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COURSE DESCRIPTION:
This intermediate-advanced course will provide a systems-based approach to assess the premature/medically complex infant in the NICU/PICU setting. This course will focus on understanding the co-morbidities associated with prematurity and medically complex infants and increase critical reasoning skills for the clinician to create treatment plans to advance motor and feeding skills for the infant. It will build on information provided during the “Baby Beats and Breaths” course but can be a stand-alone course for advanced clinicians working with medically complex infants. This course will provide the clinician with hands-on treatment techniques for positioning/handling infants in the Small Baby unit (infants under 32 weeks gestation), oral motor interventions to support pre-feeding/feeding development, edema management including lymphatic facilitation, post-surgical considerations for infants, trunk facilitation to support cough development, extremity facilitation to support ribcage development, pelvic floor activation for stooling, abdominal facilitation for infants with GI complications, scar assessment/treatment, and feeding techniques for infants with multi-system co-morbidities.
LEARNING OBJECTIVES:
- Identify three anatomical and kinesiological developmental changes for the premature and newborn thoracic and abdominal cavity as related to motor development for oral feeding and postural control
- Apply at least two positioning/handling interventions for small babies, with focus on interventions for infants 28 weeks and younger
- Identify three neurological and gastrointestinal co-morbidities of prematurity (including anatomical changes post-surgical interventions for necrotizing enterocolitis) and the effects those co-morbidities have on feeding/motor development for the infant
- Differentiate the lymphatic system of the premature infant from that of the full-term infant and how those differences affect feeding skills
- Assess infant edema within face, extremities, and trunk using objective measurements
- Apply two treatment strategies with positioning, handling and edema management using the provided case study
- Integrate a systems approach to a current individualized care plan for a premature and/or medically complex infant
AUDIENCE:
This course is recommended for intermediate to advanced neonatal therapists, PTs, PTAs, OTs, OTAs, and SLPs, working with infants in the Neonatal Intensive Care Unit.
SCHEDULE:
Schedule – Day 1
- Updates in Literature
-Resources and References, GI, Neuro, Feeding, Sleep safe, Evidence-based Outcomes, Renal, Oral Motor
- Typical Development of Premature Infant
-Anatomy and Kinesiology of trunk, extremities, and oral cavity
- NICU Admissions
-A Systems Perspective
- Small Baby Unit
-Neonatal Therapy Interventions
-Evidence Based Practice for Infant Driven Care, Neurodevelopmental/Neuro Protective Care, Sleep Protection
-Handling/Protection for Skin protection
-STOP Approach
-Core Concepts – Side lying
Schedule – Day 2
- Core Concepts Continued
Manual Techniques and positioning
Prone, Supine, Flexion Swaddling, Developmental Diapering and family support. Positioning Considerations for medically fragile neonate
- Metabolic Bone Disease (MBD)
Boney development and cycle and Application to clinical practice
LAB
- Oral Sensory Motor Development
Review of gestational development of oral skills. Oral Cares and evidence-based practice
Manual Techniques for Oral Motor Development
Advancing to pacifier and milk drops
Environmental modifications
- Oral Feeding
-SPIN program Feeding Dyad, Assessing readiness and cues.
-Strategies for Oral Motor interventions
-Bottle selection and considerations
-Postural support and positioning
-Oral motor supports and treatment interventions
-Atypical Feeding
-GI Development and considerations
-Intro to NEC and Chart Reviews
Schedule – Day 3
- NEC/LAB Lecture GI Considerations
-Critical Reasoning and chart reviews
-Line management, TMJ mobilizations, stool facilitation, controlled oral feeding, surgical plans, scar assessment and wound healing, scar mobilizations, MFR, facilitating movement. Foot reflexology
- Nutritional Considerations and Positioning options to support GI
-LAB Positioning, burping techniques, considerations for thickening feeds, tech for stooling
- Abdominal Wall Defects
-Gastroschisis, Omphalocele
-Strategies and Surgical outcomes
-Therapy assessment and treatment
-Abdominal Facilitation Lab demo
-Lit Review
- Neurological System
-Review of PVL, IVH, Cerebellar Hemorrhage, hydrocephalus
- LAB for premature infants with Brain injuries
-Motor facilitation and postural control
Schedule – Day 4
- Oral Motor Facilitation for “Term” babies, with Brain injury
-Alignment and Support for feeding
- Hypoxic Ischemic Encephalopathy (HIE)
-Equipment, Monitoring, complications, clinical and oral feeding considerations
- Skeletal System
-Arthrogryposis
-Hip Dysplasia
-Osteogenesis imperfecta-
- Cardiopulmonary System
-Fetal vs Newborn circulation and Anatomy
-Preterm vs Term
-Impacts on Chest Wall development
-CHD Types and screenings
-Surgical Options, precautions, addressing scar tissue, Red Flags
-Outcomes and Developmental Care
-Case Studies
-Post surgical Oral Feeding outcomes
- Lymphatic and circulation System
-Development, assessment, management, clinical reasoning, contraindications
-LAB Extremity Sequences, face sequence for fluid movement
- Goal Writing/Charting/Documentation and closing
- Post-test
Holly Schifsky, OTR/L, CNT, NTMTC, CBIS, has worked in pediatrics for the past 28 years with the past 17 years in a level IV NICU. She is a Certified Neonatal Therapist, Certified Neonatal Touch and Massage Therapist, Certified Brain Injury therapist, a member of National Association of Neonatal Therapists, and has completed 6-month mentorship in infant/child NDT.
She has worked within the NICU and NICU follow-up clinic to maximize patient and family outcomes for the most complex premature and medically-fragile term infants. Holly received her BS in OT from the University of North Dakota. She is a faculty member for the Neonatal Touch and Massage certification; and Manuel Edema Mobilization training. She is the recipient of the National Association of Neonatal Therapists Clinical Excellence award in 2018, due to her clinical expertise and dedication to advancing the therapeutic interventions for NICU infants with cardiopulmonary conditions.
Financial Disclosure: Holly Schifsky receives an honorarium from Education Resources, Inc.
Non-Financial Disclosure: Holly Schifsky has no relevant non-financial relationships to disclose.
Once you purchase an online course you will have access to the course materials. If you have purchased this course, please ensure you have logged in to your account in order to take the exam.
Once you purchase an online course, you will have the opportunity to take an exam to test your retention of the material. If you have purchased this course, please ensure you have logged in to your account in order to take the exam. The exam must be completed with a pass rate of 80% or more in order to receive your certificate of attendance.
Continuing Education Hours for disciplines not listed below: 16 contact hours (1.6 CEUs). Intermediate level. License #______________.
Education Resources Inc. is an AOTA Approved Provider of professional development. Course approval ID# 02868. This Distance Learning-Independent course is offered at 16 contact hours 1.6 CEUs. Intermediate Level, OT Service Delivery. AOTA does not endorse specific course content, products or clinical procedures. This course can be used toward your NBCOT renewal requirements for 16 units. This course meets the approval of the TX Board of OT Examiners. Approved for FL Occupational Therapists for 19 continuing education hours, #_______. ASHA CEUs are awarded by the ASHA CE Registry upon receipt of the CEU Participant Form from the ASHA. Approved CE Provider for up to 1.6 CEU’s. ASHA credits are accepted by the TX Department of License and Renewal. This course has been approved by the MD State Board of Physical Therapy Examiners for __ Continuing Education Hours. Approved by the MN Board of Physical Therapy for ____ CE Hours, #______. Approval #____ by the NJ State Board of Physical Therapy Examiners for ___ CEC's. Approved sponsor by the State of IL Department of Financial and Professional Regulation for Physical Therapy for 19 contact hours. The Illinois Early Intervention Training Program has approved this event for ____ hours of EI credential credit in the area of Intervention. Approved provider by the NY State Board of Physical Therapy for 19 contact hours (1.9 CEUs). Education Resources is an approved agency by the PT Board of CA for 16 contact hours. This activity is provided by the TX Board of PT Examiners accredited provider #2810017TX for 16 CCUs and meets continuing competence requirements for PTs and PTAs licensure renewal in TX. Approved Provider by the NM Board of Physical Therapy for 16 CE Hours. Approved Provider for OK State Board of Medical Licensure & Supervision #BAP202310003. This course meets the criteria for __ hours that can be applied toward the Neonatal Therapy National Certification. 12 hours of this course qualify towards the discipline-specific hours for the 20-hour requirement for NDTA re-certification. They do NOT qualify towards the 8-hour NDTA Instructor requirement for re-certification.
Education Resources Inc., 266 Main Street, Suite 12, Medfield, MA 02052 508-359-6533
