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Updated: Jan 5, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal behavior and social behavior and sensory issues in 18-month toddlers
Akiko Tokunaga1, Tomitaro Akiyama2, Tsunetake Miyamura3
1Department of Psychiatric Rehabilitation Science, Unit Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Insights
Neonatal behavioral assessments, including orientation and motor skills, may predict later social and sensory issues in toddlers. Early detection of autism spectrum disorder (ASD) is crucial for timely intervention.
Area of Science:
- Neonatal development
- Developmental pediatrics
- Autism spectrum disorder research
Background:
- Early detection and intervention are critical for children with autism spectrum disorder (ASD).
- Identifying early behavioral markers can facilitate timely support.
- This study investigates neonatal behavioral predictors of later social and sensory development.
Purpose of the Study:
- To prospectively examine the relationship between neonatal behavioral features and social behavior/sensory issues at 18 months.
- To identify specific neonatal behavioral clusters associated with later developmental outcomes.
- To explore potential early indicators for autism spectrum disorder risk.
Main Methods:
- 105 healthy, full-term infants were assessed using the Neonatal Behavioral Assessment Scale (NBAS) within the first week of life.
- At 18 months, infants were evaluated using the Japanese version of the Modified Checklist for Autism in Toddlers (M-CHAT-JV) and the Infant/Toddler Sensory Profile (ITSP).
- Statistical analyses included comparisons between M-CHAT-JV positive/negative groups and correlation/regression analyses.
Main Results:
- 15.2% of infants were M-CHAT-JV positive at 18 months.
- Significant differences in NBAS orientation and motor clusters were found between M-CHAT-JV positive and negative groups.
- NBAS orientation and motor clusters correlated with specific sensory processing patterns (e.g., low registration, auditory processing, sensation avoiding, tactile processing).
- NBAS orientation and ITSP low registration were significant predictors of M-CHAT-JV status at 18 months.
Conclusions:
- Neonatal behavioral features, particularly orientation, are associated with social behavior and sensory profiles at 18 months.
- These findings suggest the potential utility of NBAS in identifying infants at risk for developmental differences, including those related to ASD.
- Early identification through neonatal assessments may pave the way for earlier interventions.
Background:
There has long existed a need for early detection and early intervention for children with autism spectrum disorder. Accordingly, the aim of this study was to demonstrate, in a prospective manner, the relationship between behavioral features during the neonatal period and social behavior and sensory issues at 18 months.
Methods:
Participants were 105 full-term infants considered "healthy" by an obstetrician. The behavioral features of the infants were evaluated using the Neonatal Behavioral Assessment Scale (NBAS) between 2 and 7 days after birth. Follow-up assessments were conducted 18 months later using a Japanese version of the Modified Checklist for Autism in Toddlers (M-CHAT-JV) and the Infant / Toddler Sensory Profile (ITSP).
Results:
Sixteen (15.2%) of the 105 infants were M-CHAT-JV-positive. There were significant differences between the M-CHAT-JV-positive and M-CHAT-JV-negative groups in two of the NBAS clusters: orientation and motor. We observed a significant negative correlation between the NBAS orientation cluster and the ITSP "low registration" and "auditory processing" sections, as well as between the NBAS motor cluster and the ITSP "sensation avoiding" and "tactile processing" sections. Logistic regression analysis showed that the NBAS orientation cluster and ITSP low registration were significantly associated with the M-CHAT-JV at 18 months.
Conclusions:
The results suggest a relationship between the NBAS orientation cluster in full-term neonates and their social behavior and sensory features at 18 months.
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