Infant Toddler Development Training
Module 6, Lesson 1
Premature infants contribute significantly to the morbidity and mortality rates discussed earlier in this lesson. Additionally, premature infants and the role of the ITDS were introduced in Module 1 of the ITDS series. The ITDS may be on the team for families who have premature infants. It is important that the ITDS understand terminology related to prematurity when reading reports or participating in team discussions.
In review, the preterm or premature infant is an infant who is born before the 37th week of gestation usually weighing less that 2,500 grams (5 ½ pounds). If an infant is born at 37 weeks or more and weighs less than the 2,500 grams, the infant is said to be small for gestational age. In addition, any infant with birth weight less than 2,500 grams, no matter what the gestational age, is considered low birth weight.
Technology such as incubators, mechanical ventilators, advanced laboratory procedures, antibiotics, and surfactant (to help the premature infant's lungs work better) make it possible to save smaller babies born at younger gestational ages. However, with more infants surviving, the issues of morbidity or the problems related to prematurity have increased.
Neurological Correction for Premature Infants
The ITDS must be aware of a very important concept when working with premature babies especially up to the age of two years. This is the concept of neurological correction. The age of the child until the chronological age of two years is adjusted to represent the time that would have been spent in utero rather than the actual age of the child. This is referred to as the adjusted age.
The concept of neurological correction is an important consideration when assessing the development of a premature infant. Professionals who administer developmental tests need to calculate the chronological, as well as the adjusted age, for a premature infant until the infant is two years of age. This adjusted age should be used when calculating the scores on most developmental evaluation/assessment protocols.
Why is it important to understand adjusted age?
A general rule of thumb is that most premature infants are kept in the hospital until they reach a weight of about five pounds or until they reach the term age when they would have been delivered. This is of course providing that the presence of a severe medical condition does not delay the transition to the home.
What family stressors should the ITDS be aware of that are inherent in the NICU experience?
An excellent resource on Premature Infants is available to help the ITDS gain insight on how families feel about and cope with the NICU experience and the transition home. This material was created specifically for parents of premature infants and healthcare providers.
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