Heidelise Als, whose research revolutionized care for premature babies, dies at 81

Highly observant and determined to improve the prospects of premature babies, Dr. Als pioneered new approaches to their care that have spread across the country and around the world.

Via Zoom, she was still teaching medical staff in places as far away as Africa when she suffered a ruptured brain aneurysm while at her home in Tunbridge, Vermont, and died on 18 August at Dartmouth-Hitchcock Medical Center in Lebanon, NH.

At 81, Dr. Als was director of infant and child neurobehavioral studies at Boston Children’s Hospital and professor emeritus of psychology at Harvard Medical School.

In the 1980s, she founded the Individualized Newborn Developmental Care and Assessment Program, or NIDCAP – a system by which nurses and health professionals could be trained to integrate her findings into daily care. .

At an age when many are long retired, Dr. Als was vigorously involved in running the nonprofit International Federation NIDCAP, which she founded to expand her research away from the hospital where she was the pioneer of a more complete understanding of preterm infants.

“She was very clear about what she wanted her impact to be,” said Gloria McAnulty, an assistant professor of psychiatry at Harvard Medical School and a member of the nonprofit’s board of directors. “She wanted to be the voice of the newborn and teach others to interpret that voice and respond to it.”

The foundation of Dr. Als’ work was professional and personal. While a graduate student in psychology and married to her first husband, she gave birth to her son Christopher, who suffered brain damage during the birthing process that led to significant developmental issues, including a disorder. convulsive.

Feeding Christopher was an education in how adults should listen to how babies communicated their needs.

“I learned from him to watch him and believe what he tells me,” Dr. Als told the Globe in 2019. “I learned that he influences me in many ways more than I don’t influence him.”

This led her to create what she called the Synactive Theory of Development, which became the cornerstone of the newborn’s individualized developmental care and assessment program.

By focusing on the developmental care of premature babies, Dr. Als essentially changed the field.

“Heidi was brilliant,” wrote Deborah Buehler, NIDCAP Federation International board chair, in a tribute project she plans to present at the organization’s annual meeting of trainers in October.

“And in every way, Heidi had an extraordinary ability to be completely present. Present in conversation, observation, evaluation, training, mentoring, writing,” wrote Buehler, a developmental psychologist. what Heidi does, she does it with full attention, with heart, with skill and with conviction, and in each of these moments, she has created change.

One of three siblings, Heidelise Als was born in Krumbach, Germany on November 8, 1940. Her parents were Elizabeth Broicher Als, who raised the children, and Heinrich Als, a lawyer and senior judge.

The fragility of her own childhood in the middle and after World War II “made me wonder how people developed their emotions and character,” she said in 2019.

A 1963 graduate with a Bachelor of Education from the University of Würzburg in Germany, she was an elementary school teacher when she realized she wanted to go back to school.

“I’ve always been fascinated by the differences between children,” she said in 2008. “How did they get there? Why is life challenging for some people while others thrive? »

Marriage to an American brought her to Philadelphia, where she went to graduate school at the University of Pennsylvania and had Christopher, who now lives in Copake, NY, in the respected Camphill Village community for adults with disabilities. intellectual.

Dr. Als, whose first marriage ended in divorce, earned a master’s degree in education in 1968 and a doctorate in developmental and educational psychology in 1975.

Postdoctoral studies and research work with renowned pediatrician Dr. T. Berry Brazelton brought her to Boston Children’s Hospital.

It was there that she met Dr. Frank H. Duffy, a neurologist. One day, she borrowed a piece of equipment from him, then accidentally spilled coffee on him as they stood in line outside a coffee machine.

A budding friendship led them to work together professionally. “We started collaborating,” he said, “and the collaboration turned into a marriage.”

They divided their time between Boston and Tunbridge, where she tended a flower garden and became an accomplished horsewoman.

“I realized how much Heidi has done – not just for the world or for babies, but for me,” Duffy said.

“She extended her view of human behavior, development and agency to everyone in her life,” he said. “But she focused on the babies because they were the most deserving and needy.”

Still, “as she was to the kids, she was to her co-workers,” Duffy said, “and she has a lot of people who adore her.”

Watching Dr. Als observe other people was a lesson in how to pay close attention — how to let the little details speak volumes, his friends said.

“She’s seen it all, actually,” McAnulty said. “You would walk into an elevator with Heidi and a mother holding a baby, and by the time we got off the elevator, Heidi knew all about that person.”

Dr. Als “noted every detail,” McAnulty said. “She could see if they hadn’t laced their shoes. She would see if they looked a little pale. She would notice if they were smiling, if they were holding their child’s hand. She would notice if they met her gaze.

This kind of careful observation led Dr. Als to change his profession’s approach to caring for premature babies by dimming the lights, dimming the sounds in the room, allowing infants to move and encouraging contact. between parents and babies.

“I observed her compassionate, reassuring, and thoughtful interactions with families,” Buehler wrote.

“The parents knew she had seen their child, had really seen them, and that they also felt understood,” Buehler added. “Heidi’s conversations with parents have always acknowledged the realities and challenges of life and parenthood.”

Dr. Als “focused on strengths, supports and next steps,” Buehler wrote. “It’s the same life-affirming, life-changing approach that we felt as interns and mentees.”

A service was held for Dr. Als, who, in addition to her husband and son, leaves behind three stepchildren, Victoria Duffy Hopper of New York and Lisa Duffy and Stephen Duffy, both of Florida; one brother, Heinzpeter of Germany; one sister, Urselmarie of Montreal; two grandchildren; and a great-grandchild.

Learning to listen to premature babies and their parents “often doesn’t take much,” Dr. Als said in 2019.

“It’s about being next to someone and reducing the stress, so that the hands are soft, the baby relaxes and the mother thrives,” she said. “It’s wonderful to see when that happens.”

And that, she added, is “what you’re really in the field for.”

Bryan Marquard can be reached at bryan.marquard@globe.com.