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  1. Pickler, Rita H. PhD
  2. McGrath, Jacqueline M. PhD
  3. Reyna, Barbara A. MS
  4. McCain, Nancy PhD
  5. Lewis, Mary BS
  6. Cone, Sharon MS
  7. Wetzel, Paul PhD
  8. Best, Al PhD


The purpose of this article is to introduce a model of neurodevelopmental risk and protection that may explain some of the relationships among biobehavioral risks, environmental risks, and caregiving behaviors that potentially contribute to neurobehavioral and cognitive outcomes. Infants born before 30 weeks of gestation have the poorest developmental prognosis of all infants. These infants have lengthy hospitalization periods in the neonatal intensive care unit (NICU,) an environment that is not always supportive of brain development and long-term developmental needs. The model supports the premise that interventions focused on neuroprotection during the neonatal period have the potential to positively affect long-term developmental outcomes for vulnerable very preterm infants. Finding ways to better understand the complex relationships among NICU-based interventions and long-term outcomes are important to guiding caregiving practices in the NICU.