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Updated: Aug 5, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Prediction of developmental problems and functional disabilities in infancy]
A M Rostad1, H Martinsen, D E Eilertsen
1Habiliteringstjenesten for barn Innherred sykehus, Levanger.
Insights
High cumulative non-optimality scores in infancy effectively identify children with developmental problems by age four. This prospective study offers a sensitive and specific screening method for early intervention and improved child health outcomes.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Context:
- Early identification of developmental problems is crucial for timely intervention.
- Existing methods for identifying childhood disabilities have limitations.
- A need exists for validated, efficient screening tools in primary care settings.
Purpose:
- To evaluate the predictive value of a cumulative non-optimality score in infancy for identifying developmental problems at age four.
- To assess the sensitivity, specificity, and predictive values of this novel screening method.
- To determine the feasibility of implementing this method within routine child health services.
Summary:
- A prospective study followed 1,217 children from pregnancy to age four, collecting medical, motor, neurological, attention, social, family, and environmental data.
- A cumulative non-optimality score was developed and validated against diagnoses of functional disability at age four in 926 children.
- The method demonstrated high sensitivity (87.5%), specificity (93%), and negative predictive value (99.5%), outperforming comparable tools.
Impact:
- The findings suggest a highly accurate and practical tool for early detection of developmental issues in children.
- Successful implementation in Norway's child health centers could significantly improve early intervention rates.
- This approach has the potential to enhance long-term child health and developmental trajectories through early identification and support.
Abstract:
Methods to identify developmental problems in children have been requested for a long time. We wanted to find out whether high scores of cumulative non-optimality during infancy indicated disability or developmental problems. In a prospective study, a population of children (n = 1,217) was followed from pregnancy until the age of four. Medical, motor, and neurological data, as well as information about attention and social interaction were added in a cumulative non-optimality score. Information about family and environment was also included. When the children were four years of age, multiple methods were used to identify those with disability and developmental problems. Complete data were obtained for 926 children. The predictive values of the instrument were based on children diagnosed as functionally disabled at the age of four (n = 32). The sensitivity was 87.5%, specificity 93%, positive predictive value 30.8% and negative predictive value was 99.5%. These values are higher than those of comparable methods. The method could be implemented in the normal Norwegian "child health centre" without difficulty. The discussion in this article focuses on whether or not the method should be implemented in the ordinary health care system.
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