Neonatal Behavioural Assessment Scale (NBAS)

Developed by Dr. Brazelton and his colleagues in 1973, the NBAS is a recognised neurobehavioural assessment tool, used worldwide in research and clinical settings. 

The NBAS is designed to document the newborn’s contribution to the parent-infant system, the competencies and individual differences of the newborn, as well as any vulnerabilities. Its interactive nature provides a clear and complete profile of the baby’s behaviour, and how it must feel to parent the baby.

It can be used with full-term babies (from birth to two months old), but also with premature babies (from 35 weeks gestation) and with developmentally delayed babies.

There are a total of 53 items, some of which are administered and some observed by the clinician during the assessment, including:

  • Behavioural items which assess the infant’s behavioural response to positive and negative stimuli;
  • Reflex items, which assess the infant’s neurological status;
  • Supplementary items to capture the range and quality of the behaviour of frail, high-risk infants.

The practitioner’s role during the assessment is to facilitate the newborn’s best performance, allowing the baby to demonstrate the full range of his/her capabilities. Doing so will provide a good understanding of the newborn’s capacity to interact with caregivers and the environment.

The NBAS is a valuable way of creating a rapport with parents and alerting them to the newborn’s behaviour, which can be seen as the baby’s language.  It can be used as an intervention (e.g. with postnatally depressed mothers), since observing the NBAS can help sensitise parents to the behavioural capacities of the newborn, improve mother-infant reciprocity and enhance paternal involvement. 

It can also be used as an educational tool for staff, as it can help them understand the caregiver’s response to the infant and the kinds of interactions he or she is likely to have. When summarising the NBAS with parents and staff, there can be a discussion of caregiving implications and follow-up planning.

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