DEVELOPMENTAL ASSESSMENT OF YOUNG CHILDERN 4

Developmental assessment of Young children 4 (1+3)

Lesson 9:Neurobehavioural Assessment of Newborn Infant

Contribution of different fields for neonatal assessment

The history of assessment techniques in infancy has shown a progressive transition from search for gross structural abnormalities to new emphasis on cognitive, emotional and social development of the young child. Different field/disciplines like developmental neurology, behavioural pediatrics and developmentally psychology have contributed for evolving neonatal assessment.

Field details	Areas Emphasized for assessment	Details about Persons & their contributions
Developmental neurology	Evaluation of reflexes. Observational studies to detect early signs of infant abnormality	Paine (1960): Developed neurological examination for infants. It include tests of – Neuromotor behavior (muscle tone, quality of primitive reflexes) sensory abilities cranial nerves speech mental state state of consciousness assessment of full term and preterm infants. Peiper: Concentrated on reflex behavior devised a scheme for observing new born’s control of posture and movement. Andre Thomas : Gave importance to observation of spontaneous movement of child and reflexes and their effects on infant behaviour. Introduced the concepts of Active Vs passive muscle tone (when manipulated by the examiner) Extensibility (increased muscle tone/spasticity) Vs Flaccidity (low muscle tone/ hypotonic).
Behavioural pediatrics	Emphasis on maturation Normative examination of visual and auditory responses	Arnold Gesell: Documented developmental mile stones for infants and preschoolers. Widely used scales like Bayley’s scale of Infant Development and Denver Developmental screening scale draw heavily from Gesell’s schedules.
Developmental psychology	3 principles identified for new born assessment	The three principles are Development is hierarchical: Development has order, steps or stages and there is mutual dependence from one step to another. Development is dialectical: At each developmental step or stage and with each developmental task, the achievement and its integration into overall functioning is subject to the relationship between the infant and the context or environment. In which the development occurs. The infant and the physical and social context are seen in mutual ongoing transactions each contributing to change in the other and to itself. Development is teleological: Teleology is the view that developmental changes are guided not only by mechanical forces but by movement towards certain goals.

Draw backs of neurological field:

• No attempts to assess behavioural capabilities and individual differences in infant attention or ability to manage and respond to social and nonsocial stimuli.
• Not given importance to know the effects of neonatal behavior on care givers, interactions with care givers and contribution of the care giving context.