Purposeful Language Exposure by Neonatal Nurses and Caregivers in the NICU.

Background: Preterm infants are at significant risk of neurocognitive deficits including language delay. Extended hospitalization in the neonatal intensive care unit (NICU) causes missed opportunities for language exposure at critical developmental periods of neural pathways for language processing. Healthcare providers (HCPs), particularly nurses, may be instrumental in providing infant-directed speech to improve neurodevelopmental outcomes.

Purpose: To evaluate current evidence to determine what is known about the characteristics of HCP communication to infants in the NICU.

Search/strategy: Four databases and forward searching were used to respond to the clinical question: "What is known about the characteristics of HCP communication to infants in the NICU?" Empiric, primary research studies published in English without date restriction were included.

Findings: Eight studies, primarily descriptive, were reviewed. Overall, infant-directed speech was rarely provided by HCPs. Language was more often directed to sicker infants, occurred in contexts of procedural pain, and was sometimes combined with touch. Perceptions of language by nurses, infants, and parents as well as inhibitors and benefits of infant-directed speech were reported.

Implications for practice: As frontline neonatal providers, nurses can serve as role models of infant-directed speech for parents, helping them gain comfort and understand the importance of speaking to their preterm infants. Nurses can also provide much-needed language nutrition to preterm infants when parents cannot be present.

Implications for research: Methods to reduce barriers and support infant-directed speech in the NICU require testing. Predictive modeling using measures of language exposure in the NICU may support differences in neurodevelopmental outcomes.