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Updated: Aug 16, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Concurrent validity of the Neurobehavioural Assessment for Pre-term Infants (NAPI) at term age
Chaya Hyman1, Laurie M Snider, Annette Majnemer
1Early Intervention, New York, USA.
Background:
Accurate measurement of neonatal neurological integrity is critical for early identification of pre-term and full-term infants at-risk for developmental disability. The Neurobehavioural Assessment for Pre-term Infants (NAPI) was developed to measure the progression of neurobehavioural development in pre-term infants born between 32 weeks post-conceptional age (PCA) and term. This instrument has many unique advantages; however, criterion validity is unknown and results are subsequently difficult to interpret.
Objectives:
This study examined the concurrent validity of the NAPI against a criterion instrument, the Einstein Neonatal Neurobehavioural Assessment Scale (ENNAS), which measures similar constructs and has demonstrated excellent reliability and validity.
Methods:
A sample of 41 pre-term and full-term infants (40 +/- 2 weeks) was assessed with the NAPI and ENNAS on the same day.
Results:
The findings demonstrated that correlations between similar NAPI clusters and ENNAS clusters ranged from 0.35-0.65 and correlations between many similar individual NAPI and ENNAS items ranged from 0.40-0.60. Two NAPI clusters also discriminated between normal, abnormal and suspect performance on the ENNAS.
Conclusion:
The NAPI has many unique advantages as a tool. It examines neonates serially, has established weekly normative data and requires minimal infant handling. This study provides new validation of the NAPI instrument.
