STANDARDIZATION OF THE NRN: NEUROBEHAVIORAL SCALE

对于正常或高危婴儿围产期的神经行为表现，目前还没有全面、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心理测量学量表，即新生儿重症监护研究网络神经行为量表（NNNS），为围产期的胎龄（GA）群体以及性别和/或种族/民族群体制定新生儿神经行为表现的标准化规范。NNNS的标准化将是新生儿学、儿科学、小儿神经学和儿童发育研究的重要方法学进步。它将为评估神经行为状态与医疗和社会地位变量之间的关系提供规范，并评估医疗和发育干预（包括新生儿重症监护室生态的变化和早期干预）对围产期和老年期神经行为状态的影响。此外，标准化的工具将有助于比较研究和发展大型数据基。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，并允许将个体婴儿与规范进行比较评估。我们建议对720名婴儿样本进行前瞻性纵向研究，按(1)GA: 1] 28-33周进行分层；[2] 34-37周；[3] 38 ~ 42周；(2) 3个种族/族裔群体（黑人、西班牙裔、白人）；(3)性别。在我们排除标准的范围内，婴儿的医疗和社会地位将自由变化。每个GA组的婴儿将接受三次NNNS检查：1]在医学稳定+3天或出生+1天时，2]足月（即足月组与出生+1天相同），3]在GA 44周时。将使用趋同的测量方法仔细定义胎龄。

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.