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Arousal, Attention, and Neurobehavioral Assessment in the Neonatal Period: Implications for Intervention and Policy
Author(s) -
Gardner Judith M.,
Karmel Bernard Z.,
Freedland Robert L.,
Len Elizabeth M.,
Flory Michael J.,
Miroshnichenko Inna,
Phan Ha T. T.,
Barone Anthony,
Harin Anantham
Publication year - 2006
Publication title -
journal of policy and practice in intellectual disabilities
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.592
H-Index - 30
eISSN - 1741-1130
pISSN - 1741-1122
DOI - 10.1111/j.1741-1130.2006.00049.x
Subject(s) - arousal , intervention (counseling) , psychology , bayley scales of infant development , brainstem , developmental psychology , medicine , pediatrics , cognition , neuroscience , psychomotor learning , psychiatry
Neonatal assessments should provide valid estimates of behavior and neurological status, reflect recovery from acute effects, predict subsequent outcome, and point to specific intervention strategies for any problems noted. The authors report relations among measures designed to evaluate early behavioral capabilities and dysfunctions in areas frequently disrupted by central nervous system (CNS) injury that involve arousal‐modulated attention and elicited and spontaneous movements, to each other and to the Bayley Scales of Infant Development over the first 2 years. Infants were classified into four CNS injury groups based on auditory brainstem responses and cranial ultrasonography. CNS injury was associated with all behavioral measures in neonates, but the strength of the relationships changed for each over time, as did the degree and time‐course for performance recovery. CNS findings alone were insufficient to predict later outcome. Early behavioral evaluations were better predictors into the second year and indicated that: (1) high‐risk infants who performed normally as neonates had normal development; (2) those with early transient abnormalities appeared to normalize by 4 months but started to decline by 13–16 months; and (3) consistently abnormal early behavior predicted the worst outcome. Use of multiple measures in the neonatal period and repeated assessments across early infancy provide a useful and accurate approach for evaluating recovery from CNS injury, predicting later mental and motor performance and helping to design early intervention strategies.