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Evaluation

Are you evaluating a preterm infant?

Gender of the patient

At delivery was there?

• low gestational age?

• low birthweight?

• small for gestational age (SGA) and/or growth restriction?

• birth asphyxia?

• significant adverse labor events?

• significant brain damage (injury, structural)?

• an intra-uterine infection and/or chorioamnionitis?

• preterm premature rupture of the membranes?

• a twin or multiple gestation?

• poor neonatal intensive care?

Does/Did the infant?

• have significant birth defects?

• have chronic lung disease?

• have necrotizing enterocolitis?

• have apnea and bradycardia?

• develop hyperbilirubinemia?

• have seizures?

• have nutritional deficiencies?

• show a slow growth velocity (failure to thrive)?

• have a small head circumference?

• have significant hypothyroidism?

• have one or more significant infections?

• have an adverse genetic disorder?

• exposure to toxins?

Is the family affected by?

• interference with maternal-infant interaction?

• lack of developmental interventions or developmental care?

• low socioeconomic status?

• parental mental health issues (substance abuse, etc)?

• poor family dynamics (divorce, etc)?

• abuse and neglect?

Results

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