Assessment in the Early Years
Dr. A. Bakshi
Brazelton Neonatal Assessment Scale (BNAS)
For infants between 3 days and 8 weeks of age
Index of a newborn’s competence
Developed in 1973 by a Howard pediatrician, Dr. T. Berry Brazelton and his colleagues. Produces 47 scores: 27 behavioral items and 20 elicited responses BNAS: Special Contributions
When the Scale was published in the early 1970s, people were just beginning to appreciate the infant's full breadth of capabilities, and the only tests available were designed to detect abnormalities. The Scale was designed to go beyond available assessments by revealing the infant's strengths and range of individuality, while still providing a health screen. BNAS: Key Assumptions
First, infants, even ones that seem vulnerable, are highly capable when they are born. "A newborn already has nine months of experience when she is born," Dr. Brazelton notes. "She is capable of controlling her behavior in order to respond to her new environment." Second, babies "communicate" through their behavior, which, although it may not always seem like it, is a rational language. “While babies may not speak their first word for a year, they are born ready to communicate with a rich vocabulary of body movements, cries and visual responses: all part of the complex language of infant behavior”. Not only do infants respond to cues around them, like their parents' faces, but they also take steps to control their environment, such as crying to get a response from their caregivers. Third, infants are social organisms, individuals with their own unique qualities, ready to shape as well as be shaped by the caregiving environment. BNAS: Areas represented by Scores
Responses to stress
Ability to habituate to sensory stimuli
BNAS: What the Test Measures
Based on the premise that when infants are born they face four developmental tasks vital to their growth. The Scale examines how well the infant manages these interrelated tasks and sees if the baby may need extra caregiving support in some areas.
BNAS: Four Developmental Tasks in Infancy as Construed by Brazelton The First Developmental Task
The most basic challenge facing newborns is to regulate their breathing, their temperature and the rest of their autonomic system, which needs to be functioning properly before infants can concentrate on other developmental areas. High-risk infants may spend most of their energy trying to maintain their autonomic systems, so they cannot focus on other areas of growth. Sights and sounds may overtax them, so looking at their mother's face may disturb their breathing or noise may set off tremors, startles or color changes, signals that are assessed by the Scale. The Second Developmental Task
Next, infants strive to control their motor system.
Inhibiting random movements and controlling activity levels lets the newborn focus her energy on other developmental tasks vital to growth. If the baby is having difficulty in this area, caregivers can help her by providing as much tactile support as necessary to help her settle down, such as holding or swaddling her. The Scale assesses the quality of the baby's tone, activity level and reflexes. The Third Developmental Task
Once the baby can manage motor behavior, she will be ready to tackle the next sphere in her developmental agenda: "state" regulation. State is a key developmental concept that describes levels of consciousness, which range from quiet sleep to full cry. The infant's ability to control her states enables her to process and respond to information from her caregiving environment. The NBAS examiner looks at how an infant controls her states, and at the transition from one state to another. For example, the exam reveals how an infant responds to light,...
Kaplan & Saccuzzo (2005)
BSID study material was photocopied from Kaplan and Saccuzzo (2005)
Denver Developmental Screening Test II (DDST-II): Purpose & Content
Normative sample: Originally, 1036 English-speaking children from
Colorado, approximating the occupational and ethnic distribution of that state
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