Date of Submission

2026

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Jessica Glass Kendorski, PhD, NCSP, BCBA-D

First Advisor

Katy Tresco, PhD

Second Advisor

Virginia Salzer, PhD

Third Advisor

Brigid Garvin, PhD, NCSP, BCBA

Abstract

Preterm infants are at elevated risk for developmental delays across cognitive, language, and motor domains, yet factors associated with engagement in NICU follow-up care remain poorly understood, particularly in diverse, urban populations. This study examined developmental outcomes at initial NICU follow-up and explored factors associated with follow-up completion among high-risk preterm infants. Participants included 174 infants enrolled in a hospital-based NICU follow-up program who completed an initial developmental screening using the Bayley Scales of Infant and Toddler Development, Fourth Edition Screener (Bayley-4 Screener). A subset of 58 infants completed a second screening visit. Binary logistic regression was used to examine perinatal, individual, and psychosocial/environmental predictors of follow-up completion.

At the initial visit, the majority of infants were classified as Borderline or High Risk across all five developmental domains, with receptive communication emerging as the area of greatest concern. Among completers, paired-samples t-tests indicated statistically significant increases in raw scores from Visit 1 to Visit 2 across all domains, with effect sizes ranging from small (receptive communication, d = -0.35) to large (gross motor, d = -1.64). Logistic regression analyses indicated that perinatal risk factors were the strongest predictors of follow-up completion. Specifically, lower Apgar scores at 5 minutes and classification as small for gestational age were significantly associated with return for a second visit. Psychosocial and environmental factors did not significantly predict follow-up completion.

These findings underscore the high developmental vulnerability of preterm infants at initial NICU follow-up and suggest that medical severity at birth is a key driver of continued engagement in follow-up care. Results highlight the importance of early developmental monitoring and support targeted outreach to families of medically complex infants to promote sustained follow-up participation.

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