Twenty-item behavioral neurological assessment for normal newborns in 12 cities of China

Based on the method of Brazelton and Amiel-Tison for behavioral neurological measurement in the newborn and our own experience, we formulated a 20-item neonatal behavioral neurological assessment (NBNA). For setting up a practical method and a normal range of its scores in China, we examined 714 normal newborns (male 369, female 345), with NBNA at the age of 2-3, 12-14, 26-28 days for a total of 2,142 times, in 12 provinces of China from May to October 1988. NBNA contains 5 clusters: behavior (6 items); passive tone (4 items); active tone (4 items); primary reflexes (3 items); and general assessment (3 items). Each item has 3 scales (0,1,2). Twenty items have a maximum of 40 scores. Among the 2,142 times examined, 90.4% of the 714 newborns had 39-40 scores, 97% greater than 37 and none below 35. Measurements of the first, second and third time revealed that the total scores increased with age. The difference was statistically significant. The abilities of auditory and visual orientations and active neck tone improved obviously with age. NBNA shows distinct stability and reliability. The score is not influenced by geographic location; the scoring system is simple and the manipulation takes only ten minutes.