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The purpose of this statement is to describe the role of the occupational therapist in the neonatal intensive care unit (NICU) and provide guidance in the areas of occupational therapy evaluation and intervention. In-depth knowledge of the foundational topics presented in this guideline is required to achieve the level of expertise required to practice comprehensively, safely, and effectively in a NICU.
Occupational therapy practice with infants in the NICU and their families is high risk, specialized, and appropriate only for occupational therapists with advanced knowledge of and skills in neonatal care. Interventions with infants and families require continuous assessment and a dynamic approach to intervention planning. As such, intervention in the NICU context is not a recommended area of practice for occupational therapy assistants because such knowledge and skills are beyond the scope of their practice.
Introduction
Occupational therapists work with clients of all ages; understand all stages of development; acknowledge spiritual and cultural factors; and have expertise in listening, assimilating, and communicating. The clinical and professional reasoning that occupational therapists bring to the NICU is based on the understanding of medical factors, human development, and the interplay between the environment and the sensory system.
Additionally, what sets occupational therapy apart as a unique discipline is its strong educational foundation in mental health, enabling occupational therapists to assess clients' psychosocial strengths and needs and intervene as appropriate. Occupational therapy's multifaceted and holistic approach to the NICU environment includes comprehensive management of the infant and family and support of staff. Neuroprotective and developmentally appropriate interventions are critical, considering their influence on short- and long-term outcomes of the child and family. Individualized support of life roles (occupations) in the NICU has bearing on the developmental trajectory from infant to toddler, preschooler, and beyond. Occupational therapists are thus positioned to be essential members of the NICU team, offering the clinical expertise to assess and treat the occupational skills of the family and infant from delivery to discharge in the hospital environment.
Knowledge of neonatal neurodevelopment, neurobehavioral organization, the musculoskeletal system, family attachment and bonding, infant and parent or caregiver mental health, stress management, and advanced age-appropriate feeding practices and techniques is essential. Additional knowledge of grief reactions, social structures, attachment, medical procedures, and other issues relating to the...