Dear everyone who has emailed me with requests for further information on Heidielise Als' work - I'll try to find out if there is a web site and share that with you.  She has done extensive research for 20+ years and has published many articles re: developmental care.  While I'm at work tomorrow, I'll look at the references at the end of these articles and post them for everyone who is interested.   NIDCAP is not the only developmental care program, but it is widely known and seems to be a very helpful tool.  We do an assessment on a baby by observing respirations, heart rate, breathing rhythm, color changes, motor changes and state changes every 2 minutes (and documenting).  Ideally, we get a 10 minute baseline assessment before a caregiver comes to the bedside to do an intervention.  We observe and document throughout the intervention, and also for 10-15 minutes after the intervention; hopefully, the baby has returned to baseline by then.  We then do an in-depth write up of our assessment and make recommendations for changes in environment, bedspace and bedding, direct caregiving.  We write up a medical summary from the chart and figure the baby's nutritional/growth status from his measurements and use the Ponderal Scale Index (PSI).  In my most recent NIDCAP, I observed a full-term healthy baby in our nursery (just because I'm supposed to do at least one of these "big" babies to qualify for reliability).  This baby had been circumcised about 20 minutes before I came to assess.  During my assessment, he had his diaper changed and a heel stick for lab draws.  After the caregiver left the bedside, this poor infant stopped breathing for about 10-12 seconds. (A few seconds more and I would have had to intervene.)  If those things can cause a full term healthy infant to stop breathing, what's happening inside the tiny, immature, vulnerable bodies of our precious wee ones?  Just food for thought...
Dani Hudspeth