Neurobehavioral Assessment of High-Risk Neonates

Abstract

, content and e v a l u a t i o n method were made known p r i o r t o t h e experience. Evaluation was done i n the above emphasis areas. Student a t t i t u d e s were q u a n t i f i e d using pre-established c r i t e r i a .Students, upon completion of t h e c l e r ks h i p and l a t e r a s housestaff, were asked t o permit 2 supervisors t o evaluate t h e i r performance a s housestaff. One hundred f i f t e e n s t u d e n t s responded and 153 e v a l u a t i o n s were made by housestaff supervisors. Performance was analyzed and comparisons made of emphasis a r e a s an w e l l a s between c l e r k s h i p , housestaff, and Nat i o n a l Board performances. Performance was compared t o s p e c i a l t y choice and graduates indicated the degree of c l e r k s h i p influence, i f any, on t h e i r choice.Achievement wan documented by: National Boards (NB) (Pass: Clerkship-99%/~S-97%); e v a l u a t i o n of housestaff (HS)(96% no d e f ic i t i n ped. knowledge, average o r above performance: c l e r k s h i p -79%/NB-99%); and r e t r o s p e c t i v e assessment by HS (objectives highl y appropriate-47% and preparation e x p e c i a l l y strong-612). There were n o t a b l e d i f f e r e n c e s i n performances f o r various o b j e c t i v e s and a l l exce a t t i t u d e c o r e l a e w t h a p e c i a l t cho ce (ped. HS significan!fy higher than 5 an3 o i s i x s p e c i a l t y c i o i c e s ) . GESTATIONAL AGE ESTIMATION IN SICK NEWBOWSCecelia Daum. Diane Kurtzberg. Bruce Grellong, Susan Albin and Herbert Vaughan (Spon. by Lawrence Gartner),Departmenta of P e d i a t r i c s , Neuroscience and Psychiatry. Albert E i n s t e i n College of Medicine, Bronx, New YorkThe Dubowitz examination f o r e s t i m a t i o n of g e s t a t i o n a l age is o f t e n d i f f i c u l t o r impossible t o administer i n i t s e n t i r e t y i n s i c k i n f a n t s , e s p e c i a l l y those receiving v e n t i l a t o r y support. A shortened v e r s i o n of t h e examination has been devised which permits assessment of g e s t a t i o n a l age with minimal l o s s of p r e d i c t i v e accuracy. The complete Dubowitz examination was adminiatered t o 112 i n f a n t s from 29 t o 42 weeks g e s t a t i o n a l age. Factor a n a l y s i s and atepwise r e g r e s s i o n were performed t o i d e n t i f y t h e items t h a t contributed preponderantly t o t h e t o t a l variance. Three non-discriminating items (edema, s k i n c o l o r , posture) were eliminated on t h e b a s i s of t h e s e analyses, a s well a s t h r e e a d d i t i o n a l items (lanugo, head l a g , v e n t r a l suspension) which cannot be assessed i n i n f a n t s on r e s p i r a t o r s . The shortened s c a l e c o r r e l a t e d highly with t h e t o t a l Dubowitz score ( r -.985), providing a n instrument which can be admini s t e r e d t o s e r i o u s l y ill i n f a n t s with l i t t l e l o s s of pred i c t i v e accuracy (95% confidence l i m i t * 1 week). NEUROBEHAVIORAL ASSESSMENT OF HIGH-RISK NEONATE...

Brain Volume and Neurobehavior in Newborns with Complex Congenital Heart Defects

“…The Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS) 18 was administered by 1 of 2 evaluators trained in assessing neonatal neurobehavioral status and blinded to clinical neurologic findings and MRI results. The ENNAS was selected as a comprehensive yet efficient assessment of neonatal neurologic and neurobehavioral status, which has been previously used to evaluate newborns with CHD.…”