Record of Shared Care Name Birthdate Level II Level III Comments/ Concerns Neonatal Follow-Up Program Recommended Visit Schedule Center Center Coaching and Visit Timing Goals Intervention Goals (Approximate date) (Circle areas of concern) Coaching: 4 – 8 weeks Attachment Signs and symptoms Regulation (feeding, sleeping) of depression and Positioning (safety and beginning help available of intervention) Safe sleep Maternal/family health Normalizing infant’s wellbeing/depression/anxiety need for external and link to primary care if support for regulation needed Developmental cues for feeding 4 months Coaching: Attachment Gross Motor Development as a Motor strategies reflection of overall development with the main goal being identification of early concern (vision, hearing, cognition, motor) Introduce concept of coaching Provide feedback to parents re: feeding, motor development 8 months Change from stationary to Coaching: dynamic movement as a marker Movement as it for overall development (gross relates to and fine motor development) temperament Assessment and Transition postures coaching, not diagnosis Mealtime strategies Feeding to eating – shift to Sleep hygiene becoming an independent eater
Record of Shared Care Name Birthdate Neonatal Follow-Up Program Recommended Visit Schedule Level II Center Level III Center Comments/ Concerns Visit Timing (Approximate date) Goals (Circle areas of concern) Coaching and Intervention Goals 4 – 8 weeks Attachment Regulation (feeding, sleeping) Positioning (safety and beginning of intervention) Maternal/family health wellbeing/depression/anxiety and link to primary care if needed Coaching: Signs and symptoms of depression and help available Safe sleep Normalizing infant’s need for external support for regulation Developmental cues for feeding 4 months Attachment Gross Motor Development as a reflection of overall development with the main goal being identification of early concern (vision, hearing, cognition, motor) Introduce concept of coaching Provide feedback to parents re: feeding, motor development Coaching: Motor strategies 8 months Change from stationary to dynamic movement as a marker for overall development (gross and fine motor development) Assessment and coaching, not diagnosis Feeding to eating – shift to becoming an independent eater Coaching: Movement as it relates to temperament Transition postures Mealtime strategies Sleep hygiene
4.-SharedCareForm_2018JAN22.docx