Baby's CHD Inpatient Developmental Consultation

A developmental consultation is a service provided by an expert in infant development to a baby and the baby's primary caregivers. It should take place before a baby is discharged home from the hospital.

This consultation should usually include:

1. an interview with the parents about their baby's development

2. an assessment of the baby's development

3. guidance and support for the family

Developmental consultations normally include an conversation between the developmental expert and the baby's primary caregivers. This conversation is called a "psychodiagnostic interview."

The goal of the interview is for the evaluator to learn from the parents, who are the experts on their own baby. The evaluator asks the parents questions that help to determine how the baby is developing, what the baby needs to work on next, and what help or resources the family will need.

During a developmental assessment, an expert in infant development interacts with the baby and talks with the baby's primary caregivers.

The assessment may be completed by one of several types of clinicians:

• psychologist

• developmental-behavioral pediatrician

• neonatal or behavioral neurologist

• pediatric nurse practitioner

• occupational therapist

The goal of the assessment is to determine:

• What the baby can do

• What the baby cannot yet do

• Patterns in the baby's development

• Strengths in the baby's development

• Weaknesses in the baby's development

• What goals the baby should work on next

• What interventions the baby needs

• Any further testing the baby requires

An inpatient developmental assessment measures a baby's functioning, and their developmental progress so far. It should be performed by a clinician who has expertise in early development, and expertise in the assessment of babies in a critical care setting.

It can include one or more standardized tests that measure functions such as:

• how sensitive a baby is, and how strongly they react to their environment

• how a baby regulates their mood

• how well a baby can calm themself

• how a baby moves their body, and how they organize their movements

• how a baby pays attention, and what draws their attention

• how a baby regulates their alertness

• how easily a baby can get used to a new sight or sound

Every developmental consultation should include offering guidance, support, and resources to the family.

This may include:

• teaching them about their child's development

• describing what to expect in the next weeks and months

• demonstrating activities that will promote the baby's development

• providing a written development plan, with goals and activities to reach those goals

• scheduling their next neurodevelopmental appointment (often the 6-12 month neurological assessment)

• referring them to services, including Early Intervention (EI), and setting up the first visit if possible

• determining any other resources or services the family needs in order to care for their baby's developmental needs at home

For many families with heart defects, an inpatient developmental consultation is their first contact with a developmental care team. It can forge a relationship between families and providers, and set patients up for a lifetime of recommended neurodevelopmental care.

This content was reviewed by a psychologist at Boston Children's Hospital.

Developmental care is best when it is local. Families local to Boston can receive care from the Cardiac Neurodevelopmental Program (CNP). Families from other regions can use the link below to find their local care team.