Agreement between the neonatal neurological examination and a standardized assessment of neurobehavioural performance in a group of high-risk newborns.
The degree of agreement between the neonatal neurological examination and a standardized neurobehavioural assessment was investigated in a group of 32 newborns with congenital heart defects. A paediatric neurologist performed a neurological examination, and an occupational therapist administered the Einstein Neonatal Neurobehavioural Assessment Scale on all subjects. Both examiners independently evaluated each subject, and were blinded to the diagnosis, to perinatal status and to each other's clinical findings. Statistical analysis demonstrated a significant association between the overall impression between both examiners (p < .0001), with a crude agreement of 96.9%. Sixteen neonates were determined to be normal and 15 abnormal by both examiners, with disagreement in only one subject. Although two distinct approaches were employed in the neurological assessment of high-risk newborns, both assessments evaluate the maturity and integrity of the immature central nervous system. The results demonstrate a strong agreement between these two approaches, suggesting that the neonatal neurological examination is consistent and valid.
Limperopoulos
C
C
School of Physical and Occupational Therapy, Department of Neurology, McGill University, Montreal, Quebec, Canada.
Majnemer
A
A
Rosenblatt
B
B
Shevell
M I
MI
Rohlicek
C
C
Tchervenkov
C
C
D000161:Acoustic Stimulation; D002490:Central Nervous System / Q000502:physiology; D015331:Cohort Studies; D003243:Consciousness / Q000502:physiology; D005069:Evaluation Studies as Topic; D005121:Extremities / Q000502:physiology; D006330:Heart Defects, Congenital / Q000503:physiopathology*; D006801:Humans; D018730:Infant Behavior / Q000502:physiology*; D007231:Infant, Newborn; D009068:Movement / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000502:physiology; D009207:Myoclonus / Q000503:physiopathology; D009424:Nervous System Physiological Phenomena; D009460:Neurologic Examination; D015588:Observer Variation; D010775:Photic Stimulation; D012018:Reflex / Q000502:physiology; D012026:Reflex, Stretch / Q000502:physiology; D015203:Reproducibility of Results; D012307:Risk Factors; D016037:Single-Blind Method; D012894:Sleep Stages / Q000502:physiology; D013391:Sucking Behavior / Q000502:physiology; D014202:Tremor / Q000503:physiopathology