This is equivalent to the previous 3 day course - there will be pre-course virtual presentations to watch followed by 2 days of face-to-face teaching (both days must be attended)
COURSE TUTORS: Peta Smith and Adare Brady
The observation and handling of the fragile infant in the administration of the Lacey Assessment of the Preterm Infant (LAPI) assessment tool has evolved since being developed in 1980. It is an assessment tool specifically to document the motor development of the preterm infant at preterm age whilst in the intensive and special care nurseries.
The LAPI course focuses on the importance and relevance of the early research findings of Joan Lacey et al on the neonatal nurseries of the Royal Prince Alfred Hospital, University of Sydney, Australia which has led to the development of the LAPI as it is performed today, within the constraints of the modern intensive care nurseries environment, and the tool’s adaptation to improve diagnostic accuracy over time, especially in the post surfactant era, with younger and smaller babes surviving in the NICU and discharged at younger age.
The LAPI is used both to monitor the infant’s normal development over time, as well as to identify infants who are at high risk of motor impairment.
The LAPI has been designed to ensure there is minimal handling of the very young infant, by focusing on the observation and analysis of spontaneous movements and resting postures. A small amount of handling is required to remove some clothing and change the infant’s position and to assess tone. The items included in the examination are those shown to have a maturational sequence at preterm age (Lacey et al, 1985, 1987, 1990, 1998, 2004), thereby differing from assessment methods formulated for term infants and documents why the immature infant requires an assessment method specific to the intensive care nursery and the utilisation ofitems withan unique maturational sequence at preterm age.
This course is delivered at advanced level and is open to physiotherapists/occupational therapists/neurodevelopmental therapists working in NICU or who have access to NICU.
The assessment can only be used with infants in the NICU/SCBU – it cannot be used in out-patient or home settings.
The tutors are very experienced neonatal specialist physiotherapists, who each have over 20 years’ experience working on neonatal intensive care units, assessing and handling extremely premature infants.
Course objectives
The participants will be able to appreciate:
- The importance and relevance of early research findings leading to the development of the LAPI as an assessment tool for premature infants within the constraints of the modern Intensive Care environment
- The adaptation, over time, of the assessment, especially in the post surfactant era with younger and smaller babes surviving in the NICU and discharged at younger age
- Why the immature infant requires an assessment method specific to the intensive care nursery and the utilization of items with an unique maturational sequence at preterm age
- The analysis and grading of the different postures/movements the preterm infant uses to achieve:
- Protective side turning of the head
- Anti-gravity resting postures of the legs in prone and supine
- Upper limb to lower limb ratio
- Pelvic elevation
- Head to body axis alignment
- Spontaneous movements
- The possible effects of neonatal events on preterm rates of maturation and thereby better understand the diagnostic significance.
Please note, some of the lectures will be pre-recorded and must be viewed before the 2 day course