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Practice Guidelines for the Physical Therapist in the Neonatal Intensive Care Unit (NICU)

Sweeney Jane K. PhD PT PCS; Heriza, Carolyn B. EdD, PT; Reilly, Marie A. PhD, PT; Smith, Catherine MEd, PT, PCS; VanSant, Ann F PhD, PT
Pediatric Physical Therapy: Fall 1999

Neonatal physical therapy is an advanced practice, subspecialty area within pediatric physical therapy. Because of the structural, physiological, and behavioral vulnerabilities of neonates, pediatric physical therapists need postprofessional precepted training and experience before providing neonatal care. Theoretical frameworks, scientific basis, clinical training criteria, and a decision-making algorithm are described to guide pediatric physical therapists working in neonatal intensive care unit (NICU) settings. Clinical competencies for neonatal physical therapy practice are outlined according to roles, proficiencies, and knowledge areas. The unique role of the neonatal physical therapist is highlighted as a postural control and movement specialist within behavioral, environmental, and family contexts in the NICU. Handling infants in NICU settings is considered inappropriate for student physical therapists and physical therapist assistants and aides because each contact involves ongoing examination, interpretation, as well as multiple adjustments of procedures, interventions, and sequences to minimize risk to infants who may be potentially unstable. The guidelines are intended to provide a structure for clinical training, practitioner competency evaluation, and clinical paths for neonatal physical therapy services. A glossary of selected terminology is included in the Appendix.

© 1999 Lippincott Williams & Wilkins, Inc.