For assessing the quality of neurodevelopmental care in the NICUs,what tool is preferred?
Developmental assessment is performed using Bayley
Scales of Infant Development II (BSID-II) until postnatal 42 months. (Bayley N. Bayley Scales of Infant Development-II. San Antonio, TX: Psychological Corp; 1993).
The Bayley is beneficial for assessing outcome after NICU discharge. However, the assessment of short term outcome is possible prior to NICU discharge. I prefer the NICU Network Neurobehavioral Scale for a comprehensive measure of outcome prior to discharage. It gives 13 summary scores of function: habituation, orientation, arousal, tolerance of handling, self regulation, asymmetry, sub-optimal reflexes, hypertonia, hypotonia, excitability, lethargy, stress, and quality of movement. However, this tool requires that the infant can tolerate multiple position changes over approximately 20 minutes. It also requires a certified examiner. The Dubowitz is a 34 item tool that can be administered in approximately 10 minutes. The Premie Neuro is appropriate for infants between 23-37 PMA, and an abbreviated from can be used for infants who are still intubated. If attempting to discriminate CP, Prechtl's General Movement assessment may be a good choice. If assessing feeding, the Neontal Oral Motor Asessment. There are other tools that are used in the NICU, including the NAPI, APIB, TIMP,
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