A Pilot Validation Study of the Newborn Behavioral Observations System: Associations with Salivary Cortisol and Temperament.
Jayme L Congdon, J Kevin Nugent, Beth M McManus and 2 others
PMID 32858579WHAT IT FOUND
In healthy infants, the Newborn Behavioral Observations system's Organization of State subscale correlated with lower stress reactivity and less infant negativity.
Motor and Autonomic subscales showed poor reliability. The tool may serve as a brief proxy for regulation, but requires further validation.
Key findings
01The Organization of State subscale was associated with lower cortisol reactivity to the assessment.
02The Organization of State subscale was associated with lower maternal reports of infant negativity.
03The Motor and Autonomic subscales had poor internal consistency and were excluded from further analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only relatively healthy, term infants, so findings may not apply to preterm or clinically at-risk populations. The Motor and Autonomic subscales showed poor reliability, limiting the utility of the full NBO profile. Inter-rater reliability could not be precisely calculated because some items require direct in-person scoring. The sample was predominantly low-income and racially/ethnically diverse, which may affect generalizability to other populations. This was a pilot study with a small sample size and cross-sectional design, so it cannot establish predictive validity or causality.
Declared interests
Dr. Nugent, a co-author, is an author of the proprietary NBO system and receives royalty income from it. The study was supported by NIH grants.
The easy way to misread this
Do not assume the entire NBO system is validated. Only the Organization of State subscale showed acceptable reliability and validity in this sample; the Motor and Autonomic subscales performed poorly and should not be interpreted as reliable measures of those domains in healthy term infants.