Developmental Observer 20 25 | V O L 1 8 | N O . 1 The Official Publication of the NIDCAP® Federation International Dr. Heidelise Als was more than a mentor; she was a guiding force in shaping my career and fostering my personal growth. Her commitment to compassionate care continues to impact my approach to developmental care, along with engagement with life, family, and my professional career. Dr. Als shared her life experiences generously, weaving personal insights into her philosophy. Her support extended to fostering my professional growth and instilling faith in my potential, which remains a constant source of motivation. To me, she was family, always available with sage advice and encouragement. I draw directly from the principles Dr. Als instilled in me. I strive to embody her philosophy that the care we provide effects outcomes and lifelong development. Her words, “It matters how we listen to the voice of and care for each newborn and each family. It matters how we care for one another and for ourselves,” continue to inspire my approach. These words serve as a powerful reminder of the profound responsibility we hold as professionals in newborn care to deliver thoughtful, individualized attention during the earliest and most critical stages of a child’s development. The Heidelise Als Lecture – 35th NIDCAP Trainers Meeting 2024 Shaped by Wisdom: Dr. Heidelise Als’ Impact on My Professional Journey The path forward is rich with opportunities. -Samantha Butler INSIDE The Heidelise Als Lecture ................... 1 Editorial .............................................................. 2 The Synactive Model: ........................... 6 Individuals, Hospitals, and Systems Abstracts from the 2024 .................. 9 NIDCAP Trainers Meeting Poster Abstracts from the ............. 16 2024 NIDCAP Trainers Meeting Behind the Scenes ............................... 24 Global Perspectives ........................... 27 NIDCAP Training Centers ................ 31 Worldwide: France NIDCAP Training Centers ............... 35 DOI:10.14434/do.v18i1.40856Samantha Butler, PhD DOI:10.14434/DO.V18I1.40852 Continued on p.2 2 • 2025 • Developmental Observer This issue offers insights from the recent 35th NIDCAP Trainers Meeting, highlighting the exchange of knowledge that defines our global community. These meetings continue to grow in strength and scope, showcasing an outstanding diversity of information and experiences. The picturesque setting of Toulouse in the south of France provided a vibrant backdrop for the event, which also served as an invaluable opportunity for networking among delegates representing many countries. In this issue, Samantha Butler shares the wisdom and legacy of Heidelise Als, taking us on her inspirational NIDCAP jour- ney—a testament to vision and dedication. Deborah Buehler introduces us to an innovative perspective on the Synactive Theory, exploring its application across all areas of care. The abstracts featured in this issue reflect the diversity and depth of the meeting. From groundbreaking research and new educational approaches to parent-led initiatives and strategies for expanding NIDCAP expertise. Additionally, we are de- lighted to include poster abstracts that highlight the incredible work of our NFI members. For the first time, we have translated several articles from the original French, making their valuable content accessible to a broader audience. This new venture was made possible thanks to the generous assistance of Kiki Remont, and I extend my grat- itude for her efforts. I would love to hear your thoughts on this new approach to fostering accessibility and understanding. Thank you for your continued engagement and dedication to advancing the NIDCAP mission. Kaye Spence AM FACNN Senior Editor – Developmental Observer Adjunct Associate Professor Australasian NIDCAP Training Centre/ University of Western Sydney Editorial Cover image: Photograph used with permission of the mother in Shanghai DOI:14434/do.v18i1.40855 A French Treat Dedication to Care From the first moment I observed Dr. Als with an infant, I was struck by her profound compassion and keen insight into the experiences of newborns and their families. Her dedication to improving care for the most fragile patients deeply resonated with me. She demonstrated that even the smallest adjustments, rooted in respect and understanding, could create a transfor- mation on the well-being of others. Dr. Als’ influence guides how I create environments that prioritize family-focused developmental practices. Dr. Als emphasized that every detail matters, not just in medicine but in every aspect of how we present ourselves. She reminded us that we are public figures and thus all interactions matter and deserve intention. Whether creating an environment to uplift others, preparing for an assessment, or organizing a meeting, attention to detail shapes how messages are received and how others feel within that space. She emphasized the power of projecting confidence, clarity, and empathy to rear connec- tion and trust. This philosophy has extensively shaped my approach, driving me to approach interactions and decisions with thoughtfulness, ensuring that I reflect a sense of well-be- ing, respect, and intentionality. Philosophy and Mentorship This deep commitment to care was also reflected in her ap- proach to mentoring. Dr. Als embodied an extraordinary work ethic, dedicating countless hours to her mission and inspiring others with her drive and high expectations. Her approach to training was rigorous and comprehensive. Through the NIDCAP curriculum, she cultivated a philosophy of thoughtful engage- ment, observation, and practice, cultivating a community of clinicians dedicated to individualized developmental care. I feel a profound responsibility to honor and carry forward her vision. In my own NIDCAP training efforts, I strive to uphold her meaningful approach, providing structure and depth while also offering additional guidance to make the process accessi- ble and encouraging for trainees. This sense of responsibility drives me to motivate others to see the insights she uncovered, publish meaningful research, and promote transformative care practices that improve outcomes for infants and families. Dr. Als fostered a commitment to listening to, supporting, and inspiring others. Through her example, I advocate for the vital role we play in the lives of infants, their families, and others. I believe that as a professional in the field of neurodevelopment, Acknowledgments: External Reviewers 2024 – Samantha Butler, Marzieh Hasanpour, Kiki Remont. Erratum: Vol 17, No 3, page 16. The image caption should read: Dr. Mohammad Heidarzadeh and Dr. Marzieh Hasanpour. Continued on p.3 2025 • Developmental Observer • 3 Jeffrey R. Alberts, PhD, is Professor of Psychological and Brain Sciences at Indiana University -- Bloomington (USA). Jeff is also a NIDCAP Professional and blends his lab studies with similar research at Cincinnati Children’s Hospital Medical Center. gretchen Lawhon, PhD, RN, FAAN, is the Clinical Nurse Scientist with Newborn Special Care Associates, at Abington Jefferson Health and a NIDCAP Master Trainer. gretchen has reviewed articles for peer reviewed journals. gretchen has extensive experience as a clinical nurse scientist and has authored numerous articles in her areas of expertise. María López Maestro, MD, is a Neonatologist at the Hospital 12 de Octubre in Madrid, and is a NIDCAP Trainer and Member of the National Committee for the implementation of Developmental Centered Care in Spain. Maria has 10 research works. https://orcid.org/0000-0002-0545-6272. Debra Paul, OTR/L, is an Occupational Therapist and NIDCAP Professional at Children’s Hospital Colorado in Aurora, Colorado and the Column Editor for the Family Voices section for the Developmental Observer. Debra writes policies and guidelines which requires succinct writing and an eye for editing.  Kaye Spence AM is a Clinical Nurse Consultant and clinical researcher with numerous publications in peer reviewed journals and several book chapters and is a peer reviewer for eight professional journals. She is a past Editor of Neonatal, Paediatric and Child Health Nursing. https://orcid.org/0000-0003-1241-9303  Diane Ballweg, MSN, is the Developmental Specialist at WakeMed Hospital in Raleigh, North Carolina, USA. Diane’s writing and editing experience also includes reviewing for several peer reviewed journals and authoring several journal publications and book chapters related to developmental care. Deborah Buehler, PhD, has a degree in developmental psychology and is a NIDCAP Master and APIB Master Trainer with expertise in developmental care within newborn and infant intensive care nurseries. Her work has focused on NIDCAP research, education and mentorship, and awareness. Deborah has authored and co-authored papers and manuals pertaining to NIDCAP care. Sandra Kosta, BA, NFI Executive Director of Administration and Finance, has been an Associate Editor for the Developmental Observer since 2007. As a Research Specialist at Boston Children’s Hospital, Sandra has co-authored several papers on the effectiveness and long-term outcomes of NIDCAP Care. Editorial Board we hold a position of immense responsibility, to serve as the bridge between science, clinical care, compassion, and advocacy. Our role transcends the walls of hospitals and the pages of med- ical journals; we serve as the voices for those who cannot stand up for themselves. Advocacy in this context is not merely a choice, it is an ethical obligation. We are called to utilize our ex- pertise, our voices, and our influence to ensure that our patients, their families, and our colleagues are recognized and prioritized. By doing so, we fulfill our moral duty to make a meaningful difference in the lives of those who rely on us most. I see advocacy as a natural extension of compassion, whether we are caring for a newborn in the ICU, mentoring colleagues, or helping others navigate professional challenges. One of the most compelling reasons for our activism is the simple fact that hospitalized newborns cannot speak for them- selves. Infants, particularly those undergoing surgical inter- ventions, are in their most vulnerable state. When we advocate for newborns, we are addressing their immediate medical needs and nurturing the foundation of their future health and developmental outcomes. As is the motto of NIDCAP, we are the voice of the newborn, ensuring that every decision made respects individuality and promotes growth. Dr. Heidelise Als and Dr. Samantha Butler. Continued on p.4 4 • 2025 • Developmental Observer Dr. Als created NIDCAP, which provided a way to observe and understand infant behavior, minimize stressful experienc- es, decrease the separation of infants from parents, and op- timize development with consistent caregiving. The art of read- ing infant behavior, a skill Dr. Als pioneered and emphasized, provided an understanding of the infant’s unique experiences and responses. By prioritizing observation, we collaborate with infants to enhance their development in a personalized way. I strive to motivate others in thoughtful interpretation of infant behavior, moving beyond surface-level solutions to connect with our patients, ensuring that every interaction is meaningful and tailored to a family’s unique circumstances. This approach was especially crucial during my transition from newborn medicine to the world of cardiology, where infant behavior varies greatly, but the ability to read and respond to cues remains invaluable in providing effective care. Dr. Als frequently reminded us of the meaningful influ- ence of language in shaping perceptions and practices. She prioritized choosing words thoughtfully, because the language we use in policies, discussions, and everyday speaking reflects our values and priorities. This mindful use of language encour- ages us to affirm the roles of infants and families and avoid diminishing their significance. In my professional career, I am mindful of the power language holds and the impression it has on how we perceive relationships, responsibilities, and roles within the ICU. NIDCAP care involves creating a culture where the language used consistently respects and values fam- ilies, team members, and the infants themselves, reinforcing a collaborative and compassionate approach to care. Dr. Als’ teachings went beyond advocating for infants and families and extended to highlighting the importance of nour- ishing all members of the team. This includes acknowledging the perspectives of professionals whose contributions are often overlooked. Therapists, environmental services staff, and other essential contributors are vital to creating a cohesive, nurturing environment. Their expertise elevates the care we provide and enriches discussions around standards of practice. I actively in- corporate diverse perspectives, seeking out a multidisciplinary team that includes family members, various disciplines, and inpatient staff. I take great pride in our collaborative team, where we learn from and promote one another, cultivating an atmosphere of mutual respect and shared purpose. Inspiration for Growth Dr. Als was a positive energy in the field of newborn med- icine. She supported engaging with the infant rather than simply offering treatment, at a time when the medical world often overlooked the individuality and humanity of newborns and failed to fully acknowledge the challenging path faced by the parents of an ill child. She moved us to strive for more. Her perseverance acknowledged that rousing change can be challenging. Her example continuously drives my commitment to carry forward her vision, ensuring that thoughtful, individ- ualized care remains a priority, even when faced with barriers. Her work moves me to continue my efforts, knowing that this approach holds transformative potential. She instilled the importance of continuous learning, reminding us that knowledge is ever evolving. Her dedication to education stimulates me to seek growth through research, collaboration, and reflection. This commitment ensures that care practices advance alongside new discoveries, improving how we care for newborns and their families. Dr. Als placed great importance on reflective processing, urging us to thoughtfully consider every interaction. This approach shaped my connection between theory and prac- tice to make intentional decisions. It also fostered a deeper understanding of how each moment fosters the emotional development of both the infant and their family, along with the professional course of myself and others. Gratitude and Aspiration Reflecting on my journey, I feel immense gratitude for Dr. Heidelise Als. Her guidance provided inspiration, motivation, and unwavering support. She demonstrated that true leader- ship is about accompanying others and her belief in me served as a guiding light in both my professional and personal life. By promoting collaboration, amplifying the perspectives of often overlooked professionals, emphasizing the importance of reading and responding to infant behaviors, focusing on the significance of every detail, and committing to lifelong learn- ing, I strive to fulfill and advance Dr. Als’ vision of thoughtful, intentional, and individualized care. “She supported engaging with the infant rather than simply offering treatment, at a time when the medical world often overlooked the individuality and humanity of newborns and failed to fully acknowledge the challenging path faced by the parents of an ill child.” 2025 • Developmental Observer • 5 Carrying the Vision Forward: Inspiring the Future of Developmental Care Together with the NIDCAP family and the NIDCAP Federation International, I am dedicated to ensuring that her profound impact on newborn care and developmental practices flourishes. Her legacy lives on in the countless lives she touched, reminding me daily of the difference one person can make in the world and that we can all do more. The path forward is rich with opportunities to expand the transformative principles of NIDCAP. Future research must continue to evaluate the impact of NIDCAP on outcomes for infants and families, as well as quality improvement initiatives and feasibility studies in diverse healthcare settings. Disseminating knowledge through impactful publications and engaging presentations will ensure that these principles reach a wider audience, inspiring others to adopt and innovate upon Dr. Als’ approach. Additionally, increasing accessibility to NIDCAP training is crucial. Efforts to create online resources, mentorship programs, and multidisciplinary collaborations can foster a global community of practitioners who are passionate about developmental care. By embracing continuous learning and reflection, and by championing advocacy and education, we can honor Dr. Als’ legacy and inspire the next generation of caregivers to amplify her vision. Together, we can ensure that her teachings continue to transform lives, reminding all of us of the extraordinary power of compassion, intentionality, and individualized care. Samantha Butler PhD Attending, Developmental and Clinical Psychologist Director, Inpatient Neurodevelopment, Cardiac Neurodevelopmental Program (CNP) Director, National NIDCAP Training Center Department of Psychiatry & Behavioral Sciences, Boston Children’s Hospital Associate Professor, Psychiatry (Psychology), Harvard Medical School, USA NIDCAP Federation International Board of Directors and Staff 2024 PRESIDENT Deborah Buehler, PhD NIDCAP Master Trainer APIB Trainer Director, West Coast NIDCAP and APIB Training Center email: nfipresident@nidcap.org CO-TREASURER Gloria McAnulty, PhD National NIDCAP Training Center email: gloria.mcanulty@childrens. harvard.edu CO-TREASURER Jennifer Hofherr, MS, OTR/L, CNT National NIDCAP Training Center NIDCAP Trainer Children's Hospital of University of Illinois NIDCAP Training Center email: jennifer.hofherr@nationwide childrens.org SECRETARY Jean Powlesland, RN, MS NIDCAP Trainer Director, Children’s Hospital of University of Illinois NIDCAP Training Center email: nidcapchicago@gmail.com Fatima Clemente, MD NIDCAP Trainer Co-Director, São João NIDCAP Training Center email: clemente.fatima@gmail.com Mandy Daly, Dip. H Diet and Nutrition, ACII, DLDU Family Representative, Dublin, Ireland email: mandy.daly@yahoo.co.uk Jennifer Degl, MS Family Representative, New York, USA email: jenniferdegl@gmail.com Monique Oude Reimer, RN NIDCAP Trainer Sophia NIDCAP & APIB Training Center Rotterdam, The Netherlands Charlotte Tscherning, MD, PhD Division Chief of Neonatology Oslo University Hospital, Norway email: charlottecasper66@gmail.com Juzer Tyebkhan, MBBS NIDCAP Trainer Director, Edmonton NIDCAP Training Centre email: juzer.tyebkhan@ albertahealthservices.ca Dorothy Vittner, PhD, RN, FAAN Senior NIDCAP Trainer West Coast NIDCAP & APIB Training Center email: dvitt8@gmail.com STAFF Sandra Kosta, BA Executive Director of Administration and Finance email: sandra.kosta@childrens. harvard.edu FOUNDER OF THE NIDCAP FEDERATION INTERNATIONAL, INC. Heidelise Als, PhD 1940-2022 NIDCAP Founder, Past President 2001-2012 Senior NIDCAP Master Trainer Senior APIB Master Trainer Director, National NIDCAP Training Center, 1982-2022