assessment and specialized programming.. · Multidisciplinary teams in the NICU are on the rise.. · Neonatal therapists report more evidence-based practice and involvement in research..