PCPs: Please Refer Your NICU Graduate Patients for a Children’s Therapy Follow-up at the 4-Month Check-up:
What patients are served by the Follow-up Program?
The Children’s Therapy team of therapists sees any child born under 35 weeks gestational age, or with other feeding/motor development concerns during their NICU/post-birth stay at VMC.
How does this Children’s Therapy service currently function?
One month following discharge, we call families to check-in on progress and recommend a developmental follow-up evaluation at our Children’s Therapy outpatient clinic at 4-months adjusted age, or earlier if there are persisting concerns.
What is changing to the existing service?
To increase family engagement in their child’s care and to establish more direct contact with their primary care providers, we are now asking the families to request a referral from their PCP and contact us at 4-months adjusted age to schedule.
In order to provide the best service to our families, we are requesting that at the 4-month well child visit PCPs remind families of NICU graduates of their recommended follow-up visit and write a referral to Children’s Therapy (open for PT/OT/SLP). This will also establish a solid point of communication between our clinic and their PCPs to make sure we are fully looped into the patient's care and allow for ongoing scheduling if recommended.
NOTE: Our neonatologists will continue to put in referrals should a child need to be seen before 4-months adjusted age.
When is this change happening?
This service change went in to effect January 2019.
Why is early follow-up important for post-NICU/high-risk Infants?
Evidence demonstrates that former preemies and medically-fragile infants are at higher risk of developmental delays. A large 2017 cohort study in France found that 36.2% of children born at 32-34 weeks gestation without cerebral palsy were scoring 2 or more standard deviations below the norm on The Ages and Stages Questionnaire at age 2, as were 40.7% of children born at 27-31 weeks gestation and 50.2% of children born at 24-26 weeks gestation.1 An article published in 2019 notes that while rates of moderate to severe cerebral palsy have gone down, there is increased awareness of the impact of mild cerebral palsy and developmental coordination disorder, both of which seem to be increasing in this population, and that language delays and disorders are common in this population. 2 These differences appear to continue beyond childhood, as studies have found lower motor scores persisting into adolescence3 or even early twenties. 4Thus, evidence-based practice demonstrates that early follow-up is of great importance in this population of infants.
Who can I contact for more information about the Follow-up Program?
Call Children’s Therapy at 425.690.3513 (new number as of May 6), front desk for scheduling questions or you can ask to speak to a member of the NICU Follow-up team (feeding/communication (SLP); motor (PT/OT); sensory (OT)).
What other services does Valley Children’s Therapy offer?
Children's Therapy is pleased to offer a variety of services to serve the needs of your patients! Our clinic offers physical, occupational, speech-language and feeding therapies for children ages 0-19 years. We thank you for your referrals and the opportunity to work with your patients. If you have any questions about our program, we encourage you to please call our clinic at 425.690-3513.
References:
Pierrat V, Marchand-Martin L, Arnaud C et. al. Neurodevelopmental outcome at 2 years for preterm children born at 22 to 34 weeks gestation in France in 2011: EPIPAGE-2 cohort study. BMJ 2017;358:j3448. doi: 10.1136/bmj.j3448
McGowan EC, Vohr BR. Neurodevelopmental follow-up of preterm infants: What is new? Pediatr Clin N Am 2019;66:509–523
de Kievet JF, Piek JP, Aarnoudse-Moens CS, Oosterlaan, J. Motor development in very preterm and very low-birth-weight children from birth to adolescence: a meta analysis. JAMA. 2009;302(20):2235-2242
Husby IM, Skranes J, Olsen A, Brubakk AM, Evensen KAI. Motor skills at 23 years of age in young adults born preterm with very low birth weight. Early Human Development. 2013;89:747-754.