Predictors of Parental Presence in the Neonatal Intensive Care Unit.

BACKGROUND: Parental presence in the neonatal intensive care unit (NICU) may affect preterm infants' developmental outcomes. However, few studies have described predictors of parental presence in the NICU. PURPOSE: To identify sociodemographic, clinical, environmental, and maternal psychological factors that predict parent presence in the NICU. METHODS: Using a prospective cohort design, 66 preterm infants between 32 and 40 weeks' corrected gestational age were recruited at 2 level III NICUs in the United States. Data for length of parental presence were collected for 48 consecutive hours from daily visitation logs and medical records. A general linear model was estimated to identify significant predictors of parental presence. RESULTS: Parental presence varied considerably, with a mean percentage of visitation time of 32.40%. The number of children at home (P = .003), presence of neurological comorbidity (P < .001), room type (P < .001), surgical history (P < .001), and perceived stressfulness of the NICU (P = .03) each had large main effects on parental presence, and room type and surgical history (P = .004) had a large interaction effect on parental presence. These predictors accounted for 65.8% of the variance in parental presence. IMPLICATIONS FOR RESEARCH: Future research aimed at understanding predictors of parent presence is essential for developing interventions and designing NICUs that support parental presence. IMPLICATIONS FOR PRACTICE: Understanding factors that contribute to parental presence may help healthcare providers identify infants at risk for low parental presence and thus be able to provide greater support to these infants and their families. As a result, this may help improve outcomes and attachment.

Influence of Quiet Time on the Auditory Environment of Infants in the NICU.

OBJECTIVE: To determine the influence of quiet time on the auditory environment of infants in the NICU and to compare the effect of quiet time by room type, bed type, and infant clinical acuity. DESIGN: Cross-sectional, descriptive comparison study. PARTICIPANTS: Sixty-six infants born at less than 38 weeks gestation who were between 32 and 40 weeks postmenstrual age. SETTING: The auditory environments of infants in two level 3 NICUs within a pediatric hospital system in the Southeastern United States. Each NICU implemented quiet time for 4 hours per day. METHODS: We assessed the auditory environment of the participants using Language Environmental Analysis technology. We used paired t tests to assess differences in the auditory environment during quiet versus nonquiet time and to compare the effect of quiet time by room type, bed type, and clinical acuity. RESULTS: During quiet time, the auditory environment of participants had 13% more silence, 17% fewer electronic sounds, 25% less speech, and 30% fewer words than during nonquiet time. We observed greater differences in quiet time versus nonquiet time for infants in open bays and incubators and infants who had greater acuity. CONCLUSION: Our results support the implementation of quiet time to increase silence and reduce exposure to electronic sounds for infants in the NICU. Additional research is necessary to further examine the effect of quiet time on the auditory environment of infants in the NICU with consideration of environmental and clinical variables.

The Power of Language Nutrition for Children's Brain Development, Health, and Future Academic Achievement.

Language Nutrition, a term created to describe language exposure that is rich in quality and quantity and delivered in the context of social interactions, is crucial for a child's development and is strongly associated with his/her future literacy, academic achievement, and health. However, significant differences in children's early language environments contribute to disparities in their educational and health trajectories. Interventions, including book distribution programs, coaching parents to enrich their child's language environment, and public awareness campaigns, have all been shown to positively influence a child's access to language-rich interactions. Incorporating Language Nutrition coaching and literacy promotion into pediatrics is a promising platform for building the capacity of parents to provide language exposure to their children. By teaching parents both how and why to treat their child as a conversational partner and by modeling such interactions, pediatric health care providers can help parents set their children on a pathway toward literacy, educational success, and health.