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Updated: Jul 11, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A single case study of the communication development of a high-risk neonate, from birth to discharge from a neonatal
Alethea McInroy1, Alta Kritzinger
1Clinic for High Risk Babies (CHRIB), Centre for Early Intervention in Communication Pathology, Department of Communication Pathology, University of Pretoria, South Africa.
Since preterm and low birth weight infants display a high-risk for communication disorders or delays, the Neonatal Intensive Care Unit (NICU) provides the earliest opportunity where family-centered early communication intervention (ECI) services can be initiated. Extensive knowledge about high-risk neonates exists, but there appears to be limited knowledge about the emergence of early communication skills in these neonates. The aim of the study was to provide a systematic description of the successive communication developmental steps of a high-risk neonate on a weekly basis, from birth to discharge from a NICU, in order to guide further research on a larger scale. An A-type single case study design was used to collect prospective data over 14 sessions during the participant's 51-day stay in the NICU. Using a comprehensive data-collection protocol, rich data sets were gleaned over time. The results are described as a chronology of events contributing to the participant's risk status and influencing his early communication development. The successive emergence of the different components of language skills in the participant provided new insights into the communication development of a preterm neonate and should be further investigated. An ECI programme and guidelines for implementation in the NICU are discussed as a treatment option.
Since preterm and low birth weight infants display a high-risk for communication disorders or delays, the Neonatal Intensive Care Unit (NICU) provides the earliest opportunity where family-centered early communication intervention (ECI) services can be initiated. Extensive knowledge about high-risk neonates exists, but there appears to be limited knowledge about the emergence of early communication skills in these neonates. The aim of the study was to provide a systematic description of the successive communication developmental steps of a high-risk neonate on a weekly basis, from birth to discharge from a NICU, in order to guide further research on a larger scale. An A-type single case study design was used to collect prospective data over 14 sessions during the participant's 51-day stay in the NICU. Using a comprehensive data-collection protocol, rich data sets were gleaned over time. The results are described as a chronology of events contributing to the participant's risk status and influencing his early communication development. The successive emergence of the different components of language skills in the participant provided new insights into the communication development of a preterm neonate and should be further investigated. An ECI programme and guidelines for implementation in the NICU are discussed as a treatment option.
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