Early Intervention Strategies for Success

Sharing What Works in Supporting Infants & Toddlers and the Families in Early Intervention

Early Intervention Strategies for Success, Tips, Insight and Support for EI Practitioners


Sleeping premie

Preemie Pop Quiz

Do you know the stats on prematurity? Take this pop quiz to see what you know and keep reading for answer and tips you can use when supporting preemies and their families!

1. A premature birth is one that occurs before ___ weeks gestation.

2. Approximately how many children are born premature each year?

3. When do most premature births occur – before or after 34 weeks gestation?

4. We correct for prematurity up until a child turns _______ years of age.

5. Almost ___% of pregnancies with multiples (twins, triplets, etc.) result in preterm births.

6. True or False: Prematurity is the leading cause of long-term disability related to the nervous system  in children.

7. True or False: Most preemies will eventually catch up to their full-term peers in terms of developmental abilities.


1. Premature birth is defined as a delivery that occurs prior to 37 weeks gestation. (Source: CDC, 2014)

2. Approximately 1 in 9 children are born premature each year. In 2012, 455,918 children were born premature. (Source: CDC, 2014)

3. In 2012, about 8% of premature births occurred when the infant was between 34-36 weeks gestation. Approximately 3% of premature births occurred when the infant was under 34 weeks. (Source: National Vital Statistics Report, 2013)

4. According to the Infant & Toddler Connection of Virginia, we correct a child’s age for prematurity up until 18 months of age. Other programs and medical professionals might correct up until a child turns 2-2 1/2 years of age, depending on guidelines for that program. (Source: I&TC of VA Practice Manual)

5. Approximately 60% of births of multiples occur before 37 weeks gestation. (Source: healthychildren.org)

6. The earlier a child is born, the higher the risk that the child will experience developmental and medical challenges. Even in children born as late-term preemies (between the ages of 34-36 weeks), research has found that they are at significantly higher risk for negative outcomes (Source: NIH, 2014). Being born premature places a child at higher risk for intellectual disabilities, visual and hearing impairment, respiratory challenges, feeding issues, and cerebral palsy. (Source: CDC, 2014)

7. It’s important to remember that, while preemies are higher risk for many conditions, most preemies eventually catch up to their same-aged peers!

Preemies & Early InterventionMother holds preemie

All EI programs support preemies and their families at one time or another. Of course, not all preemies are referred to EI, or will even qualify for services, but EI can be a wonderful resource for families of those who do. When supporting families of preemies, here are a few important things to keep in mind:

Take time to listen to the family’s story – For most families, a premature birth marks a significant, unexpected and often frightening event in their lives. The family has had to adjust their lives to accommodate an unexpected hospital stay for the mother and child, quickly prepare for a child they might not have expected to arrive for months, adjust work and child care schedules, etc. They might have been visiting the child at the hospital for months following the delivery and be anxious about bringing a fragile child home. Taking the time to let them share their experience can be a powerful way to begin the early intervention relationship. I remember meeting a family of a very premature baby and in listening to their story, finding out that this child had a twin sister who died shortly after the delivery. This information was not provided in the referral paperwork and really shaped their perspective on the child we were supporting – and their underlying fear of losing her too.

Remember the family system – Because the referral we receive is for the child, it can be easy to forget the effects of the premature birth on the whole family. Parents, siblings, and extended family are all impacted by this event. It’s important to keep this in mind when considering service delivery options and how best we can support the child and family.

Keep the parent-child attachment in the forefront – Preemies are often whisked away to receive medical care immediately after delivery. Opportunities to hold and bond with the child may be different than they would have been with a child born full-term. While we don’t ask “do you feel attached to your baby?” we can observe and support that attachment process. Many believe that all relationships are based on early attachments, so keeping an eye on infant mental health with preemies is important. Observe how the parent holds, feeds and comforts the child and provide support if the parent struggles with early care.

Monitor the child’s reactions & adjust the environment – Use careful observation to monitor how the infant reacts to environmental stimuli. If needed, help the parent adjust the environment to avoid overstimulating the child. Preemies can be fussy and struggle to regulate themselves, but with a little help, can adjust well. If the child startles easily, cries often, or shows signs of overstimulation (e.g., arching, yawning, sneezing, gaze aversion, fanning out the hand), help the parent look for ways to adjust noise, lighting levels, or interactions to a tolerable level. For some preemies, using one sense at a time for interaction can help. For example, talking to and touching the preemie at the same time might be too much, so help the parents and siblings learn to do one or the other while interacting until the baby can tolerate more.

Keep a close eye on development – In Virginia, preemies qualify for EI if they’re born less than or equal to 28 weeks gestation or if they have a NICU stay greater than or equal to 28 days. Because we know that all preemies are at higher risk for developmental delays or disabilities, it’s so important to monitor development and health closely. Encourage families to keep all follow-up appointments. Monitor vision, hearing, and motor development especially closely. As the child grows, watch for any signs of delay across development. Keep in mind that correcting for prematurity up to 18 months really isn’t a magic number for catching up. It’s just a benchmark for eligibility; some preemies won’t qualify after 18 months of age as the gap between their chronological age and adjusted ages closes, but others may continue to show developmental delays and benefit from intervention.

However premature a child is, do your best to provide support that is individualized for the child and family while taking into account the risks associated with prematurity. Be hopeful about the future and keep in mind that the support you provide to this tiny person and his or her family could make a lifelong difference!

Let’s celebrate National Prematurity Awareness Month by sharing tips for supporting preemies and their families in the comments below! What’s your best strategy for engaging a preemie?

For more information, visit the Virginia Early Intervention Professional Development Center website to find a Prematurity topic page with links to a prematurity resource landing pad (PDF, New Window), an archived webinar (Prematurity and Early Intervention: Prevalence, Issues and Trends), a free online module (An Early Interventionist’s Guide to Prematurity), and tons of other great resources!

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