NeoNatal Neurobehavioral Scale (NNNS-II)

The NeoNatal Neurobehavioral Scale (NNNS-II) examinesJoVE, 2014: Dr. Bigsby administering the NNNSJoVE, 2014: Dr. Bigsby administering the NNNS the neurobehavioral organization, neurological reflexes, motor development - active and passive tone, and signs of stress and withdrawal of the at-risk and drug-exposed 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 substance-exposed infants. 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 is probably not appropriate for infants less than 34 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 45 weeks (adjusted or conceptional age), but it may prove useful with even older infants.

Application of the NNNS-II
Research with High Risk Infants including Pre-term and Substance Exposed Infants
• 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

Watch an overview of how the NNNS is administered in the Journal of Visualized Experiments.


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

  Click here for NNNS-II training and certification information.