Brazelton Neonatal Behavioral Assessment Scale

Norm of Brazelton Neonatal Behavioral Assessment Scale

Normal reflexes and responses to stimulation in the newborn. Girls show higher levels of functioning when compared to boys in newborn infants of optimal health.


Usage of Brazelton Neonatal Behavioral Assessment Scale

Evaluation of the newborn-caretaker unit to assess infant's behavior and responses to the environment and to provide recommendations for caregiving and interactions. This test has been primarily used in the research arena, although it has been applied clinically to assess neurobehavioral functioning in full-term infants who were exposed to cocaine and to assess tactile-kinesthetic stimulation in preterm infants.


Description of Brazelton Neonatal Behavioral Assessment Scale

The newborn is administered the Neonatal Behavioral Assessment Scale (NBAS) multiple times in the first 10 days of life to study four levels of function of the neonate: physiologic, motor, state, and attentional/ interactional. Function is determined by assessment of the response to 28 behavioral items with 7 supplementary items, all scored on a 9-point scale, and 18 reflex items, scored on a 4-point scale. The hypothesis is that a newborn's behavior is dependent on not only genetics but also intrauterine nutrition, infection, drug abuse, and perinatal events. All these factors contribute to a child's temperament and may explain why different babies respond to touch, sound, or visual stimuli in different ways. Once the child has been assessed, Brazelton believes that recommendations can be made how best to interact with that child by describing the behavioral strengths and weaknesses.


Professional Considerations of Brazelton Neonatal Behavioral Assessment Scale

Consent form NOT required.

  1. If the scale is to be used for research, training is required. Training takes up to several months, with renewal certification every 3 years. This is necessary for reliability of the test.
  2. Obtain a manual, training handbook, examination video, and testing kit, which are available from the Brazelton Institute, 1295 Boylston St., Suite 320, Boston, MA 02215 (617) 355–4959.
  3. Obtain needed equipment: light, rattle, and bell.
  4. Provide a quiet environment and dim lighting.



  1. Using the scoring manual, the baby and caregiver are evaluated, and a score is given.


Postprocedure Care

  1. None.


Client and Family Teaching

  1. The test is more accurate if a caretaker is available to interact with the neonate during the test.
  2. The test takes about 30 minutes to perform.
  3. Repetition improves the reliability of the test.


Factors That Affect Results

  1. The tester must be appropriately trained.
  2. If the neonate is crying, hungry, or sleepy, assessment may not be accurate.