Related Experiment Video
Updated: May 28, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Reliability, sensitivity and responsiveness of the Infant Behavioral Assessment in very preterm infants
K Koldewijn1, J van Hus, A van Wassenaer
1Department of Rehabilitation, Academic Medical Center, University of Amsterdam, The Netherlands. k.koldewijn@amc.uva.nl
Insights
The Infant Behavioral Assessment (IBA) reliably evaluates neurobehavioral organization in very preterm infants. This tool demonstrates good sensitivity and responsiveness, aiding in developmental assessments.
Area of Science:
- Neonatal development
- Neurobehavioral assessment
- Developmental pediatrics
Background:
- Very preterm infants face challenges in neurobehavioral organization.
- Accurate assessment tools are crucial for early intervention.
- The Infant Behavioral Assessment (IBA) is a potential tool for evaluating this population.
Purpose of the Study:
- To investigate the reliability, sensitivity, and responsiveness of the Infant Behavioral Assessment (IBA).
- To evaluate neurobehavioral organization in very preterm infants using the IBA.
- To establish the clinimetric properties of the IBA for this specific infant group.
Main Methods:
- Assessed inter-rater reliability using 40 videotaped IBA observations scored by two independent observers.
- Evaluated sensitivity by comparing IBA results in 169 infants based on developmental risk factors.
- Calculated effect sizes to determine responsiveness between 0 and 6 months corrected age in intervention and control groups, including subgroups with oxygen dependency.
Main Results:
- Achieved 93% inter-rater agreement for the total assessment, with moderate to good Kappa agreement in behavioral categories.
- Found significant differences in IBA results between infants with and without developmental risk factors.
- Demonstrated responsiveness through larger effect size differences in randomized groups with oxygen dependency compared to the total randomized groups.
Conclusions:
- The Infant Behavioral Assessment (IBA) exhibits satisfactory to good clinimetric characteristics.
- The IBA is a reliable and valid tool for assessing neurobehavioral organization in very preterm infants.
- These findings support the use of the IBA in clinical and research settings for very preterm populations.
Aim:
The aim of this study is to investigate the reliability, sensitivity and responsiveness of the Infant Behavioral Assessment (IBA) to evaluate neurobehavioural organization in very preterm infants.
Methods:
Videotaped assessments of very preterm infants participating in a recent trial served to evaluate a standardized IBA observation. Inter-rater reliability was based on 40 videos scored by two independent observers, using percentage agreement and weighted Kappa's. Sensitivity was evaluated by comparing the IBA results of 169 infants at 35-38 weeks postmenstrual age, dichotomized according to two developmental risk factors. For responsiveness, the effect size (ES) was calculated between 0 and 6 months corrected age in all intervention and control infants and in subgroups of high-risk intervention and control infants with oxygen dependency ≥28 days.
Results:
Inter-rater agreement was 93% in the total assessment; Kappa agreement was moderate to good in the behavioural categories. Significant differences were found between groups with or without risk factors. Larger differences between ESs in the randomized groups with oxygen dependency ≥28 days than in the total randomized groups reflect the responsiveness of the IBA.
Conclusion:
In this study, we found satisfactory to good clinimetric characteristics of the IBA in very preterm born infants.
