Toward a global understanding of neonatal behaviour: adaptation and validation of the Neonatal Behavioural Assessment Scale (NBAS) in the UK and rural Gambia

TY - JOUR

T1 - Toward a global understanding of neonatal behaviour

T2 - adaptation and validation of the Neonatal Behavioural Assessment Scale (NBAS) in the UK and rural Gambia

AU - Katus, Laura

AU - Rozhko, Maria

AU - Torrance, Christine

AU - Fadera, Tijan

AU - Njai, Fabakary

AU - Perapock Amadó, Marta

AU - Milosavljevic, Bosiljka

AU - McCann, Samantha

AU - Minteh, Mustapha

AU - Jammeh, Malang

AU - Barlow, Jane

AU - Elwell, Clare E.

AU - Moore, Sophie E.

AU - Lloyd-Fox, Sarah

N1 - Publisher Copyright: © 2024 The Authors

PY - 2025/3

Y1 - 2025/3

N2 - There is a need of expanding research on neonatal behaviour to encompass diverse global populations. However, few measures appropriate for use from birth in diverse cultural contexts exist. We present data from rural Gambia and the UK using the Neonatal Behavioural Assessment Scale (NBAS). In Phase 1, the scale was piloted for use in The Gambia, highlighting great utility for use in this setting. Adaptations included 1) additional explanation of some items to caregivers and 2) omission of items where the home environment necessitated to do so. In Phase 2, the NBAS was administered in both the UK and The Gambia. Item level comparisons across the sites showed fewer state changes in Gambian infants and a greater degree of examiner facilitation throughout the session. Factor analysis within the larger Gambian cohort indicated best model fits where first-order factors mapping onto each NBAS subscale were accompanied by a second-order ‘Self-Organising System’-factor, mirroring prior factor analytic studies on the scale. Further, the habituation subscale had to be omitted from analyses due to large amounts missing data, highlighting potential differences across subscales when implementing the NBAS across diverse settings. We found associations between our NBAS factor scores and NBAS supplementary items. Examining known risk factors for early neonatal development, we found associations of the Social Interactive and Self-Organising System factor with pregnancy anxiety and gestational age at birth and birthweight, but not maternal anaemia. Our findings inform future studies seeking to understand the interplay between cultural contexts, perinatal factors, and early neurobehavioural development.

AB - There is a need of expanding research on neonatal behaviour to encompass diverse global populations. However, few measures appropriate for use from birth in diverse cultural contexts exist. We present data from rural Gambia and the UK using the Neonatal Behavioural Assessment Scale (NBAS). In Phase 1, the scale was piloted for use in The Gambia, highlighting great utility for use in this setting. Adaptations included 1) additional explanation of some items to caregivers and 2) omission of items where the home environment necessitated to do so. In Phase 2, the NBAS was administered in both the UK and The Gambia. Item level comparisons across the sites showed fewer state changes in Gambian infants and a greater degree of examiner facilitation throughout the session. Factor analysis within the larger Gambian cohort indicated best model fits where first-order factors mapping onto each NBAS subscale were accompanied by a second-order ‘Self-Organising System’-factor, mirroring prior factor analytic studies on the scale. Further, the habituation subscale had to be omitted from analyses due to large amounts missing data, highlighting potential differences across subscales when implementing the NBAS across diverse settings. We found associations between our NBAS factor scores and NBAS supplementary items. Examining known risk factors for early neonatal development, we found associations of the Social Interactive and Self-Organising System factor with pregnancy anxiety and gestational age at birth and birthweight, but not maternal anaemia. Our findings inform future studies seeking to understand the interplay between cultural contexts, perinatal factors, and early neurobehavioural development.

KW - Cultural adaptation

KW - Neonatal Behavioural Assessment Scale (NBAS)

KW - Neonatal hebaviour

KW - Perinatal risk factors

KW - The Gambia

KW - UK

UR - https://www.scopus.com/pages/publications/85211023888

U2 - 10.1016/j.infbeh.2024.102017

DO - 10.1016/j.infbeh.2024.102017

M3 - Article

C2 - 39637622

AN - SCOPUS:85211023888

SN - 0163-6383

VL - 78

JO - Infant Behavior and Development

JF - Infant Behavior and Development

M1 - 102017

ER -