History and description of the Neonatal Intensive Care Unit Network Neurobehavioral Scale
Abstract
This article provides an introduction and background to the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS). First is a summary of the history of the field of infant assessment. This is followed by a description of the NNNS, including its basic features and how the NNNS differs from other examinations. We then describe the biobehavioral basis for the examination and review studies in which the NNNS has been used. Finally we discuss the developmental model on which the NNNS is based and consider the implications of using the examination.
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The NNNS was developed for the National Institutes of Health to assess effects of prenatal drug exposure in infants.
“The NNNS was developed for the National Institutes of Health to assess effects of prenatal drug exposure in infants.12, 21”
From Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days (2009) · cites this paper as [12]
Cites
The Integrative Action of the Nervous System.
Sherrington, C. (1907) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-190734120-00021 · Cited by 4,136 · see citing works
The problem of serial order in behavior
Lashley, K. S. (1951) · MPG.PuRe (Max Planck Society) · Cited by 2,734 · see citing works
Eimas, P. D., Siqueland, E. R., Jusczyk, P., & Vigorito, J. (1971) · Science · doi:10.1126/science.171.3968.303 · Cited by 2,154 · see citing works
Neonatal Behavioral Assessment Scale
Salkind, N. J. (2005) · Encyclopedia of Human Development · doi:10.4135/9781412952484.n438 · Cited by 1,328 · see citing works
The behavioural states of the newborn infant (a review)
Prechtl, H. F. R. (1974) · Brain Research · doi:10.1016/0006-8993(74)90454-5 · Cited by 1,177 · see citing works
Clinics in Developmental Medicine
Humphreys, P. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4831-9649-7.50021-9 · Cited by 1,146 · see citing works
Condon, W. S., & Sander, L. W. (1974) · Science · doi:10.1126/science.183.4120.99 · Cited by 729 · see citing works
The origins of reciprocity : The early mother-infant interaction
Brazelton, T. B., Koslowski, B., & Main, M. (1974) · Cited by 682 · see citing works
Cerebral Mechanisms in Behavior: The Hixon Symposium
(1952) · JAMA · doi:10.1001/jama.1952.02930120090037 · Cited by 652 · see citing works
The neurological examination of the full term newborn infant
Prechtl, H. F. R. (1977) · Medical Entomology and Zoology · Cited by 543 · see citing works
Infant Perception: from Sensation to Cognition
(1975) · Elsevier eBooks · doi:10.1016/c2013-0-10515-6 · Cited by 433 · see citing works
Lester, B. M., Tronick, E. Z., LaGasse, L., Seifer, R., Bauer, C. R., Shankaran, S., Bada, H. S., Wright, L. L., Smeriglio, V. L., Lu, J., et al. (2002) · PEDIATRICS · doi:10.1542/peds.110.6.1182 · Cited by 317 · see citing works
Self-citationNeurological evaluation of the maturity of newborn infants.
Amiel‐Tison, C. (1968) · Archives of Disease in Childhood · doi:10.1136/adc.43.227.89 · Cited by 313 · see citing works
The Maternal Lifestyle Study: Drug Use by Meconium Toxicology and Maternal Self-Report
Lester, B. M., ElSohly, M. A., Wright, L. L., Smeriglio, V. L., Verter, J. I., Bauer, C. R., Shankaran, S., Bada, H. S., Walls, H. C., Huestis, M. A., et al. (2001) · PEDIATRICS · doi:10.1542/peds.107.2.309 · Cited by 307 · see citing works
Self-citationSmoking during pregnancy and newborn neurobehavior
Law, K. L., Stroud, L. R., LaGasse, L. L., Niaura, R., Liu, J., & Lester, B. M. (2003) · PEDIATRICS · doi:10.1542/peds.111.6.1318 · Cited by 307 · see citing works
Self-citationThe causes, controls, and organization of behavior in the neonate.
Wolff, P. H. (1966) · PubMed · Cited by 293 · see citing works
Speech Perception in Early Infancy
Eimas, P. D. (1975) · Elsevier eBooks · doi:10.1016/b978-0-12-178602-1.50012-9 · Cited by 251 · see citing works
Theory and Research in Behavioral Pediatrics
(1991) · Springer eBooks · doi:10.1007/978-1-4615-3680-2 · Cited by 241 · see citing works
Fantz, R. L., Fagan, J. F., & Miranda, S. B. (1975) · Elsevier eBooks · doi:10.1016/b978-0-12-178601-4.50010-4 · Cited by 240 · see citing works
The Maternal Lifestyle Study: Drug exposure during pregnancy and short-term maternal outcomes
Bauer, C. R., Shankaran, S., Bada, H. S., Lester, B. M., Wright, L. L., Krause-Steinrauf, H. J., Smeriglio, V. L., Finnegan, L. P., Maza, P. L., & Verter, J. I. (2002) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2002.121073 · Cited by 196 · see citing works
Self-citationContextual Effects in Infant Speech Perception
Eimas, P. D., & Miller, J. L. (1980) · Science · doi:10.1126/science.7403875 · Cited by 177 · see citing works
The automatic grasping responses of infants
Twitchell, T. E. (1965) · Neuropsychologia · doi:10.1016/0028-3932(65)90027-8 · Cited by 153 · see citing works
Olfactory responses and adaptation in the human neonate.
Engen, T., Lipsitt, L. P., & Kaye, H. (1963) · Journal of Comparative and Physiological Psychology · doi:10.1037/h0043633 · Cited by 148 · see citing works
Toward a Research Instrument for the Assessment of Preterm Infants’ Behavior (APIB)
Als, H., Lester, B. M., Tronick, E. Z., & Brazelton, T. B. (1982) · Springer eBooks · doi:10.1007/978-1-4899-0442-3_2 · Cited by 146 · see citing works
Self-citationThe neurological examination of the infant
Thomas, A., Chesni, Y., Dargassies, S. S.-A., Mackeith, R., Polani, P. E., & Clayton-Jones, E. (1960) · Medical Entomology and Zoology · Cited by 118 · see citing works
Effects of In Utero Substance Exposure on Infant Neurobehavior
Napiorkowski, B., Lester, B. M., Freier, M. C., Brunner, S. M., Dietz, L. J., Nadra, A., & Oh, W. (1996) · PEDIATRICS · doi:10.1542/peds.98.1.71 · Cited by 103 · see citing works
Self-citationMechanisms of Action of Drugs of Abuse on the Developing Fetal Brain
Malanga, C. J., & Kosofsky, B. E. (1999) · Clinics in Perinatology · doi:10.1016/s0095-5108(18)30070-8 · Cited by 92 · see citing works
Rosenblith, J. F. (2009) · Biologia Neonatorum · doi:10.1159/000239814 · Cited by 56 · see citing works
Neurological development in the full-term and premature neonate
Dargassies, S. S.-A. (1977) · Cited by 55 · see citing works
Behavioural and other Measurements in the Neonate
Lind, J. (1971) · Proceedings of the Royal Society of Medicine · doi:10.1177/003591577106400503 · Cited by 53 · see citing works
Die Hirntätigkeit des Säuglings
Peiper, A. (1928) · Springer eBooks · doi:10.1007/978-3-642-92085-1 · Cited by 35 · see citing works
Die Hirntätigkeit des Säuglings
Peiper, A. (1928) · Springer eBooks · doi:10.1007/978-3-662-33021-0_10 · Cited by 24 · see citing works
Heparin Treatment of Recent Transient Ischemic Attacks: A Safety Study
Dahl, T., Sandset, P. M., & Abildgaard, U. (1993) · Cerebrovascular Diseases · doi:10.1159/000108694 · Cited by 2 · see citing works
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Spittle, A. J., Doyle, L. W., & Boyd, R. N. (2008) · Developmental Medicine & Child Neurology · doi:10.1111/j.1469-8749.2008.02025.x · Cited by 372 · see citing works
Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days
Stroud, L. R., Paster, R. L., Papandonatos, G. D., Niaura, R., Salisbury, A. L., Battle, C., Lagasse, L. L., & Lester, B. (2009) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2008.07.048 · Cited by 102 · see citing works
Self-citationMaternal smoking during pregnancy and neonatal behavior: a large-scale community study
Stroud, L. R., Paster, R. L., Goodwin, M. S., Shenassa, E., Buka, S., Niaura, R., Rosenblith, J. F., & Lipsitt, L. P. (2009) · PEDIATRICS · doi:10.1542/peds.2008-2084 · Cited by 96 · see citing works
Everson, T. M., Marsit, C. J., Michael O’Shea, T., Burt, A., Hermetz, K., Carter, B. S., Helderman, J., Hofheimer, J. A., McGowan, E. C., Neal, C. R., et al. (2019) · Scientific Reports · doi:10.1038/s41598-019-42654-4 · Cited by 82 · see citing works
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- Authors
- Lester, B. M., & Tronick, E. Z.
- Affiliations
- Brown University (US)
- Harvard University (US)
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2004-03-01
- Volume
- 113
- Issue
- Supplement_2
- Pages
- 634-640
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2123556867
- Cited by
- 154
- References
- 33
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 12 · 2020: 5 · 2019: 10 · 2018: 8 · 2017: 4 · 2016: 8 · 2015: 9 · 2014: 9 · 2013: 11 · 2012: 8
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- neonatal neurobehavioral assessment, developmental model, neonatal intensive care
- MeSH terms
- Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Intensive Care Units, Neonatal, Male, Neonatal Abstinence Syndrome, Neuropsychological Tests, Pregnancy, Prenatal Exposure Delayed Effects, Risk, Reproducibility of Results, Neonatal Screening, Infant Behavior, History, 20th Century
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