AIMS AND OBJECTIVES: Suck development is a challenging hurdle for preterm infants who endure an extensive oxygen history due to respiratory distress syndrome (RDS). The fine structure of the non-nutritive suck (NNS) was studied in preterm infants according to RDS severity. DESIGN AND METHODS: Recordings of NNS were completed cribside in the neonatal intensive care unit (NICU) in 55 preterm infants distributed among one healthy control group and two RDS infant groups. NNS pressure amplitude (cmH(2)0) and within-burst suck cycle period (ms) were the dependent measures extracted from digitized records of pacifier nipple compression pressure. RESULTS AND CONCLUSIONS: RDS preterm infants demonstrated significant differences in NNS suck pressure amplitude compared to healthy preterm infants. Periods of oxygen supplementation restrict orofacial movement and limit orosensory experiences necessary for suck development and neural maturation. RDS infants may be excellent candidates for patterned oral stimulation programs designed to advance the maturation of sucking skills.

PURPOSE: To determine the interrater and test-retest reliabilities and construct validity of the Premie-Neuro, a standardized neurologic assessment tool for preterm infants. SUBJECTS: Thirty-four preterm infants (mean gestational age at birth 29 Ϯ 3.7 weeks, mean birth weight 1343.2 Ϯ 696.3 g) participated in the study. DESIGN: A prospective repeated-measures design was used to assess the reliability and validity of the Premie-Neuro. METHODS:The Premie-Neuro was administered twice on consecutive days and then weekly through 37-weeks postmenstrual age or hospital discharge. At discharge, infants' medical histories were reviewed and a Neurobiologic Risk Score (NBRS) was used to determine risk for poor neurodevelopmental outcomes. MAIN OUTCOME MEASURE: Premie-Neuro raw scores and classifications were analyzed to determine the tool's reliability. Construct validity was measured by determining whether the Premie-Neuro could discriminate between infants identified as high-risk or low-risk for neurodevelopmental delays by using a NBRS of 5 as the cutoff for high-and low-risk infants. RESULTS: The intraclass correlation coefficients for interrater and test-retest reliability varied from 0.391 to 0.556 and from 0.493 to 0.592, respectively. Analysis of variance revealed that the Premie-Neuro raw scores for infants with NBRS Ͼ 5 were significantly worse than those for infants with NBRS Ͻ 5 (P ϭ .000-.010). C CONCLUSIONS: The Premie-Neuro is a valid assessment tool for discriminating between preterm infants at high and low risk for neurodevelopmental delay. Interrater reliability of the Premie-Neuro was poor, and test-retest reliability of the Premie-Neuro was fair to moderate. The Premie-Neuro may be acceptable for assessing groups of infants, but there is no evidence that reliability is sufficient for clinical decision-making for individual infants. More research needs to be done to improve the reliability of the Premie-Neuro and assess other facets of the Premie-Neuro's reliability.