Adele Luxa was the first pediatric occupational therapist (OT) of the nearly 50 OTs now at Johns Hopkins All Children’s to join the hospital. That was back in December 1987. Fast forward to 2017 and she marked another first—as one of the first acute care rehab specialists in the state of Florida to achieve a new national certification and earn the credentials of Certified Neonatal Therapist, or CNT.
Luxa came to what was then All Children’s Hospital from Children’s Hospital of Michigan. “They had advertised for a physical therapist, but I was able to make a strong case for the importance of occupational therapy and was hired as an OT,” she explains. Now there are 48 OTs across the Johns Hopkins All Children’s health system. Luxa has focused on inpatient care for almost 20 years and is one of four OTs on the acute care rehab team, working exclusively with hospitalized patients.
Though she has always worked with neonatal intensive care unit (NICU) patients, in recent years these babies have been her main focus.
The emergence of neonatal therapy as a specialty reflects the progress that has been made in saving premature and critically ill babies. She’d always had a strong interest in these tiny patients, but OT was not a regular part of NICU care during the early part of Luxa’s career. “Years ago many of our NICU patients were not nearly as premature or as sick,” she explains.
As the NICU began to treat many medically complex and extremely premature babies, developmental care became part of the unit’s comprehensive approach. “It’s been a blessing to work with these patients and their families,” Luxa says. She works with the smallest babies and medically fragile infants, helping parents become comfortable with kangaroo care and how to hold their baby, teaching infant massage, and showing families how to avoid overstimulating their newborn. She makes an effort to help parents see their baby’s potential and progress, focusing on a baby’s strengths during what can be a tense and fearful time.
“Neurodevelopmental care is our standard of care,” she says, noting that Dr. Prabhu Parimi, director of the Johns Hopkins All Children’s Maternal, Fetal & Neonatal Care Institute, is very committed to this approach.
Luxa develops individualized care plans for her patients—“microtherapy for micropreemies.” She gets to know the baby’s family, teaches helpful techniques and prepares a detailed plan of assignments, helping parents know what to focus on as they get ready to take their baby home from the hospital. She’s happy when she is able to see her patients’ progress; she is on-call to see patients at the NICU Follow-up Clinic and sometimes even stops by the outpatient OT department.
Neonatal therapy is a relatively new approach to providing developmental and rehab services to medically complex infants in the NICU. The first certification exam was given in winter 2017, and Luxa was one of four therapists in the state of Florida to earn the certification. She will be an invited speaker at the 2018 National Association of Neonatal Therapists.
She’s glad that the critical role of the rehab therapist in improving outcomes for NICU patients has been formally recognized through this national certification. Most of all, she is glad to be able to make a big difference for her tiny patients.