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Updated: Apr 27, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A four year follow-up of infants with early signs of neuro-developmental deviation
Insights
High-risk infants identified with early dystonic signs showed developmental delays and variability at age four. Continued monitoring is crucial as many early signs may be transient.
Area of Science:
- Neurodevelopmental Pediatrics
- Child Psychology
- Developmental Neurology
Background:
- Early neurodevelopmental signs in high-risk infants can be transient and variable.
- Longitudinal follow-up is essential for understanding developmental trajectories.
Purpose of the Study:
- To investigate the four-year neuro-sensory-motor and general developmental progress of infants identified as 'dystonic' at four months.
- To compare the developmental outcomes of 'dystonic' infants with a matched 'non-dystonic' control group.
Main Methods:
- Longitudinal study tracking 15 'dystonic' infants and a matched control group.
- Assessment of neuro-sensory-motor and general developmental performance up to four years of age.
Main Results:
- At four years, the 'dystonic' group exhibited significantly lower developmental competence and greater variability across all assessed areas compared to controls.
- Only one child in the 'dystonic' group was ultimately diagnosed with cerebral palsy, highlighting the transient nature of early signs.
Conclusions:
- Early 'dystonic' signs in high-risk infants predict poorer developmental outcomes at four years.
- The transient nature of some early neurodevelopmental signs necessitates ongoing follow-up.
- Findings underscore the importance of continued monitoring for potential school-related difficulties in this cohort.
Abstract:
The transient and variable nature of abnormal or deviant neuro-developmental signs during the early post-term months of 'high risk' infants, has been recognized. Careful longitudinal follow-up of these children is indicated. This study investigates the neuro-sensory-motor and general developmental progress over four years, of a group of children who were identified as 'dystonic' at the adjusted age of four months. The developmental performance of these 15 children was compared with a matched group of children. The results indicated that at four years of age the 'dystonic' group of children were developmentally less competent and more variable in all areas assessed than their 'non-dystonic' peers. Only one child was ultimately diagnosed as cerebral palsy indicating the transient nature of quite marked early signs. The implications for possible problems at school emphasize the need for continued follow-up of this group of children.

