The High-Risk Infant Follow-Up (HRIF) program at UC San Diego Health provides special examinations for infants and toddlers whose condition puts them at increased risk for neurological problems or developmental delays.
The goal is to provide early diagnosis and treatment, which may prevent or reduce long-term problems associated with prematurity and serious newborn illness, and/or concerns related to not meeting appropriate developmental milestones (such as cognition, fine and gross motor skills, and speech and language).
At each two-hour visit, a pediatric nurse practitioner or pediatrician will give the child a physical exam, neurological exam and a developmental assessment. These evaluations, which are in addition to routine pediatric care with the primary care provider, include:
- Standardized tests to evaluate your child's development
- Observation of how your child plays with toys and interacts
- Assessment of your child’s motor skills, mental skills and language development
- Examination of their muscle strength and reflexes
Parents will have ample time to ask questions at each visit. The evaluation results are discussed with you and may be sent to your child’s primary care provider and other community service providers.
We work with families to ensure children receive any needed services to help them achieve their maximum potential. This may include referrals or recommendations for physical, occupational and speech therapy, psychological testing services, nursing care, parenting education, California's Early Start program or other services.
Children are usually seen every six months for their first two to three years.
Candidates for referral to the HRIF program include patients who:
- Are born premature (less than 34 weeks' gestation)
- Have a birth weight less than or equal to 1,500 grams
- Had intra-uterine exposure to alcohol, marijuana, methamphetamine, cocaine, opiates, or certain prescription medications known to have potential risks (such as psychotropic and anti-seizure medications)
- Were exposed to any agent that might cause a birth defect
- Were exposed to the Zika virus
- Have congenital anomalies or genetic disorders that might affect developmental outcomes
- Had failure to thrive
- Have not met developmental milestones (speech and language, motor skills, cognitive skills, social skills)
- Are in a high-risk social situation (parent with a developmental disability, teen parent, current or history of foster care placement, domestic violence)
A provider or parent/caregiver can refer a child if they have a concern regarding the child's development.
Neonatologists, pediatricians, specialists, or other community providers (Early Start, therapists, public health nurses, etc.) can submit a referral for any child whose condition may increase their risk for neurological problems or developmental delays.
Many insurance plans cover the cost of this appointment, but check with your health plan to make sure. We work with
many insurance plans and are members of several medical groups.