Neonatal intensive care; Incubators (Pediatrics); Bayley Scales of Infant Development; Infants--Care--United States


Infants who have been hospitalized in a neonatal intensive care unit (NICU) may present with a multitude of challenges that put them at risk for delayed development. Early Intervention and specialized NICU follow up clinics are in place to help identify NICU graduates’ need for therapy services. Well-established, standardized assessments, such as the Bayley Scales of Infant and Toddler Development (BSID-III) are utilized by occupational and physical therapists when making recommendations for therapy. The purpose of this retrospective chart review (N=104) was to identify the extent to which BSID-III motor scores were predictive of a referral for further developmental therapy in infants who were seen in NICU follow-up and to examine how therapist clinical judgment related to BSID-III scores. Independent sample t-tests conducted to compare motor performance to recommendations for motor therapy found there was a significant difference in the gross motor scores for those who were and were not recommended for motor therapy. Quality, quantity, and variability of motor skills emerged as recurring themes in therapist’s clinical judgment for initiating motor therapy, despite BSID-III scores that were within normal limits. Findings from this study indicate that the factors that influence follow-up recommendations are complex and that test scores alone were not indicative of whether or not a referral was given. Information gathered from this study may help increase understanding of how BSID-III scores and clinical judgment relate for therapists recommending motor therapy for NICU graduates.

First Advisor

Kari Tanta, PhD, OTR/L, FAOTA

Second Advisor

George Tomlin, PhD, OTR/L

Date of Completion

Spring 2013

Degree Type







Degree Name

Master of Science in Occupational Therapy (MSOT)

Date of Award



Occupational Therapy


University of Puget Sound