The first months of life are a period of rapid physical, emotional and social development, and can be a sensitive stage for both the baby and the family. A structured assessment tool may help a trained professional and caregivers understand the baby's behaviour and responses. This article explains the scale, its intended use and its limitations.
What Is the NBAS?
The Neonatal Behavioral Assessment Scale (NBAS) is a tool designed to observe and analyse infant behaviour during the first two months of life. The scale allows us to create a newborn behavioural profile that helps assess how the little one responds to different forms of stimulation and copes with sleep, crying and feeding. Importantly, the NBAS is not a diagnostic tool; rather, it helps us understand the child's individual needs and adapt care to their temperament and responses.
All of this is intended to provide early, targeted support for the child's emotional and social development and enable them to build a healthy attachment style.
Which behaviours can be assessed using the NBAS scale?
The NBAS includes 28 items, which make it possible to assess the child's behaviour. These include:
- Responses to Stimulation – how the child responds to visual, tactile and auditory stimuli.
- Reflexes – assessment of the newborn’s reflexes, which are crucial to physical and neurological development.
- Social Interactions – observing how the little one responds to the carer's presence and whether they show interest in the carer's face, voice and touch.
In addition, the scale includes seven supplementary items used when assessing higher-risk infants, such as babies born prematurely, with low birth weight or with health conditions.
The scale makes it possible to assess a child’s behaviour in different states, providing a fuller understanding of how a newborn responds in different situations:
- Sleep state: the NBAS makes it possible to assess how a baby responds when sleep is disturbed, including whether they can fall asleep again and how they manage transitions between deep and light sleep.
- State of wakefulness – from drowsiness to full alertness, when the baby shows an interest in their surroundings, responds to stimuli and is more active.
- Crying - the NBAS helps assess how a child responds to intense crying and what strategies they use to calm themselves.
What Are the Benefits of Using the NBAS?
The Neonatal Behavioral Assessment Scale (NBAS) can help caregivers understand how a newborn communicates and responds. This information may help them adapt their interactions and support an emerging emotional bond.
Understanding the child's individual needs - Every child has unique needs and a unique temperament. The NBAS enables detailed observation, making it easier to adapt the child's daily rhythm, environment and style of care to their individual responses.
Early identification of developmental difficulties - Although the NBAS is not a diagnostic tool, it helps identify potential difficulties in a child's development, such as difficulty with self-soothing or problems regulating sleep. Noticing such difficulties early makes it possible to take action sooner to support the child's development.
Helping to build trust in the carer – For parents and others close to the baby, using the scale can be an opportunity to become more closely involved in the child’s dynamic development. Observing the baby in different states and noting their reactions gives carers greater confidence and strengthens the sense of security the child feels in their relationship with the carer.
The source states that more than 700 research projects worldwide use the Neonatal Behavioral Assessment Scale (NBAS). It describes the NBAS as a collaborative observation by a trained professional and the parents, intended to help them understand a newborn's individual behavioural characteristics and adapt early care accordingly. It further suggests that this may support emotional and social development and the developing parent-child relationship.