597 - Improving Early Intervention Access through Team NEMO (Neurodevelopment and Early Movements Observation) Consult

Poster Number: 597
Publication Number: 597.2007

Background: Raising parental awareness for high-risk Neonatal Intensive Care Unit (NICU) graduates could improve access to early intervention(EI). Team NEMO consult, around NICU discharge, was initiated as part of the implementation of the International guidelines for the early detection of cerebral palsy. The consult was led by a developmental-behavioral pediatrician and families were counseled about the importance of neurodevelopmental follow up in the High-risk infant follow up (HRIF) clinic and given information about community-based early intervention (EI) services through the Regional centers (RC).

Objective: This study was completed to examine the impact of Team NEMO consult on the connection to EI services.

Design/Methods: A retrospective chart review of a cohort of 614 infants [404 pre-implementation (PRE) from 2012-2017 and 210 from 2019-2022 post-implementation (POST)] attending the HRIF clinic was done. We compared the proportion of infants connected to RC and EI services in those with and without developmental delays (DD) in the two time periods at their first (V1) and second (V2) standard visits at HRIF.

Results: Demographic characteristics of the study population are shown in Table 1. There was a higher proportion of English-speaking families in POST. There were no other significant demographic differences. Majority of the study population was male, Caucasian and non-Hispanic with private insurance. Mean (standard deviation) corrected gestational age (CGA) at V1 was 7.4 months (5.9) in PRE and 3.5 months (1.8) in POST. Connection to RC improved from 36% in PRE to 52% in POST(p < 0.001). In PRE, the CGA of babies connected to RC (9.8 months) was significantly higher (p < 0.001) than those who were not (6.2 months), but this difference was not seen in POST. In PRE, factors that were associated with connection to RC include birth weight, birth gestation, NICU length of stay and days on respiratory support. These factors were no longer associated with connecting to RC in POST. Among babies with DD at V1, more infants in POST vs PRE were connected to RC (80% vs 52%, p< 0.01) and receiving EI (56% vs 41%, p=0.2) (Figure 1). At V2, mean (SD) CGA of babies in was 14.5 months(6.2) in PRE and 13.5(3.5). Connection to RC improved from 64% in PRE to 79% in POST (p=0.04) and connection to EI improved from 58% in PRE to 71% in POST (p=0.059). Among babies with DD at V2, more infants in POST vs PRE were connected to RC (100% vs 77%) and receiving EI (94% vs 70%) (Figure 1)

Conclusion(s): Team NEMO consult resulted in earlier age of connecting EI and possibly improved developmental outcomes at 12 months CGA.