The aim of developmental care is to offer the child the optimal conditions necessary to achieve harmonious development, when disease, accident or handicap interferes with normal development.
Developmental care can be defined trough a personalized approach
- It forms an integral part of the somatic and psychological care proposed for the child and of the support provided by the family.
- It meets the child’s individual needs working closely with the parents and family members.
The brain of newborns and growing children during its development is shaped by sensory, motor, socio-emotional, affective and cognitive experiences. Developmental care is aimed at supporting the developing brain.
Today numerous approaches to developmental care, functional reeducation, neuro-psycholigical or psychiatric treatments exist.
Some are aimed more particularly at newborn and premature babies others are adapted to older children.
Among these approaches, several have been developed by a few pioneers such as T. Berry Brazelton, Heidelise Als, Andreas Fröhlich, André Bullinger.
In the United States, T. Berry Brazelton has created the Newborn Behavorial Assessment Scale (NBAS) to assess term-born babies. It is intended for use by both clinicians and research personnel. It has been in use for more than twenty years as an evaluation tool to study the effects of inter-uterine deficiencies, premature birth, caesarean delivery, maternal drug use and malnutrition, as well as of other unpredictable pre- or perinatal conditions.
It also helps doctors to evaluation the behaviour of newborn babies in order to make parents aware of their infant’s abilities and to discover what worries them.
The NBO is a structured set of observations, to observe the infant's behavioral capacities and identify the kind of support the infant needs for its successful growth and development. The NBO system consists of a set of 18 neurobehavioral observations, which describe the newborn's capacities and behavioral adaptation from birth to the third month of life. While it describes the infant's capacities, the NBO provides parents with individualized information about their infant's behavior, so that they can appreciate their baby's unique competencies and vulnerabilities and thereby understand and respond to their baby in a way that meets its developmental needs.
On the basis of T.B. Brazelton’s work, H. Als of the Harvard University, has conceived the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP). The NIDCAP is a care programme destined for premature newborns. Its aim is to optimize the neuro-developmental behaviour of these children who are born too early by reducing their stress and by replying to their specific needs in collaboration with their families. Parents and care givers collaborate in order to create a favourable environment and an individualized care programme for the child. Individualisation of care and integration of the parents into care are achieved by reading the infant’s behavioural cues by specially trained caregivers and feed-back to the parents.The analysis includes the evaluation of the newborn’s response to stimuli, its attempts to regulate sleep-wake status and their capacity and regulatory capacity. Study results are consistent and demonstrate improved breathing, feeding behaviour and growth, and more importantly improved neurodevelopmental outcome, along with improved brain maturation both in structure and function for the infants who received neonatal individualized developmental care, as compared to the control groups who received the NICU’s current best practice.
In Europe, A. Fröhlich has developed the concept of Basic Stimulation. This is a concept designed to help people during critical situations in their life when their abilities to communicate and control are seriously reduced, limited or even permanently impaired.
The central aspect of this concept is competent sensory awareness, communication and (body) motion.
By offering simple and basic means and help for exchanges of communication (on different levels) these abilities are supposed to be saved, guarded and developed.
Basic stimulation is a form of holistic (body related) physical communication, always addresses the basic, simple and primary needs of people who suffer when going through a crisis, for seriously impaired people. It is too a comprehensive guidance for development in very early stages of life.
A. Bullinger proposes a Developmental Approach based on the study of the sensory-motor period described by J. Piaget and the neuropsychological integration field discovered by J. De Ajuriaguerra.
The concepts he has developed are adaptable to children of all ages, or even to adults with sensory-motor problems.
The individualization of developmental care is based on close observation of the child’s sensory-motor behaviour, in turn based on the respect of the child’s rhythm, its adaptation to postural supports, the regulation of sensory solicitations and the support of oral sphere activity.
An important part of this method is the establishment of a concrete approach to the meeting with the child and its parents and to the sensory-motor assessment. This examination helps to understand the developmental process, the organizational methods and the potential of a person. It seeks to highlight the means at a person’s disposal to interact with his/her environment. This tool is complementary to the traditional methods of clinical evaluation and to psychometric examinations.
The parents are integrated into this approach in their role as principal partners.
Other paramedical specializations in the therapeutic field participate fully in the development of the child. Physiotherapy, ergotherapy, psychomotricity, orthophony, specialized education… to name but a few.
By reuniting all these professional fields on EadCare’s exchange platform, the children and their families will benefit from a multi-disciplinary care programme based on valid scientific concepts.
Basal Stimulation according to A. Fröhlich
Sensory-motor Developmental Care based on the concepts of A. Bullinger
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European Foundation for the Care of Newborn Infants (EFCNI)