KATHYSHUM
Anaheim City SchoolsFederal legislation has increased the emphasis on the delivery of a continuum of services from birth through school age for infants and toddlers who are at risk. The problem is who should be delivering services to the families of these children. This study attempts to view primarily the role of the neonatal intensive care unit (NICCJ) in this process. To determine the ideal provision of services to families and infants at risk, a review of literature is presented indicating that support for families is needed during the infants' stay in the NICCI, during transition to home, and after returning to home. In an attempt to describe the actual nonmedical services being provided to families in the NICCI, all 94 NICCIs in the state of California were surveyed. The survey results indicated that MICCIs generally provided comprehensive services to families while the infant was in the hospital, less sewice to the family during the transition home, and very little support and follow-up after the infant returned home. Further studies can determine how community agencies and professionals can pick up where the NICCJ leaves off, thereby providing a continuum of services to families and infants at risk.The enactment of P.L. 99-457 (Education of all Handicapped Children Act, Amendments of 1986), P.L. 101-476 (Individuals with Disabilities Act [IDEA] of 1990), and P.L. 102-119 (Amendment to IDEA of 1991) has given impetus to the provision of services to infants and toddlers who are at risk, along with their families. This rejuvenation of infant and toddler services has, on the one hand, created a myriad of new and vital information about quality practices for service and non-medical intervention. On the other hand, the aforementioned legislation has created greater confusion between education and other service agencies as to who should be delivering what services to whom and when. Aggravating the situation fur-ther is the enigma the neonatal intensive care unit (NICCJ) remains for many early childhood professionals and families. This descriptive study will review selected current practices in the NICCJ, including the organization of neonatal care, family involvement, and building teams of professionals and agencies. Literature on issues and trends pertaining to familyrelated services in the NICCJ will be presented as well as descriptive information about prevailing practices in California NICCJs.
CURRENT PRACTICES
Organization of neonatal CareIn the United States, neonatal care is organized according to geographic regions. Medical ). The differences are based on population density, size and financial resources of the facility, the skill and experience of the medical staff, proximity to larger facilities, and equipment or services available. NICGs are typically identified as Level I, II, or HI, depending upon the degree of services provided to neonates.The Level I unit is found in a community hospital that has services and equipment to deal with normal pregnancies, deliveries, and newborns. However, e...
