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Understanding the type and frequency of current neonatal intensive care unit (NICU) therapy services and predictors of referral for therapy services is a crucial first step to supporting positive long-term outcomes in very preterm infants. This study enrolled 83 very preterm infants (<32 weeks, gestational age mean 26.5 ± 2.0 weeks; 38 male) from a longitudinal clinical trial. Race, neonatal medical index, neuroimaging, and frequency of therapy sessions were extracted from medical records. The Test of Infant Motor Performance and the General Movement Assessment were administered. Average weekly sessions of occupational therapy, physical therapy, and speech therapy were significantly different by type, but the magnitude and direction of the difference depended upon the discharge week. Infants at high risk for cerebral palsy based on their baseline General Movements Assessment scores received more therapy sessions than infants at low risk for cerebral palsy. Baseline General Movements Assessment was related to the mean number of occupational therapy sessions but not physical therapy or speech therapy sessions. Neonatal Medical Index scores and Test of Infant Motor Performance scores were not predictive of combined therapy services. Medical and developmental risk factors, as well as outcomes from therapy assessments, should be the basis for referral for therapy services in the neonatal intensive care unit.

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Families (n = 12) with infants born at <29 weeks gestation shared their experiences while in the NICU and transitioning home. Parents were interviewed 6-8 weeks after NICU discharge, including some during the acute phase of the COVID-19 pandemic. Findings regarding the parent experience in the NICU were focused around challenges navigating parent-infant separation, social isolation, communication difficulties, limited knowledge of preterm infants, mental health challenges. Parents also discussed supports that were present and supports they wished were present, as well as the impact of COVID-19 on their experiences. In the transition to home, primary experiences included the sudden nature of the transition, anxiety around discharge preparation, and the loss of the support from nursing staff. During the first few weeks at home, parents expressed joy and anxiety, particularly around feeding. The COVID-19 pandemic limited emotional, informational, and physical support to parents and resulted in limited mutual support from other parents of infants in the NICU. Parents of preterm infants in the NICU present with multiple stressors, rendering attending to parental mental health crucial. NICU staff need to address logistical barriers and familial priorities impacting communication and parent-infant bonding. Providing multiple opportunities for communication, participating in caretaking activities, and meeting other families can be important sources of support and knowledge for parents of very preterm infants.

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This study was conducted to gather information to inform key stakeholders in Virginia's Early Childhood Mental Health workforce who are involved in the Infant Mental Health Endorsement® . An "Endorsement® indicates an individual's efforts to specialize in the promotion and practice of infant or early childhood mental health within his/her own chosen discipline" (Virginia Association for Infant Mental Health, 2021). The following research questions guided this study: (1) who is part of the infant mental health endorsed workforce in Virginia; (2) what are the benefits and barriers to the Endorsement® process. A total of 115 individuals who were or are involved in the Endorsement® as endorsees or advisors were participants in the study. Participants cited many benefits of obtaining their Infant Mental Health Endorsement® , including general professional development and connecting to other professionals in the field. Barriers to obtaining the Endorsement® included time and financial restraints related to obtaining reflective supervision from a qualified Reflective Supervisor. Results from the study will be used to inform the Infant Mental Health Endorsement® process, and applied to the Early Childhood Mental Health Endorsement® in 2023.

Este estudio se llevó a cabo para recoger información para informarles a las partes interesadas de la fuerza laboral del campo de Salud Mental en la Temprana Niñez de Virginia que participan en el Endoso® de Salud Mental Infantil. Un "Endoso® o Aceptación indica los esfuerzos de un individuo de especializarse en la promoción y práctica de salud mental infantil o en la temprana niñez dentro de su escogida disciplina." (Asociación de Salud Mental Infantil de Virginia, 2021). Las siguientes preguntas investigativas guiaron este estudio: 1) ¿quién es parte de la aceptada fuerza laboral de salud mental infantil en Virginia?; 2) ¿cuáles son los beneficios y obstáculos al proceso de Endoso® o Aceptación? Un total de 115 individuos que estaban o están participando en el proceso de Endoso® como personas que aceptan o como consejeros fue el número de participantes en el estudio. Los participantes citaron muchos beneficios de obtener su Endoso® de Salud Mental Infantil, incluyendo el desarrollo profesional general y la conexión con otros profesionales en el campo. Entre los obstáculos de obtener el Endoso® se incluyen las restricciones de tiempo y financieras relacionadas con conseguir una supervisión con reflexión por parte de un Supervisor con Reflexión calificado. Los resultados del estudio se usarán para apoyar el proceso de Endoso® de Salud Mental Infantil y aplicar el Endoso® de Salud Mental en la Temprana Niñez en 2023.

Cette étude a été faite pour rassembler des données afin d'informer les parties prenantes clés du personnel de Santé Mentale de la Petite Enfance de l'état de Virginie aux Etats-Unis d'Amérique qui sont impliqués dans l'initiative d'endossement Infant Mental Health Endorsement®. Un "endossement" ("Endorsement®") "indique les efforts d'un individu pour se spécialiser dans la promotion et la pratique de la santé mentale du nourrisson ou de la petite enfance au soin de sa propre discipline choisie ¼ (Virginia Association for Infant Mental Health, 2021). Les questions de recherche suivantes ont guide cette étude: 1) qui fait partie du personnel endossé de la santé mentale de la petite enfance en Virginie; 2) quels sont les avantages et les obstacles au processus d'endossement (Endorsement®). Un total de 115 individus qui étaient ou sont impliqués dans l'endossement ou des conseillers ont constitué les participants à l'étude. Les participants ont indiqué plusieurs bénéfices à obtenir leur Endossement de Santé Mentale de la Petite Enfance, y compris la formation professionnelle générale et les contacts avec d'autres professionnels du domaine. Les obstacles à l'obtention de l'Endossement ont inclus le manque de temps ou les restrictions financières liées à l'obtention de la supervision de réflexion d'un Superviseur de Réflexion qualifié. Les résultats de cette étude seront utilisés afin d'améliorer le processus de l'endossement Infant Mental Health Endorsement®, et appliqués à l'endossement Early Childhood Mental Health Endorsement® en 2023.

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BACKGROUND: Children born of low birth weight (LBW) and/or premature may have developmental delays and difficulties. The vulnerability, without early intervention, would have detrimental lifelong effects. OBJECTIVES: This study examined 1) the relationship between LBW and prematurity and the occurrence and timing of children's receipt of developmental and special education services; and 2) whether poverty intersects with LBW and prematurity affecting service receipt. METHODS: This population-based study used cross-sectional data from the National Survey of Children's Health which consisted of approximately 52,000 participants aged 1-17 between 2017 and 2018 in the United States. We conducted logistic regression to analyze the predictive relationship of LBW/prematurity and the occurrence of receiving developmental and special education services. We then conducted ordered logistic regression to examine whether LBW and prematurity predicted the timing of receiving developmental and special education services. Further, we conducted moderating analyses to examine whether the predictive relationships above varied with poverty. The analyses listed above were weighted to reflect the population drawn. RESULTS: Children born with LBW and prematurity were more likely to receive developmental and special education services and they tended to receive services earlier than those born at normal weight and term. Educational disparities were evident among children in low-income families. Children of LBW in low-income families were less likely to receive earlier services than those in affluent families. CONCLUSIONS: This study indicates developmental and special education needs of children born LBW and/or premature. With restrained assets, low-income families may need more assistance to promote optimal development for their children.

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Implicitly-held unconscious associations and attitudes may not align with the beliefs we hold outwardly or explicitly but can affect our professional perceptions, decisions, and actions. In a phenomenological study identifying strategies used to support families in vulnerable circumstances, we conducted nine focus groups to examine how early interventionists (EIs) described families and children, the language they used, and how they used it. Thematic qualitative analysis revealed three themes about families: perceptions of parenting, perceptions of capability, and perceptions of priorities. How EIs characterized families and their interactions with families were both reflective of and counter to family-centeredness and, at times, indicative of implicit bias. This study addresses a critical gap in the field, given the lack of empirical research available about implicit bias in early childhood intervention professionals. Implications for personnel preparation and practice change are discussed to begin the necessary work of moving the field toward more culturally sustaining practices.

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Early interventionists (EIs) support families of infants and toddlers with delays and disabilities. Children with disabilities are a high risk for abuse and neglect. To understand how or whether trauma-informed practices are utilized in early intervention, 28 EIs participated in focus groups to share their experiences, challenges, and strategies when supporting children with disabilities who have also been abused. A thematic analysis was used to analyze the data. Participants indicated that they experienced challenges related to identifying signs and symptoms of child abuse and neglect, making decisions regarding their role as a mandated reporter and differentiating between family circumstances (i.e., poverty) and abuse and neglect. Participants also indicated that their educational programs did not prepare them to utilize trauma-informed practices or prepare them to work with children who have been abused or neglected. Overall, the EI system supports individuals with disabilities who are more vulnerable to abuse, neglect, and maltreatment. However, this study indicates EIs do not feel prepared or confident to support children who have experienced abuse. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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This article is based mainly on a digital transcript of burials for 126 Bedfordshire parishes 1538-1851, and a county index of wills for the same period. The comparison of probate with burial register data indicated that there was little long-term change over time in burial under-registration, with between 21 and 27 per cent of will entries missing in the registers. There was also little variation between parishes of different population sizes, suggesting that burial under-registration was predominantly a random process linked to clerical negligence. A comparison of 1841 and 1851 census data, linked to the Bedfordshire burial database, revealed that missing burials amongst married couples was 29 per cent, similar to that found in the probate/burial register comparison in the 1840s. These findings on the adequacy of burial registers suggest that similar research on others counties will be necessary in order to establish reliable conclusions about England's population history.

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OBJECTIVE: To investigate the association between poverty, birthweight, and infant weight gain in Hertfordshire, 1923-1939. DESIGN: Cohort study based on the Hertfordshire Health Visitors' Register (HHVR). SETTING: The population of Hertfordshire, and a sub-sample of five Hertfordshire towns-Hoddesdon, Berkhampstead, Hertford, Hitchin, and Bishops Stortford-extracted from the HHVR. SUBJECTS: Some 71 201 live birth entries in the HHVR and a sample of 13,649 live birth entries for the five towns. MEASURE OF POVERTY: Rateable value of birth addresses reflecting market and rental value of housing. MAIN OUTCOME MEASURES: Birthweight, and infant weight gain (z score of weight at one year minus z score of birthweight). RESULTS: In Hertfordshire as a whole there was a reduction in mean birthweight from 7.7 pounds (lbs) in 1923 to 7.4 lbs in 1939. Over the same time period there was an increase in mean infant weight gain, although with a degree of variation within the trend. In the sample of five towns there was no association between rateable value and birthweight, but a significant association between rateable value and both weight at one year, and weight gain during the first year of life. CONCLUSION: In Hertfordshire average birthweight declined, whereas weight gain during the first year of life tended to increase, at a time when, nationally, calorific intake and per capita consumption of a range of nutritional ingredients was rising. Poverty, as measured by rateable value, did not correlate with birthweight but was associated with weight gain during the first year of life. These findings suggest that nutritional poverty had a more significant influence on post-natal weight gain than it did on birthweight.

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