A comparative analysis of the validity of several approaches to the scoring of the behavior of the preterm infant

A group of very low birthweight preterm infants (mean WEIGHT = 1193.6 g; mean gestational AGE = 31.1 weeks) were examined with the PREMIE. The PREMIE is a modification of the scoring system of the full term Brazelton Neonatal Behavioral Assessment (BNBAS) examination for use with preterm infants. Infants were assessed during the acute phase of cardio-respiratory illness (mean AGE = 7 days) and during the recovery phase (mean AGE = 22 days). Many modifications in procedure were required. Several analyses were performed to assess the redundancy and the comparative validity of the scoring systems of the PREMIE, the BNBAS, and the BNBAS + (the BNBAS plus a set of five additional preterm items). Results indicated that the three scoring systems were highly redundant, that they were equally related to physiologic and clinical variables, and that they were similar in their sensitivity to behavioral change and stability. Overall the results offered little in the way of differentiating among these three scoring systems with this group of infants, raising doubts about the need to use the PREMIE or other scoring systems like it for many research purposes.