The document discusses the past, present, and future of developmental care. It traces the evolution of developmental care from its origins in the 1970s to the current understanding that it should be the overarching philosophy of newborn and family-centered care. The goals of developmental care are to support the positive neurodevelopment of infants and the emotional support of families. Going forward, the document predicts that developmental care will become incorporated into health professional education and be embraced as the standard framework for delivering neonatal care.

1. Developmental Care: Past, Present, Future
Carole Kenner, PhD, RNC-NIC, FAAN
Dean/Professor School of Nursing
Associate Dean Bouvé College of Health Sciences
President, Council of International Neonatal Nurses
Boston, MA, USA

4. Objectives
 Discuss the past, present, and future of developmental care
 Describe the goals of developmental care

5. Individualized, Family-Centered Developmental Care
(IFDC)
 Framework for providing care to support positive
neurodevelopment of the infant and emotional support of family

6. What is Developmental Care
 An awareness of the interaction between the environment and the
infant and family
 Macroenvironment
 Microenvironment
 Responsibility of the interdisciplinary team-including the family
 Requires a partnership with the family

7. No Visitors Please
 Used to be a common policy
 Still is in some countries

8. Minimum Handling Protocol
 Can be Overused

9. Evolution of Developmental Care
 1976 Toward Improving the Outcome of Pregnancy
 Planning guidelines for Neonatal Intensive Care Units (NICUs)
March of Dimes
 1978 Assembly Bill AB 757 for High Risk Infants
 Family needs and services
 Follow up Care
 1979 Kangaroo Care in Bogotá, Columbia Drs. Rey and Martinez
 1980’s Newborn Individualized Developmental Care and
Assessment Program (NIDCAP) starts

10. The Evolution Continues
 1987 Graven Conference for Physical and Developmental
Environment of the High Risk Newborn
 1991 Developmental Care Concepts based on work from Dr.
Heidelise Als in Boston, MA
 1992 Recommend Standards for Newborn ICU Design
 1992 Institute for Patient- And Family-Centered Care
 1993 Kenner Comprehensive Neonatal Nursing Text
 1998 the Philosophy of Developmental Care introduced at East
Tennessee Children’s Hospital

11. The Evolution Continues
 1999 For Profit Company Children’s medical Ventures started
producing Developmental Care Products
 2000 Brussels, Belgium reports on impact of NICU environment
on Premature Infants
 2001 NIDCAP (The Newborn Individualized Developmental Care
and Assessment Program) Federation International formed
 2004 Littleton Adventist Hospital (Littleton, CO) completes $2.5
Million (US dollar) NICU that supports neurodevelopmental,
family-centered, and high tech care

12. The Evolution Continues
 2005 Journal of Perinatology article discusses decline in mortality among
NICU infants-medical residents include developmental care
 2008 Cincinnati Children’s Hospital (Cincinnati, Ohio USA) designated
at a Training Center for Optimal Developmental Care for Infants
 One of 17 worldwide-10 US NIDCAP Centers, 6-Europe, 1-South
America
 Since then has spread to Australia, New Zealand, Asia, Middle East
 http://www.nidcap.org/training_centers.aspx#Europe

13. National Association of Neonatal Nurses (NANN)
 2008 Blueprint for Developmental Care Competencies
 Council of International Neonatal Nurses (COINN) supported
NANN’s efforts
 Consider this a “standard” of care
 Yet….

14. The Universe for Developmental Care
 New Conceptual Framework
 Gibbins, Hoath, Coughlin, Gibbins, & Franck, 2008
 Includes Institute of Medicine’s (IOM) emphasis on patient
focused care, safety, and quality improvement.

15. Developmental Care
 2002 Declared a useless therapy in a US professional journal
 Interdisciplinary support grows – Nurses, Doctors, Occupational
Therapists, Physical Therapists

16. Text

17. PREDICTIONS FOR DEVELOPMENTAL CARE
IN THE 21ST CENTURY
 Developmental care will be embraced as the philosophy of
newborn, infant, and family-centered care.
 Use of a “core curriculum” by health professionals and families
will grow and foster its use as a standard of neonatal care.
 Developmental care will be a model for interdisciplinary education
and healthcare management.
 Developmental care will be a part of standard orientation and
continued competency evaluation for health professionals who
work with newborns, infants, children, and their families

18. PREDICTIONS FOR DEVELOPMENTAL CARE
IN THE 21ST CENTURY
 Developmental care will become the framework from which
neonatal care is delivered.
 Developmental care will be incorporated as an essential part of
health professional education—basic and advanced, no matter what
the discipline.
 Families will be partners in care and not visitors in the NICU any
longer.
 Developmental care teams will be an expectation in neonatal care
delivery.

19. PREDICTIONS FOR DEVELOPMENTAL CARE
IN THE 21ST CENTURY
 Evidence will mount to support positive healthy outcomes for
newborns, infants, and their families when developmental care is
the overarching philosophy of care.
 Interdisciplinary research studies will increase to examine various
aspects of developmental care.

20. European Foundation for the Care of Newborn Infants
(EFCNI) (Karlsfeld, Germany)
 http://www.efcni.org/