By Barry M. Lester, Ph.D., & Edward Z. Tronick, Ph.D.

For use with healthy and at-risk preterm infants and full term infants at risk because of prenatal substance exposure or other conditions, NNNS™ enables clinicians’ and researchers’ comprehensive assessment of neurobehavioral functioning, with a focus on neurologic, stress, and withdrawal signs that sets it apart from other tools. Early interventionists, clinicians, or other trained NICU personnel can use NNNS™ to gather key information on infants through 6 weeks of age, and as early as 30 weeks for preterm infants. The NNNS™ exam assesses 115 items in three categories:

• neurological items that assess active and passive muscle tone, primitive reflexes, and central nervous system integrity
  
  
• behavioral state, sensory, and interactive responses
  
  
• stress/abstinence items
  

Professionals assess the items and generate summary scores for stress, withdrawal, and the major domains of neurobehavioral performance. Because of its standardized administrative format, NNNS™ allows professionals to conduct this assessment objectively without influencing the infant’s responses, and normed scores for at-risk and healthy infants allows evaluation of the infant’s relative performance.

With this easy-to-use, 20-minute tool, professionals will get the most complete, valid, and accurate picture of the infant’s current functioning — critical information they’ll use to recommend appropriate interventions and guide families in reading their child’s cues, fostering strong attachments, and increasing their confidence as caregivers. NNNS™ is also useful for a wide variety of clinical functions, including hospital use, referrals, home visits, therapy evaluations, and family consultations.

NNNS™ includes:

• NNNS™ Manual. The manual includes detailed instructions on administering and scoring the NNNS™ exam, a discussion of the tool’s clinical applications, normative data on both healthy and at-risk infants, an explanation of summary scores, and background information on how NNNS™ was developed.
  
  
• NNNS™ Scoring Sheet. This 12-page form helps users record scores for the 115 items assessed.
  
  
• NNNS™ Tool Kit. The kit contains all the materials required to conduct NNNS™ assessment, including a ball, bell, rattle, flashlight, foot probe, and head supports.
  

The Manual
ISBN 1-55766-757-8
Spiral-bound
256 pages / 8.5 x 11
2004 / $50.00
Stock# 7578

Scoring Sheets (package of 20)
ISBN 1-55766-763-2
Saddle-stitched
8 pages / 8.5 x 11
2004 / $30.00
Stock# 7632

Note: The NNNS™ Tool Kit and Complete NNNS™ Set may not be available for RUSH shipping.

Professional development on this title is available through Brookes On Location!

About the Authors
Contributors
Foreword
T. Berry Brazelton

Preface and Acknowledgments

1. Introduction to the NICU Network Neurobehavioral Scale (NNNS)
   Barry M. Lester & Edward Z. Tronick
   
   
2. Using the NNNS
   Barry M. Lester & Edward Z. Tronick
   
   
3. The NNNS Procedures and Scoring of Items
   Barry M. Lester & Edward Z. Tronick with T. Berry Brazelton
   
   
4. Clinical Applications for the NNNS
   Rosemarie Bigsby, C.F. Zachariah Boukydis, Linda Lagasse, & Barry M. Lester
   
   
5. Summary Statistics of the NNNS Scores from the Maternal Lifestyle Study (MLS): A Quasi Normative Sample
   Barry M. Lester, Edward Z. Tronick, Linda Lagasse, Ronald Seifer, Charles R. Bauer, Seetha Shankaran, Henrietta S. Bada, Linda Wright, Vincent L. Smeriglio, & Jing Liu
   
   
6. Normative Neurobehavioral Performance of Healthy Infants on the NNNS
   Edward Z. Tronick, Karen Olson, Rebecca Rosenberg, Lisa Bohne, Jing Liu, & Barry M. Lester
   
   Appendix A  NNNS Scoring Sheet
   Appendix B  Glossary of Acronyms