Dr. Bigsby's research focuses on the actions and facial expressions used by infants to signal their wants and needs to caregivers, and the relation between these behaviors and regulation of physiologic functions such as heart-rate and oxygen saturation. Other research interests include developmental interventions and outcomes for preterm infants in the NICU, feeding issues of early infancy, and the relation between early motor development and maternal life style.

Research involvement and publications reflect a long-standing interest in motor behavior of premature and other high-risk infants, particularly with regard to development of self-regulatory and feeding competencies and positive interaction with caregivers. An initial study of the presence of the aymmetrical tonic neck reflex, the attributes of stimulus objects and related patterns of reaching among preterm and full-term infants formed the foundation for a dynamical systems approach to development which could be woven into her clinical approach to infants at risk. For her doctoral dissertation work, Dr. Bigsby further explored dynamical processes by investigating the relation between motor behaviors and physiologic regulation among previously sick preterm and healthy term infants at 3 months corrected age. This work was continued within the clinical context of the neonatal intensive care unit (NICU) as a pilot project studying these same motor behaviors in the sick preterm population, and their relation to physiologic stability and positioning practices, through coding of videotaped observations of the infants before, during and after nursing care.

She has coauthored a textbook on NICU interventions (Developmental and Therapeutic Interventions in the NICU - Brookes Publishing) and is coauthor of a tool for assessment of fine and gross motor development of high risk infants during the first year of life (Posture and Fine Motor Assessment of Infants (PFMAI) – Psychological Corp/Pearson), which involved Rasch analysis for scaling of items and forming criterion for norm referencing. She has acted as a consultant and trainer for the infant motor assessments used in the multi-site NIH funded "Maternal Lifestyles Study", including the PFMAI and the Peabody Scales of Motor Development, to demonstrate subtle differences between infants who have been exposed to illegal substances in-utero and those who have not. She also has participated in the development of clinical applications for the Neonatal Network Neurobehavioral Scale (NNNS). Dr. Bigsby has mentored graduate students in their study of preterm infant behavior, and the relation between infant sensory and feeding issues, and is currently working with a multi-disciplinary group of professionals in the NICU to develop an approach to initiating and progressing breast and bottle feeding in the NICU.

Currently, she is collaborating with other NICU professionals on a consensus panel, conducting systematic literature review and developing standards and competencies for developmental family-centered care of the newborn in the intensive care unit.  

Travel Award to attend Physical and Developmental Environment of the High-Risk Infant Conference, January 26-29, 2005; March of Dimes Birth Defects Foundation, Rhode Island Chapter.

Research Grant #399469, 1995-1996, $5000.00, Reliability and Validity of the Posture and Fine Motor Assessment of Infants, Parts I and II.  American Occupational Therapy Foundation, Co-Principal Investigator.

Research Grant #4680-105, 1992 - 1993, $1000.00;  Motor Behaviors as Cues to Cardiorespiratory Response in Preterm Infants.  American Occupational Therapy Foundation, Principal Investigator.

ORIGINAL PUBLICATIONS IN PEER-REVIEWED JOURNALS

1. Browne, J.V., Jaeger, C.B., Kenner, C., Aarvedson, J.C., Bigsby, R., Cicco, R., Hatfield, B., Hynan, M.T., Kolberg, K.J.S., McElroy, J., McGrath, J., Phillips, R., Ross, E., Salisbury, A., Smith, K., Sweeney, J.K.  (2020).  Executive Summary:  Standards, competencies, and recommended best practices for infant-and family-centered developmental care in the intensive care unit.  Journal of Perinatology, 40, 5-10.  https://doi.org/10.1038/s41372-020-0767-1.

2. Lester, B.M., Salisbury, A.L., Hawes, K., Danserau, L.M., Bigsby, R., Laptook, A., Taub, M., Lagasse, L.L., Vohr, B.R., Padbury, J.F. (2016). 18-Month follow-up of infants cared for in a single-family room neonatal intensive care unit. The Journal of Pediatrics, 177, 84-90.

3.  

   Single Family Room Neonatal Intensive Care Unit Improves Infant Medical and Neurobehavioral Outcome. Lester, B.M., Hawes, K. Abar, B., Sullivan, M., Miller, C., Bigsby, R., Laptook, A., Salisbury, A., Taub, B., Lagasse, L., Padbury, J. (2014). Pediatrics, 134, 4, 754-760.

4. Lester, B.M., Andreozzi-Fontaine, L, Tronick, E., Bigsby, R. (2014). Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale.  Journal of Visualized Experiments, 25, 90, e3368, doi:10.3791/3368.
5. Bigsby, R., LaGasse, L., Lester, B.M., Shankaran, S., Bada, H. Bauer, C. & Liu, J. (2011). Prenatal cocaine exposure and motor performance at 4 months. American Journal of Occupational Therapy, 65, 5, 60-68.
6. Lester, B. M., Miller, R. J., Hawes, K., Salisbury, A., Bigsby, R., Sullivan, M. C., Padbury, J. F.  (2011). Infant Neurobehavioral Development. Seminars in Perinatology, 35, 8-19.
7. Hwang, Y., Vergara, E., Lin, C., Coster, W.J., Bigsby, R., Tsai, W. (2010). Effect of prefeeding oral stimulation on feeding performance of preterm infants. Indian Journal of Pediatrics, 77, 8, 869-873.
8. Hwang, Y., Lin, C., Coster, W.J., Bigsby, R., Vergara, E. (2010). Effectiveness of cheek and jaw support to improve feeding performance of preterm infants. American Journal of Occupational Therapy, 64, 886-894.
9. Vergara, E., Anzalone, M; Bigsby, R;, Gorga, D.; Holloway, E.; Hunter, J.; Laadt, G.; Strzyzewski, S. (2006). Specialized knowledge and skills for occupational therapy practice in the neonatal intensive care unit. The American Journal of Occupational Therapy, 60, 6, 659-668.
10. Miller-Loncar, C., Lester, B. M., Seifer, R., Lagasse, L. L., Bauer, C. R., Shankaran, S., Bada, H. S., Wright, L. L., Smeriglio, V. L., Bigsby, R., & Liu, J. (2005). Predictors of motor development in children prenatally exposed to cocaine. Neurotoxicology and Teratology, 27, (2), 213- 220.
11. Miller-Loncar, C., Bigsby, R., High, P., Wallach, M, & Lester, B.M.  (2005). Infant colic and feeding difficulties. Archives of Disease in Childhood, 89, 908-912.
12. DeSantis, A., Coster, W., Bigsby, R., & Lester, B.M.  (2004). Colic and fussing in infancy, and sensory processing at 3 to 8 years of age. Infant Mental Health Journal, 25, (6), 522-539.
13. Boukydis CFZ, Bigsby R, Lester BM. (2004).  Clinical Use of the Neonatal Intensive Care Unit Network Neurobehavioral Scale. In: Lester, BM & Tronick, EZ (Eds), The Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS). Pediatrics, 113. (3), 679-689.
14. Grenier, I.R ., Bigsby, R., Vergara, E. R, & Lester, B. M.  (2003). Comparison of motor self-regulatory and stress behaviors of preterm infants across body positions. The American Journal of Occupational Therapy, 57, (3) 289-297.
15. Gorga, D., Anzalone, M., Holloway, E., Bigsby, R., Hunter, J., Strzyzewski, S., Vergara, E.  (2000). Specialized knowledge and skills for occupational therapy practice in the neonatal intensive care unit.The American Journal of Occupational Therapy, 54, (6), 641-648.
16. Lester, B. M., LaGasse, L. L., & Bigsby, R.  (1998). Prenatal cocaine exposure and child development: What do we know and what do we do? Seminars in Speech and Language, 19 (2), 123-146.
17. Case-Smith, J., Bigsby, R., & Clutter, J. (1998). Perceptual motor coupling in the development of grasp. American Journal of Occupational Therapy, 52 (2), 102-110.
18. Meyer, E. C., Lester, B. M., Boukydis, C. F. Z., & Bigsby, R. (1998). Family-based intervention with high-risk infants and their families. Journal of Clinical Psychology in Medical Settings; 5 (1),49-69.
19. Bigsby, R., Coster, W., Lester, B. M., Peucker, M. R. (1996). Motor behavioral cues of term and preterm infants at three months. Infant Behavior and Development, 19, 3, 295-307.
20. Bigsby, R. (1983). Reaching and asymmetrical tonic neck reflex in preterm and full-term infants. Physical and Occupational Therapy in Pediatrics, 3, (4), 25-42.   

 

OTHER PEER-REVIEWED PUBLICATIONS

1. Bigsby, R.  (2021).  Developmental care in the NICU:  New evidence-based standards, competencies, and recommendations.  OT Practice, American Occupational Therapy Association, 26, 5, 26-28.
2. Bigsby, R. & Lee, YJ.  (2010).  Neonatal screening and supportive interventions to promote neurobehavioral development.  Medicine & Health/Rhode Island, 93, 5, 139-141.
3. Bigsby, R.  (2007).  Book/media review:  Focus on the Brain:  A toolkit of evidence-based practices to support preterm development in the NICU.  Part 1:  The science of preterm infant development; Part 2:  Clinical practices for special care nurseries; No matter how small:  Parent’s guide to preterm infant behavior and development.  Vida Health Communications, Inc., Cambridge, MA, 2006.  Journal of Developmental & Behavioral Pediatrics, 28, 5, 429.
4. Lester, B. M., Bigsby, R., & Miller-Loncar, C.  (2004).  Infant massage:  So where’s the rub?  Social Policy Report of the Society for Research in Child Development, 18, 1, 8.
5. Bigsby, R.  (2002).  Book review:  The Preemie Parents' Companion, by Susan L. Madden, Boston, MA, The Harvard Common Press, 2000, 393 pp.  Journal of Developmental & Behavioral Pediatrics, 23, 1, 59-60. 
6. Bigsby, R.  (1994).  Motor behaviors as cues to cardiorespiratory reactivity in full-term and preterm infants at three months corrected age.  Dissertation.  Boston University.
7. Lester, B., Bigsby, R., High, P., & Wu, S.  (1995).  Principles of intervention for preterm infants in the NICU.  In Optimizing the Neonatal Intensive Care Environment:  Proceedings of the 10th Conference in Pediatrics, (pp. 59-72).  Canadian Paediatric Society.  Montreal:  Abbott Laboratories, Limited.
8. Bigsby, R.  (1992).  Motor behaviors as cues to physiological state in preterm infants:  Application of sensory integration theory to occupational therapy practice with neonates.  Monograph.  In Proceedings of Symposium '92:Current Topics in Sensory Integration, Torrance, CA:  Sensory Integration International.

 

BOOKS AND BOOK CHAPTERS

1. Bigsby, R.  (in press).  Occupational Therapy in the Neonatal Intensive Care Unit.  In J.O’Brien & H. Miller-Kuhaneck (Eds.).  Case-Smith’s Occupational Therapy for Children and Adolescents; 8^th Edition.  New York, NY: Elsevier.

2. Bigsby, R.   (in press).  Sensory integration applications with infants in neonatal intensive care and early intervention.  In A.C. Bundy, S.J. Lane, & S. Mulligan (Eds.).  Sensory Integration Theory and Practice; 3^rd Edition.  Philadelphia, PA:  F.A. Davis.

3. Bigsby, R.  (2010).  Fueling development by enhancing infant-caregiver relationships: Transformation in the developmental therapies.  In B.M. Lester, & J.Sparrow (Eds.)  Nurturing Children and Families: Building on the Legacy of T.Berry Brazelton.  (pp. 219-280).  Oxford, UK:  Wiley-Blackwell.

4. Bigsby, R., Boukydis CFZ, LaGasse, L.L., Lester BM.  (2004). Clinical Applications for the NNNS.  In: Lester, BM & Tronick, EZ (Eds), NICU Network Neurobehavioral Scale Manual. (pp. 85-182).  Baltimore:  Paul H. Brookes.
5. Vergara, E., & Bigsby, R.  (2004). Developmental and Therapeutic Interventions in the NICU.  Baltimore:  Paul H. Brookes.  (Second Printing, January 2007).
6. Bigsby, R.  (2003).  Overview of infant and child developmental models.  In, E. B. Crepeau, E. S. Cohn & B. A. B. Schell (Eds.) Willard and Spackman's Occupational Therapy (10th ed., pp. 243-245), Philadelphia: Lippincott Williams and Wilkins.
7. Case-Smith, J., & Bigsby, R.  (2001).   Motor assessment.  In L. T. Singer & P. S. Zeskind (Eds.), Biobehavioral Assessment of the Infant (pp. 423-442).  NY:  The Guilford Press.
8. Case-Smith, J., & Bigsby, R.  (2000).  Posture and Fine Motor Assessment of Infants.  San Antonio, TX:  Psychological Corporation/Harcourt Assessment Co..
9. Vohr, B. R., Cashore, W. J., Bigsby, R.  (1999).  Stresses and interventions in the neonatal intensive care unit.  In M. D. Levine, W. B. Carey, & A. C. Crocker (Eds).  Developmental-Behavioral Pediatrics, 3rd Edition (pp. 263-275).  Philadelphia:  W. B. Saunders Co.
10. Bigsby, R.  (1998).  Overview of infant and child developmental models.  In M. Neistadt, & E. Crepeau (Eds.)  Willard and Spackman’s Occupational Therapy, 9th Edition, (pp. 543-545).  Philadelphia:  J. B. Lippincott Co.

Inaugural Pioneer in Neonatal Therapy Award, 2015, National Association of Neonatal Therapists (NANT) for “contributing tirelessly to establish and advance the field of neonatal therapy.”

The AOTA Service Commendation, The American Occupational Therapy Association, 2007; for authorship of “Specialized knowledge and skills for occupational therapy practice in the neonatal intensive care unit.”

Roster of Fellows of The American Occupational Therapy Association (F.A.O.T.A.) For advancing occupational therapy with infants and children, June, 1993

Service Award, The American Occupational Therapy Association, 1992.

 

Invited Member, International Consensus Panel on NICU Developmental Care Practices, representing OT Profession, Annual Gravens Conference on the Physical and Developmental Environment of the High Risk Infant,  2013 to present.

Member, NICU Task Force, American Occupational Therapy Association, 1999 to present

Manuscript Reviewer, American Journal of Occupational Therapy, 1995 to present

Proposal Reviewer, AOTA National Conference 1988 to present

Resource Person in Sensory Integration, AOTA, Sensory Integration Special Interest Section, 1992 to present

Resource Person in Pediatrics, AOTA Practice Division, 1994 to present

Member, National Association of Neonatal Therapists, January, 2011 to present

Member, Infant Massage USA, 2004 to present

Resource Person, Infant Massage USA, January, 2011 to present

Advisory Board - OT Consultant, Infant Massage USA, May, 2012 to present

Member, Faculty Advisory Board, New England Institute of Technology Master of Science Program in Occupational Therapy, 2009 to 2013; Program for Occupational Therapy Assistants, 1996 to 2009.

Member, Advisory Board, Rhode Island Association for Infant Mental Health, 2004/2005       

Rhode Island Committee for Comprehensive System of Personnel Development for Early Intervention, Pre-service Education Committee, 1992 to 1999

Member, Professional Advisory Committee, Visiting Nurses Association, Inc., Providence, R.I., 1985 to 2001

Representative for State of Rhode Island on AOTA Representative Assembly, 1986-1992; Service Award, The American Occupational Therapy Association, April, 1992

Alternate Representative for RI, AOTA, 1985-1986

Chair, R.I. Pediatric Special Interest Section of AOTA, 1985-1988

Member, Executive Board, Rhode Island Occupational Therapy Association, 1985-1992

Board of Directors, Thumb Area Easter Seal Society, Port Huron, MI 1976-1978

UNIVERSITY TEACHING ROLES

Supervisor, Master-Level Occupational Therapy Students of Boston University, Springfield College, New England Intitute of Technology January, 2004 to present.

“Development of Human Performance Abilities”, OT 329/OT 529 4 credit undergraduate and entry level masters course; 30 students, Department of Occupational Therapy, Sargent College of Allied Health Professions, Boston University, Boston, MA, Fall, 1991.

“Neuroscience Applications for Rehabilitation”, OTS 293, 4 credit course for 11 post-professional graduate students, Boston School of Occupational Therapy, Tufts University, Medford, MA, Fall, 1991.

HOSPITAL TEACHING ROLES

“Developmental Considerations for Infants in Neonatal Intensive Care, and Family-Centered Interventions During the Hospital Stay and the Transition Home”  - Monthly didactic/practicum training for pediatric residents of the Brown University School of Medicine, Developmental and Behavioral Rotation, January through June, 1994 to present.

“Evidence-based Developmental Interventions in the NICU and Newborn Nurseries” – ½ hour presentation for pediatric residents as part of Newborn Curriculum, Monthly, in the NICU, January through March, 2010 to present.

“Feeding issues in the NICU and Newborn Nurseries”  - ½ hour presentation for pediatric residents as part of Newborn Curriculum, Monthly, in the NICU, April through June, 2010 to present.

“Developmental and Family Centered Care in the NICU” – 2 hour instruction for all newly hired RN’s preparing to begin working in the NICU, Women & Infants’ Hospital, 2001 to present.

“Introduction to Infant Massage” – 1 - 2 hour instruction for Newborn Nursery staff, Women & Infants’ Hospital, June 22, 2005; November 16, 2005; March 15, 2006; August 9, 2006.

“Brachial Plexus Injury:  Assessment & Intervention for Neonates” -  Perinatal Management Seminar, Women & Infants’ Hospital, May 10, 2006.

“Developmental Care:  Interventions in the NICU” – 1 hour instruction for NICU staff, Women & Infants’ Hospital, given 14 times, November 28, 2005 through January 21, 2006.

“The Fragile Infant in the NICU:  Recognizing Pain & Stress – 1 hour instruction for NICU staff, Women & Infants’ Hospital, given 8 times, November 28, 2006 through December 18, 2006.

“Swallowing Dysfunction in the Neonate – Assessment & Intervention” – Perinatal Management Seminar, Women & Infant’s Hospital, March 28, 2007.

“Swallowing Dysfunction in the Neonate – Complex Patient Presentations” – Neonatal Fellows’ Seminar, Women & Infants’ Hospital, July 26, 2007.

“Challenges to Implementation of A Pathway for Developmental Care in the NICU” – Perinatal Management Seminar, Women & Infants’ Hospital, July 23, 2008.

“Evidence-Based Developmental Interventions in the NICU”, Neonatal Fellows’ Seminar, Women & Infants’ Hospital, October 22, 2009; Developmental and Behavioral Pediatrics Fellows’ Seminar, Hasbro Children’s Hospital, January 22, 2010.

“A Relationship-Based Approach to Developmental Support of High Risk Infants & Their Families in the NICU”  Infant Mental Health Program, Brown Center for the Study of Children At Risk. WIH – 2 –day course for NICU Professionals - June 7-8, 2010.

“Neurobehavioral Assessment of the Preterm Infant”- 1 hour presentation with B. Lester -  Perinatal Management Seminar, WIH Dept of Pediatrics, July 14, 2011 “Developmental and Feeding Interventions in the NICU at WIH”  - 1/2 hour presentation for visiting neonatologists from Vancouver, BC., March 29, 2011.

“The High Five on the Upper Extremity Program - Perinatal Management of Brachial Plexus Injury and Fractured Clavicle” - 1 hour presentation -  Perinatal Management Seminar, WIH Dept of Pediatrics,  April 6, 2011.

“Non-Pharmacologic Treatment of Reflux” – 1 hour presentation – Perinatal Noon Conference – Presented with Lynne Pryztac, January 31, 2013.

“Current Approaches to Initiating and Progressing Breast and Bottle Feeding in the NICU: Cue-Based Feeding, Infant Driven Feeding, Co-Regulated Approach – Which is Best for Infants, Parents & Staff? – 45 minute invited presentation for NICU Shared Governance Committee, June 20, 2013.

“Assessing Readiness for and Quality of Breast and Bottle Feeding in the NICU”, WIH NICU, Noon Conference, January 30, 2014 – 1 hr.

“Assessing Readiness for and Quality of Breast and Bottle Feeding in the NICU”, Kent Hospital NICU, February 24, 2014 – 1hr.

“Breastfeeding the High Risk Infant:  Challenges and Interventions”  RI Breastfeeding Coalition Annual Conference, March 10, 2014 – 1hr.

“Assessing Readiness for and Quality of Breast and Bottle Feeding in the NICU”, NICU NNP Noon Conference, WIH, March 27, 2014– 1hr.

“Readiness for and Progression of Breast and Bottle Feeding in the NICU:  Putting the Breast First” – Perinatal Management Conference – April 16, 2014 – 1 hr. 

“Assessing Readiness for and Quality of Breast and Bottle Feeding in the NICU”, WIH NICU, Breast Feeding Fair, May 29, 2014 – 6 hr.

“Sensory Impact of NICU Environment”  Hasbro Children’s Hospital – Seminar for Fellows in Developmental and Behavioral Pediatrics – January 12, 2015 – 1 hr.

“Sensory Impact of NICU Environment”  WIH NICU, Seminar for NICU Fellows, May 14, 2015 – 1 hr.

“Thickening Feedings as an Intervention for Dysphagia”  WIH NICU, Perinatal Noon Conference, July 30, 2015 – 1 hr.

“Feeding Difficulties in the Newborn” – Perinatal Management Conference, WIH.  December 16, 2015 – 1 hr.

“Feeding Difficulties in the Newborn – Grand Rounds – Hasbro Children’s Hospital – April 15, 2016 – 1hr.

“Feeding Challenges of the Late Preterm Infant:  The Great Imposters”  Noon Conference, WIH NICU -   December 29, 2016 – 1 hr.

“Evidence-Based Developmental Interventions in the NICU”  Seminar for NICU Fellows, June 29, 2017 – 1hr.

“A Multi-Disciplinary Approach to Ankyloglossia (Tongue-Tie)  Perinatal Management Conference, WIH  March 27, 2019 – 1 hr.