Neurodevelopment

Neonatal Occupational Therapy

Why on earth would you need an occupational therapist (OT) in a neonatal unit? After all babies don’t have any occupations.

Occupational Therapy (OT) is a profession that little is known about and it is often easily misunderstood.  It is not until you have worked with an OT, or have received OT that you can begin to understand what they bring to the NICU MDT.

Every activity in life can be viewed as an occupation.  Occupations include; riding a bicycle, holding a pencil, making a cup of tea, learning to breast feed or sleeping.  It is the job of an OT to help you achieve your chosen occupation.

OT’s are the only healthcare profession trained in both physical and mental health.  They are therefore in the unique position to understand how each aspect of health will influence the other.  An OT will never look at an individual in isolation but will always explore how the environment, the family and friendships influence occupation.

In short they say that medicine is about adding days to life.  Whereas Occupational Therapy is about adding life to days!

The role of the OT in the NICU is diverse and multifaceted and includes:

  • FAMILY: Supporting the family, working at the families pace to support parenting occupations, providing information on preterm development, behavourial cues and sensory development and resources, running groups and classes.
  • ENVIRONMENT: continually assessing the environment, does it meet the infant’s developmental, sensory and family needs.
  • NEUROBEHAVIOURAL: helping the infant achieve self-regulation, working with the staff and family to understand each baby’s coping strategies, avoidance cues, and interactive behaviours.
  • NEUROMOTOR: supporting the infant’s musculoskeletal/motor development and function.
  • SENSORY: assessing the infant’s sensory development and promoting and optimal environment.

The role of the OT at Starlight Neonatal Unit includes:

Leading on Developmental Care: we are currently following the 7 neuro-protective measures and focusing on a new concept every 4 months.  Each neuro-protective measure has a team of professionals including OT, nurses, medics and others.

  • Running the ‘Little Stars Group’, this is a 5 week closed group, open to all parents following NICU admission. The group includes baby massage, infant development and educational sessions.
  • Parents Supper club: a monthly evening event for all parents, food is shared, the OT presents for 45 minutes on infant behaviour, sensory development and parenting in the NICU.
  • Creating infant developmental packs for all high risk infants, blanket referral for all infants. However the OT provides 1:1 sessions with all high risk infants and their parents.
  • Neurodevelopmental follow up: OT is a core member of Barnet neurodevelopmental follow up clinic and provides all term assessments, using Prechtl assessment of general movement and Neonatal Behavioural Assessment Scale (NBAS).

The role of the OT at the Whittington Hospital includes:

  • Leading on promoting Developmental care on the neonatal unit.
  • Coordinating and chairing monthly multidisciplinary developmental care meetings where the multidisciplinary team identify priorities and plan for the year.
  • Tip of the month – developing a tip of the month flyer for staff and parents to sensitise them to a specific area of focus.
  • Attendance to Friday ward rounds to support medical staff at the cot side; individualising care and improving positioning and handling practices.
  • Coordinating and implementing regular education sessions on Developmental Care to current staff and new starters.
  • Maintaining an overview of best practices in terms of equipment to support Developmental Care. We recently raised money to fund 8 state of the art recliner chairs to promote Kangaroo Care.  We are about to trial provision of aids including Zaky hands and memory foam pillows andnests.
  • Following on the success of Barnet’s ‘Little Stars’ Group we have started running a similar support group for parents at the Whittington called ‘Bright Start’. Like the Barnet group, it offers parents educational sessions as well as an opportunity to seek support from health care professionals and link in with parents who have been through similar experiences.
  • Provision of Developmental Care binder for all parents of high risk infants. The binder has been designed to support parents through their neonatal journey from admission to discharge home.
  • Provision of home visits to support parents where there are complex social or medical needs. The home visits are aimed to  help parents with the transition from hospital to home through assessment of the environment.   The home visit is also aimed at increasing parent’s confidence and sensitising them  to their infant’s development.
  • Neurodevelopmental follow up: OT is a core member of Whittington neurodevelopmental follow up clinic and provides assessments at term, three months, 6 months, one year and two years using Prechtl’s assessment of general movements and Bayley Scales of Infant Development.

Neonatal Occupational Therapy Service (Laura Perez Adamson, Whittington Health NHS) PP PDF

Neonatal Occupational Therapy, (Emily Hills, Occupational Therapist, Starlight Neonatal Unit, Barnet Hospital) PP PDF

Meet the Neurodevelopmental Team

Betty Hutchon

Head Peadiatric Occupational Therapist

Consultant Neurodevelopmental Therapist

Honorary Lecturer, University College London

Trust: Royal Free London NHS Foundation Trust

Emily Hills

Neonatal Occupational Therapist

Trust: Royal Free London NHS Foundation Trust

Laura Perez-Adamson

Senior Occupational Therapist

Trust: Whittington Health