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(cont. from previous page)  “What I remember most from our stay in the NICU was how the therapists educated us about proper
          feeding and handling techniques for a premature baby,” White said. “Harrison was so small, and they made me feel more
          comfortable and prepared when it was time to take him home.”
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          Because  of  advanced-level  competency  requirements  and  the  continuous  examination,  evaluation,  and  modification  of
          procedures during each patient contact, the NICU is a restricted practice area for certain levels of therapists.

          “Typically, we see babies at 32 weeks or more gestation, which is about two months preterm,” Zope said. “When they are born
          preterm, their systems are not geared to take stimulus and process it. They’re so small, so medically fragile, and must be handled
          very delicately or they could be inadvertently harmed through the examination and intervention procedures. At the same time,
          they’re being managed medically, and we’re constantly examining how they’re responding to the therapy.”

          Adding therapists in the NICU rounds out the efforts of the medical team and the family.

          “An infant might be in the NICU for two or three weeks, and parents can’t be there around the clock,” Hunt said. “If they’re
          preterm, they’re often not able to be with their mothers or even out of the warmer unless it’s with someone who is skilled in
          watching for signs of distress. We can take the time to do positive interactions with the babies, who need positive touch and non-
          noxious stimuli, to help balance out the poking and prodding they have to endure for medical reasons.”

          The therapists might carefully hold or position a baby in the fetal position, like he would be in the womb, rather than lying flat, to
          help him develop muscle tone by encouraging the baby to flex and push as he would do normally. The NICU also works to create
          environmental modifications to closely resemble the womb, like keeping the room warm and dark.

          “We’re looking for reflexes and signs of developmental delay,” Zope said. “Babies in the womb have mile marker reflexes they
          develop,  but  when  they’re  born  preterm  it  can  be  harder  for  them  to  develop.  We  can  start  intervening  early  to  combat  or
          minimize the deficit or effects caused by their situation. Sometimes it’s not as overt, like a cleft palate, or other times it might be
          something bigger, like a heart defect. We look at how they respond. Knowing typical neurodevelopment comes into play, as does
          understanding how several complex systems integrate in development.”

          Most of the babies that the therapists see are preterm, while some are also experiencing Neonatal Abstinence Syndrome (NAS).
          These infants are born addicted to a substance and the therapists use their techniques to help the babies through the withdrawal
          symptoms.

          “NAS babies have nervous systems that are used to being on drugs,” Hunt said. “As they go through withdrawal, you need to
          intervene  in  different  ways.  In  addition  to  medical  interventions,  we  provide  deep  pressure,  infant  massage  to  help  calm
          everything down, to help guide them through that experience.”

          NICU Manager Andrea Pratt says she is very appreciative and proud to work with the therapists in her unit.

          “As a recently upgraded Level II NICU, the care we provide to our infants and their families has tremendously impacted our
          community,” Pratt said. “Jyutika and William have come into the NICU with open arms and treated each of our infants with
          ranging diagnoses as if they are their own. The treatment the infants are receiving from these therapists is helping decrease the
          length of stay and impacting long-term developmental milestones in a positive way.”

          About the providers

          Jyutika Zope, MHA, OTR, CLT, earned a master’s degree in health administration from University of North Carolina at Chapel
          Hill, and a bachelor’s degree in occupational therapy from University of Mumbai, India. She is also certified in lymphedema
          therapy  and  is  a  member  of  the  National  Association  of  Neonatal  Therapists.  She  has  extensive  experience  in  occupational
          therapy and health care management. She is currently coordinator of inpatient rehab services with Southeastern Health.

          William Hunt, PT, DPT, CKTP, is a travel physical therapist from Cleveland, Ohio. He earned a doctorate degree in physical
          therapy from Cleveland State University in 2016. In addition, he earned a bachelor’s degree from Loyola University Chicago and
          completed his post-baccalaureate work at Northwestern University. Hunt’s physical therapy experience includes clinical practice
          and instruction from University Hospitals Rainbow Babies & Children’s Hospital in Cleveland, University of Illinois Hospital –
          Chicago and at the Louis Stokes Cleveland VA Medical Center.
































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