P2C207: Bedside Provider Engagement in Early Language Development in the NICU: A Needs Assessment

Background: Disparities in speech and language are noted between preterm infants and their term counterparts starting in infancy. The scarcity of language stimulation in the Neonatal Intensive Care Unit (NICU) is a likely contributor to the long-term differences in receptive and expressive language processing, cognitive scores, and academic skills demonstrated in preterm children in childhood. Given the implications on developmental trajectories, increasing positive auditory stimulation in the NICU through language exposure is crucial. Several studies have shown parents’ presence at bedside is associated with increased adult language exposure. However, NICU parents face significant barriers to visitation. Alternatively, bedside providers (BP), including physicians, nurses, and front-line practitioners, could provide a regular source of auditory stimulation for infants and encouragement for parents engagement in activities that increase language exposure. BP knowledge of early language development (ELD) could be paramount to promoting a language-rich environment for preterm infants and supporting their long-term development.

Methods: We performed a needs assessment to evaluate NICU BPs’ knowledge and interest in early language development (ELD) and to determine barriers to incorporation of language promotion into daily practice. We surveyed BPs including nurses, advanced practitioners, and physicians during in-service sessions at our level IV NICU. Questions were centered on when children were ready for language stimulation, identifying appropriate developmental language milestones, and understanding if BPs introduced concepts of early language development into their routine care in the hospital stay.

Results: Fifty-five BPs completed the needs assessment survey — 45 bedside nurses and 10 physicians/advanced practitioners (Table 1). The majority reported no prior training in early language development (ELD). Almost all participants (94%) said they infrequently spoke with families about ELD ( < 50% of the time, Figure 1). While there was no consensus on when participants thought parents should be counseled on ELD, most (96 %) thought counseling should occur prior to discharge. Participants (92%) strongly agreed that information about ELD is important; however, only 58% felt either fully or somewhat confident in their ability to counsel parents.

Conclusion: NICU bedside providers have significant need for education on early language and cognitive development. Additionally, we found that BPs agreed that parental education should be incorporated into NICU stays but do not yet do so; and most are unsure when this education should be provided. To address this gap in knowledge, interactive early language education tools are needed for NICU bedside providers as well as parents.