User:Pasitachida/PAL: Pacifier Activated Lullaby

PAL: Pacifier Activated Lullaby
PAL: Pacifier Activated Lullaby is a pacifier fitted with an adaptor housing a computer chip that activates a CD player outside the incubator. Developed in 2000 by Dr. Jayne M. Standley along with the Center for Muisc Research at Florida State University, the PAL is used during music therapy interventions in the Neonatal intensive-care unit to promote and reinforce non-nurtritive sucking (NNS) opportunities on premature infants. Dr. Standley found that infants could differentiate between silence and musical stimuli, which meant infants could be positevely reinforced with music when they sucked with enough endurance and strength.

The sensors in the PAL detect correct Non-Nurtritive Sucking characteristics and actiavte a CD player which reproduces lullabies through small speakers placed binaurally in the incubator above the infant´s head.

Music Protocol
Lullabies are selected for this intervention by credentialed music therapists following a basic criteria:
 * no changes in tempo
 * no changes in volume level (65db scale C)
 * no key changes
 * higher vocal ranges (mainly female vocals)
 * the native language of the infant to promote language input opportunities

The music is sustained for 10 seconds after recieving the first suck and it fades out if it is not reactivated by another one, therefore making the presentation of musical stimuli contingent on the sucking behavior of the infant. provisions are made in the protocol to discontinue the intervention if signs of infant distress are observed.

Results
Studies have shown that contingent music, such as pacifier activated lullabies, increased pacifier sucking rate of premature infants more than 2.5 times (standley 2000) and that they have also increased subsequent feeding rates Recent reasearch obvserved that a PAL intervention can significantly shorten gavage feeding days and reduced lenght of hospitalization for premature infants when used at the specific gestation age of 34 weeks. some criteria for referral are:


 * Infant has been determined to tolerate two simultaneous modes of stimulation.
 * Infant has no severe abnormalities that affect ability to suck/feed or to learn.
 * Infant has no indication of infection requiring quarantine.