Neurobehavioral Assessment of the Preterm Infant (NAPI)

Methods

The NAPI was developed at Stanford University. Large samples of premature infants were recruited from five intensive and intermediate care nurseries. Rigorous studies of two independent cohorts established the NAPI's reliability, developmental and clinical validity. The NAPI provides normative data on the week-to-week changes and progress of preterm infants between 32 weeks and term.

The NAPI is now being used by investigators in many different countries all over the world. Two recent studies have shown that the NAPI significantly correlates with later development as measured by the Bayley Scales of Infant Development.

The methodological and statistical approach used resulted in a relatively brief and gentle instrument consisting of seven reliable and developmentally valid clusters and single-item neurobehavioral dimensions that represent a conceptually and clinically meaningful spectrum of preterm infant functions. These dimensions are:

  1. Motor development and vigor
  2. Scarf sign
  3. Popliteal angle
  4. Alertness and orientation
  5. Irritability
  6. Quality of crying
  7. Percent sleep ratings

Additionally, the procedure includes a number of summary rating scales involving the quality of spontaneous movements, of visual behavior, and crying.

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