Addressing Developmental Delays in Premature Babies

About 1 in 10 babies are born preterm, or before completing the normal 37 to 40 weeks of pregnancy. Babies who miss the important growth and development that occurs in the final weeks of gestation may be at risk for developmental delays or disabilities.

Identifying and treating developmental issues as early as possible can help babies reach their full potential, says Carmen de Lerma, M.D., director of the Baptist Health South Miami Hospital Child Development Center.

Programs such as the one offered at the Child Development Center provide personalized care that addresses developmental delays in the early years. “Our physical therapists, occupational therapists and speech-language pathologists work together to develop therapy plans that are tailored to each individual child’s needs at each stage of development,” Dr. de Lerma said.  “The interdisciplinary nature of our treatment is one of our center’s key strengths.”

November is National Prematurity Awareness Month, an opportunity to focus on preventing premature birth and addressing the health complications that can come with it. 

The prevalence of neurodevelopmental disabilities varies by child. Some developmental red flags, such as the ones listed below, suggest the need for an evaluation and treatment.  

Developmental delays, by age group:

        0 to 3 months

• Turning head to one side and not visually following toys from side to side
• Stiffness or floppiness
• Not reacting to noises or able to localize speaker with eyes
• Not producing vowel like sounds/coos
  
  4 to 6 months

• Arching the body and/or keeping hand(s) tightly clenched
• Lacking variety of movements on the floor
• Not recognizing words like “mama,” “bye” or “no” and not responding to his/her name
• Not babbling and using sounds like “p,” “b” or “m”
  
  7 to 9 months

• Inability to sit up
• Inability to bring hands together and transfer objects from hand to hand or bring toys to mouth
• Difficulty bearing weight on hands and arms
• Not using words like “mama” or dada”
• Limited babbling and/or not gesturing “up” or “bye-bye”
  
  10 to 12 months

• Consistently standing or walking on tiptoes
• Consistent asymmetrical movement patterns
• Lack of desire to move
• Not holding bottle or cup by handles or bringing spoon to mouth by 1 year
• Not rolling a car, building a two-block tower, engaging in playful interactions or giving toys upon request
• Not using more words vs. gestures
• Not imitating simple actions (peek-a boo) and sounds (animal sounds)
  
  18 months to 2 Years

• Not catching a playground ball, walking and jumping in place
• Not using a fork, dropping tiny objects in a jar, building a tower with six blocks
• Unable to follow simple commands, answer simple questions and use two- to three-word sentences
• Vocabulary is less than 200 words at age 3
• Speech is not intelligible 50 percent of the time  

Other red flags, says Dr. de Lerma, include:

• Lack of orientation to name by age 12 months
• Lack of pointing to or gesturing to indicate interest, like pointing to an airplane flying overhead, by age 14 months
• Lack of pretend play, like feeding a doll, by age 18 months

In most cases, the earlier that premature babies are born, the more likely it is that they will have developmental problems. Therapy for some premature babies begins during their stay in the hospital’s neonatal intensive care unit (NICU), says Dr. de Lerma.

Physical therapists help with range of motion, strength and movement patterns. In the NICU, physical therapists can provide gentle treatment that focuses on positioning and handling.

Occupational therapists help children develop fine motor (small muscle), sensory motor and visual motor skills. For example, occupational therapists can assist infants in grasping and releasing toys.

Speech-language pathologists help with oral motor skills such sucking and swallowing coordination and feeding, which can impact a newborn’s ability to take in food during the critical early months of development. As the infant grows, speech-language pathologists target language and social communication abilities.

The therapy team collaborates with other healthcare providers and parents to provide individualized care that ensures the best outcome for the child. “Parents are an important part of the therapy process,” Dr. de Lerma said. “Since the majority of care happens outside of our Center walls, we educate parents so they can provide the best care at home.”

Parents who suspect that their child may not be on the right developmental path can call 786-662-5080 to schedule an evaluation at the South Miami Hospital Child Development Center.