REGULAR ARTICLE Neonatal Behavioral Assessment Scale as a predictor of cognitive development and IQ in full-term infants: a 6-year longitudinal study Josefa Canals (josefa.canals@urv.cat) 1 , Carmen Hernández-Martínez 1 , Griselda Esparó 2 , Joan Fernández-Ballart 3 1.Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain 2.Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain 3.Medicina Preventiva i Salut Pu ´ blica, Universitat Rovira i Virgili and CIBER Fisiopatologı ´a de la Obesidad y Nutricio ´ n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain Keywords Follow-up study, Infant development, Intelligence, Neonatal behaviour, Self-regulation Correspondence Josefa Canals, Facultat de Cie ` ncies de l’Educacio ´i Psicologia (Campus Sescelades), Universitat Rovira i Virgili, Ctra. de Valls s / n, (43007) Tarragona, Spain. Tel: +34977257897 | Fax: 977558088 | Email: josefa.canals@urv.cat Received 4 November 2010; revised 15 March 2011; accepted 31 March 2011. DOI:10.1111/j.1651-2227.2011.02306.x ABSTRACT Aim: To evaluate the predictive capacity of neonatal behaviour on infant mental and psychomotor development at 4 and 12 months, and infant intelligence at 6 years. Method: Eighty full-term newborns were followed from 3 days until 6 years. Neona- tal behaviour was assessed by the Neonatal Behavior Assessment Scale (NBAS) at 3 days postpartum, infant mental and psychomotor development was assessed by the Bayley Scales for Infant Development at 4 and 12 months, and child intelligence was assessed by the Wechsler Preschool and Primary Scale of Intelligence at 6 years. Results: Neonatal general irritability was the predictor of mental development at 12 months. Self-regulation behaviours were predictors of psychomotor development at 4 and 12 months and verbal and total intelligence quotient at 6 years. Neonatal orientation was a predictor of performance Wechsler subtests related to visomotor abilities and attention. Conclusions: Neonatal self-regulation behaviours were the best predictors of infant development and intelligence. We suggest that the NBAS could be a useful tool to observe behaviours related to later development in healthy infants. One of the most important functions of the paediatrician in the public health system is to protect children’s health and ensure their optimal development. The development of high-risk infants [e.g. very low birth weight (VLBW), prema- ture births and deprived environments] has been followed and controlled from a wide variety of disciplines and there is a considerable amount of literature on the issue (1–3). However, the lack of formal developmental and behavioural screening tools for low-risk infants means that they may only be sent for specific assessment when parents, teachers or caregivers observe a disorder, or clearly impaired devel- opment. In this study, we have investigated early behaviour- al predictors of child development in healthy, full-term newborns. Until the 1980s, psychological opinion tended to favour discontinuity theories of cognitive development; indeed, the classic longitudinal studies on mental development found little stability in performance from infancy to later child- hood (4,5) and subsequent research seemed to confirm these early results, concluding that standardized infant tests were not good predictors of later intelligence. However, some studies suggest that several early indicators of later cognitive developmental outcome can be identified (6). In this regard, some studies have reported that such informa- tion-processing measures as habituation, visual recognition memory or immediate retentive memory in infants under Abbreviations NBAS, Neonatal Behavior Assessment Scale; BSID, Bayley Scales for Infant Development; PDI, Psychomotor development index; MDI, Mental development index; WPPSI, Wechsler Pre- school and Primary Scale of Intelligence; TIQ, Total intelligence quotient; IQ, Intelligence quotient; CBCL, Child Behavior Check List; STAI, State-Trait Anxiety Inventory; BDI, Beck Depression Inventory; VLBW, Very low birth weight. Key notes • Neonatal irritability and self-regulation are related to cognitive development and intelligence both short term and long term. Moreover, neonatal orientation is also related to infant’s performance in tasks that require visomotor abilities and attention. These neonatal char- acteristics may be early markers of development. • Assessing neonatal behavioural characteristics can help paediatricians to detect and predict infant cognitive development. • The Neonatal Behavior Assessment Scale is an appro- priate tool for detecting behaviours in infants at risk of subsequent developmental problems. Acta Pædiatrica ISSN 0803–5253 ª2011 The Author(s)/Acta Pædiatrica ª2011 Foundation Acta Pædiatrica 2011 100, pp. 1331–1337 1331