Neonatal Growth and Development Clinic

What is the Columbia Neonatal Growth and Development (GraD) Clinic?

Infants born early or with a critical illness are at risk of developmental delays, such as motor delays, speech delays, or cognitive delays. The team at the Columbia Neonatal GraD Clinic performs specialized developmental tests to evaluate infants after discharge from the hospital, and provides families with resources and individualized care they may need from infancy into childhood. Our team includes a pediatric nurse practitioner, neonatologists (doctors that specialize in the care of infants), a developmental-behavioral pediatrician, a pediatric psychologist, and a physical therapist. We work with families through each step of the assessment and testing process.

What key services does the Columbia Neonatal GraD Clinic provide?

Our goal is to identify any developmental delays as early as possible. Research shows that intervening early on developmental delays improves children’s long-term outcomes. Early identification of delays also enables our team to ensure that your baby has access to the care and support they need.

Who qualifies for the Columbia Neonatal GraD Clinic?

Infants who qualify for the GraD Clinic include those:

  • born at 28 weeks or less
  • born at less than 32 weeks and less than 1,250 grams
  • born with seizures, strokes, or parenchymal hemorrhage
  • who sustained a brain injury before or during birth and who required cooling
  • born with congenital diaphragmatic hernia (CDH)
  • with tracheostomies (Trach)
  • who required extracorporeal membranous oxygenation (ECMO)
  • diagnosed with meningitis or encephalitis
  • born with hypoplastic left heart syndrome
  • with a single ventricle diagnosis

What can I expect during a GraD Clinic appointment?

A GraD Clinic appointment is longer than a typical doctor's appointment, and you may see more than one provider during a visit. Members of our team will evaluate your baby using standardized developmental tests. We strive to make the experience engaging for your child, and it may look like we are playing with your baby as we perform these tests, but these “games” help us understand how your child is processing and interacting with the world around them. We will discuss the results with you and refer to your child to any therapies or specialists if needed.

How often will my baby go to the GraD Clinic?

Your baby will have appointments periodically until they are about 30 months (about two and a half years) of age. Infants born prematurely will be evaluated based on their adjusted age (see below) until they are 24 months (about 2 years). After 24 months, your toddler will be evaluated based on his or her chronological or actual age. Toddlers typically “graduate” from the GraD Clinic at the 30-month visit. We may choose to continue follow-up for some children if there are ongoing concerns that require close monitoring.

What does ‘adjusted age’ mean?

Infants born prematurely spend time growing and developing in the NICU instead of in the womb.  Because of this we use their adjusted age to determine if a premature infant is on track for meeting developmental milestones. To determine adjusted age: Your baby’s chronological age minus how many months early they were born. For example, a 12-month-old who was three months early would have an adjusted age of nine months. If this baby is meeting the nine-month-old milestones, he would be on track for his development. Adjusted age is used to assess premature infants until their second birthday.

How is the GraD Clinic different than my baby’s pediatric primary care provider?

Your baby’s pediatric primary care provider is an important member of the care team. The GraD Clinic does not take the place of your baby’s pediatric primary care provider. Your baby still needs to attend all their pediatric primary care appointments. However, the GraD Clinic does perform more in-depth developmental tests than pediatric primary care providers and will assist you in getting connected with therapies or other resources as needed. At the end of each visit, you will receive a report that can be shared with your primary care provider and any other members of your baby’s care team, such as early intervention therapists.

How should I prepare for my baby’s GraD Clinic appointment?

We typically spend over an hour with you and interacting with your baby, so it is important that your baby or toddler arrives ready to show off their developmental skills! You can help your child have an accurate assessment by:

  • scheduling the appointment before or after nap time (not during nap time)
  • feeding your child before they arrive
  • bringing snacks
  • making sure they are dressed for playing.

For twin appointments, it is important to bring along another adult. This will enable us to evaluate one baby at a time. If your child is sick, please do not come in! It is difficult to get an accurate assessment if your child is not feeling well. Please contact us and we will do our best to reschedule you as soon as possible.

Where is the Columbia Neonatal GraD Clinic located?

We are located at New York-Presbyterian Morgan Stanley Children’s Hospital at:

  • 3959 Broadway, on the corner of 165th and Broadway
  • 11th floor North, Room 1138 (access via “Central Elevators”)

(Please ignore any automated messages or signs you see directing you to the 6th floor; this is our old location.)

When you arrive at the main entrance to the Children’s Hospital, ask for the central elevators. Take the central elevators to the eleventh floor. Look for signs pointing to room 1138, where you will check-in for your appointment.

If you drive to your appointment, you can use the the valet parking at the corner of Broadway and 165th St. (NewYork-Presbyterian Morgan Stanley Children’s Hospital). There is an hourly charge for valet parking. Please note that street parking is very limited in the area around the hospital, so plan to arrive early if you intend to look for parking on the street.

How do I contact Columbia Neonatal GraD Clinic?

Please contact us with any questions or to reschedule your appointment. You can contact us through phone, email, or MyChart message. It is important to let us know if you will not be able to make your appointment. We will try to reschedule the appointment as close to the original date as possible. This also allows us to schedule a new patient in that appointment slot.

Anketil Abreu, Clinic Coordinator
phone: 212-305-6350
email: aa2091@cumc.columbia.edu