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Neonatal Behavioral Assessment Scale

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Power point research robert bornmann

  1. 1. Robert Bornmann January 27, 2011 EDUU325
  2. 2. NBAS Purpose <ul><li>Intended to examine individual differences in newborn behavior. </li></ul><ul><li>It assesses different developmental capabilities: autonomic, motor, state and social-interactive systems </li></ul><ul><li>The test can be administered to any child by an obstetrician or clinician to supplement childcare to promote optimal development of the child. </li></ul>
  3. 3. NBAS Purpose (Con’t) <ul><li>Standardized / Criterion-referenced test </li></ul><ul><li>“ To assess and describe infant's interactions and behaviors within the context of a dynamic relationship with a caregiver. Results provide information regarding infant's ability to handle stressors and self-organize”. </li></ul><ul><ul><ul><li> </li></ul></ul></ul><ul><ul><ul><li>(DelCarmen-Wiggins, et al., nd) </li></ul></ul></ul>
  4. 4. Type of Test <ul><li>This is a developmental screening test, measured with 28 behavioral and 18 reflex items (“The Neonatal”, 2008). </li></ul><ul><li>“ The results provide information regarding infant's ability to handle stressors and self-organize” (“Section on Pediatrics”, 2005). </li></ul><ul><li>Test done through observation and testing of reflexes. </li></ul>
  5. 5. Developmental Domain <ul><li>Developmental domains examined </li></ul><ul><ul><li>autonomic, motor, state and social-interactive systems, with nine optional items </li></ul></ul><ul><li>Autonomic: the scale determines if an infant is too easily stimulated, it assesses how the body may react to stimuli by breathing regulation or set off of tremors. </li></ul><ul><li>Motor: the scale measures the infants muscle tone, reflexes and there overall activity. </li></ul><ul><li> (“Understanding”, 2008) </li></ul>
  6. 6. Developmental Domain (Con’t) <ul><li>State: (state is level of consciousness, quiet sleep to full cry) the scale determines the infants ability to transition from one state to the next and at how well the child is able to regulate each state (“Understanding”, 2008). </li></ul><ul><li>Social-Interaction: the scale looks at how the infant interacts with stimuli: such as an object presented in front of the them or response to human voices and faces. </li></ul><ul><li> (“Understanding”, 2008) </li></ul>
  7. 7. Age and Target Group <ul><li>Full term neonates 37 to 48 weeks post-conceptual age (“Section on Pediatrics”, 2005) . </li></ul><ul><li>There is not a specific population this scale is intended for, but the scale does help recognize at-risk infants. </li></ul><ul><li>It test is mostly intended for research. </li></ul><ul><li>Since infants are being measured concerning ‘states’ it is inferred that the time that is necessary to observe the child in all states, that time is not limited. Can be done in about 20-30 minutes. </li></ul><ul><li>(DelCarmen-Wiggins, et al., nd) </li></ul>
  8. 8. Scoring <ul><li>15 minutes to complete scoring </li></ul><ul><li>The 28 behavioral items are scored on a scale of 9, while the reflex items are scored on a scale of 4 </li></ul><ul><li>The scoring can be completed by the examiner; however, training in this test is a requirement. It is mentioned that the examiner should practice with up to 20-25 infants. </li></ul>
  9. 9. Results <ul><li>The results can be used to supplement the development of the infant. If a child has difficult sleeping (one of the states) then it might be suggested that swaddling and quieting of a room are necessary to support the efforts of the infant’s development. </li></ul><ul><li>It is not a high-stakes test because is does not diagnose, only determines is there is a neurological deficit when reflexes are measured. </li></ul>
  10. 10. Results (Con’t) <ul><li>These Results will help many levels of the child's development. It will first create a strong knowledge of the infant for the doctor during the exam. Parent’s will be able to understand and answer child's needs when recognizing behaviors that express specific needs: which are interpreted by the examiner. Over all this will create a strong parent-child relationship. </li></ul>
  11. 11. Reliability <ul><li>“ It is the most comprehensive examination of newborn behavior available today” (“Understanding”, 2008). </li></ul><ul><li>The Scale can be used to study the effects of wide range of perinatal variables such as maternal substance use, low birth weight, caesarian section and other pre- and perinatal variables. It is also used in cross-cultural and prediction studies. </li></ul><ul><li>These type of instruments usually are not as reliable and comprehensive assessment tools due to their brevity (DelCarmen-Wiggins, et al., nd). Nevertheless, this assessment has been around since 1973 (“Understanding”, 2008) </li></ul>
  12. 12. Validity <ul><li>The test is able to measure “information regarding infant's ability to handle stressors and self-organize” 1 , which is able to promote parent-child relationship. “Allowing predictable measurement up to the first year” 2 . </li></ul><ul><li>1 (“Section on Pediatrics” 2005) </li></ul><ul><li>2 (DelCarmen-Wiggins, et al., nd). </li></ul>
  13. 13. Sensitivity and Specificity <ul><li>According to The Brazelton website it has success cross-culturally. </li></ul><ul><li>There are testing and research sites in the following locations, showing sensitivity to multiple cultures (“Understanding”, 2008): </li></ul><ul><ul><li>Germany, Italy, England, Belgium, Switzerland, Portugal, Spain, France, Sweden, Denmark, Brazil, Japan, Thailand, Korea, Philippines, and Australia (“International”, 2008). </li></ul></ul><ul><li>Their seems to be no bias because the measurements of behavior are only rated to the understand of infant behavior language. </li></ul><ul><li>English learners should not have difficulty with this test since the test is focused in areas that do not require language skills (this is due to the measurement of birth to two months). </li></ul><ul><li>Test subjects are very young and do not need to write or answer verbally to questions. It is all done through stimuli response and observation. </li></ul>
  14. 14. Practicality and Cost <ul><li>The test will take about 20-30 minutes? </li></ul><ul><li>The test is usually preformed by a Doctor or clinician that is NBAS certified. </li></ul><ul><li>To receive the certification you must receive a specialized training. </li></ul><ul><li>The publisher provides training </li></ul><ul><li>There is a two part training totaling $2000 </li></ul><ul><li>(this is the fee for on-site training, Harvard: </li></ul><ul><li>off-site has to be scheduled) </li></ul><ul><li>The certification must be renewed every three years, costing $1000 (“2011Brazelton”, 2008) </li></ul>
  15. 15. Resources <ul><li>2011 Brazelton Institute Training Workshops. (2008). Retrieved from the Children’s Hospital Boston, The Brazelton Institute website: </li></ul><ul><li>http://www.brazelton-institute.com/workshop.html#nbas. </li></ul><ul><li>Brazelton T.B., Nugent, J.K..(1995). Neonatal Behavioral Assessment Scale. High Holborn, London: Mac Keith Press. 8. </li></ul><ul><li>DelCarmen-Wiggins, R., Carter, A.S., Carter, A.. (Eds.). (nd). Handbook of infant, toddler, and preschool mental health assessment. USA: Oxford University Press. 189. </li></ul><ul><li>International Network. (2008). Retrieved from the Children’s Hospital Boston, The Brazelton Institute website: http://www.brazelton-institute.com/biin.html. </li></ul><ul><li>Section on pediatrics: list of assessment tools used in pediatric physical therapy. (2005, June) Retrieved from: http://www.pediatricapta.org/pdfs/AssessScreenTools2.pdf. </li></ul><ul><li>The Neonatal Behavioral Assessment Scale Training Program. (2008). Retrieved from the Children’s Hospital Boston, The Brazelton Institute website: </li></ul><ul><li>http://www.brazelton-institute.com/train.html. </li></ul><ul><li>Understanding the Baby's Language. (2008). Retrieved from the Children’s Hospital Boston, The Brazelton Institute website: http://www.brazelton-institute.com/intro.html. </li></ul>