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/