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February 1993, Vol 147, No. 2 >
Article | February 1993

Developmental Needs of Infants and Toddlers Who Require Lengthy Hospitalization FREE

Heidi M. Feldman, MD, PhD; Dianna L. Ploof, EdD; Dena Hofkosh, MD; Earl L. Goehring
[+] Author Affiliations

Accepted for publication July 1, 1992.

Reprint requests to the Child Development Unit, Children's Hospital of Pittsburgh, 3705 Fifth Ave, Pittsburgh, PA 15213 (Dr Feldman).


Am J Dis Child. 1993;147(2):211-215. doi:10.1001/archpedi.1993.02160260101034.
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• Objectives.  —To describe demographic and medical characteristics of a sample of children younger than age 3 years who required lengthy hospitalization in a tertiary care hospital. To determine the proportion of children in the sample with biologic handicaps, developmental delays, or risk factors for developmental disorders who met eligibility criteria for early intervention services based on federal law PL 99-457 and state regulations.

Design.  —Survey of medical records.

Setting.  —Large, urban, tertiary care children's hospital. Patients.—All 135 children younger than age 3 years hospitalized for more than 30 days during 1990 and 1991. Interventions.—None.

Main Results.  —The most prevalent cause of lengthy hospitalization was congenital anomaly followed by chronic and perinatal conditions; 38 patients (28%) required technology assistance at the time of discharge. Seventy-three children (54%) were eligible for early intervention services based on the presence of a biologic handicap or developmental delay. An additional 48 patients (36%) were eligible for developmental screening and periodic developmental monitoring on the basis of medical and social risk factors.

Conclusions.  —Because of the high prevalence of developmental disorders and risk factors in infants and toddlers requiring lengthy hospitalizations, hospital-wide systems for identification, developmental assessment, and early intervention services should be designed and implemented.(AJDC. 1993;147:211-215)

REFERENCES

1 +
Gortmaker S, Sappenfield W.  Chronic childhood disorders: prevalence and impact . Pediatr Clin North Am . 1984;;31:3-14.
2 +
McCormick MC.  The contribution of low birth weight to infant mortality and childhood morbidity . N Engl J Med. 1985;;312:82-90.
3 +
Schreiner MS, Downes JJ, Kettrick RG, Ise C, Voit R.  Chronic respiratory failure in infants with prolonged ventilator dependency . JAMA . 1987;; 258:3398-3404.
4 +
Technology-Dependent Children: Hospital v Home Care: A Technical Memorandum (OTA)-TM-H-38 . Washington, DC: US Congress, Office of Technology Assessment, US Government Printing Office; May 1987;.
5 +
Resnick M, Davis Eyler F, Nelson R, Eitzman D, Bucciarelli R.  Developmental intervention for low birth weight infants: improved early developmental outcome . Pediatrics . 1987;;80:68-74.
6 +
Rae-Grant Q.  Psychological problems in the medically ill child . Pediatr Clin North Am . 1985;;8:653-663.
7 +
Goldberger J.  Infants and toddlers in hospitals: addressing developmental risks . Zero to Three: Bull Natl Cent Clin Infant Programs . 1988;;9:1-6.
8 +
Eiser C.  Psychological effects of chronic disease . J Child Psychol Psychiatry . 1990;;31:85-95.
9 +
Goldberger J.  Lengthy or repeated hospitalization in infancy: issues in stimulation and intervention . Clin Perinatol . 1990;;17:197-206.
10 +
 Education of the Handicapped Act Amendments of 1986 . Federal Register . (October 8) , 1986;: PL 99-457.
11 +
Rules and regulations:  Title 22-education . In: Pennsylvania Bulletin . Harrisburg, Pa: Commonwealth of Pennsylvania, Legislative Reference Bureau, Special Education Services and Programs; 1990;;20( (pt 3) ).
12 +
DeGraw C, Edell D, Ellers B, et al.  New opportunities to serve young children with special needs, PL 99-457 . J Pediatr. 1988;;113:971-974.
13 +
Blackman JA, Healy A, Ruppert ES.  Participation by pediatricians in early intervention: impetus from Public Law 99-457 . Pediatrics . 1992;;89:98-102.
14 +
Drillien CM. The Growth and Development of the Prematurely Born Infant . Edinburgh, Scotland: E & S Livingstone; 1964;.
15 +
Desmond MM, Wilson GS, Alt EJ, Fisher ES.  The very low birth weight infant after discharge from intensive care: anticipatory health care and developmental course . Curr Probl Pediatr. 1980;;10:1-50.
16 +
Als H, Lawhon G, Brown E, et al.  Individualized behavioral and environmental care for the very low birth weight preterm infant at high risk for bronchopulmonary dysplasia: neonatal intensive care unit and developmental outcome . Pediatrics . 1986;;78:1123-1132.
17 +
Shonkoff JP, Hauser-Cram P.  Early intervention for disabled infants and their families: a quantitative analysis . Pediatrics . 1987;;80:650-658.
18 +
The Infant Health and Development Program.  Enhancing the outcomes of low-birth-weight, premature infants: a multisite, randomized trial . JAMA . 1990;;263:3035-3042.
19 +
Ploof D, Feldman H.  Organizing early intervention services in a hospital setting: the developmental support project as a parallel organization . Infants Young Children . 1992;;5:28-39.
20 +
Division of Quality Control Management, American Hospital Association. International Classification of Diseases, Ninth Revision, Clinical Modification . Chicago, Ill: American Hospital Publishing Inc; 1989;.
21 +
Palfrey J, Walker D, Haynie M, et al.  Technnology's children: report of a statewide census of children dependent on medical supports . Pediatrics . 1991;;87:611-618.
22 +
Hobbs N, Perrin JM, Ireys HT, Moynihan LC, Shayne MW.  Chronically ill children in America . Rehabil Lit. 1984;;45:206-213.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Gortmaker S, Sappenfield W.  Chronic childhood disorders: prevalence and impact . Pediatr Clin North Am . 1984;;31:3-14.
2 +
McCormick MC.  The contribution of low birth weight to infant mortality and childhood morbidity . N Engl J Med. 1985;;312:82-90.
3 +
Schreiner MS, Downes JJ, Kettrick RG, Ise C, Voit R.  Chronic respiratory failure in infants with prolonged ventilator dependency . JAMA . 1987;; 258:3398-3404.
4 +
Technology-Dependent Children: Hospital v Home Care: A Technical Memorandum (OTA)-TM-H-38 . Washington, DC: US Congress, Office of Technology Assessment, US Government Printing Office; May 1987;.
5 +
Resnick M, Davis Eyler F, Nelson R, Eitzman D, Bucciarelli R.  Developmental intervention for low birth weight infants: improved early developmental outcome . Pediatrics . 1987;;80:68-74.
6 +
Rae-Grant Q.  Psychological problems in the medically ill child . Pediatr Clin North Am . 1985;;8:653-663.
7 +
Goldberger J.  Infants and toddlers in hospitals: addressing developmental risks . Zero to Three: Bull Natl Cent Clin Infant Programs . 1988;;9:1-6.
8 +
Eiser C.  Psychological effects of chronic disease . J Child Psychol Psychiatry . 1990;;31:85-95.
9 +
Goldberger J.  Lengthy or repeated hospitalization in infancy: issues in stimulation and intervention . Clin Perinatol . 1990;;17:197-206.
10 +
 Education of the Handicapped Act Amendments of 1986 . Federal Register . (October 8) , 1986;: PL 99-457.
11 +
Rules and regulations:  Title 22-education . In: Pennsylvania Bulletin . Harrisburg, Pa: Commonwealth of Pennsylvania, Legislative Reference Bureau, Special Education Services and Programs; 1990;;20( (pt 3) ).
12 +
DeGraw C, Edell D, Ellers B, et al.  New opportunities to serve young children with special needs, PL 99-457 . J Pediatr. 1988;;113:971-974.
13 +
Blackman JA, Healy A, Ruppert ES.  Participation by pediatricians in early intervention: impetus from Public Law 99-457 . Pediatrics . 1992;;89:98-102.
14 +
Drillien CM. The Growth and Development of the Prematurely Born Infant . Edinburgh, Scotland: E & S Livingstone; 1964;.
15 +
Desmond MM, Wilson GS, Alt EJ, Fisher ES.  The very low birth weight infant after discharge from intensive care: anticipatory health care and developmental course . Curr Probl Pediatr. 1980;;10:1-50.
16 +
Als H, Lawhon G, Brown E, et al.  Individualized behavioral and environmental care for the very low birth weight preterm infant at high risk for bronchopulmonary dysplasia: neonatal intensive care unit and developmental outcome . Pediatrics . 1986;;78:1123-1132.
17 +
Shonkoff JP, Hauser-Cram P.  Early intervention for disabled infants and their families: a quantitative analysis . Pediatrics . 1987;;80:650-658.
18 +
The Infant Health and Development Program.  Enhancing the outcomes of low-birth-weight, premature infants: a multisite, randomized trial . JAMA . 1990;;263:3035-3042.
19 +
Ploof D, Feldman H.  Organizing early intervention services in a hospital setting: the developmental support project as a parallel organization . Infants Young Children . 1992;;5:28-39.
20 +
Division of Quality Control Management, American Hospital Association. International Classification of Diseases, Ninth Revision, Clinical Modification . Chicago, Ill: American Hospital Publishing Inc; 1989;.
21 +
Palfrey J, Walker D, Haynie M, et al.  Technnology's children: report of a statewide census of children dependent on medical supports . Pediatrics . 1991;;87:611-618.
22 +
Hobbs N, Perrin JM, Ireys HT, Moynihan LC, Shayne MW.  Chronically ill children in America . Rehabil Lit. 1984;;45:206-213.

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