Follow-Up and Follow-Through after Discharge and Early Intervention Services

Neonatal brain injury can have impact on long-term functional outcomes. Intraventricular hemorrhage is associated with neurodevelopmental impairment (cerebral palsy, cognitive or language delay, and vision or hearing impairment) at age 2 years. Risk of significant impairment is increased by severity of hemorrhage, posthemorrhagic hydrocephalus, and white matter injury. Infants experiencing perinatal stroke most commonly face motor impairments in early childhood and beyond. Injury from hypoxia–ischemia may lead to motor delays, cognitive impairment, and behavioral challenges. Brain injury during the neonatal period can alter developmental trajectories, causing functional impairment, limitations in peer and community participation, and significant family distress. Despite this, the infant nervous system is incredibly plastic and resilient. The neonatal period is a time of active synaptogenesis and the building of larger neural networks through which to acquire motor, cognitive, and language skills. Brain injury can disrupt this process. Yet infants also display a remarkable ability to recover, adapt, and (re)gain functional abilities due to the robust developmental activity of the immature nervous system. Outcomes largely depend on injury location and extent, and environmental context. Brain injury developmental impact can be exacerbated by concomitant social adversity. Treatment delays must be identified early, and effective directed interventions initiated.