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Developmental and Therapeutic Interventions in the Nicu

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Table of Contents

Supporting Infant Occupations In The NICU; Historical Evolution Of The Neonatal Therapist's Role; Perspectives On Developmental Theories Applicable To NICU Intervention; Personnel And Teamwork In The NICU; Physical Context, Equipment, Environmental Stressors, And Sources Of Support In The NICU; Medical Management Of High-Risk Infants; Embryonic Development And Neonatal Classification. (Part Contents).

About the Author

Elsie R. Vergara, Sc.D., OTR, FAOTA, received a bachelor of science degree in physical and occupational therapy in 1968 and a master of public health degree in maternal and infant health in 1977 from the University of Puerto Rico. Her interest in neonatal care emerged during her clinical experiences in Puerto Rico. These experiences took place when major medical and technological advances in neonatal practice were occurring in the United States. Dr. Vergara moved to Boston to pursue a doctoral degree that would expand on the knowledge and skills in neonatal intervention that she had acquired through intensive self-study and her master's-level experiences. Dr. Vergara received training from respected neonatal care scholars such as Dr. Kevin Nugent and Dr. Heidelise Als, and in 1987 she earned a doctor of science degree from Boston University. Following the reauthorization of the Education of the Handicapped Act Amendments of 1986 (PL 99-457) as the Individuals with Disabilities Education Act Amendments of 1991 (PL 102-119), states began to develop educational resources and activities to prepare personnel to comply with the mandates of the law. Dr. Vergara obtained a 3-year grant from the state of Florida to design and establish a statewide training program to prepare neonatal and early intervention physical and occupational therapists. To accomplish this task, she created a series of self-study materials that the American Occupational Therapy Association published in 1993 as a two-volume set titled Foundations for Practice in the Neonatal Intensive Care Unit and Early Intervention: A Self-Guided Manual. In 1993, Dr. Vergara was inducted into the American Occupational Therapy Association's Roster of Fellows for her contributions to the enhancement of the profession through the development and promotion of educational programs in early intervention. Dr. Vergara's interest in infusing a family-centered, developmentally supportive perspective into the training and service delivery of neonatal personnel has challenged her to conduct similar training programs in countries such as Mexico and Honduras. She plans to establish two training centers in Mexico to provide ongoing preparation of neonatal personnel. Rosemarie Bigsby, Sc.D., OTR, FAOTA, earned a bachelor of science degree in occupational therapy from Western Michigan University in 1974, an advanced master of science degree in occupational therapy from Boston University in 1980, and a doctor of science degree from Boston University in 1994. She holds a Board Certification in Pediatrics from the American Occupational Therapy Association and in 1993 was named a Fellow of the American Occupational Therapy Association for her contributions to the practice of occupational therapy with infants and children. Dr. Bigsby's experience as a pediatric occupational therapist spans three decades, during which she has worked in a variety of settings as a clinician, supervisor, and consultant. When she began her career, sensory integration and early intervention were emerging practice arenas. The potential for applying principles of sensory integrative theory to practice in early intervention captured her interest, prompting her to advance her education and to eventually engage in research with preterm infants and their families. In the 1980s, following her graduate studies, she became Chief Occupational Therapist at Meeting Street School (now called Meeting Street Center), a center in East Providence, Rhode Island, for school-age children with multiple disabilities. She participated on the multidisciplinary diagnostic team as well as the Parent Program for Developmental Management, one of the first early intervention programs in the country, which was founded by the late Dr. Eric Denhoff. In 1990, she began her doctoral research under the mentorship of Dr. Barry Lester, focusing on physiologic and behavioral indicators of self-regulation in preterm infants. Since that time, she has contributed to a number of grant-funded research studies as a trainer and consultant. Dr. Bigsby has practiced in the NICU at Women & Infants' Hospital since 1992 in the combined roles of therapist, educator, and researcher. She was instrumental in translating the model for psychosocial and developmental support to NICU infants and their families first described by Dr. Elaine C. Meyer, Dr. Lester, and colleagues from a research protocol to a clinical service that is provided by the Infant Development Center team. Dr. Bigsby has authored numerous journal articles and book chapters and coauthored the American Occupational Therapy Association guidelines for NICU practice and the Posture and Fine Motor Assessment of Infants (The Psychological Corporation, 2000). She also has served as a contributor to the Neonatal Network Neurobehavioral Scale (NNNS) (Lester & Tronick, forthcoming from Paul H. Brookes Publishing Co.). Dr. Bigsby's research focuses on motor development, behavioral cues, physiologic regulation, and feeding in early infancy. She has been invited to speak both nationally and internationally, and each year, she teaches several 2-day multidisciplinary workshops on assessment and intervention in the NICU. "


"Outstanding--redefines the occupation of the therapist in terms of infant occupations."--Barry Lester, Ph.D."Professor of Psychiatry and Pediatrics, Brown Medical School" (01/01/2012) "This carefully crafted text keeps the infant and his or her caregivers in the foreground, always reminding readers that there is a tiny person and a family at the center of the NICU."--Wendy Coster, Ph.D., OTR/L, FAOTA"Program in Occupational Therapy, Boston University" (01/01/2012) "Novice and seasoned neonatal therapy clinicians can enhance their knowledge base by reflecting on the past and developing perspectives this book explores." --Susan Strzyzewski, M.Ed., OTR/L

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