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The neonatal intensive care unit (NICU) is a technologically advanced setting that provides care to infants who require highly specialized services. Infants served in the NICU are at high risk both medically and developmentally, requiring a team approach to their complex care. Physical therapists who work in the NICU provide examination, evaluation, and intervention to these high-risk infants. NICU care is a specialized area within pediatric physical therapy, involving a different approach than that used in other types of pediatric settings. Due to the physiological, medical, and developmental issues facing infants in the NICU, physical therapists require pediatric experience and advanced training to safely provide services (Sweeney, Heriza, & Blanchard, 2009). This chapter provides a basic overview of service delivery in the NICU. Further study is required for physical therapists wishing to work in the NICU, especially the most intensive level III and IV nurseries.
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The NICU serves infants with a variety of diagnoses. Infants admitted to the NICU are born both preterm and full-term. Infants who show signs of central nervous system (CNS) impairment, specific neuromuscular or orthopedic problems, multiple medical or genetic problems, neonatal abstinence syndrome, abnormal feeding behaviors, and other symptoms that put infants at risk for developmental problems are often referred to physical therapy (Ross, Heiny, Conner, Spener, & Pineda, 2017) (Table 15.1).
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Full-term infants are those infants born between 37 and 42 weeks of gestation. Infants who are born at less than 37 weeks of gestation are considered preterm (Darcy, 2009; Engle, Tomashek, Wallman, & Committee on Fetus and Newborn, 2007). Infants are also classified according to ...