Heidelise Als, PhD
|Hospital Title||Director, Neurobehavioral Infant and Child Studies|
|Academic Title||Associate Professor of Psychiatry (Psychology)|
320 Longwood Avenue
Boston MA 02115
Dr. Heidelise Als is a researcher and clinician who has focused her life research on the behavioral organization of the newborn infant, especially the preterm and high risk infant. From neurobehavioral and neurophysiological studies performed by our group and others, it is clear that the preterm infant at school age emerges as significantly more at risk for attention deficit disorder, lower IQ, difficulties in social-emotional functioning and self-regulation, and increased need for specialized school services. These differences may be attributable at least in part to the difference in sensory experience of the immature nervous system when cared for outside the uterus before term. The hypothesis that we have derived from these findings is that environmental input may lead to altered pathway development due to unexpected and overwhelming sensory experience, which in turn may lead to deviant developmental functioning, especially of cortical association areas. Dr. Als is the author of the APIB (Assessment of Preterm Infants' Behavior) and the originator of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), an individualized, behaviorally-based developmental care model which is changing Newborn Intensive Care Units (NICUs) around the world. These neurobehavioral assessment methodologies were developed to address the issues of differentiation and modulation of functioning seen as indices for the study of neuro- organizational differences and disturbances. Additionally, NIDCAP and APIB were developed for the education and training of staff and the support of parents in reading the infant's behavioral cues in order to implement all care collaboratively with the infant. Study results are consistent and demonstrate improved lung function, feeding behavior and growth; reduced length of hospitalization, improved neurodevelopmental function, along with improved brain structure and function for the infants who received individualized developmental care, as compared to the control groups who received the respective NICU's current best practice. Dr. Als is the founder of NIDCAP Federation International (NFI), a professional membership organization.
The aims of Dr. Als and her colleagues' research is firstly to assess the immature nervous system's readiness for sensory input and to document the infant's current active behavioral efforts towards developmental differentiation and thresholds to disorganization. Secondly, they aim to modify the environment and caregiving in keeping with an individual infant's current thresholds to disorganization. Thirdly, they aim to test the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), a behaviorally-based approach, in long-term follow-up studies throughout infancy, childhood, and adolescence. Dr. Als has received over 15 grant awards from the U.S. Department of Education and the National Institute of Health for her research and authored over 60 articles and chapters.
About Heidelise Als
Heidelise Als received an MS in Education from the Graduate School of Education, University of Pennsylvania and a PhD in Human Learning and Development from the Graduate School of Arts & Sciences, University of Pennsylvania. Her postgraduate training took place at the Child Development Unit at Children's Hospital Boston. Dr. Als is a developmental, educational, and licensed clinical psychologist with over 30 years of experience in undertaking and managing major research efforts involving high risk and preterm infants and families in medical settings, and in longitudinal follow-up. She furthermore holds a research associate appointment in Newborn Medicine at the Brigham and Women's Hospital, Boston, and an adjunct pediatric psychology appointment at the Spaulding Rehabilitation Hospital in Boston. In 1987 she received the Award of Excellence of the Boston Institute for the Development of Infants and Parents, in 1988 the Senator D'Amico Award of the Massachusetts Early Intervention Consortium, and in 1995 CINN-Elekta Decade of the Brain Award. She is the founder and President of the NIDCAP Federation International, a non-profit organization which provides national and international training for advanced professionals in the field of NICU developmental care implementation.
- Als H: Towards a synactive theory of development: Promise for the assessment of infant individuality. Infant Mental Health Journal, Winter 1982; 3(4):229-243.
- Als H, Lester BM, Tronick E, Brazelton TB: Manual for the assessment of preterm infants' behavior (APIB). In Fitzgerald HE, Lester BM, Yogman MW (eds). Theory and Research in Behavioral Pediatrics, Vol. 1. New York: Plenum Press, 1982: 65-132.
- Als H, Duffy FH, McAnulty G: Behavioral differences between preterm and fullterm newborns as measured with the APIB system scores: I. Infant Behavior Development, 1988; 11:305-318.
- Als H, Duffy FH, McAnulty G: The APIB, an assessment of functional competence in preterm and fullterm newborns regardless of gestational age at birth: II. Infant Behavior Development, 1988; 11:319-331.
- Als H, Lawhon G, Duffy FH, McAnulty GB, Gibes-Grossman R, Blickman JG: Individualized developmental care for the very low birthweight infant: Medical and neurofunctional effects, Journal of the American Medical Association, 1994; 272: 853-858.
- Als H, Gilkerson L, Duffy FH, McAnulty GB, Buehler DM, VandenBerg K, Sweet N, Sell E, Parad RB, Ringer SA, Butler SC, Blickman JG, Jones KJ. A three-center randomized controlled trial of individualized developmental care for very low-birth-weight preterm infants: Medical, neurodevelopmental, parent and care giving effects. J Dev Behav Pediatr, 2003;24:399-408.
- Als H, Duffy FH, McAnulty GB, Rivkin MJ, Vajapeyam S, Mulkern RV, Warfield S, Huppi P, Butler S, Conneman N, Fischer C, Eichenwald E. Early experience alters brain function and structure. Pediatrics, 2004;113:846-857.
- Als H., Butler S., Kosta S., & McAnulty G. The assessment of preterm infants' behavior (APIB): Furthering the understanding and measurement of neurodevelopmental competence in preterm and fullterm infants. Mental Retardation & Developmental Disabilities Research Reviews, 2005;11(1): 94-102.