Program
Newborn Individualized Developmental Care and Assessment Program (NIDCAP)
Topic: Early Intervention, Parenting, Sleep
Target Population: Infant/Toddlers, Parents
Sector: Medical Setting
Target Audience
This program is delivered to premature infants, their parents, and other family members and is intended to impact premature infants.
Summary
Newborn Individualized Developmental Care and Assessment Program (NIDCAP), a comprehensive, family-centered intervention, is designed to reduce the possible negative impact of the newborn intensive care unit (NICU) (e.g., bright lights, frequent interruptions of sleep) and to provide a NICU environment and care system that supports early brain development. The program's long-term goal is to improve preterm-born children's development.
Evidence
Many studies have been conducted that evaluate NIDCAP, including multiple randomized trials. Three of these trials demonstrated better brain structure and function for children who are 8 to 9 years old. For example, NIDCAP youth performed better than youth who had not experienced NIDCAP on some measures of executive function and visual and spatial abilities. One quasi-experimental study indicated less psychomotor delay in NIDCAP children at 2 years of age compared to those in a control group. One quasiexperimental study that examined the impact of the program on mothers found significantly lower levels of stress and anxiety in mothers in the intervention group, compared to mothers in the control group. For secondary outcomes reported on the program's website, namely reduced days in NICU and improved weight gain, outcomes are mixed; some studies show positive effects on these outcomes, and others show no significant difference between NIDCAP and non-NIDCAP infants. Results tend to vary depending upon which outcomes are assessed and may be impacted by other factors such as gestational age and mother’s smoking status during pregnancy.
Components
NIDCAP, which is implemented by certified NIDCAP professionals, intends to adapt the NICU experience to meet the unique needs of each newborn. The intervention begins when the infant is admitted to the NICU and includes the following:
- Offer suggestions based on neurobehavioral observations and instruct parents and staff regarding how to support the infant's development;
- Time medical procedures based on the infant's sleep-wake cycle and provide relaxation periods;
- Support and guide caregivers in understanding the infant's stress and comfort signs and in adapting care in response to those signs;
- Encourage parents to hold their infant as much as possible and cradle the infant during stressful and difficult procedures; and
- Provide supportive accessories, such as terry cloth buntings, hammocks, pillows, and special pacifiers.
Previous Use
NIDCAP was developed in 1984 in the United States. Currently, there are NIDCAP training centers in the United States, Argentina, Belgium, Denmark, France, Italy, The Netherlands, Norway, Portugal, Spain, and Sweden.
Training
Preparation to implement NIDCAP occurs at the nursery-wide level, and sites are encouraged to develop a 5-year plan. Training for individuals typically lasts 12 months and includes readings, an initial 3-day session, practice observations, and work sessions with trainers. Please visit https://nidcap.org/professionals/supports-for-nursery-change/nidcap/#training or use details in the Contact section for more information.
Considerations
Considerations for implementing NIDCAP include obtaining funding for program costs (i.e., nursery certification), allocating time for training, and recognizing that this is a comprehensive intervention that requires long-term commitment and may involve significant changes to NICU operations.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Implementation
If you are interested in implementing NIDCAP, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Time
Implementation time will vary as NIDCAP provides daily support to infants and their families while infants are in the NICU.
Cost
The Nursery Program Application and Review Process costs $29,220. Please use details in the Contact section for additional information on implementation costs.
Evaluation Plan
To move NIDCAP to the Effective category on the Clearinghouse Continuum of Evidence, the studies that found positive effects for brain development beyond the 2-year follow-up point need to be replicated by an independent research team.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Contact
Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu
You may also contact NIDCAP Federation International, Inc. by mail P.O. Box 3303, Woburn, MA 01888, email info@midcap.org, or visit https://nidcap.org/about-us/contact-us/
Source
https://nidcap.org/professionals/supports-for-nursery-change/nidcap/ and McAnulty et al. (2010)
References
Used in Placement
Als, H., Gilkerson, L., Duffy, F. H., McAnulty, G. B., Buehler, D. M., Vandenberg, K., ... Jones, K. J. (2003). A three-center, randomized, controlled trial of individualized developmental care for very low birth weight preterm infants: Medical, neurodevelopmental, parenting, and caregiving effects. Journal of Developmental and Behavioral Pediatrics, 24(6), 399-408. https://doi.org/10.1097/00004703-200312000-00001
Als, H., Lawhon, G., Duffy, F. H., McAnulty, G. B., Gibes-Grossman, R., & Blickman, J. G. (1994). Individualized developmental care for the very-low-birth-weight preterm infant - medical and neurofunctional effects. JAMA: The Journal of the American Medical Association, 272(11), 853-858. https://doi.org/10.1001/jama.272.11.853
Kiechl-Kohlendorfer, U., Merkle, U., Deufert, D., Neubauer, V., Peglow, U. P., & Griesmaier, E. (2015). Effect of developmental care for very premature infants on neurodevelopmental outcome at 2 years of age. Infant Behavior & Development, 39, 166-172. https://doi.org/10.1016/j.infbeh.2015.02.006
Khosravan, S., Khoshahang, M., Heidarzadeh, M., & Basirimoghadam, M. (2020). Effect of NIDCAP home care follow-up program of preterm newborns on maternal anxiety and stress. Annali Di Igiene, 32(6), 627-634. https://doi.org/10.7416/ai.2020.2384
Klein, V., Zores-Koenig, C., Dillenseger, L., Langlet, C., Escande, B., Astruc, D., ... & Strasbourg NIDCAP Study group. (2021). Changes of infant-and family-centered care practices administered to extremely preterm infants during implementation of the NIDCAP program. Frontiers in pediatrics, 9, 718813.
McAnulty, G., Duffy, F., Butler, S., Parad, R., Ringer, S., Zurakowski, D., & Als, H. (2009). Individualized developmental care for a large sample of very preterm infants: Health, neurobehaviour and neurophysiology. Acta Paediatrica, 98(12), 1920-1926. https://doi.org/10.1111/j.1651-2227.2009.01492.x
Peters, K. L., Rosychuk, R. J., Hendson, L., Cote, J. J., McPherson, C., & Tyebkhan, J. M. (2009). Improvement of short- and long-term outcomes for very low birth weight infants: Edmonton NIDCAP trial. Pediatrics, 124(4), 1009-1020. https://doi.org/10.1542/peds.2008-3808