Beyond the NICU: Making the Transition Home.

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Course description and overview

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  • Signs and implications of autonomic instability
  • Long-term developmental issues common to NICU graduates
  • Feeding the former preemie
  • Family Issues and critical support during the difficult and scary transition to home
  • How craniofacial anomalies change the equation
  • Weaning from tube-feeding
  • Positive Touch as a therapeutic modality


Day One: Making the Transition Home

Program Description and Overall Goal:

As the numbers of infants in the NICU are rising, more therapists are being called on to treat our youngest patients but few community-based therapists know what to expect when given the responsibility for assessing and treating NICU graduates. The purpose of this 8-hour presentation is to assist in multidisciplinary staff training of inpatient discharging therapists, outpatient and home health agency personnel as they care for the rising number of NICU graduates and their families as they are discharged to home. The course will cover issues unique to the preemie and the very sick newborn, exploring ways the therapist can care for the infant, and educate and empower the caregivers as they navigate this difficult transition. Participants will be taught how to read the child’s behavioral cues, integrating this information into both assessment and treatment of feeding and developmental issues and possible resources to access. Through labs, each attendee will practice infant handling and positioning techniques. Finally issues surrounding program implementation, including suggested competencies, will be discussed based on ASHA, AOTA, and APTA guidelines.

Educational Objectives:

At the completion of this course participants will be able to:

  • Explain common issues faced by NICU graduates and their families.
  • List signs and symptoms of GER and compensatory strategies that might be employed to reduce aversion.
  • List core competencies necessary to treat this population.
  • Discuss therapeutic interventions that can support the NICU graduate’s development.
  • Describe specific behavioral approach/avoidance cues displayed by these infants that can be used to support successful nippling and breastfeeding.

Instruction Method and Course Materials to be used:

Lecture, PowerPoint, Videos, Hands-on Manipulation of Equipment, Return Demonstration of Therapeutic Techniques, Handouts, Discussion, and Question and Answer.

Participants need to bring a doll (preferably a soft one or one that is easily moveable), baby blanket, bottle (any type), and a washcloth.


Agenda | Day One | Thursday, October 8th

7:30 Registration / Sign-in
8:00 Where They Came From

  • Classifications of Prematurity
  • Neurologic Development
  • Implications of Gestational Age
  • Infant-Driven Developmental Care
10:00 Break
10:15 Common Developmental Issues

  • Visual (ROP, Strabismus, Nystagmus, Tracking)
  • Musculoskeletal (Torticollis, Plagiocephaly, Abnormal Tone)
12:00 Lunch
1:00 Feeding Development & Dysphagia

  • Cue-Based Feeding
  • Effects of Positioning on Swallowing and Development
  • Appropriate Nipples/Bottle System Selection
  • Thickening Concerns and Cautions
  • Supporting Breastfeeding
3:00 Break
3:15 GER: Signs/Symptoms & Treatment (Direct and Indirect)
3:45 Family Issues and supportive strategies
4:30 Program Implementation Guidelines
5:00 Q&A
5:30 End


Day Two: Advanced Practices in Craniofacial Anomalies, G-tube and Therapeutic Touch

Program Description and Overall Goal:

In a continuation of “Beyond the NICU-Making the Transition Home” we will expand our scope to dig more deeply into conditions that may affect the sick newborn: craniofacial anomalies and dependence on a gastrostomy tube and ways to help.

The presence of a cleft or other craniofacial anomaly can interfere with the eating and swallowing process, affecting respiratory health, nutrition, oral-motor and speech development, and even parent-child bonding. Although evaluating swallow function in a patient with a craniofacial anomaly can be quite complex and intimidating, we will discover some basic, easy-to-learn principles for analyzing how the anatomy impacts the physiology and the importance of taking into account the changes that occur over the course of the surgical intervention, therapy and physical growth. Also, Therapy doesn’t stop because a child gets a gastrostomy tube. The process of weaning from a G-tube should actually begin on the first day of placement. Learn what to do in therapy while the tube is there, how to minimize complications and negative consequences, and how to put the pieces in place to facilitate decreased dependence or eventual weaning. Finally we will learn how to promote stability and reduce stress by stabilizing the autonomic nervous system – a necessary foundation for development. We can even help facilitate and integrate oral reflexes necessary for feeding and speech. Walk away with a thorough understanding of how anatomy drives feeding and techniques to help.

Educational Objectives:

At the completion of this course participants will be able to:

  • Explain the pressure/valve model of swallowing.
  • Demonstrate appropriate touch techniques for use in moderating the autonomic nervous system in infants.
  • Outline the effects of craniofacial anomalies on feeding and swallowing by site of lesion
  • Discuss the key components necessary for tube weaning and how to address them in therapy.


Instruction Method and Course Materials to be used:

Lecture, Powerpoint, Videos, Hands-on Manipulation of Equipment, Return Demonstration of Therapeutic Techniques, Handouts, Discussion, and Question and Answer.

Participants need to bring a doll (preferably a soft one or one that is easily moveable) and baby blanket.


Agenda | Day Two | Friday, October 9th

7:30 Registration / Sign-in
8:00 How Craniofacial Anomalies Affect Feeding and Swallowing and what to do about it:

  • Pressure/Valve model of swallowing
  • Cleft Lip
  • Cleft Palate
10:00 Break
10:15 How Craniofacial Anomalies Affect Feeding (Cont’d)

  • Cleft Lip and Palate
  • Micrognathia
  • Midface Retrusion
  • Tracheostomy
12:00 Lunch
1:00 G-Tubes Now and Later

  • Indications for Placement
  • Complications & Consequences
  • Meal Concept
  • Establishing Readiness for Weaning
  • Weaning Procedures
3:00 Break
3:15 Touch as a Therapeutic Modality

  • Benefits of positive touch with research
  • Types of positive touch
  • Practicing Infant Massage Techniques
5:00 Q&A
5:30 End



These courses have been submitted to TSHA, TOTA, and TPTA for approval. Please check back later for up to date credentialing information.


We would like to give a huge shout out and thank you to The Woman’s Hospital of Texas, Department of Pediatric Rehabilitation Services for hosting this seminar!

The Woman’s Hospital of Texas
Department of Pediatric Rehabilitation Services
7600 Fannin
Houston, Texas 77057

Nearby hotels:

Please call or go online to negotiate your best rate.
Crowne Plaza Hotel Houston (Near Reliant/Medical Center)
8686 Kirby Drive

Holiday Inn Express Hotel & Suites
1810 Bell Street

Courtyard Houston Medical Center
7702 Main Street



We will have the course materials up soon. Please check back later.