Background: Exposure to the voice and language during the critical period of auditory development associated with the third trimester is thought to be an essential building block for language. Differences in the auditory experience associated with early life in the NICU may increase the risk of language delays for premature infants. NICU nurses are fundamental in the care of premature infants; how they use their voices may be important in understanding auditory experiences in the NICU. This study examined voice use behaviors of NICU nurses in the United States and their current knowledge of early auditory development. Method: An opt-in, online questionnaire. Results: Nurses reported using their voice more as the age of infants approached term gestation and speaking to infants was the most common type of voice use. Both infant and nurse factors influenced reported voice use decisions in the NICU. Nurses did not believe the NICU auditory environment to be sufficient to meet early auditory needs of premature infants but did believe that premature infants are exposed to adequate voice sounds. Conclusions: A gap in knowledge regarding the importance of early exposure to voice sounds may be a barrier to nurses using their voices to support early auditory development.

A significant component of care for infants with bronchopulmonary dysplasia (BPD) is providing an optimal environment for supporting neurodevelopment and growth. Interventions that support the behavioral and physiologic stability of this population may play an important role in improving overall outcomes. Contingent singing is a music intervention that allows the caregiver to tailor certain musical elements, such as rhythm and tempo, to match behavioral and physiologic cues and support the infant in achieving optimal stabilization. A randomized crossover design was used to study the effect of contingent singing on the behavioral state and physiologic measures compared to standard care practices in the neonatal intensive care unit (NICU). Data were collected on a sample of 37 infants diagnosed with BPD. There were no significant differences in the physiologic measures or behavioral states of infants in the contingent singing sessions compared to control sessions. Parents and staff reported favorable views of music therapy in the NICU, and there were no adverse responses from infants during contingent singing. Further research is needed to determine the effectiveness of this intervention on the physiologic stability of infants with BPD.