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Updated: Nov 18, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Early developmental screening and intervention for high-risk neonates - From research to clinical benefits
Alicia Jane Spittle1, Peter John Anderson2, Sarah Jane Tapawan3
1Department of Physiotherapy, University of Melbourne, Grattan St, Parkville, VIC, 3052, Australia.
Insights
Advances in neonatal care increase survival for very preterm infants, but they face high risks of neurodevelopmental delays. Early interventions are crucial, yet screening and treatment timing vary globally, necessitating targeted approaches for at-risk infants.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Neurodevelopmental disorders
Background:
- Neonatal care advancements have improved survival rates for very preterm infants and those with complex medical needs.
- These infants remain at high risk for neurodevelopmental delays, including motor, cognitive, and emotional/behavioral challenges.
- Early identification and intervention are critical for improving outcomes in high-risk infants.
Purpose of the Study:
- To highlight the need for standardized developmental screening practices globally.
- To emphasize the importance of timely initiation of early interventions for at-risk infants.
- To advocate for targeted approaches and further research on the cost-effectiveness of developmental surveillance and interventions.
Main Methods:
- Review of current literature on neonatal survival, neurodevelopmental risks, and early intervention strategies.
- Analysis of global variations in clinical practices for developmental screening and intervention.
- Identification of high-risk infant populations for targeted support.
Main Results:
- Despite increased survival, significant neurodevelopmental challenges persist in very preterm and complex-needs infants.
- There is considerable global variability in recommended developmental screening protocols and the timeliness of intervention.
- Evidence supports the efficacy of early interventions, but implementation gaps exist.
Conclusions:
- Standardized, evidence-based developmental surveillance and early intervention are essential for improving long-term outcomes in high-risk neonatal populations.
- Targeting resources towards infants most at risk is crucial, given resource limitations.
- Further research into the cost-effectiveness of surveillance and early intervention programs is warranted.
Abstract:
With advances in neonatal care there has been an increase in survival rates for infants born very preterm and/or with complex needs, such as those who require major surgery, who may not have survived decades ago. Despite advances in survival, these infants remain at high-risk for a range of neurodevelopmental delays and/or impairments including motor, cognitive and emotional/behavioural challenges. Research has improved our ability to identify which infants are at high-risk of developmental delay and/or impairments, and there is mounting evidence that early interventions can improve outcomes of these infants. However, clinical practice varies throughout the world regarding recommendations for developmental screening. Moreover, intervention, when available, is often not commenced early enough in development. Given limited resources, those infants most at risk of developmental impairments and their families should be targeted, with further research needed on the cost-effectiveness of surveillance and early interventions.
