STANDARDIZATION OF THE NRN: NEUROBEHAVIORAL SCALE

对围产期正常或高危儿的神经行为表现缺乏全面、标准化、规范化的评估。该项目的具体目标是使用一种独特的综合性心理测量量表，新生儿重症监护研究网络神经行为量表（NNNS），在围产期为胎龄（GA）组和（如适用）性别和/或种族/民族组制定新生儿神经行为表现的标准化规范。NNNS的标准化将是儿科学、儿科学、小儿神经学和儿童发育研究的一个重要方法学进步。它将提供规范来评估神经行为状态与医疗和社会地位变量之间的关系，并评估医疗和发育干预（包括NICU生态和早期干预的变化）对围产期和老年神经行为状态的影响。此外，一个标准化的工具将有助于比较各项研究和建立大型数据库。标准化规范将对临床护理产生重大影响，因为规范将识别功能异常或可疑的新生儿，并允许与规范相比对个别婴儿进行评估。我们建议对720名婴儿的样本进行前瞻性纵向研究，按（1）GA：1] 28-33周; 2] 34-37周; 3] 38-42周;（2）3个种族/民族组（黑人、西班牙裔、白色）;和（3）性别分层。在我们的排除标准范围内，婴儿的医疗和社会地位将自由变化。每个GA组中的婴儿将用NNNS检查三次：1]医学稳定+3天或出生+1天，2]足月（即，对于足月组，这与出生+1天）和GA 44周时的3]相同。将使用收敛度量仔细定义几何年龄。

There is no comprehensive standardized, normed assessment of neurobehavioral performance of normal Or high risk infants during the perinatal period. The specific aim of this project is to develop standardized norms for newborn neurobehavioral performance for gestational age (GA) groups and where appropriate, gender and/or race/ethnicity groups during the perinatal period using a uniquely comprehensive psychometrically sound scale, the Neonatal Intensive Care Research Network Neurobehavioral Scale (NNNS). Standardization of the NNNS will be a significant methodological advance for research in neonatology, pediatrics, pediatric neurology, and child development. It will provide norms to evaluate relations between neurobehavioral status and medical and social status variables, and to evaluate the effects of medical and developmental interventions (including changes in NICU ecology and early intervention) on neurobehavioral status during the perinatal period and at older ages. Furthermore, a standardized instrument will facilitate comparison of studies and the development of large data bases. Standardized norms will have a significant impact on clinical care because norms will identify neonates who are functionally abnormal or suspect and permit the evaluation of individual infants in comparison to the norms. We propose to carry out a prospective longitudinal study on a sample of 720 infants stratified by (1) GA: 1] 28-33 weeks; 2] 34-37 weeks; 3] 38-42 weeks; (2) 3 racial/ethnic groups (Black, Hispanic, White); and (3) gender. Within the boundaries of our exclusion criteria, the medical and social status of the infants will be free to vary. Infants in each GA group will be examined with the NNNS three times: 1] when medically stable +3 days or at Birth + 1 day, 2] Term (i.e., for the term group this is the same as Birth +1 day), and 3] at 44 weeks GA. Gestational age will be carefully defined using the converging measures.