Portal de Periódicos da CAPES

Importance of behavioral assessment of the neonate

1976; Elsevier BV; Volume: 7; Issue: 2 Linguagem: Inglês

10.1016/s0045-9380(76)80013-8

1535-6329

T. Berry Brazelton, Winifred B. Parker, Barry Zuckerman,

Infant Development and Preterm Care

Summary An assessment of the neonate's behavioral responses should be a part of every pediatric examination. A behavioral assessment reflects the capacity for integration of the central and autonomic nervous systems and therefore is a window to the wellbeing of the newborn. In order to fully understand and evaluate the significance of the newborn's behavior, it is essential to put this examination into context by a complete prenatal and perinatal history. Behavioral assessments of the newborn are being increasingly utilized to evaluate effects of intrauterine experiences, such as fetal malnutrition, exposure to alcohol and drugs, obstetric procedures such as maternal anesthesia and analgesia, cesarean section, as well as the effects of technics in neonatal management, such as phototherapy and drugs. Behavioral assessments can give us insights into individual differences among neonates and cross-cultural differences among groups of newborns. Behavioral assessments over time will give us insight into a baby's capacity to adapt to his environment and to overcome the physiologic stresses of delivery. We can begin to assess a baby's potential availability for processing information necessary to future progress. It may predict to his capacity to capture the attachment energies of his environment as well. In its most limited use, neonatal behavior becomes a sensitive indicator of the integrity of the central nervous system. In a more general sense, behavioral responses can be tied to other responses to reflect the integrity of the whole organism. And, eventually, the infant's capacity for total responses can become a measure of prediction for the response of the environment to him. Thus, behavioral assessment in the neonatal period can predict to at-riskness in the infant himself and to deficits in his environment as he becomes a participant in parent-infant interaction. Evaluation of a baby's abilities to respond and style of response provides the clinician with a powerful tool in his role of helping parents to foster a child's physical and emotional wellbeing. The pattern of recovery of his potential for behavior over the first week becomes the most important way of predicting not only to his immediate coping capacity but to his future reactions to stress. Thus, several assessments in the perinatal period become of significance. It is important now to follow up our neonatal behavioral assessment with behavioral assessments throughout the first year of life to begin to understand how developiental processes include both the infant's capabilities and those of his environment, as well as the relationship between them. This will give us a better handle on our goals to optimize emotional as well as physical development in our work with parents and their infants.