Since 2011 Vanderbilt University Medical Center has provided services for women with substance use disorder and their children. In 2021, to address the increasing toll the opioid crisis was having on pregnant and postpartum women and their infants, the Firefly Program was created to offer expanded, multidisciplinary outpatient clinical care spanning OB-GYN, pediatrics and psychiatry that includes neurodevelopmental monitoring of infants from birth to 12 months of age.
The Firefly Program was established after the Centers for Medicare & Medicaid Services, through the Maternal Opioid Misuse model in partnership with TennCare, provided funds for the services.
Originating from the success of the Firefly Program, a new initiative dedicated to infants and young children exposed to opioids in utero was started. SHINE (Support and Healing for Infants with Neonatal Exposures) offers neurodevelopmental care embedded within a medical home for infants and young children with neonatal opioid exposures.
“This program focuses on the prevention and early detection of developmental delays and differences, given that opioid exposure places these children at higher risk,” said Neill Broderick, PhD, Vanderbilt Kennedy Center (VKC)(TN IDDRC, UCEDD, LEND) researcher and assistant professor of Pediatrics at Monroe Carell Jr. Children’s Hospital at Vanderbilt. “We have learned, and studies support, that children with intrauterine exposure to opioids may experience differences in how their nervous system develops. These differences can manifest in many ways such as sensory integration differences, emotional and/or behavioral dysregulation and learning differences, among others.
“We want to ensure that families and children have the support they need to optimize developmental outcomes.”
SHINE is funded through a $2.3 million community grant from the Tennessee Opioid Abatement Council, which was created in 2021 to determine distribution of monies received from lawsuits related to the opioid crisis.
The three-year funding will allow Broderick and her team, working in collaboration with general pediatrics, pediatric rehabilitation (physical therapy, occupational therapy and speech therapy) and the Firefly Program, to ensure that patients are connected to the proper support and interventions.
“We want to help patients and caregivers build resiliency and early relational health,” Broderick said. “The more we can intervene, and the earlier we can do so, the more impact we can have on the brain’s early plasticity.”
For the past three years, Broderick has conducted developmental screenings during the first year of life for children enrolled in the Firefly Program. After hearing from caregivers of these infants, Broderick and her team determined that there was sufficient evidence for programming to optimize early developmental outcomes, and hopefully, readiness for school.
The SHINE program clinic, which is housed within Vanderbilt Children’s Primary Care One Hundred Oaks, supports children from birth to 6 years old.
There are multiple pathways to receive care. The SHINE program clinic will be embedded in the medical home for some patients. Neurodevelopmental care will be provided with well-child checkups for those patients. Neurodevelopmental consultation is also available for ongoing developmental monitoring as well as specific developmental concerns. The SHINE program clinic collaborates with the Firefly Program to streamline pediatric care with the mother’s care.
The SHINE program clinic is run by Broderick, who serves as the neurodevelopmental director, and Anna Morad, M.D., associate professor of Pediatrics and director of Newborn Nursery, who serves as the pediatric director. Additional support is offered by Amy Dishong, NP, Michelle McPherson (lactation consultant), Rosemary Richiez, LMSW, family care coordinator and Mary Ann Gill, the program manager.
To reach the program, call 615-875-7879.
