Table 1.

NICU Network Neurobehavioral Scale summary scales

Summary scale	Description
Habituation	Decreased infant responding to various auditory and visual stimuli; mean of items (range 1–9)
Attention	Infant response to experimenter stimuli, indicated by appropriate head turning, gaze, and sustained alertness; mean of items (range 1–9)
Handling	Score based on the strategies the experimenter used during orientation tasks to keep the infant in an alert state; mean number of strategies used (range 0–1)
Quality of movement	Measure of smooth infant control of motor activity, lacking startles, tremors, and jitters; mean of items recoded for good motor control (range 1–9)
Regulation	A broad scale based on the infants’ ability to coordinate their movements, physiology, and state; also incorporates the infants’ ability to be soothed and their responses to the experimenter’s cuddling and consoling; mean of items recoded for good regulation (range 1–9)
Nonoptimal reflexes	Reflex responses from the infant that are weaker or stronger than what is optimal or expected; sum of items recoded for nonoptimal reflexes (range 0–15)
Asymmetric reflexes	Number of times that reflexes on one side of the infant’s body are stronger or weaker relative to the other side; sum of items recoded for asymmetric responses (range 0–15)
Stress/abstinence	Number of observed infant stress/abstinence signs across various organ systems; mean number of observed stress signs (range 0–1)
Arousal	Infant’s level of arousal, including motor activity in response to handling, irritability, and fussiness during the examination; mean of items recoded for high arousal (range 1–9)
Hypertonicity	Increased muscle rigidity and tone, especially in the infant’s arms, legs, and trunk; sum of items recoded for hypertonic indicators (range 0–10)
Hypotonicity	Increased muscle laxity and decreased tone, especially in the infant’s arms, legs, and trunk; sum of items recoded for hypotonic indicators (range 0–10)
Excitability	Increases in arousal, as assessed by the infant’s motor, state, and physiological activity; sum of items recoded for excitable behavior (range 0–15)
Lethargy	Decreases in arousal, as assessed by the infant’s motor, state, and physiological activity; sum of items recoded for lethargic behavior (range 0–15)