Polly Kellner MSOT, OTR/L
Research Coordinator I
Master of Science (MS)
in Occupational Therapy
2016 | Washington University in St. Louis
Bachelor of Arts (BA)
in Psychology and Educational Studies
2014 | Carleton College
Heiny, E., Wolf, S., Collins, M., Kellner, P. D., & Pineda, R. (2021). Factors related to enrollment in early therapy services following neonatal intensive care unit discharge. Acta Paediatrica, 110(5), 1468-1474. https://doi.org/10.1111/apa.15700 Show abstract
Aim. Early therapy can improve developmental outcomes for preterm infants. However, preterm infants who are referred have low enrollment in early therapy services following neonatal intensive care unit (NICU) discharge. This manuscript aims to investigate the relationship between infant medical and sociodemographic factors and enrollment in early therapy services post‐NICU discharge, when system‐related barriers to access are minimized.
Methods. This was a retrospective investigation of 89 families with infants born ≤ 32 weeks gestation. Families were approached for enrollment into early therapy services following NICU discharge through Baby Bridge programming, which aims to improve access to therapy services following NICU discharge.
Results. Seventy‐three (82%) families enrolled in early therapy services, and 16 (18%) families declined. Parents were more likely to enroll in early therapy if they had public insurance (p=0.01), a maternal psychiatric diagnosis (p=0.02), or additional children under 18 years in the home (p=0.01). No infant medical factors were related to enrollment.
Conclusion. Although enrollment rates were high, 18% of families refused therapy services, despite removing system‐related barriers to access. Targeted interventions can be developed to increase enrollment in early therapy services among populations who are most likely to refuse therapy services after NICU discharge.
Keywords. Baby Bridge program; birth to three; development; early intervention; preterm infant
Kwon, J., Kellner, P., Wallendorf, M., Smith, J., & Pineda, R. (2020). Neonatal feeding performance is related to feeding outcomes in childhood. Early Human Development, 151, 105202. https://doi.org/10.1016/j.earlhumdev.2020.105202 Show abstract
Aim. Define relationships of early feeding performance with feeding outcomes in childhood, while assessing the predictive validity of the Neonatal Eating Outcome Assessment.
Study design. Ninety-one infants (44 preterm infants born ≤32 weeks at term-equivalent age and 47 full-term infants within 4 days of life) had feeding evaluated using the Neonatal Eating Outcome Assessment and the Neonatal Oral Motor Assessment Scale (NOMAS). At 4 years of age, 39 of these infants (22 preterm infants and 17 full-term infants; 43% follow-up rate) had parent-report measures of feeding conducted using the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and Pediatric Eating Assessment Tool (PediEAT).
Results. Lower Neonatal Eating Outcome Assessment scores were related to higher PediEAT scores (p = 0.01; r = −0.44), but were not related to BPFAS scores (p = 0.17; r = −0.23). Relationships were not detected between the NOMAS and BPFAS (p = 0.35; r = 0.17), and relationships between the NOMAS and PediEAT failed to reach significance (p = 0.06; r = 0.34). There was a relationship between the BPFAS and PediEAT scores at 4 years (p < 0.001; r = 0.66). Preterm infants performed poorer than full-term infants on the Neonatal Eating Outcome Assessment (p < 0.001) and NOMAS (p < 0.001), but no differences were detected in preterm compared to full-term performance on the BPFAS (p = 0.87) and PediEAT scores (p = 0.27).
Discussion. Neonatal feeding performance is an important predictor of feeding outcomes at 4 years of age. The Neonatal Eating Outcome Assessment has predictive validity, and the Pediatric Eating Assessment Tool has concurrent validity with relationships to another childhood feeding tool.
Keywords. Oral motor, Neonatal intensive care unit, Development, Assessment, Neonatal Eating Outcome Assessment, Outcome
Pineda, R., Durant, P., Mathur, A., Inder, T., Wallendorf, M., & Schlaggar, B. L. (2017). Auditory exposure in the neonatal intensive care unit: Room type and other predictors. The Journal of Pediatrics, 183, 56-66.e3. https://doi.org/10.1016/j.jpeds.2016.12.072 Show abstract
Objective. To quantify early auditory exposures in the neonatal intensive care unit (NICU) and evaluate how these are related to medical and environmental factors. We hypothesized that there would be less auditory exposure in the NICU private room, compared with the open ward.
Study design. Preterm infants born at ≤ 28 weeks gestation (33 in the open ward, 25 in private rooms) had auditory exposure quantified at birth, 30 and 34 weeks postmenstrual age (PMA), and term equivalent age using the Language Environmental Acquisition device.
Results. Meaningful language (P < .0001), the number of adult words (P < .0001), and electronic noise (P < .0001) increased across PMA. Silence increased (P = .0007) and noise decreased (P < .0001) across PMA. There was more silence in the private room (P = .02) than the open ward, with an average of 1.9 hours more silence in a 16-hour period. There was an interaction between PMA and room type for distant words (P = .01) and average decibels (P = .04), indicating that changes in auditory exposure across PMA were different for infants in private rooms compared with infants in the open ward. Medical interventions were related to more noise in the environment, although parent presence (P = .009) and engagement (P = .002) were related to greater language exposure. Average sound levels in the NICU were 58.9 ± 3.6 decibels, with an average peak level of 86.9 ± 1.4 decibels.
Conclusions. Understanding the NICU auditory environment paves the way for interventions that reduce high levels of adverse sound and enhance positive forms of auditory exposure, such as language.
Keywords. preterm; senses; environment; language