Advances in neonatal and infant behavioral assessment: toward a comprehensive evaluation of early patterns of development.
01 Feb 1987-Journal of Developmental and Behavioral Pediatrics (J Dev Behav Pediatr)-Vol. 8, Iss: 1, pp 39-50
TL;DR: The need for measures that are more predictive based on infant behavior is highlighted and a discussion of a number of experimental techniques that seem to hold great promise for developmental prediction and clinical application are discussed.
Abstract: Recognizing the impressive range of behavioral capacities of newborn infants, clinicians and researchers have long searched for valid assessment instruments to help evaluate infant behavior. Behavioral assessments with high predictive validity would aid the goals of developmental diagnostic, prognostic, and treatment programs for infants born at risk from biological or environmental circumstances. The failure of current assessments to predict developmental outcome based on infant behavior may be due to the limited information about higher central nervous system (CNS) functioning obtained from available measures, or to the very dynamic nature of CNS organization in young infants. We begin our review by discussing some major functional characteristics of neonates and then proceed to describe critically the commonly used methods of neurological and behavioral assessment. Noting the need for measures that are more predictive, we turn next to a discussion of a number of experimental techniques that seem to hold great promise for developmental prediction and clinical application. J Dev Behav Pediatr 8:39–50, 1987. Index terms: neonatal assessment, newborn behavior, developmental prediction.
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TL;DR: Evidence is provided for an association between low-level prenatal PCB and DDE exposures and poor attention in early infancy and further analyses will focus on whether organochlorine-associated decrements in attention and attention-related skills in infancy persist in later childhood.
Abstract: OBJECTIVE: This study was designed to assess whether prenatal organochlorine exposure is associated with measures of attention in early infancy. METHODS: We investigated an association between cord serum polychlorinated biphenyls (PCBs) and p,p´-dichlorodiphenyl dichloroethene (DDE) levels and measures of attention from the Neonatal Behavioral Assessment Scale (NBAS) in a cohort of 788 infants born 1993‐1998 to mothers residing near a PCB-contaminated harbor and Superfund site in New Bedford, Massachusetts. RESULTS: Medians (ranges) for the sum of four prevalent PCB congeners and DDE levels were 0.19 (0.01‐4.41) and 0.30 (0‐10.29) ng/g serum, respectively. For the 542 subjects with an NBAS exam at 2 weeks, we observed consistent inverse associations between cord serum PCB and DDE levels and NBAS measures of alertness, quality of alert responsiveness, cost of attention, and other potential attention-associated measures including self-quieting and motor maturity. For example, the decrement in quality of alert responsiveness score was ‐0.51 (95% confidence interval, ‐0.99 to ‐0.03) for the highest quartile of exposure to the sum of four prevalent PCB congeners compared with the lowest quartile. We found little evidence for an association with infant orientation, habituation, and regulation of state, assessed as summary cluster measures.
89 citations
Cites background from "Advances in neonatal and infant beh..."
...However, behavioral or related functional health outcomes are difficult to measure in early infancy; there are few tests available for this age group, and generally such assessments have limited reproducibility and poor long-term predictive value (Gorski et al. 1987)....
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TL;DR: Significant neurobehavioral maturation takes place between 40 and 44 weeks PCA in preterm infants, with the greatest changes occurring in the most pre term infants.
Abstract: The purpose of this study was twofold: (1) to explore potential changes in the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) from 40 to 44 weeks postconceptional age (PCA) and (2) to determine the relationship between the BNBAS scores and feeding behaviors in preterm infants at 40 and 44 weeks PCA. The BNBAS and sucking behavior measurements were completed on 104 preterm infants at 40 and 44 weeks PCA. The Orientation (p = .001), Motor (p = .001), Range of State (p = .001), Autonomic Regulation (p = .01), and Reflexes (p = .00) clusters were significantly more mature at 44 weeks PCA than at 40 weeks. Infants that were extremely early born (n = 24) had a significantly larger change in BNBAS scores over time as compared to the more mature preterm infants (n = 77), largely catching up with their more mature preterm counterparts. At 40 and 44 weeks PCA, the BNBAS cluster scores for orientation (p = .02), motor (p = .048), range of state (p = .048), and regulation of state (p < .001) were significantly related to the average maximum pressure, adjusted for gestational age and weeks PCA. Significant neurobehavioral maturation takes place between 40 and 44 weeks PCA in preterm infants, with the greatest changes occurring in the most preterm infants. These findings highlight the relationship between neurobehavioral maturation and feeding behaviors.
34 citations
01 Jan 2015
25 citations
TL;DR: Behavior responsiveness to human speech and gentle stroking of the limbs was assessed in 15 very low birth-weight infants.
Abstract: Behavioral responsiveness to human speech and gentle stroking of the limbs was assessed in 15 very low birth-weight infants (VLBW:
23 citations
TL;DR: In this paper, the authors compared abilities of the Alberta Infant Motor Scale (AIMS) and the Harris Infant Neuromotor test (HINT), during the infant's first year, in predicting scores on the Bayley Scales of Infant Development (BSID) at age 2 and 3 years.
Abstract: Aim We compared abilities of the Alberta Infant Motor Scale (AIMS) and the Harris Infant Neuromotor Test (HINT), during the infant’s first year, in predicting scores on the Bayley Scales of Infant Development (BSID) at age 2 and 3 years
Method This prospective study involved 144 infants (71 females, 73 males), assessed with the HINT and AIMS at 4 to 65 and 10 to 125 months and with the BSID at 2 and 3 years Inclusion criteria for typical infants (n=58) were the following: 38 to 42 weeks’ gestation, birthweight at least 2500g, and no congenital anomaly, postnatal health concern, nor major prenatal or perinatal maternal risk factor For at-risk infants (n=86), inclusion criteria were any of the following: less than 38 weeks’ gestation, birthweight less than 2500g, maternal age older than 35 years or younger than 19 years at infant birth, maternal psychiatric/mental health concerns, prenatal drug/alcohol exposure, multiple births, or use of reproductive technology
Results For the overall sample, the early (4–65mo) HINT had higher predictive correlations than the AIMS for 2-year BSID-II motor outcomes (r=−036 vs 026), and 3-year BSID-III gross motor outcomes (r=−045 vs 031), as did the 10- to 125-month HINT (r=−055 vs 047) Correlations were identical for 10- to 125-month HINT and AIMS scores and 3-year BSID-III gross motor (r=−058 and 058) and fine motor (r=−035 and 035) subscales When the sample was divided into typical and at-risk groups, predictive correlations were consistently stronger for the at-risk infants Categorical predictive analyses were reasonably similar across both tests
Interpretation Results suggest that the HINT has comparable predictive validity to the AIMS and should be considered for use in clinical and research settings
22 citations
Cites background from "Advances in neonatal and infant beh..."
...In 1987, Gorski et al.(2) commented on the failure of infant assessments to predict later developmental outcomes....
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...In 1987, Gorski et al.2 commented on the failure of infant assessments to predict later developmental outcomes....
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