Neonatal slp

BACKGROUND: Post hospital discharge newborn feeding education mostly focuses on breastfeeding and is primarily targeted at term infants. Preterm and late-preterm infants are at risk for poor feeding postdischarge, and feeding challenges are common after discharge from the neonatal intensive care unit (NICU). Families often have questions about feeding their infants after hospital discharge. PURPOSE: The goal of this project was to collect data on what questions parents have about feeding their baby after discharge and what strategies may be helpful to improve feeding experiences...

BACKGROUND: Although considered an advanced area of practice, there has been insufficient standardization in clinical training and preparedness for occupational therapists (OTs), physical therapists (PTs), and speech-language pathologists (SLPs) practicing in the neonatal intensive care unit (NICU). The first step in developing a neonatal therapy certification process was to conduct a practice analysis. PURPOSE: To describe: 1) the collection of OTs, PTs, and SLPs working in NICUs, 2) educational and professional preparation to practice in the NICU, and 3) interest in neonatal therapy national certification...

Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). New approaches to rehabilitation practice in the NICU have evolved over the past decade that aim to promote child health and development. AIMS: The aim of this study was to describe the current roles of the occupational therapist (OT), physical therapist (PT) and speech-language pathologist (SLP) in Canadian NICUs as compared to the roles documented in an earlier national survey conducted 15 years ago...

BACKGROUND: 22q11.2 deletion syndrome (22q11.2DS) is a very broad phenotypic spectrum disorder. It can affect many organs or systems. 22q11.2DS is the most common microdeletion syndrome in humans, with a prevalence ranging from one in every 2000 to one in 4000 newborns. It seems to be more prevalent than reported and under-recognized or undiagnosed because of its inherent clinical variability and heterogeneity. In France, 15,000 patients may be affected by this disease, more than half without knowing it...

OBJECTIVES: 1) To describe the use of occupational therapy (OT), physical therapy (PT) and speech-language pathology (SLP) services in a level IV neonatal intensive care unit (NICU), 2) to describe predictors of early therapy usage, and 3) to test the hypothesis that more NICU-based therapy will relate to better neurobehavioral outcomes. METHODS: Seventy-nine infants born ≤32 weeks gestation had therapy interventions, as standard of care, tracked across NICU hospitalization...

The requirements of evidence-based practice in 2017 are motivating new theoretical foundations and methodological tools for characterizing neonatal feeding behavior. Toward that end, this article offers a complex dynamical systems perspective. A set of critical concepts from this perspective frames challenges faced by speech-language pathologists and allied professionals: when to initiate oral feeds, how to determine the robustness of neonatal breathing during feeding and appropriate levels of respiratory support, what instrumental assessments of swallow function to use with preterm neonates, and whether or not to introduce thickened liquids...

There is an ultimate need for efficacious vaccines against human cytomegalovirus (HCMV), which causes severe morbidity and mortality among neonates and immunocompromised individuals. In this study we explored synthetic long peptide (SLP) vaccination as a platform modality to protect against mouse CMV (MCMV) infection in preclinical mouse models. In both C57BL/6 and BALB/c mouse strains, prime-booster vaccination with SLPs containing MHC class I restricted epitopes of MCMV resulted in the induction of strong and polyfunctional (i...

Laryngeal cleft (LC) is a congenital malformation that leads to the unusual communication between the esophagus and the laryngotracheal complex. It is a rare disease, mostly prevalent among male individuals. The goal of this study was to describe the evaluation and intervention by the speech language pathologist of a female newborn diagnosed with LC type I, admitted on the University Hospital of Universidade de São Paulo, in her second hospitalization due to small weight gain and pneumonia. She was submitted to a bedside clinical evaluation of the swallowing and the most important occurrence was frequent gagging...

BACKGROUND: Auditory neural myelination (ANM) as evaluated by auditory brainstem evoked response (ABR) during the neonatal period has been used as a surrogate outcome for long-term neurodevelopment. The validity of ANM as a surrogate outcome for long-term neurodevelopment has not been well studied. AIM: Evaluate the association of ABR I-V interpeak latency (IPL), an index of ANM, at 35 week postmenstrual age (PMA) with language outcome at 3 years of age. DESIGN: Prospective study...

In 2004, the American Speech and Language Association (ASHA) established the primary roles and responsibilities of the speech and language pathologists (SLP) in the Neonatal Intensive Care Unit (NICU) breaking down the skills and knowledge needed to become a member of the neonatal team. It establishes as main parameters the evaluation and intervention in communication, feeding and swallowing: parents and caregivers counseling and education: as well as the collaboration and education of the neonatal team. In the NICU, the SLP works in the preparation to initiate the nutritive sucking process and describes maturation levels for nutritive sucking with bottle and breastfeeding The SLP establishes an intervention plan for the development of safe feeding and swallowing skills as well as for the training of parents and caregivers during the process...

BACKGROUND: Infants receiving prolonged parenteral nutrition (PN) are at risk of PN-associated cholestasis (PNAC). This can progress to hepatic failure and death if PN cannot be discontinued. Fish oil-based parenteral lipid preparation (FOLP) has been shown to be beneficial in case studies. OBJECTIVES: (1) To evaluate whether FOLP could halt or reverse the progression of PNAC compared with soy-based parenteral lipid preparation (SLP) and (2) to assess the effects of FOLP on liver function and physical growth...

Neonatal androgenization masculinizes the GH axis and thus may impact on liver gene regulation. Neonatal testosterone administration to female mice decreased (defeminized) female predominant GH-dependent liver gene expression (Hnf6, Adh1, Prlr, Cyp3a41) and did not modify male predominant genes (Cyp7b1, Cyp4a12, Slp). Female predominance of Cis mRNA, an inhibitor of episodic GH signaling pathway, was unaltered. At birth, Cyp7b1 promoter exhibited a higher methylation status in female livers, while the Hnf6 promoter was equally methylated in both sexes; no differences in gene expression were detected at this age...

OBJECTIVES: To evaluate data regarding neonatal mortality and short term morbidity among iatrogenic late preterm (ILP) and spontaneous late preterm (SLP) twin births, and to estimate whether medical interventions - induction of labor in this particular context, are associated with better or poorer outcomes. MATERIAL AND METHODS: Retrospective analysis of 110 late preterm dichorionic twin pregnancies was performed basing on medical charts data. All twins were delivered in years 2005-2011 at the 1st Department of Obstetrics and Gynecology Medical University of Warsaw Late preterm twins, defined as those delivered between 34 + 0-36+ 6 weeks of gestation, were divided into spontaneous and iatrogenic preterm births...

Working in neonatal intensive care units (NICU) is considered to be advanced practice for speech-language pathologists (SLPs) requiring post-graduate specialised education and ongoing clinical mentoring, not easily accessible within some countries such as Australia. This review investigated whether there was evidence to support SLPs as core NICU team members, rather than fleeting therapists. The review found that the roles and responsibilities of SLPs in NICUs included assessment and intervention of preterm infant communication, feeding and swallowing using a family-centred approach...

The development of the vertebrate vascular system is mediated by both genetic patterning of vessels and by angiogenic sprouting in response to hypoxia. Both of these processes depend on the detection of environmental guidance cues by endothelial cells. A specialized subtype of endothelial cell known as the tip cell is thought to be involved in the detection and response to these cues, but the molecular signaling pathways used by tip cells to mediate tissue vascularization remain largely uncharacterized. To identify genes critical to tip cell function, we have developed a method to isolate them using laser capture microdissection, permitting comparison of RNA extracted from endothelial tip cells with that of endothelial stalk cells using microarray analysis...

Aloe vela leaf gel extract (AGE) are widely used as cosmetic and pharmaceutical ingredients because of its versatile skin care properties. In order to enhance the bioavailability of AGE, liposomes encapsulating AGE were prepared and examined for their interfacial and biochemical properties. The liposomes prepared from a soybean lecithin (SLP-WHITE, 1.0 wt%) by the Bangham method gave relatively a good trapping efficiency up to the AGE concentration of 0.5 wt%. The stable liposomes were then prepared from 1...

OBJECTIVE: To estimate the prevalence of chronic conditions and/or disability in intensive care units admitting children (Pediatric Intensive Care Unit [PICU]) or both neonates and children (Neonatal and Pediatric Intensive Care Unit [NPICU]) and to describe available rehabilitation resources. DESIGN: A cross-sectional study on two separate days, using a web questionnaire. SETTING: NPICU/PICUs affiliated to the Groupe Francophone de Réanimation et Urgences Pédiatriques and the Réseau Mère-Enfant de la Francophonie...

Patients in adult, pediatric, and neonatal intensive care settings often require the services of a speech-language pathologist. It is common practice to consult a speech pathologist to determine whether a patient is ready to initiate oral intake or help a patient with an artificial airway communicate. Assessments for dysphagia are initially clinical and conducted at bedside. Results from the clinical evaluation help determine if and when an instrumental examination should be completed. Patients who are tracheostomized, or had been, and those who were intubated for a prolonged period are at risk for aspiration...

AIM: To validate a non-nutritive sucking (NNS) scoring system for oral feeding in preterm newborns (PTNB). METHODS: A cohort study was carried out in two phases. In phase one of the study, 22 mastered speech-language pathologists received the protocol and procedure for a NNS scoring system to evaluate the content and presentation of the form and to define the grading scale. In phase two, six speech-language pathologists evaluated 51 PTNBs weekly, using the defined scoring system...

Over the past decade, speech-language pathologists (SLPs) have increased their involvement in the assessment and management of infants and children with complex feeding and swallowing problems. Given the complex problems demonstrated by these infants and children that vary across a range of conditions and degrees of severity, SLPs need to increase their knowledge in all the topics covered in this issue. This article will discuss the current state of evidence-based decision making, levels of evidence for studies of treatment efficacy, ethical principles in evidence-based decision making, and ethical decision-making considerations with feeding and swallowing issues using examples of three types of populations of infants and children with complex feeding and swallowing problems...