The Developmental Care Program centers on finding ways to accurately assess and effectively treat stress and pain responses in preterm infants in the Neonatal Intensive Care Unit. We are conducting a comprehensive program of research that includes studies which are descriptive, mechanistic and interventionist; outcome measures ranging from cellular to behavioural levels; and mothers, fathers and infants born from the earliest gestational ages to term.


Evaluating change in virtual reality adoption for brain injury rehabilitation following knowledge translation
Disability and Rehabilitation: Assistive Technology
Glegg, S.M.N. and Holsti, L. and Stanton, S. and Hanna, S. and Velikonja, D. and Ansley, B. and Sartor, D. and Brum, C.
DOI: 10.3109/17483107.2015.1111944

Defining procedural distress in the NICU and what can be done about It
Neonatal Network
Schiavenato, M. and Holsti, L.
DOI: 10.1891/0730-0832.36.1.12

A Systematic Review of the Predictive Validity of Neurobehavioral Assessments During the Preterm Period
Physical and Occupational Therapy in Pediatrics
Craciunoiu, O. and Holsti, L.
DOI: 10.1080/01942638.2016.1185501

Beyond Acute Pain: Understanding Chronic Pain in Infancy
DOI: 10.3390/children3040026

A Systematic Review of the Predictive Validity of Neurobehavioral Assessments During the Preterm Period.
Craciunoiu O, Holsti L
PubMed: 27314272

Salivary Cortisol Based Early ACTH Test for Identifying Adrenal Insufficiency in Low Birth Weight Infants.
Hochwald O, Holsti L, Osiovich H
PubMed: 27299340

Comment on the Paper by van den Bosch et al. Entitled 'Prematurity, Opioid Exposure and Neonatal Pain: Do They Affect the Developing Brain': The Impact of Subtle Messaging.
Holsti L, Zwicker JG, Grunau RE
DOI: 10.1159/000442081
PubMed: 26670662

Oral glucose during targeted neonatal echocardiography: is it useful?
Lavoie PM, Stritzke A, Ting J, Jabr M, Jain A, Kwan E, Chakkarapani E, Brooks P, Brant R, McNamara PJ, Holsti L
DOI: 10.1136/archdischild-2015-308191
PubMed: 26054971

Neonatal pain and developmental outcomes in children born preterm: a systematic review.
Valeri BO, Holsti L, Linhares MB
DOI: 10.1097/AJP.0000000000000114
PubMed: 24866853

The development of the Pediatric Motivation Scale for rehabilitation.
Tatla SK, Jarus T, Virji-Babul N, Holsti L
DOI: 10.1177/0008417414556884
PubMed: 26281433

Using colors to assess pain in toddlers: validation of "the rainbow pain scale"-a proof-of-principle study.
Mahon P, Holsti L, Siden H, Strahlendorf C, Turnham L, Giaschi D
DOI: 10.1177/1043454214555197
PubMed: 25416519

Therapists' perceptions of social media and video game technologies in upper limb rehabilitation.
Tatla SK, Shirzad N, Lohse KR, Virji-Babul N, Hoens AM, Holsti L, Li LC, Miller KJ, Lam MY, Van der Loos HF
DOI: 10.2196/games.3401
PubMed: 25759148

A Randomized Controlled Trial of the Use of Oral Glucose with or without Gentle Facilitated Tucking of Infants during Neonatal Echocardiography.
Lavoie PM, Stritzke A, Ting J, Jabr M, Jain A, Kwan E, Chakkarapani E, Brooks P, Brant R, McNamara PJ, Holsti L
DOI: 10.1371/journal.pone.0141015
PubMed: 26496361

The fathers'support scale: Neonatal intensive care unit (FSS: NICU): Development and initial content validation
Journal of Neonatal Nursing
Mahon, P. and Albersheim, S. and Holsti, L.
DOI: 10.1016/j.jnn.2014.09.007

The GestureTek virtual reality system in rehabilitation: a scoping review.
Glegg SM, Tatla SK, Holsti L
DOI: 10.3109/17483107.2013.799236
PubMed: 23713408

The effects of motivating interventions on rehabilitation outcomes in children and youth with acquired brain injuries: a systematic review.
Tatla SK, Sauve K, Jarus T, Virji-Babul N, Holsti L
DOI: 10.3109/02699052.2014.890747
PubMed: 24661000

Using virtual reality in clinical practice: A multi-site exploratory study.
Glegg SM, Holsti L, Stanton S, Hanna S, Velikonja D, Ansley B, Sartor D, Brum C
DOI: 10.3233/NRE-141152
PubMed: 25238866

Evidence for outcomes of motivational rehabilitation interventions for children and adolescents with cerebral palsy: an American Academy for Cerebral Palsy and Developmental Medicine systematic review.
Tatla SK, Sauve K, Virji-Babul N, Holsti L, Butler C, Van Der Loos HF
DOI: 10.1111/dmcn.12147
PubMed: 23550896

Factors influencing therapists' adoption of virtual reality for brain injury rehabilitation.
Glegg SM, Holsti L, Velikonja D, Ansley B, Brum C, Sartor D
DOI: 10.1089/cyber.2013.1506
PubMed: 23713844

Pain in people with chronic obstructive pulmonary disease (COPD).
HajGhanbari B, Holsti L, Road JD, Darlene Reid W
DOI: 10.1016/j.rmed.2012.03.004
PubMed: 22531146

Terms used to describe pediatric videofluoroscopic feeding studies: a Delphi survey.
St Pierre AE, Reelie BA, Dolan AR, Stokes RH, Duivestein JA, Holsti L
PubMed: 22822693

The use of an early ACTH test to identify hypoadrenalism-related hypotension in low birth weight infants.
Hochwald O, Holsti L, Osiovich H
DOI: 10.1038/jp.2012.16
PubMed: 22402482

Occupational therapists play an important role in managing pain in infants in neonatal intensive care units | Les ergothérapeutes jouent un rôle déterminant dans la gestion de la douleur chez les bébés dans les unités de soins intensifs en néonatalogie
Occupational Therapy Now
Holsti, L.

Does breastfeeding reduce acute procedural pain in preterm infants in the neonatal intensive care unit? A randomized clinical trial.
Holsti L, Oberlander TF, Brant R
DOI: 10.1016/j.pain.2011.07.022
PubMed: 22014760

Assessing pain in preterm infants in the neonatal intensive care unit: moving to a 'brain-oriented' approach.
Holsti L, Grunau RE, Shany E
DOI: 10.2217/pmt.10.19
PubMed: 21874145

Measures of knowledge and skills for evidence-based practice: a systematic review.
Glegg SM, Holsti L
DOI: 10.2182/cjot.2010.77.4.4
PubMed: 21090063

Content validation of the infant malnutrition and feeding checklist for congenital heart disease: a tool to identify risk of malnutrition and feeding difficulties in infants with congenital heart disease.
St Pierre A, Khattra P, Johnson M, Cender L, Manzano S, Holsti L
DOI: 10.1016/j.pedn.2009.04.009
PubMed: 20816559

Considerations for using sucrose to reduce procedural pain in preterm infants.
Holsti L, Grunau RE
DOI: 10.1542/peds.2009-2445
PubMed: 20403938

Paediatric occupational therapy: addressing parental stress with the sense of coherence.
Stokes RH, Holsti L
DOI: 10.2182/cjot.2010.77.1.5
PubMed: 20302187

A preventive care program for very preterm infants improves infant behavioural outcomes and decreases anxiety and depression in caregivers.
Holsti L
DOI: 10.1016/S1836-9553(10)70012-6
PubMed: 21213943

Obsessional slowness: a case study.
Lam W, Wong KW, Fulks MA, Holsti L
DOI: 10.1177/000841740807500413
PubMed: 18975671

Long-term outcome after neonatal intraparenchymal echodensities with porencephaly.
Sherlock RL, Synnes AR, Grunau RE, Holsti L, Hubber-Richard P, Johannesen D, Whitfield MF
DOI: 10.1136/adc.2006.110726
PubMed: 17704104

Fathers' experiences in the neonatal intensive care unit: a search for control.
Arockiasamy V, Holsti L, Albersheim S
DOI: 10.1542/peds.2007-1005
PubMed: 18182470

Is it painful or not? Discriminant validity of the Behavioral Indicators of Infant Pain (BIIP) scale.
Holsti L, Grunau RE, Oberlander TF, Osiovich H
DOI: 10.1097/AJP.0b013e318158c5e5
PubMed: 18180641

Initial validation of the Behavioral Indicators of Infant Pain (BIIP).
Holsti L, Grunau RE
DOI: 10.1016/j.pain.2007.01.033
PubMed: 17382473

Extremity movements help occupational therapists identify stress responses in preterm infants in the neonatal intensive care unit: a systematic review.
Holsti L, Grunau RE
DOI: 10.1177/000841740707400306
PubMed: 17616017

Relationships between adrenocorticotropic hormone and cortisol are altered during clustered nursing care in preterm infants born at extremely low gestational age.
Holsti L, Weinberg J, Whitfield MF, Grunau RE
DOI: 10.1016/j.earlhumdev.2006.08.005
PubMed: 16979857

Long-term consequences of pain in human neonates.
Grunau RE, Holsti L, Peters JW
DOI: 10.1016/j.siny.2006.02.007
PubMed: 16632415

Biobehavioural reactivity to pain in preterm infants: a marker of neuromotor development.
Grunau RE, Whitfield MF, Fay T, Holsti L, Oberlander T, Rogers ML
DOI: 10.1017/S0012162206001010
PubMed: 16700939

Behavioral responses to pain are heightened after clustered care in preterm infants born between 30 and 32 weeks gestational age.
Holsti L, Grunau RE, Whifield MF, Oberlander TF, Lindh V
DOI: 10.1097/01.ajp.0000210921.10912.47
PubMed: 17057556

Prior pain induces heightened motor responses during clustered care in preterm infants in the NICU.
Holsti L, Grunau RE, Oberlander TF, Whitfield MF
DOI: 10.1016/j.earlhumdev.2004.08.002
PubMed: 15814212

Neonatal procedural pain exposure predicts lower cortisol and behavioral reactivity in preterm infants in the NICU.
Grunau RE, Holsti L, Haley DW, Oberlander T, Weinberg J, Solimano A, Whitfield MF, Fitzgerald C, Yu W
DOI: 10.1016/j.pain.2004.10.020
PubMed: 15661436

Specific Newborn Individualized Developmental Care and Assessment Program movements are associated with acute pain in preterm infants in the neonatal intensive care unit.
Holsti L, Grunau RE, Oberlander TF, Whitfield MF
DOI: 10.1542/peds.114.1.65
PubMed: 15231909

Does prone or supine position influence pain responses in preterm infants at 32 weeks gestational age?
Grunau RE, Linhares MB, Holsti L, Oberlander TF, Whitfield MF
DOI: 10.1097/00002508-200403000-00003
PubMed: 14770046

Are there developmentally distinct motor indicators of pain in preterm infants?
Morison SJ, Holsti L, Grunau RE, Whitfield MF, Oberlander TF, Chan HW, Williams L
DOI: 10.1016/S0378-3782(03)00044-6
PubMed: 12782425

Developmental coordination disorder in extremely low birth weight children at nine years.
Holsti L, Grunau RV, Whitfield MF
DOI: 10.1097/00004703-200202000-00002
PubMed: 11889346

Are twitches, startles, and body movements pain indicators in extremely low birth weight infants?
Grunau RE, Holsti L, Whitfield MF, Ling E
DOI: 10.1097/00002508-200003000-00007
PubMed: 10741817

Upper extremity performance and self-care skill changes in children with spastic cerebral palsy following selective posterior rhizotomy.
Loewen P, Steinbok P, Holsti L, MacKay M
DOI: 10.1159/000028720
PubMed: 9876248

Bedside application of the Neonatal Facial Coding System in pain assessment of premature neonates.
Grunau RE, Oberlander T, Holsti L, Whitfield MF
DOI: 10.1016/S0304-3959(98)00046-3
PubMed: 9718246

Extremely premature (
Whitfield MF, Grunau RV, Holsti L
DOI: 10.1136/fn.77.2.F85
PubMed: 9377151

Honours & Awards

Canadian Child Health Clinician Scientist Program Career Award - 2005-2009

Tier 2 Canada Research Chair in Neonatal Health and Development - 2010-2020

Research Group Members

Leisha Vandermey
Amber Prince-Hensold
Sasha Pavlovich
Stephanie Glegg