Neurobehavioral assessment from fetus to infant: The NICU network neurobehavioral scale and the fetal neurobehavior coding scale

Abstract

This review provides an overview and definition of the concept of neurobehavior in human development. Two neurobehavioral assessments used by the authors in current fetal and infant research are discussed: the NICU Network Neurobehavioral Assessment Scale and the Fetal Neurobehavior Coding System. This review will present how the two assessments attempt to measure similar processes from pre to post-natal life by examining three main components of neurobehavior: neurological, behavioral and stress/reactivity measures. Assessment descriptions, strengths and weaknesses, as well as cautions and limitations are provided.

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

“…They are also key because they show that normal healthy infants are not a homogeneous population; that their neurobehavioral organization is affected by factors in environments not usually associated with risk. In other normative samples, the exam has been used in relation to fetal behavior, 49 and infant temperament. 50,51 Thus, although the NNNS was designed for high risk infants it also appears to be sensitive to neurobehavioral variability in low risk populations as well.…”

Fetal Neurology—Lesson Learned and Future Challenges

“…The experience acquired with the Amiel-Tison's Neurological Assessment at Term (ATNAT) helps us in interpretation of fetal movements. 39,54,55 The domain of fetal neurology is already too extensive, but the focus of interest is mainly second trimester, despite the fact that spontaneous fetal mobility emerges and has already became differentiated at a very early age. 56 This means that we will take into a consideration period of pregnancy from 20 till 40 weeks of gestation, including the end of the neuronal migration and the postmigratory phase corresponding to the development of neocortex.…”

“…[58][59][60][61] "Disturbances" is a term that refers to events or processes that in some way influence the expected pattern of brain maturation. 55 Those events or processes are many, with consequences varying from very conspicuous to very subtle. It should be kept in mind what many neurologists emphasize, that morphology does not always correspond to neurological outcome.…”

“…It should be kept in mind what many neurologists emphasize, that morphology does not always correspond to neurological outcome. 39,54,55 The opposite view is the one from pediatricians and neurophysiologists, who are involved in long-term followup studies, and they are certainly not that optimistic. It would be wise to consider long run prognosis, for each specific type of fetal brain damage and make appropriate decisions for conservative management.…”

“…39,55 The same sign should be searched for postnatally, as a part of neurological examination. 62 The majority of pediatricians believe that the main obstacle for early prediction of CP based on a functional observation of the fetus such as visual observation by 4-D sonography, is due to the "precompetent" stage of most of the motor behavior observed in utero.…”