Vandenberg Kathleen A
West Coast NIDCAP & APIB Training Center, California Special Start Training Program, Department of Education, Mills College, 5000 MacArthur Blvd, Oakland, CA 94603, USA.
Early Hum Dev. 2007 Jul;83(7):433-42. doi: 10.1016/j.earlhumdev.2007.03.008. Epub 2007 Apr 30.
The newborn infant in the neonatal intensive care unit (NICU) is cared for with highly advanced medical technology, but the incidence of disability and neurodevelopmental problems among survivors remains high and problematic. Preterm birth disrupts the developmental progression of brain structures and affects development of the sensory systems. The Synactive Theory of Development provides a framework to conceptualize the organization of the neurobehavioral capabilities in the early development of the fetus, newborn and young infant. The infant's ability to regulate and control behavior emerges through continued interaction with the environment and is expressed through five systems: autonomic/physiology, motor, state, attention/interaction and self-regulation. In the healthy full term newborn the five subsystems are mature, integrated, synchronized and managed smoothly. The less mature, healthy or sick preterm newborn may be unable or partially able to manage environmental inputs, demonstrating over-reactive responses and poor tolerance from even minimal input. Loss of control and stress responses become frequent unless the environment and caregivers work to read the infants' messages and thresholds for sensitivity and adjust care and handling and the environment based on the infant's behavioral communications. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is a comprehensive program which includes a behavioral observation methodology and creation of individual family centered developmental caregiving support of the infant's own developmental goals. The NIDCAP approach seeks to support the infant's stabilization and organization of the autonomic, motor, and state systems at each level of maturation, while minimizing stressful events.
新生儿重症监护病房（NICU）中的新生儿接受着高度先进的医疗技术护理，但幸存者中残疾和神经发育问题的发生率仍然很高且存在问题。早产会扰乱脑结构的发育进程，并影响感觉系统的发育。发展的协同理论提供了一个框架，用于将胎儿、新生儿和婴儿早期发育中神经行为能力的组织概念化。婴儿调节和控制行为的能力通过与环境的持续互动而出现，并通过五个系统表现出来：自主神经/生理系统、运动系统、状态系统、注意力/互动系统和自我调节系统。在健康的足月儿中，这五个子系统是成熟的、整合的、同步的且能顺利运行。不太成熟、健康或患病的早产儿可能无法或只能部分应对环境输入，对即使是最小的输入也会表现出过度反应和耐受性差。除非环境和护理人员努力解读婴儿的信息以及敏感度阈值，并根据婴儿的行为交流调整护理、处理方式和环境，否则失去控制和应激反应会频繁出现。新生儿个体化发育护理与评估项目（NIDCAP）是一个综合项目，包括一种行为观察方法，以及围绕婴儿自身发育目标创建以家庭为中心的个体化发育护理支持。NIDCAP方法旨在支持婴儿在每个成熟阶段自主神经、运动和状态系统的稳定和组织，同时尽量减少应激事件。
