Parent perceptions and the assessment of developmental vulnerability

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Teaching and Leadership


Gail Ensher


Developmental vulnerability, Early intervention, Play-based assessment, Parent

Subject Categories

Health Psychology | Pre-Elementary, Early Childhood, Kindergarten Teacher Education | Special Education and Teaching


There is substantial variation across the United States as to whether or not all children admitted to a neonatal intensive care unit (NICU) should be considered at-risk and eligible for Early Intervention services. The literature suggests that the NICU experience is a significant source of stress for parents and that it may have long-term effects on how parents perceive their children. The developmental issues surrounding parent perceptions of vulnerability have not been studied in detail. The purpose of this study was to determine if parents' perceptions of their children's vulnerability for health and developmental concerns were influenced when their children received short-term medical intervention in a neonatal intensive care unit (NICU). These parent perceptions were compared to those of parents whose children were not admitted to a NICU. A serial, play-based screening instrument was utilized to assess whether any developmental differences existed between these groups of infants.

This non-experimental, descriptive study included 31 families, seen over a 1-year period, each with four home visits. All infants were at least 36 weeks gestational age, had a birth weight of 5 lbs, 8 oz., and were ineligible for neonatal follow-up services. The prospective sample was divided into two separate groups--the NICU group (N = 16) and the Typical control group (N = 15). The data record consisted of both qualitative and quantitative sources including: Syracuse Dynamic Assessment ( SDA ) Initial Caregiver Interview Guide ; audio transcription of the interviews; Syracuse Play-Based Assessment ( SPBA ); closure questions and anonymous survey; and a SPSS 10.0 database of demographic variables and developmental scores.

The primary results indicated: (1) There were no substantial differences found between the NICU and Typical groups in the degree that caregivers worried about their children's health or development during the first year. (2) Infants who have had a brief precautionary visit to a neonatal intensive care unit (NICU) do differ significantly (p < 0.05) in certain developmental measures (Cognitive and Total Development scores) at 4 months from children who have not had this experience, but these differences were not evident at 12 months. There were no significant differences in Social-Emotional, Neuromotor, Sensory-Perceptual, or Language scores.


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