I. New born Follow-up Unit 

Three clinics are functioning under this unit  

a. Early Stimulation Clinic

The early stimulation clinic of CDC offers early developmental stimulation to all newborn  babies with birth weight less than 1800gm till one year of age. A randomized control trial  conducted at CDC showed that the Child Development Centre (CDC) model early stimulation  therapy done in the first year of postnatal life, in improving the developmental outcome of  at-risk neonates at one and two years of age (Nair, M & Philip, Elsie & Jeyaseelan, Lakshmanan  & George, Babu & Mathews, Suja & Padma, K. (2009). Effect of Child Development Centre Model  Early Stimulation Among At-risk Babies - A Randomized Controlled Trial. Indian pediatrics. 46  Suppl. s20-6.).  

Objectives 

• Offering early developmental stimulation to all newborn babies with birth weight less  than 1800gm till one year of age 
• Motivating the parent to stimulate the baby with appropriate stimuli 
• Lactation counselling to all mothers with LBW babies 

Clinic set up: 

• The clinic functions in CDC on all week days from 9.00 am to 3.00pm except on  holidays. 
• All the newborn babies with birth weight less than 1800 referred from OBN and IBN  clinics of SAT Hospital are being followed up. 

Services offered 

• All the babies attending the clinic receive the following services. 
• Periodic growth monitoring of children- weight, length, head circumference
• Developmental screening using Trivandrum Developmental Screening Chart (TDSC)  and Denver Developmental Screening Test (DDST) and CDC Grading for motor milestones  
• Neurological assessment by Amiel-Tison method of assessment 
• Developmental assessment using Developmental Assessments Scales for Indian  Infants (DASII)done at one and two years of age 
• Auditory, tactile, visual and motor stimulation  
• Lactation counselling for mothers 

b. Late Pre-term Clinic (34 weeks to 36 weeks 6 days) 

There is increasing evidence that late preterm babies (Gestational Age 34-0/7wks to 36- 0/6 wks) are at increased risk of short term developmental morbidities as compared to  term counterparts. A study assessing the outcome of parent based early stimulation  model on neurodevelopment of late preterm infants showed that early stimulation  pivoting around parent-child in late preterm babies has positive influence on  Neurodevelopmental outcome at 12 months of corrected age. (Ashwini N K, Babu G, Deepa  B. Outcome of CDC Kerala Early Stimulation Model on Neurodevelopment of Late Preterm  Infants. Acad J Ped Neonatol. 2017; 3(1): 555603.) 

The clinic functions on all week days and the services are offered from 9.00 am to 3.00  pm  

Objectives  

• Periodic assessment of late preterm from birth to 24 months 
• Sensory oriented stimulation for late preterm babies. 
• Stimulating the child through normal developmental channel. 
• Teaching the parents to stimulate the baby with appropriate stimuli.
• Assessing parenting skills and educating. 

Service offered 

• Lactation counseling 
• Health education 
• Developmental assessment using TDSC, DDST, Amiel-Tison method and CDC Grading for  motor milestones 
• Hearing & Vision Screening  
• Growth Monitoring 
• Infant massage and tactile stimulation  
• Early intervention based on developmental assessment 
• Evaluation, diagnosis and treatment plan for medical problems by Developmental  Pediatrician 

c. At Risk Baby Clinic  

At-risk babies are more likely to develop developmental delay and hence regular  developmental follow-up at fixed interval is planned for these children. Research studies  have shown that early intervention is effective in improving the developmental status of at  risk babies (Upadhyay, R.P., Taneja, S., Strand, T.A. et al. Early child stimulation, linear growth  and neurodevelopment in low birth weight infants. BMC Pediatr 22, 586 (2022).) 

Objective 

• Reducing childhood disability through early detection and intervention program  
• Assessing the developmental status of new-borns who are at risk for developing  developmental delay  
• Assessing and monitoring the growth status  

Clinic Set-up 

The Clinic is functioning at Child Development Centre on all Tuesdays and Fridays from 9am  to 1 pm except on holidays. 

Low Birth Weight babies and those babies who were admitted to the In-born and Out-born  nurseries at SAT Hospital Thiruvananthapuram are being given appointment. All children  will be categorized on risk basis as mild, moderate and severe. All mild risk babies will be  followed up at 4th month, then at 1 year, moderate-risk babies will have the follow up  regimeat 2,4,8,12 months. All babies in severe risk categories will be followed up monthly  till one year. 

Services Offered 

• Health Education – Breast-feeding, weaning, supplementary foods, immunization,  parenting etc. 
• Growth monitoring– weight, length & Head Circumference measurement 
• Developmental assessment using Trivandrum Developmental Screening Chart (TDSC) &  CDC Grading for motor milestones 
• Developmental Screening using Denver Developmental Screening Test (DDST) 
• Neurological evaluation using Ameil-Tison method of neurological evaluation  6. Assessment of social age using Vineland Social Maturity Rating Scale 
• Early Intervention services (general stimulation techniques) for all children 
• Specific mother oriented therapy for those children showing mild developmental delay 
• Screening for hearing problems using OtoAcoustic Emission test  
• Screening for visual abnormalities by the ophthalmologist 
• Screening for medical problems by the Developmental Paediatrician. 
• Appropriate referrals to various specialty, if found necessary. 
• Follow up in pre-school – 3 ½ years and further need based follow up