Intervening early and effectively: Sunnybrook redefines neonatal developmental care

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Sumaiya can’t believe how far her son has come. Born at 23 weeks of pregnancy and weighing only a pound, he was intubated in Sunnybrook’s neonatal intensive care unit (NICU) for four months. Today, her son is preparing to attend junior kindergarten, a milestone that once seemed out of reach.

“Sunnybrook’s Neonatal Follow-Up Clinic: his thriving is all down to them,” Sumaiya says, explaining that the team of occupational therapists, physical therapists, nurses, and neonatologist/developmental pediatricians have provided support since before his discharge from the hospital. “They got to know every aspect of his development, and truly walked alongside us, seeking to recognize my son’s potential.”

For over five decades, Sunnybrook’s Neonatal Follow-Up Clinic has been a leader in developmental care for infants born before 30 weeks’ gestation or those who experienced significant medical complications during their NICU stay. What makes the clinic especially unique is its leadership by a physician dually trained in neonatology and developmental pediatrics, an integrated subspecialty shared by only a handful of programs across the country.

This dual expertise bridges acute neonatal care with long-term developmental support, allowing for a model that is proactive, coordinated, and relationship-based. The clinic provides specialized consultation in physical, motor, and cognitive development and follows children through to nine years of age. This long-term support helps families navigate school transitions and engage early with educators to foster success in learning environments.

Sunnybrook’s team brings nationally recognized expertise in the early identification of cerebral palsy. It has helped establish provincial benchmarks for screening, referral, and early intervention through the Canadian Neonatal Follow-Up Network. More recently, the clinic has incorporated the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T) into its routine assessments, along with other standardized tools, offering a timely and reliable way to identify early social communication differences and autism spectrum disorders, and to tailor supports accordingly.

Sumaiya recalls that many of her son’s early visits to the clinic centred on play. “An occupational therapist would sit with him, some toys, and gently observe and interact with him,” she explains.

Dr. Rudaina Banihani, neonatologist and developmental pediatrician, and director of the clinic, explains that this approach is both intentional and evidence-based. “The clinic has shifted toward targeted, play-based interventions during the first year of life,” she says. “We know that the most effective supports happen early, before concerns fully emerge. Through play, we’re laying the neural groundwork for communication, self-regulation, and relationships. Our occupational therapists coach caregivers to engage with their children with intention.”

These early sessions are more than developmental observation; they are collaborative moments where the care team partners with families to embed strategies into everyday routines such as feeding, dressing, diapering, and shared play.

“They really followed his cues, and went from there,” says Sumaiya, explaining that eventually he was diagnosed with autism spectrum disorder. “They have been there every step of the way, from practical tips for simple things like putting on his socks, to support for classroom interventions and liaising with my workplace when I required additional time off.”

Dr. Banihani emphasizes that the clinic’s mission is not only to “follow up,” but to “follow through”—building long-term, strengths-based partnerships with families and systems, and holding steady to the belief that every child has the capacity to thrive.

“It takes a village to raise a kid, and I got my village through Sunnybrook,” says Sumaiya.