The NeoNatal Neurobehavioral Scale (NNNS-II, pronounced as “ens 2”) examines the neurobehavioral organization, neurological reflexes, motor development -- active and passive tone, as well as signs of stress of the at-risk and healthy infant. It was designed to provide a comprehensive assessment of both neurological integrity and behavioral function. Additionally, the NNNS documents the range of withdrawal and stress behavior likely to be observed in assessment and intervention with infants exposed to substances. This neurobehavioral assessment is applicable to term, normal healthy infants, preterm infants and infants at risk due to factors such as prenatal substance exposure. As such, it is a useful tool for both researchers and clinicians. 

The exam is performed on infants who are medically stable in an open crib or isolette. Although a precise lower gestational age limit has not been set, the exam may not be appropriate for infants less than 33 weeks of age. The upper age limit may also vary depending on the developmental maturation of the infant. A reasonable upper age limit is approximately 48 weeks (adjusted or conceptional age), but it may prove useful with even older infants.

Application of the NNNS-II

• Research with Infants who are High-Risk including those who are born Pre-term and Infants who are Exposed to Substances
• Beneficial for Consultation with Parents, Families and Health Care Professionals
• Clinical Assessment for Management of Infants in NICU or Normal Nurseries
• Assists in Discharge Planning
• Assists with the Development of Early Intervention Plans

Invaluable To: Pediatricians, Neonatologists, Neurologists, Psychiatrists, Nurses, Psychologists, Occupational Therapists, Physical Therapists, & Early Intervention Professionals

The Journal of Visualized Experiments presents an overview of how the NNNS is administered.

Journal of Visualized Experiments -- NNNS

NOTE: Use of the NNNS or NNNS-II requires training and certification.