Today's medical advances in technology are making it possible to safely deliver and medically manage many infants born prematurely. These premature infants now comprise a large percentage of the children followed by early intervention programs. Most of these infants are referred to early intervention programs prior to their discharge from the Neonatal Intensive Care Units (NICU's). Though the hospital NICU's work closely with the families to prepare them for their child's discharge home, many families report feeling overwhelmed by the prospect of caring for this tiny infant without the support of the medical staff that they have come to trust. Early intervention programs can play an important role in assisting these families to feel comfortable in caring for, and interacting with their child. Children born prematurely, particularly under 32 weeks gestation, are at risk for a variety of developmental problems. One problem common to many premature infants is a difficulty coping with the stimulation of their environment. Because their nervous systems are still immature, they can become easily stressed, disorganized by the activity in their environment. Once stressed, these infants may become difficult to calm. Though full term infants may startle easily or show signs of stress as well, unlike the preemie, they have more effective strategies for calming themselves (i.e., bringing a hand to their mouth, bringing arms to chest, etc.)

When infants are easily stressed and difficult to calm, it can impact their ability to learn because they are unable to obtain and sustain an active alert state. It can also affect the development of the parent-infant relationship. Parents may become discouraged or frustrated when they are unable to calm their child, or when the child is not alert and responsive to their interactions. The early intervention professional can assist the family, to help the infant attain a calm alert state for social interaction and learning. It is important to recognize that since an infant is unable to speak he/she attempts to communicate through his or her behaviors. We In turn, El professionals must consider, respect and value parental input. They must communicate frankly and in a manner easily understood so families are able to make informed decisions about their child's program.