Neonatal Behavioral Assessment Scale (NBAS)
Barlow, J., Herath, N., Bartram Torrance, C., Bennett, C. and Wei, Y. (2018). The Neonatal Behavioral Assessment Scale (NBAS) and Newborn Behavioral Observations (NBO) system for supporting caregivers and improving outcomes in caregivers and their infants. Cochrane Database of Systematic Reviews.
Purpose:
The purpose of this article is to look at the effects of the Newborn Behavioral Observations (NBO) & Neonatal Behavioral Assessment Scale (NBAS) on caregiver-infant interaction. It also looks at caregivers & infants from different family styles (single parents, first-time parents, etc.), socioeconomic status & complications during pregnancy or birth.
Study Population:
This article includes 16 randomized control trials looking into the NBAS & NBO as an intervention. Participants were selected from a labor and delivery hospital with participants being from both rural and urban areas. 11 of the studies assessed the interaction between the infant and mother, while 2 studies looked at infant and father interaction & 2 studies looked at the interaction with both parents. The age of the infants ranged from 34 weeks gestational age up to 12 weeks following delivery.
Outcome Measures:
All 16 of the studies used either the NBAS or the NBO with most studies also utilizing other outcome measures. They included: Price Adaptation Scale, Paternal Attitude Scale, Infant Characteristics Questionnaire, Parenting Stress Index, Bayley Scales of Infant Development, Nursing Child Assessment Feeding Scale, Infant Behavior Assessment Record, Maternal Representations Questionnaire, CARE-Index, Neonatal Perception Inventory, Ainsworth Interaction Scale, Modified Degrees of Bother Scale, Carey Infant Temperament Questionnaire, Home Visiting Index, Broussard Neonatal Perception Inventory, Edinburgh Postnatal Depression Scale, Mother-Infant Sensitivity, & Cohler Maternal Attitude Scale
Interventions:
Due to this article being a review of 16 studies, interventions varied. All of the studies included at least one control group in which they did not receive the NBAS or NBO as an intervention. Nine of the studies performed the intervention one time, five studies performed the intervention two times, one study performed the intervention three times, and one study performed the intervention seven times. The intervention was, typically, initially performed while the infant was still in the hospital during the first 24-72 hours of life. The duration of the intervention ranged from less than 30 minutes up to 60 minutes. Seven studies did not report the duration of their intervention session. Follow-up was done as early as 10 days post-partum up to 9 months.
Results:
Seven of the studies were able to undergo a meta-analysis, which revealed a statistically significant difference between the control and intervention groups in the quality of the caregiver-infant interaction. Caregiver mental health showed no significant difference between the control and intervention groups. No significant difference was found between groups for infant social, emotional, cognitive, and motor development. There was also no significant difference between groups for the caregiver’s perception of the infant, caregiver stress, caregiver reflection, and caregiver confidence. Lastly, a significant difference favoring the intervention groups showed that caregivers who received the NBAS or NBO as an intervention had a better understanding of their infant’s behavior.
Major Strengths/Limitations:
The strengths of the study are that they did a large review of the literature on this topic before narrowing it down to 16 articles that fit their inclusion criteria. The article also includes an abstract in plain language. This is useful as those without extensive knowledge of the language used in research and in the health profession will be able to review and understand the article. Some of the limitations of the article are that much of the evidence included was rated as low or very low. Most of the studies used were from families with two parents or of high socioeconomic status. This makes it hard to relate this to infants and caregivers who do not fall into those groups. I would have liked more information on the differences between the different populations included in several of the studies.
Overall Conclusions:
Overall, there continues to be limited research on the use of the NBAS and NBO for caregiver and infant interactions. More research also needs to be performed to determine the most appropriate population as the studies in this review widely varied. As stated above in the results, it could have a positive impact on the relationship of the caregiver and infant as well as improving the knowledge of the caregiver on their infant’s behaviors.
2 responses to “Neonatal Behavioral Assessment Scale (NBAS)”
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I think it is interesting that the NBAS which is an outcome measure was utilized as an intervention to identify areas of improvement for newborn and caregiver interaction. The significant difference showing that the intervention group had a better understanding of their newborn’s behavior may perhaps mean that this outcome measure should be utilized for all newborns and their caregiver. This is a time where many parents would benefit from the knowledge how their child responds to certain noises, and stimuli and to be able to use that information at home. This can take some of the “guesswork” out of why their newborn is acting the way they are.
Great article summary Taylor. As Trishia previously mentioned, the NBAS should be a tool that is utilized on a much more frequent basis because it could be very helpful to parents (especially first-time parents) of a newborn. With that being said, I also can’t help but wonder if all parents would utilize this outcome measure, or if threy’d rather just go with the flow of whatever their newborn brings to each day without the privilege of having the added knowledge.