NIDCAP Introductory Lecture Part 3: Theoretical Foundation

gretchen Lawhon, PhD, RN, FAAN and Dorothy Vittner, PhD, RN, FAAN, present Part 3 of an eight-part series of NIDCAP Didactic Introduction lectures about the NIDCAP model of care. The series affords the knowledge and theoretical basis to understand the main components of neonatal care based on NIDCAP principles.

Upon completition of the lecture participants will be able to:
1. Describe the historical context of neurobehavioral assessment
2. List four concepts underlying both the Brazelton Newborn Behavioral Assessment Scale and the Assessment of Preterm infant Behavior.

gretchen Lawhon, PhD, RN, FAAN, is a clinical nurse scientist who has worked in the arena of newborn intensive care for 40 years and has 44 years experience as a nurse. She was cofounder of the Newborn Individualized Developmental Assessment Program (NIDCAP) and co-investigator in several of the early research studies supporting an individualized developmentally supportive approach to care of infants and families in the newborn intensive care unit. Dr. LawhonÕs dissertation examined the Facilitation of Parenting within the Newborn Intensive Care Unit, from the University of Washington, School of Nursing.

Dr Lawhon worked as Neonatal Clinical Nurse Specialist for the U. S. Dept. of Education funded NICU Transition and NICU Follow-Through Projects, was involved in early intervention outreach and served as Co-Chair, Lucas County Ohio Early Intervention Collaborative Group and Vice-president and Board of Directors member of the Collaborative Network of Lucas County, Ohio Inc. Dr. Lawhon was co-investigator of the NINR funded Stability of Infant Responses to Painful Procedures study. While Director of the Mid-Atlantic Newborn Individualized Developmental Care and Assessment Program (NIDCAP) Center and Associate Professor of Pediatrics in the Cooper Medical School of Rowan University (2005 Ð 2014), she was responsible for the clinical implementation of developmentally supportive care in the NICU by provision of NIDCAP observational assessments, APIB evaluations, participation in clinical rounds with an emphasis on the integration of developmentally supportive care, and consultation and collaboration with families in the NICU as well as the infant follow-up program.
Dr. Lawhon has served as Vice President (2001 Ð 2012), President (2012 Ð 2016), and a Director of the Board (2001 Ð 2018) for the NIDCAP Federation International. She is a Master NIDCAP Trainer currently guiding the development of the Japan National NIDCAP Center in development. Dr. Lawhon has extensive experience as a clinical nurse scientist and has authored numerous articles in her areas of expertise. Currently she is the Clinical Nurse Scientist with Newborn special care associates, pc at Abington Jefferson Health in Abington, Pennsylvania. Dr. Lawhon provides neurobehavioral evaluations of infants in the special care nursery and in the Abington Center for Newborn Wellness, a bridge clinic supporting infants and families transitioning from the hospital to home and community. Dorothy Vittner, PhD, RN, FAAN, has a background of 30 years in Neonatal/Perinatal nursing which includes more than 20 years research experience that has focused on the care of high-risk infants and their families. Her professional responsibilities have focused on infant neurobehavioral functioning as well as training multidisciplinary health care professionals on infant behavior and development to improve outcomes for hospitalized infants. Dorothy is a Senior NIDCAP Trainer, a member of the NIDCAP Federation Board of Directors, serving as Vice-President, and is the Chair of the NFI Program Committee. Dorothy currently holds a faculty position at the Egan School of Nursing and Health Studies, Fairfield University in Fairfield, Connecticut.
She has a longstanding interest in Reflective Process implementation to support health care professionalsÕ emotion well-being and functioning with repeated and prolonged stress exposure. Dorothy has clinical expertise with translating complex developmental theories into practice. She has lectured around the world, has published many peer-reviewed articles and book chapters. She completed her PhD from the University of Connecticut, School of Nursing. Her research interests are related to bio-behavioral mechanisms of supporting developing mother-father-infant relationships specifically oxytocin release and how it modulates premature infantsÕ behavioral, autonomic and stress responses. Uncovering the neurobiological basis of early parent-infant interaction is an important step in developing therapeutic modalities to increase parent engagement and improve health outcomes.
The experience of early life stress in hospitalized infants whether the Newborn Intensive Care Unit, Pediatric Intensive Care Unit or Cardiac Intensive Care Unit has implications for both long- and short-term infant development. Dorothy has examined the relationship between early life experiences particularly trauma and chronic stress and effects on parent engagement. She has collaborated on research teams that have demonstrated associations between early life stress with parent interactions and developmental outcomes both at discharge from the NICU and beyond. Understanding the implications in this and other studies is important to developing targeted intervention strategies to further support care practices for all high-risk infants.
Dorothy also completed an interdisciplinary fellowship with the Leadership Education in Neurodevelopmental & Related Disabilities (LEND Program) and worked for more than 10 years for the Connecticut Department of Developmental Disabilities, Division of Quality Management. In this role she provided consultation and regulatory oversight to public and private organizations to identify gaps within systems of care for individuals with developmental disabilities across the lifespan that influences health outcomes.