Table 1.
NNNS Summary Scale Score Definitions
| 1. |
Attention: Ability to localize and track (follow?) animate and inanimate auditory and visual stimuli |
| 2. |
Asymmetric reflexes: Number of asymmetric responses to elicited reflexes |
| 3. |
Excitability: High levels of motor, state, and physiologic reactivity |
| 4. |
Habituation: Response decrement to repeated auditory and visual stimuli during sleep. |
| 5. |
Handling: Extent to which handling strategies were used during attention sequence to maintain alert state |
| 6. |
Hypertonicity: Hypertonic responses in arms, legs, or trunk or in general tone |
| 7. |
Hypotonicity: Hypotonic response in arms, legs, or trunk or in general tone |
| 8. |
Lethargy: Low levels of motor, state, and physiologic reactivity |
| 9. |
Quality of Movement: Attributes of motor control including smoothness, maturity, lack of startles and tremors |
| 10. |
Regulation: Capacity to modulate arousal, organize motor activity, physiology, and state in response to stimulation |
| 11. |
Non-optimal reflexes: Number of poor scores to elicited reflexes |
| 12. |
Stress/abstinence: Number of stress and abstinence signs observed during the exam. |
| 13. |
Arousal: Level of arousal maintained during the exam including state and motor |
Summary scores for the NNNS were developed by using an approach that combined conceptual and statistical (coefficient apha) aggregation of items and scores. The summary scores were first developed on a random selection of one half of the sample and then “replicated” on the second half of the sample. Scores on the summary variables indicate “higher/more” or “lower/less” of the behavior not necessarily “better” or “worse.” For example, a high score on “handling,” refers to an infant who requires substantial handling to elicit attention, indicating that they are difficult to test; a high score on hypertonia means that the infant was more hypertonic, and a high score on hypotonia means that the infant was more hypotonic. The habituation scale was not used in the present analysis because too few infants were asleep at the one month visit to the clinic.