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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Preterm neonates treated in intensive care units: development of interaction behavior in the first year of life]
M R Pedromônico1, M F Azevedo, B I Kopelman
1Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Insights
Preterm infants show developmental delays in social interaction, particularly those with neurological impairments or extended hospital stays. These factors impact their ability to engage and build self-awareness.
Area of Science:
- Neonatal Development
- Infant Psychology
- Developmental Pediatrics
Background:
- Preterm infants often experience altered developmental trajectories.
- Neonatal intensive care unit (NICU) stays can impact early social-emotional development.
- Understanding interaction patterns is crucial for supporting preterm infant development.
Purpose of the Study:
- To characterize social interaction in low-birth-weight preterm infants during their first year.
- To identify factors influencing interaction development in this vulnerable population.
Main Methods:
- Longitudinal observation of 53 preterm infants (birth weight <2000g, NICU stay ≥10 days) over one year.
- Assessment of 17 key interactive behaviors.
- Analysis considering age, sex, birth weight, newborn classification, hospitalization duration, and neurological diagnosis.
Main Results:
- Preterm infants demonstrated interactional development, albeit slower than full-term peers.
- Communicative behaviors were not significantly influenced by sex, birth weight, or gestational age classification.
- Longer postnatal hospitalization correlated with reduced mirror-image smiling.
- Neurologically impaired infants exhibited significantly fewer social interaction behaviors (e.g., smiling, peek-a-boo, protesting departure, pointing, following commands).
Conclusions:
- Neurological disabilities are associated with delayed complex social interaction skills in preterm infants.
- Extended hospitalization (>35 days) may affect self-body construction and personality development.
Abstract:
OBJECTIVE: The aim of this research was to characterize the interaction during the first year of preterm infants whose weight was lower than 2000g and who had been in neonatal intensive care units for at least 10 days. METHOD: Fifty-three infants were observed during a year, twenty-one being boys and thirty-two girls. These infants were assessed regarding seventeen kinds of behavior which we considered important in person to person relationship, i.e., behavior which led to interaction or maintained it. In our analysis we considered the age at which the child was seen, sex, weight at birth, new born classification, time of hospitalization and neurological diagnosis.RESULTS: An analysis of the results showed that there was an evolution in the way preterm infants interacted although the progress was smaller than the one of their pair terms. The occurrence of communicative behavior was not affected by sex, weight at birth or newborn classification (adequate or small for gestational age). The postnatal time of hospitalization affected the occurrence of the behavior smiles to the reflected image in mirror. The infants diagnosed as being neurologically impaired showed a statistically significant smaller occurrence of behaviors: respond to smiles and speech by smiling, play peek-a-boo, protest at mothers departure, point to desired objects and carry out given orders. CONCLUSIONS: The infants diagnosed as having neurological disabilities showed a delay in more complex forms of interaction. The infants with more than 35 days of hospitalization showed alteration in the self-body construction, related to personality build up.
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