NICU Neurodevelopmental & High-Risk Infant Follow-up Clinic
The NICU Neurodevelopmental Clinic at Rady Children’s Hospital–San Diego provides ongoing evaluation and support for infants and young children who are at risk for developmental or neurological problems following neonatal intensive care. Our goal is to ensure early identification of potential challenges and to connect families with the resources they need for optimal growth and development.
The clinic sees children cared for in the NICUs at Rady Children’s and partner hospitals including Scripps Memorial Hospital La Jolla, Scripps Encinitas, Scripps Mercy (San Diego and Chula Vista), Palomar Medical Center, and Rancho Springs Medical Center. Most insurance plans cover clinic visits; if authorization is required, our team will coordinate with your pediatrician or insurance provider.
Who We See
Infants and young children who were born prematurely, had low birth weight, or experienced medical complications at birth may be referred for follow-up evaluation. California Children’s Services (CCS) requires all hospitals with Level III NICUs to provide neurodevelopmental follow-up for high-risk infants.
Infants may be eligible if they:
- Were born before 32 weeks’ gestation
- Had a birth weight of 1,500 grams or less
- Required oxygen for more than 28 days or were diagnosed with chronic lung disease
- Had cardiorespiratory depression, low Apgar score (≤ 3 at 5 minutes), or required pressor support
- Were treated with ECMO or inhaled nitric oxide
- Experienced seizure activity or documented brain injury
- Had other complications that could affect neurological development
What to Expect During a Visit
Visits typically occur around 6 months, 12–18 months, and after 2 years of age (using adjusted age for premature infants). Each appointment lasts approximately 2–3 hours and includes:
- A review of your child’s medical history since NICU discharge
- A developmental screening and physical examination by a nurse practitioner
- Assessment of neuromuscular function, growth, language, and social interaction
- Measurement of weight, height, and head circumference
- A discussion of results, recommendations, and referrals with your child’s care team
Results are reviewed by the medical director, and a detailed report is sent to your child’s primary care pediatrician. Families are encouraged to ask questions and discuss any developmental concerns.
Developmental Evaluations & Testing
Our team uses evidence-based developmental screening tools to assess each child’s progress, including:
- Bayley Scales of Infant and Toddler Development, 4th Edition – to identify risk for developmental delay
- Amiel-Tison Neuromuscular Exam – to assess muscle tone, reflexes, and range of motion
- REEL-3 – parent report measure for evaluating language skills
- M-CHAT – screening tool for autism spectrum disorder risk (ages 16–30 months)
Our Team
The clinic’s multidisciplinary team includes pediatric nurse practitioners, developmental specialists, and support staff dedicated to the care of high-risk infants.
- Brian Lane, M.D., Medical Director
- Elizabeth Valles, D.N.P., C.P.N.P.-PC, F.N.P.-C, C.C.R.N.
- Nataly Rodriguez, C.P.N.P., M.S.
- Martha Fuller, C.P.N.P.
- Haven Qualman, M.A., CCC-SLP, Manager
- Roxanne Farjadi, Administrative Coordinator
Referrals & Appointments
Referrals are typically initiated after NICU discharge. Parents may also request an appointment directly. The clinic can be reached at 858-966-8801. Children may be seen up to three times before age 3; additional follow-up is available through the Developmental Evaluation Clinic.
Frequently Asked Questions
What is the NICU Neurodevelopmental Clinic?
The clinic assists families with follow-up care for infants and young children who are at high risk for developmental and neurological problems following discharge from the neonatal intensive care unit.
We provide ongoing evaluation of growth and development, coordinate care with your infant’s pediatrician, and recommend referrals to specialty services and clinics when needed.
Why does the clinic exist?
California Children’s Services (CCS) is a state medical program created to treat children with physically handicapping conditions. CCS mandates that all hospitals with Level III NICUs provide a means to assess and follow their high-risk infants after discharge. We work closely with your pediatrician to ensure optimal screening, early identification, and follow-up referrals.
Who are the staff involved in the clinic?
- Brian Lane, M.D., Medical Director
- Elizabeth Valles, Certified Pediatric Nurse Practitioner
- Nataly Rodriguez, Certified Pediatric Nurse Practitioner
- Martha Fuller, Certified Pediatric Nurse Practitioner
- Maria Borquez, Administrative Coordinator
- Haven Qualman, M.A., CCC-SLP, BCS-S, Manager
What specific risk factors place an infant or child at risk for developmental and/or neurological problems?
CCS mandates follow-up for certain at-risk infants, including those who:
- Were born before 32 weeks of gestation
- Had a birth weight ≤ 1,500 grams
- Experienced cardiorespiratory depression at birth
- Had an Apgar score of 3 or lower at five minutes
- Had prolonged hypoxia, acidemia, hypoglycemia, or hypotension requiring pressor support
- Required medication (such as caffeine) for the treatment of apnea at discharge
- Required oxygen > 28 days and were diagnosed with chronic lung disease
- Were on ECMO
- Received inhaled nitric oxide
- Had or have documented seizure activity
- Had or have documented brain injury or intracranial pathology
- Had or have other conditions that could result in neurologic abnormalities
How many visits can my child receive?
Your infant or child can be seen up to three times in our clinic before the age of 3. For additional follow-up needs, your child can be seen at the Developmental Evaluation Clinic.
At what age is my child seen?
Infants are usually seen at about 6 months, 12–18 months, and one last visit after age 2 (using adjusted age if born prematurely).
How can my child be referred to the clinic?
After your child is discharged from the NICU, you can start the process by calling 858-966-8801. Your pediatrician may also refer your infant or young child to us.
What happens during a neurodevelopmental visit?
The visit takes approximately 2–3 hours. The child and family are seen by a nurse practitioner who gathers medical history, performs developmental and physical exams (including neuromuscular assessment), and reviews early language milestones. At the end of the visit, your child’s measurements are taken and results and recommendations are discussed.
What tests are used?
The Bayley Scales of Infant and Toddler Development, 4th Edition is used to identify risk for developmental delay.
- Amiel-Tison Neuromuscular Exam – evaluates muscle tone, range of motion, and reflexes
- REEL-3 – parent/guardian report to evaluate language skills (as needed)
- M-CHAT – screens toddlers (ages 16–30 months) for autism spectrum disorders
What happens after the visit?
Results are reviewed by the medical director, and a copy of the visit report—including recommendations and follow-up—is sent to your pediatrician.
Where will you refer my infant or child if there are concerns for delay?
We may recommend referrals to specialists, California Early Start, or Developmental Services at Rady Children’s or another provider. Your pediatrician will remain involved throughout the process.
Contact
NICU Neurodevelopmental & High-Risk Infant Follow-up Clinic
Rady Children’s Hospital–San Diego
Phone: 858-966-8801
Learn more about our Neonatology and NICU services