title: Early Therapy Services Following Neonatal Intensive Care Unit Discharge.
abstract: OBJECTIVE
  To (1) characterize early therapy services for preterm infants in the first two years of life, and (2) define factors related to accessing early therapy services.
  
  
  METHODS
  Therapy utilization after discharge from the neonatal intensive care unit (NICU) was tracked in 57 infants born ≤30 weeks gestation from 2007 to 2010. Participants returned for developmental testing at two years. Factors related to early therapy utilization were explored.
  
  
  RESULTS
  Fifty-two (91%) infants received a referral for therapy at NICU discharge but only 44 (77%) received at least one type of therapy during the first two years of life. Infants who received early therapy services were more likely to have more days on ventilation (p =.005), have single mothers (p =.047), and exhibit abnormal neurobehavior at term equivalent age (p =.03). On average, infants first received occupational therapy at a mean age of 5.1 ± 4.6 months with a median of 2.6 (1.3-9.0), physical therapy at a mean age of 4.3 ± 4.1 months with a median of 3.7 (0.1-5.5), and speech-language pathology services at a mean age of 14.0 ± 6.1 months with a median of 15.0 (11.3-17.7) months corrected age. Of the 13 children who did not receive any therapy in the first two years after NICU discharge, seven (53%) had a developmental delay at an age of two years.
  
  
  CONCLUSIONS
  In spite of high referral rates for therapy services, there is a delay in therapy activation following NICU discharge, and some infants who warrant services do not obtain them.
authors.affiliation: a Program in Occupational Therapy , Washington University , St Louis , Missouri , USA.
authors.forename: Odochi
authors.initials: O
authors.lastname: Nwabara
authors.affiliation: b Department of Psychiatry , Washington University , St. Louis , Missouri , USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Rogers
authors.affiliation: c Department of Pediatric Newborn Medicine , Brigham and Women's Hospital , Boston , Massachusetts , USA.
authors.forename: Terrie
authors.initials: T
authors.lastname: Inder
authors.affiliation: a Program in Occupational Therapy , Washington University , St Louis , Missouri , USA.|d Department of Pediatrics , Washington University , St. Louis , Missouri , USA.
authors.forename: Roberta
authors.initials: R
authors.lastname: Pineda
mesh_terms: D002658:Developmental Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*
keywords: Developmental delay; early intervention; occupational therapy; physical therapy; prematurity; speech language pathology