Brazelton scale: characteristics, and what it is for

The arrival of a new human being into the world is in most cases a reason for joy, at least when we are talking about a desired pregnancy.

After the moment of delivery, a series of small tests are carried out, in a test or battery of tests that allow us to evaluate the state of health and the reaction capacity of the newborn. One of the most typical, known and used is the Apgar test, which is usually carried out at few minutes after delivery and that allows us to get a general idea of ​​the health status of the baby.

But the Apgar test is not the only test that can be passed to a newborn, there are many others that They allow obtaining large amounts of information regarding the child's perception and response abilities. One of them is the Brazelton scale or test, a frequently used test that provides information related to the development of behaviors or the existence of reflexes. And it is about this last test that we are going to talk about throughout this article.

• Related article: "Types of psychological tests: their functions and characteristics"

The Brazelton scale: what is it?

The Brazelton test or scale, also known as the Neonatal Behavior Assessment Scale, is a tool that allows to carry out the early detection of neurodevelopmental problems.

It is a highly interactive type of test in which a series of 53 items, 35 of which analyze the behavior of infants (seven of which are considered complementary and tell us about the need to stimulate it) while the rest are aimed at assessing the existence of certain reflexes. While the behavioral items are scored based on a 9-point scale, those referring to reflexes assess good neurological status on a 4-point scale.

The Brazelton scale is considered one of the most indicated to allow identifying the existence of deficits or difficulties in skills of newborns, resulting in a very detailed evaluation that allows establishing a profile of scores regarding various aspects of Health. And even if there is no deficit as such, allows assessing the general way of reacting to the child's environment (which in turn gives us an idea of ​​his temperament) or if some behaviors are more difficult than others.

It is a very useful tool that allows obtaining results at a quantitative level, and despite the fact that it is not mandatory in the national health system, it tends to be applied in the first days of the minor's life. It also allows evaluating the existence of certain capacities both in wakefulness and during sleep, and although it generally follows a scheme or order determined in the application of the tests, a certain flexibility is allowed in its application, and the evaluation can be developed depending on the situation of the baby.

• You may be interested: "The 7 types of neurodevelopmental disorders (symptoms and causes)"

Main aspects evaluated

The Brazelton scale is a broad and fairly comprehensive scale, which includes a total of 53 items that allow us to get an idea of ​​the capacities of the newborn in different areas of the functioning. These items are grouped into a set of major aspects, factors or modules, which include groups of different tests depending on the type of classification that is carried out.

1. Autonomic nervous system

Includes assessment of reflexes and health status linked to the functioning of the autonomic nervous system. In this sense, it takes charge of the basic functions of the body, including breathing and temperature regulation, variations in skin color or the presence of tremors or startles.

• You may be interested: "Autonomic nervous system: structures and functions"

2. Motor system

A second module focused on the good state of reflexes and the ability to move, in which muscle tone is involved. It includes items such as motor maturity, the response to the hug, the general muscle tone or the lability of the child's state.

3. Habituation

This test module aims to assess the child's ability to get used to stimulation, assessing whether it is capable of inhibiting its reactions and even being able to sleep in the presence of light or repetitive stimulation. It includes tests such as decreased response to light, sound or tactile stimulation, as well as observation of its condition or response to the action of uncovering it.

4. State organization

A module that aims to answer the question of how he is able to organize himself to activate and respond to stimulation. The items that assess the level of activity, hand-mouth ability, speed of reaction to stimulation or moment of maximum excitement are part of it.

5. State regulation

In this module we observe and analyze the child's ability to manage himself and react to stimulation. It includes a series of items that assess the ability to comfort oneself or receive comfort from the environment, the ability to become irritated by stimulation or to strain to maintain attention or the ability to request help.

6. Interactive social

A set of items that can only be done when the minor is in a quiet and awake situation. They share with each other the fact that they allow evaluating the degree of reaction and the ability to follow visual and sound stimuli, especially those typical of interaction with others.

In this sense items are included that assess visual and auditory orientation, animate and inanimate, both individually and simultaneously.

7. Use of this scale

The Brazelton scale was created fundamentally to be used within the clinical setting and to serve as an instrument for detect possible anomalies in the development of newborns, which could be derived from alterations during the fetal development. However, even though it is used for this purpose, it has also received a great deal of research attention.

Often these scales have also been used not only to assess difficulties but rather as a mechanism to bring positions closer and promote interaction between the child and his environment, something facilitated by the fact that we are facing a very interactive test.

It has been observed that it helps to increase parental confidence and attitudes as well as to establish communication that allows to begin to understand and learn what the child is like.

Bibliographic references:

• Costas Moragas, C.; Fornieles Deu, A.; Botet Mussons, F.; Boatella Costa, E.; by Cáceres Zurita, M.L. (2007). Psychometric evaluation of the Brazelton Scale in a sample of Spanish newborns. Psicothema, 19, (1): 140-149. University of Oviedo Oviedo, Spain
• Domínguez Fontenla, M., Cruz Fernández, V., Abelleira Docabo, M., Amado Mera, A. and Fernández Barreiros, M. (2009). Evolutionary development of neonates: clinical utility of the Brazelon scale (NBAS). Proceedings of the X International Galician-Portuguese Congress of Psychopedagogy. Braga: University of Minho.