Early Therapy Services Following Neonatal Intensive Care Unit Discharge.

AIMS: To (1) characterize early therapy services for preterm infants in the first two years of life, and (2) define factors related to accessing early therapy services.

METHODS: Therapy utilization after discharge from the neonatal intensive care unit (NICU) was tracked in 57 infants born ≤30 weeks gestation from 2007 to 2010. Participants returned for developmental testing at two years. Factors related to early therapy utilization were explored.

RESULTS: Fifty-two (91%) infants received a referral for therapy at NICU discharge but only 44 (77%) received at least one type of therapy during the first two years of life. Infants who received early therapy services were more likely to have more days on ventilation (p =.005), have single mothers (p =.047), and exhibit abnormal neurobehavior at term equivalent age (p =.03). On average, infants first received occupational therapy at a mean age of 5.1 ± 4.6 months with a median of 2.6 (1.3-9.0), physical therapy at a mean age of 4.3 ± 4.1 months with a median of 3.7 (0.1-5.5), and speech-language pathology services at a mean age of 14.0 ± 6.1 months with a median of 15.0 (11.3-17.7) months corrected age. Of the 13 children who did not receive any therapy in the first two years after NICU discharge, seven (53%) had a developmental delay at an age of two years.

CONCLUSIONS: In spite of high referral rates for therapy services, there is a delay in therapy activation following NICU discharge, and some infants who warrant services do not obtain them.