AboutKidsHealth

 

 

Neonatal neurodevelopmental follow-up recommendations: 18 month visitNNeonatal neurodevelopmental follow-up recommendations: 18 month visitNeonatal neurodevelopmental follow-up recommendations: 18 month visitEnglishDevelopmental;NeonatologyToddler (13-24 months)NANANon-drug treatmentAdult (19+) CaregiversNA2018-04-05T04:00:00ZJacqueline Jackson, MN, NP-Paediatrics, RN (EC) (original author);​​Andrea Riekstins, MN, NP-Paediatrics, RN (EC);Jane Brettschneider, M. Sc. (A), Reg. CASLPO;Linh Ly, MD, MEd, FRCPC, FAAP;​​Lori Burton, M.Ed., BSc, O.T. Reg (Ont.);​​Lynelle Phillips, MHealth (A-Z) - ProcedureHealth A-Z<p>Recommendations to encourage neurodevelopment in babies at 18 months old who have spent time in the neonatal neurodevelopment follow-up clinic.</p><p>Talking and playing with babies are two of the most important things parents and caregivers can do to help them develop. There are many ways to encourage development. The recommendations provided are general and not all inclusive. The recommendations provide strategies to help promote gross motor skills, fine motor skills, early language development, and socialization.</p><ul><li>Gross motor skills include big movements such as rolling, crawling, standing or walking.</li><li>Fine motor skills include hand movements such as reach and grasp.</li><li>Early language development includes cooing, babbling, and a baby’s first words.</li></ul><h2>Key points</h2><ul><li>Babies who have been in the NICU or CCCU may be at risk for developmental issues due to medical problems before delivery, during delivery or after birth.</li><li>Recommendations at 18 months focus on walking, structural and functional play, and encouraging speech development.</li><li>Parents and caregivers should follow these recommendations to encourage neurodevelopment.</li></ul><h2>Neonatal neurodevelopmental recommendations at 18 months</h2><h3>Gross motor</h3><ul><li>Practice gross motor development as a whole, including coordination, on riding toys. In playgrounds practice climbing on the small climbers and slides and walking on different terrain.</li><li>Practice ball games such as kicking and throwing. Do not expect catching yet.</li><li>Play a simplified version of “Simon Says”, encouraging your child to copy some of your body movements, such as raising your arms.</li></ul><h3>Fine motor</h3><ul><li>The high chair is an excellent place for structured play and ongoing development of attention skills. </li><li>As you play, verbally label the toys your child is playing with. This encourages both fine motor practice and language skills development.</li><li>Provide opportunities for container play and introduce shape sorters and simple puzzles for play.</li><li>Practice stacking for refinement of release skills (e.g., nesting cups, rings on pole, small blocks).</li><li>Continue with cause and effect toys that have to be pushed, pulled or turned (e.g., pop-up toy).</li><li>Introduce thick crayons and encourage scribbling. Encourage these early drawing skills in a variety of ways including painting with water on a chalkboard or sidewalk chalk outdoors. Introduce connecting toys, blocks (e.g., “Duplo”) and a variety of objects with different textures, shapes, and sizes for exploration with hands.</li><li>Encourage your child to use a spoon or fork during mealtimes. </li></ul><h3>Communication/Social</h3><ul><li>Be face to face with your child. Use single words or short phrases to label, comment or ask questions. </li><li>Watch what your child is doing, wait, listen and respond. Imitate actions or sounds and keep the interaction going.</li><li>Make sure there are reasons to communicate; avoid anticipating all of your child’s needs.</li><li>Use simple picture books, with real life photos and board books when reading together. </li><li>Use simple language- always stay one step above your child’s level of communication.</li><li>Praise your child for behavior you would like to promote, such as sharing or waiting for their turn with a toy.</li><li>If there are any concerns about your child’s speech, contact your region’s Preschool Speech and Language Services.</li></ul><h3>Play</h3><ul><li>Functional play – continue playing with toys/objects as they were intended to be used.</li><li>Encourage pretend play (e.g., feeding a doll or farm animals) and taking turns.</li><li>Attendance at structured play groups, activities, and daycare will provide opportunities for interaction with peers and assist with development of routines, socialization, self-help skills, and ongoing language development.</li><li>Sing rhymes with gestures or play games to label body parts, such as “Head, shoulders, knees & toes” or “If you’re happy and you know it, clap your hands”. </li><li>Electronic media use by children younger than two years is not recommended. This includes phones, television, computers, and tablet devices.</li><li>Encourage daily, unstructured playtime, and read to your child daily to promote the developing brain.</li></ul><h3>Feeding/Growth</h3><ul><li>Continue regular visits to your family doctor/paediatrician to monitor growth.</li><li>Gradually stop giving your child a bottle and transition to using an open cup.</li><li>Limit homogenized milk intake to 500 ml per day (16 ounces) to promote a balanced diet. Juice intake is discouraged. Water is best.</li><li>Have your child see a dentist as part of routine oral health care. Healthy Smiles Ontario is a government-funded program that provides free dental care for children and youth under the age of 17 years. For eligibility requirements and enrollment details visit: <a href="https://www.ontario.ca/page/get-dental-care">https://www.ontario.ca/page/get-dental-care​</a>.</li></ul><h3>Sleep</h3><ul><li>Maintain a regular bedtime routine.</li><li>Develop a regular sleep schedule and let your child fall asleep independently.</li></ul><p>For more information on neonatal neurodevelopmental recommendations at different ages, please see the links below:</p> <ul><li> <a href="/Article?contentid=3031&language=English">Four month visit​</a></li><li> <a href="/Article?contentid=3200&language=English">Eight month visit</a></li><li> <a href="/Article?contentid=3201&language=English">Twelve month visit</a><br></li><li> <a href="/Article?contentid=3203&language=English">Thirty-six month visit​</a></li></ul><h2>At SickKids</h2><p>For more information on the Neonatal Nevelopmental Follow-Up Clinic at The Hospital for Sick Children, please visit: <a href="http://www.sickkids.ca/neonatology/what-we-do/neonatal-developmental-follow-up-program/neonatal-developmental-follow-up-program%20.html">http://www.sickkids.ca/neonatology/what-we-do/neonatal-developmental-follow-up-program/neonatal-developmental-follow-up-program%20.html</a></p><h2>Resources</h2><p><a href="http://www.caringforkids.cps.ca/">http://www.caringforkids.cps.ca/</a></p><h2>References<br></h2><p>Sinai Health Systems Neonatal Follow-Up Clinic recommendations</p><p>Neonatal developmental recommendations have been adapted with permission from Mount Sinai Hospital in Toronto.</p>
Recommandations de suivi sur le développement neurologique néonatal : visite de l’âge de 18 moisRRecommandations de suivi sur le développement neurologique néonatal : visite de l’âge de 18 moisNeonatal neurodevelopmental follow-up recommendations: 18 month visitFrenchNeonatology;DevelopmentalToddler (13-24 months)NANANon-drug treatmentAdult (19+) CaregiversNA2018-04-05T04:00:00ZJacqueline Jackson, MN, NP-Paediatrics, RN (EC) (original author);​​Andrea Riekstins, MN, NP-Paediatrics, RN (EC);Jane Brettschneider, M. Sc. (A), Reg. CASLPO;Linh Ly, MD, MEd, FRCPC, FAAP;​​Lori Burton, M.Ed., BSc, O.T. Reg (Ont.);​​Lynelle Phillips, MHealth (A-Z) - ConditionsHealth A-Z<p>Recommandations pour encourager le neurodéveloppement chez les bébés de 18 mois qui ont passé du temps dans une clinique de néonatologie.</p><p>Parler et jouer avec les bébés sont deux des choses les plus importantes que les parents et les soignants peuvent faire pour les aider à se développer. Il existe de nombreuses façons d’encourager le développement. Les recommandations fournies sont générales et non exhaustives. Les recommandations fournissent des stratégies pour aider à promouvoir la motricité globale, la motricité fine, le développement précoce du langage et la socialisation.</p><ul><li>La motricité globale comprend de grands mouvements tels que rouler, ramper, se tenir debout ou marcher.</li><li>La motricité fine comprend des mouvements de la main tels que tendre la main vers des objets et les saisir.</li><li>Le développement précoce du langage comprend le gazouillis, le babillage et les premiers mots d’un bébé.</li></ul><h2>À retenir </h2><ul><li>Les bébés qui ont été à l’UNSI ou à l’UCSI peuvent être exposés à des problèmes de développement en raison de problèmes médicaux présents avant l’accouchement, pendant l’accouchement ou après la naissance.</li><li>Les recommandations à 18 mois se concentrent sur la marche et le jeu structurel et fonctionnel, et encouragent le développement de la parole.</li><li>Les parents et les soignants devraient suivre ces recommandations pour encourager le développement neurologique.</li></ul><h2>Recommandations sur le développement neurologique néonatal de l’âge de 18 mois</h2><h3>Motricité globale</h3><ul><li>Faites-lui exercer l’ensemble du développement moteur global, y compris la coordination, à l’aide de jouets à enfourcher. Dans les aires de jeux, faites-lui s’exercer à l’escalade sur les petits grimpoirs avec glissoires et faites-le marchez sur des terrains différents.</li><li>Jouez avec des balles en exerçant son coup de pied et son lancer. Ne vous attendez pas à ce qu’il soit capable d’attraper la balle.</li><li>Jouez à une version simplifiée de « Jean dit », en encourageant votre enfant à copier certains de vos mouvements corporels, comme l’élévation de vos bras.</li></ul><h3>Motricité fine</h3><ul><li>La chaise haute est un excellent endroit pour le jeu structuré et le développement continu de la capacité d’attention.</li><li>Pendant que vous jouez, nommez les jouets avec lesquels votre enfant joue, afin de favoriser à la fois sa motricité fine et le développement de ses compétences linguistiques.</li><li>Offrez des possibilités de jeu avec des contenants et introduisez des trieuses de formes et des casse-têtes simples.</li><li>Faites-lui s’exercer à empiler des objets pour qu’il améliore ses capacités de les lâcher (par ex., tasses imbriquées, anneaux sur un poteau, petits blocs).</li><li>Continuez par les jouets reposant sur le principe de cause et d’effet qui doivent être poussés, tirés ou tournés (par ex., un jouet pop-up).</li><li>Introduisez les crayons épais et encouragez le gribouillage. Encouragez ces habiletés précoces en dessin de diverses façons, y compris l’aquarelle sur un tableau ou le dessin à la craie sur le trottoir. Introduisez des jouets, des blocs (par ex., « Duplo ») et une variété d’objets de différentes textures, formes et tailles pour l’exploration avec les mains.</li><li>Encouragez votre enfant à utiliser une cuillère ou une fourchette pendant les repas.</li></ul><h3>Communication et aptitudes sociales</h3><ul><li>Soyez face à face avec votre enfant. Utilisez des mots simples ou des phrases courtes pour désigner, commenter ou poser des questions.</li><li>Regardez ce que fait votre enfant, attendez, écoutez et répondez. Imitez ses actions ou ses sons et continuez l’interaction.</li><li>Assurez-vous qu’il y a des raisons de communiquer; évitez d’anticiper tous les besoins de votre enfant.</li><li>Utilisez des livres d’images simples comportant des photos de la vie réelle et des livres en carton lorsque vous lisez ensemble.</li><li>Utilisez un langage simple – soyez toujours un cran au-dessus du niveau de communication de votre enfant.</li><li>Félicitez votre enfant pour le comportement que vous aimeriez promouvoir, comme partager ou attendre que ce soit son tour de jouer avec le jouet.</li><li>Si vous vous faites du souci pour les capacités langagières de votre enfant, communiquez avec les services d’orthophonie pour les enfants d’âge préscolaire de votre région.</li></ul><h3>Jeu</h3><ul><li>Jeu fonctionnel : qu’il continue de jouer avec des objets et ses jouets en respectant le but dans lequel ils ont été conçus.</li><li>Encouragez les jeux de simulation (par ex., nourrir une poupée ou des animaux de ferme) et apprenez à l’enfant à attendre son tour.</li><li>La participation à des groupes de jeu structurés, à des activités et à des services de garde offrira des occasions d’interaction avec les pairs et aidera à l’adoption de routines, à la socialisation, à l’entraide et au développement continu du langage.</li><li>Chantez des comptines en faisant des gestes ou jouez à des jeux pour identifier les parties du corps, comme « Tête, épaules, genoux, orteils » ou « Si tu aimes le soleil, tape des mains ».</li><li>L’utilisation des médias électroniques (téléphone, télévision, ordinateur, tablette) par des enfants de moins de deux ans n’est pas recommandée.</li><li>Encouragez quotidiennement des jeux non structurés et lisez à votre enfant pour favoriser le développement du cerveau.</li></ul><h3>Alimentation et croissance</h3><ul><li>Continuez à visiter régulièrement votre médecin de famille ou votre pédiatre pour surveiller la croissance.</li><li>Cessez graduellement de donner le biberon à votre enfant et passez graduellement à une tasse ouverte.</li><li>Limitez la consommation de lait homogénéisé à 500 ml (16 onces) par jour pour favoriser une alimentation équilibrée. La consommation de jus est découragée. L’eau est le meilleur choix.</li><li>Faites en sorte que votre enfant voie un dentiste dans le cadre de ses soins de santé bucco-dentaire de routine. Beaux sourires Ontario est un programme financé par le gouvernement qui offre des soins dentaires gratuits aux jeunes de moins de 17 ans. Pour connaître les critères d’admissibilité et les détails sur l’inscription, visitez le site https://www.ontario.ca/fr/page/obtenir-des-soins-dentaires.</li></ul><h3>Sommeil</h3><ul><li>Maintenez une routine régulière au coucher.</li><li>Adoptez un horaire de sommeil régulier et laissez votre enfant s’endormir de façon autonome.</li></ul><p>Pour plus d’informations sur les recommandations sur le développement neurologique à différents âges, veuillez cliquer sur les liens ci-dessous :</p> <ul><li> <a href="/Article?contentid=3031&language=French">Visite à l’âge de quatre mois</a></li><li> <a href="/Article?contentid=3200&language=French">Visite à l’âge de huit mois</a></li><li> <a href="/Article?contentid=3201&language=French">Visite à l’âge de douze mois</a></li><li> <a href="/Article?contentid=3203&language=French">Visite à l’âge de trente-six mois</a><br></li></ul><h2>À l’hôpital SickKids</h2><p>Pour plus de renseignements sur la clinique de suivi néonatal de l’Hospital for Sick Children (SickKids), veuillez visiter <a href="http://www.sickkids.ca/neonatology/what-we-do/neonatal-developmental-follow-up-program/neonatal-developmental-follow-up-program%20.html">http://www.sickkids.ca/neonatology/what-we-do/neonatal-developmental-follow-up-program/neonatal-developmental-follow-up-program%20.html</a>.</p><h2>Ressources</h2><p> <a href="http://www.caringforkids.cps.ca/">http://www.caringforkids.cps.ca/</a><br></p><h2>Références</h2><p>Recommandations de la Clinique de suivi néonatal de Sinai Health Systems</p><p>Les recommandations sur le développement néonatal ont été adaptées avec la permission de l’Hôpital Mount Sinai de Toronto.</p>

 

 

Neonatal neurodevelopmental follow-up recommendations: 18 month visit3202.00000000000Neonatal neurodevelopmental follow-up recommendations: 18 month visitNeonatal neurodevelopmental follow-up recommendations: 18 month visitNEnglishDevelopmental;NeonatologyToddler (13-24 months)NANANon-drug treatmentAdult (19+) CaregiversNA2018-04-05T04:00:00ZJacqueline Jackson, MN, NP-Paediatrics, RN (EC) (original author);​​Andrea Riekstins, MN, NP-Paediatrics, RN (EC);Jane Brettschneider, M. Sc. (A), Reg. CASLPO;Linh Ly, MD, MEd, FRCPC, FAAP;​​Lori Burton, M.Ed., BSc, O.T. Reg (Ont.);​​Lynelle Phillips, MHealth (A-Z) - ProcedureHealth A-Z<p>Recommendations to encourage neurodevelopment in babies at 18 months old who have spent time in the neonatal neurodevelopment follow-up clinic.</p><p>Talking and playing with babies are two of the most important things parents and caregivers can do to help them develop. There are many ways to encourage development. The recommendations provided are general and not all inclusive. The recommendations provide strategies to help promote gross motor skills, fine motor skills, early language development, and socialization.</p><ul><li>Gross motor skills include big movements such as rolling, crawling, standing or walking.</li><li>Fine motor skills include hand movements such as reach and grasp.</li><li>Early language development includes cooing, babbling, and a baby’s first words.</li></ul><h2>What is the Neonatal Neurodevelopmental Follow-Up Clinic?</h2><p>The Neonatal Neurodevelopmental Follow-Up Clinic is a specialized clinic for children who had medical complications related to, or immediately after, their birth. This clinic assesses gross-motor skills, fine-motor skills, social development, language and learning ability at specific ages to determine if the child is developing normally.</p><p>The majority of patients seen in the Neonatal Neurodevelopmental Follow-Up Clinic are referred from a Neonatal Intensive Care Unit (NICU) or a Cardiac Critical Care Unit (CCCU). Babies who have been admitted to the NICU or CCCU may be at risk for developmental issues due to medical problems before delivery, during delivery or after birth. These recommendations may be used to encourage development in babies who have not spent time in the NICU or CCCU, but still require care in the Neonatal Neurodevelopmental Follow-Up Clinic. Talk to your child’s doctor to see if you should be following these guidelines with your baby. </p><p>Babies and toddlers are assessed at specific ages in the clinic and given recommendations that parents and caregivers can refer to at home to help their baby achieve their maximum potential. These recommendations are for 18 months corrected age, as most of the babies followed in the clinic were premature at birth.</p><p>If you are concerned about your baby’s development, speak with your primary healthcare provider.</p><h2>Key points</h2><ul><li>Babies who have been in the NICU or CCCU may be at risk for developmental issues due to medical problems before delivery, during delivery or after birth.</li><li>Recommendations at 18 months focus on walking, structural and functional play, and encouraging speech development.</li><li>Parents and caregivers should follow these recommendations to encourage neurodevelopment.</li></ul><h2>Neonatal neurodevelopmental recommendations at 18 months</h2><h3>Gross motor</h3><ul><li>Practice gross motor development as a whole, including coordination, on riding toys. In playgrounds practice climbing on the small climbers and slides and walking on different terrain.</li><li>Practice ball games such as kicking and throwing. Do not expect catching yet.</li><li>Play a simplified version of “Simon Says”, encouraging your child to copy some of your body movements, such as raising your arms.</li></ul><h3>Fine motor</h3><ul><li>The high chair is an excellent place for structured play and ongoing development of attention skills. </li><li>As you play, verbally label the toys your child is playing with. This encourages both fine motor practice and language skills development.</li><li>Provide opportunities for container play and introduce shape sorters and simple puzzles for play.</li><li>Practice stacking for refinement of release skills (e.g., nesting cups, rings on pole, small blocks).</li><li>Continue with cause and effect toys that have to be pushed, pulled or turned (e.g., pop-up toy).</li><li>Introduce thick crayons and encourage scribbling. Encourage these early drawing skills in a variety of ways including painting with water on a chalkboard or sidewalk chalk outdoors. Introduce connecting toys, blocks (e.g., “Duplo”) and a variety of objects with different textures, shapes, and sizes for exploration with hands.</li><li>Encourage your child to use a spoon or fork during mealtimes. </li></ul><h3>Communication/Social</h3><ul><li>Be face to face with your child. Use single words or short phrases to label, comment or ask questions. </li><li>Watch what your child is doing, wait, listen and respond. Imitate actions or sounds and keep the interaction going.</li><li>Make sure there are reasons to communicate; avoid anticipating all of your child’s needs.</li><li>Use simple picture books, with real life photos and board books when reading together. </li><li>Use simple language- always stay one step above your child’s level of communication.</li><li>Praise your child for behavior you would like to promote, such as sharing or waiting for their turn with a toy.</li><li>If there are any concerns about your child’s speech, contact your region’s Preschool Speech and Language Services.</li></ul><h3>Play</h3><ul><li>Functional play – continue playing with toys/objects as they were intended to be used.</li><li>Encourage pretend play (e.g., feeding a doll or farm animals) and taking turns.</li><li>Attendance at structured play groups, activities, and daycare will provide opportunities for interaction with peers and assist with development of routines, socialization, self-help skills, and ongoing language development.</li><li>Sing rhymes with gestures or play games to label body parts, such as “Head, shoulders, knees & toes” or “If you’re happy and you know it, clap your hands”. </li><li>Electronic media use by children younger than two years is not recommended. This includes phones, television, computers, and tablet devices.</li><li>Encourage daily, unstructured playtime, and read to your child daily to promote the developing brain.</li></ul><h3>Feeding/Growth</h3><ul><li>Continue regular visits to your family doctor/paediatrician to monitor growth.</li><li>Gradually stop giving your child a bottle and transition to using an open cup.</li><li>Limit homogenized milk intake to 500 ml per day (16 ounces) to promote a balanced diet. Juice intake is discouraged. Water is best.</li><li>Have your child see a dentist as part of routine oral health care. Healthy Smiles Ontario is a government-funded program that provides free dental care for children and youth under the age of 17 years. For eligibility requirements and enrollment details visit: <a href="https://www.ontario.ca/page/get-dental-care">https://www.ontario.ca/page/get-dental-care​</a>.</li></ul><h3>Sleep</h3><ul><li>Maintain a regular bedtime routine.</li><li>Develop a regular sleep schedule and let your child fall asleep independently.</li></ul><p>For more information on neonatal neurodevelopmental recommendations at different ages, please see the links below:</p> <ul><li> <a href="/Article?contentid=3031&language=English">Four month visit​</a></li><li> <a href="/Article?contentid=3200&language=English">Eight month visit</a></li><li> <a href="/Article?contentid=3201&language=English">Twelve month visit</a><br></li><li> <a href="/Article?contentid=3203&language=English">Thirty-six month visit​</a></li></ul><h2>At SickKids</h2><p>For more information on the Neonatal Nevelopmental Follow-Up Clinic at The Hospital for Sick Children, please visit: <a href="http://www.sickkids.ca/neonatology/what-we-do/neonatal-developmental-follow-up-program/neonatal-developmental-follow-up-program%20.html">http://www.sickkids.ca/neonatology/what-we-do/neonatal-developmental-follow-up-program/neonatal-developmental-follow-up-program%20.html</a></p><h2>Resources</h2><p><a href="http://www.caringforkids.cps.ca/">http://www.caringforkids.cps.ca/</a></p><h2>References<br></h2><p>Sinai Health Systems Neonatal Follow-Up Clinic recommendations</p><p>Neonatal developmental recommendations have been adapted with permission from Mount Sinai Hospital in Toronto.</p>https://assets.aboutkidshealth.ca/AKHAssets/Neonatal%20neurodevelopmental_18.jpgNeonatal neurodevelopmental follow-up recommendations: 18 month visitFalse

Thank you to our sponsors

AboutKidsHealth is proud to partner with the following sponsors as they support our mission to improve the health and wellbeing of children in Canada and around the world by making accessible health care information available via the internet.