Frequestly Asked Questions

In the randomized Controlled trial at child Development center, Medical College Thiruvananthapuram to measure the developmental out come of early stimulation and intervention among low birth wt. Babies the following observation were made that without intervention 44.6% of this group at 1yr have a developmental outcome level below 25th percentile position as against 26.2% in the group with intervention. This clearly shows a difference of 18.4% meaning a 41.3% reduction in poor performance in intervention group Ref : Nair MKC et al. Indian J Pediatr. 1992; 59 ; 663 - 667 Early Intervention Programe for premature infants have positive influence on cognitive out come in short to medium term. (Cochrane Database syst. Review April 2007. 16 studies made the inclusion criteria) Role of Critical period 0 - 3 yr. UNICEF draft 2001. These are concrete evidences that early intervention is effective so active action is required, which can be achieved by getting your child assessed at UMMEID CDC

By observing simple activities you can identify developmental delays e.g.: 1. Your child should smile looking at mother face by 2 months ie social smile. 2. Head control should be attained by 4 months of corrected age. 3. 8 months –not sitting without support. 4. 12 months – not standing without support. 5. Confirm that child can see and hear. 6. 14 months – not walking. 7. 18 months- regression in speech or socialization. 8. If any of these are present get your child assessed. Majority of times simple early intervention. techniques may correct these delays so there is no need for panic but expert opinion is essential.

1. Delayed social Smile. 2. Poor Eye to eye contact. 3. Not responding to Name. 4. Delayed speech, no babbling by 12 months. 5. No finger pointing, waving by 12 months. 6. Regression of language, social and play by 18 months. 7. Lack of Joint Attention

It is eye examination for preterm infants Whom to Screen? Preterm baby less than 33 weeks,less than 1500 grams Preterm less than 35 wks+ severe cardio respiratory compromise (9-12 mo) for Squint & Refractory errors Eye check 1 / yr till 6 When to screen? First FU at 4 wk of life / 31 wk gestation if this is later 1/2/3 weekly as per ICROP guidelines/ more frequently if “Plus disease” noted Till vascularization complete What to look for? Severe ROP – for LASER photocoagulation/ cryotherapy Who to screen for hearing impairment? Desirable – all neonates Mandatory – all NICU/ Risk factor Cranio facial anomalies, Family h/o hearing impairment, Asphyxia, Meningitis, ICH, Ventilated, NNJ exchange, < 1500gms,Intrauterine infections, Aminoglycosides, frusemide . When to screen? Desirable – before discharge from NICU. Mandatory with in 3 months of life How to screen? OAE at discharge within 3 months, repeat if fail – ENT exam BERA for failed OAE all “high-risk” Intervention for hearing impairment before 6 months of age to optimize language development. Early Intervention + speech therapy Hearing aid / cochlear implant