LIVE Webinar: Baby Beats and Breaths: Therapeutic Interventions for the Premature Infant with Cardiopulmonary Compromise

Holly Schifsky, OTR/L, CNT, NTMTC, CBIS

LIVE Webinar
Monday, June 28, 2021
Tuesday, June 29, 2021
8:00 am – 5:00 pm EST

*Must attend both parts*

Cost: $369.00

This intermediate-advanced course will focus on the cardiopulmonary implications for the premature or medically-complex infant as related to physiological stability, evolving motor control, sensory stability, and transition to oral motor skills that support feeding.  It will focus on advancing the critical reasoning skills of the neonatal therapist to support the infant’s ability to obtain foundational motor and sensory skills. These skills include the ability of the infant to cough, produce audible phonation, oral motor skills, swallow skills, trunk facilitation, gestational age appropriate positioning/handling to support the emergence of gross motor skills for postural stability.  You will learn movement analysis skills (via lab time and video presentations) to assess breathing patterns, facilitation techniques to support trunk development, positioning strategies to support chest wall development, and feeding techniques to maximize postural control.  We will discuss current literature as relevant to this topic and apply a systems theory approach for case study treatment planning.


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Learning Objectives
Participants completing this course will be able to:

  • Discuss anatomical and kinesiological developmental changes for the newborn chest wall
  • Discuss affects of prematurity and cardiopulmonary co-morbidities on chest wall development
  • Integrate chest wall movement assessment and treatment strategies to maximize infant outcomes
  • Understand developmental positioning and handling interventions to reduce chest wall deformities
  • Assess the affects of invasive and non-invasive pulmonary support to the facial and oral structures as related to non-nutritive sucking and oral feeding progression
  • Incorporate postural support with positioning and handling of infants for improved chest wall mobility during oral feeding
  • Integrate a systems approach to individualized care plan for the infant with cardiopulmonary compromise

Target Audience

PTs, PTAs, OTs, OTAs, and SLPs, working with infants in the Neonatal Intensive Care Unit

Course Level 

Intermediate to Advanced


Holly Schifsky, OTR/L, CNT, NTMTC, CBIS  

Holly Schifsky, OTR/L, CNT, NTMTC, CBIS is an Occupational Therapist who has worked in pediatrics for the past 25 years with the past 15 years in a level IV NICU. She is a Certified Neonatal Therapist, Certified Neonatal Touch and Massage Therapist, Certified Brain Injury therapist, an active member of National Association of Neonatal Therapists, and has completed 6-month mentorship in infant/child NDT. She has worked within the NICU and NICU follow-up clinic to maximize patient and family outcomes for the most complex premature and medically-fragile term infants. Holly received her bachelor’s degree in occupational therapy from the University of North Dakota in 1997. She has dedicated her career to clinical care and advancing developmental care practice patterns for all multidisciplinary team members. She has presented at many regional and national conferences including National Association of Neonatal Therapists, Combined Sections Meeting for APTA, Audrey Harris Vision NICU conference, and the University of Minnesota NICU conference. She provides frequent Developmental Care, Feeding Intervention, and NICU education throughout the country. She is a faculty member for the Neonatal Touch and Massage certification. She is the recipient of the National Association of Neonatal Therapists Clinical Excellence award in 2018, due to her clinical expertise and dedication to advancing the therapeutic interventions for NICU infants with cardiopulmonary conditions.

Holly receives a speaking fee for her presentation. She has no relevant non-financial relationships to disclose.


LIVE Webinar
8:00 am – 5:00 pm  EST

Day 1
Monday, June 28, 2021

8:00-9:00am – Typical Development of the infant chest wall

  • Review of anatomy and kinesiology of the chest wall, ribcage, and spine
  • Discussion of the developmental changes to the anatomical shape and function of these structures as related to gross motor development, postural control, feeding, and maturation

9:00-10:00am:   Cardiopulmonary system of the premature or critically-ill term infant: anatomical differences, congenital heart defects, and vascularization.  A therapists guide for critical reasoning.

  • Review of cardiopulmonary system and the unique changes required for the infant to have a successful in-utero to extra-utero transition
  • Common congenital heart defects and effects on infant development
  • Discussion of post-surgical cardiac repair on the developing chest wall

10:00-10:15am – Break

10:15-12:00 – Critical reasoning to assess breathing patterns for the premature infant, effects of pulmonary co-morbidities, and chest wall development.

  • Premature infant anatomy, risk for pulmonary dysfunction
  • Common pulmonary co-morbidities
  • Types of pulmonary support: ventilator settings, non-invasive support

12:00-12:45pm – Lunch

12:45-3:00pm – Assessment of breathing with movement analysis

  • Components of adaptive and maladaptive breathing patterns
  • Use of video presentation to analyze and assess breathing patterns for infants in the NICU

3:00-3:15pm – Break

3:15-4:30pm – Positioning and Handling of the 22-32 week premature infant with focus on chest wall development

Day 2
Tuesday, June 29, 2021

8:00am-9:00am – Lecture and Lab:  Musculoskeletal positioning/handling for the 32 week infant and older

  • Facilitated pelvic tuck
  • Abdominal activation
  • Transition away from developmental positioning devices and back to sleep

9:00am-10:30am – Lecture and Lab:  Musculoskeletal assessment and facilitation for infants 32 weeks and older

  • Spinal assessment for maladaptive breathing
  • Scapular and pelvic assessment and movement facilitation

10:30-10:45am – Break

10:45-12:00pm – Lecture and Lab:  ADL’s with consideration for the cardiopulmonary system

  • Diapering
  • Swaddling
  • Active prone for transition to Tummy Time
  • Oral motor development for pre-feeding skills

12:00-12:45pm – Lunch

12:45-2:00pm –  Lecture and Lab:  Feeding Interventions

  • Anatomical oral/facial assessment post invasive pulmonary support
  • Postural support
  • Auditory assessment
  • Motor behaviors

2:00-3:00pm – Infants with tracheostomy tubes

  • Affects on postural control development
  • Modification to therapeutic interventions

3:00-3:15pm – Break

3:15-4:00pm – Advancing critical reasoning using a systems approach:  consideration of scars, fascia limitations, edema, reflux (GERD)

4:00-4:30pm – Case Study:  group discussion and collaboration

4:30pm-5:00pm – Course evaluation, questions, contact information, resources



Educational Credits

15.5 contact hours

Approved for 15.5 contact hours by NYSED’s State Board for PT.

Application has been made to NJBPTE for CE credit approval.

color web&pptTSI is an AOTA Approved Provider of continuing education. AOTA does not endorse specific course content, products, or clinical procedures. Approved by AOTA for 1.55 CEUs. 15.5 contact hours, Intermediate Level, Domain of OT: Client Factors.

ASHAlogo.short This course is offered for 1.55 ASHA CEUs (Intermediate level, Professional area).