Brazelton scale: characteristics, and what it is for

, which is usually carried out a few minutes after delivery and which gives us a general idea of ​​the baby’s state of health.

But the Apgar test is not the only test that can be passed to a newborn, there are many others that 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.

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The Brazelton scale: what is it?

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

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

The Brazelton scale is considered one of the most suitable for identifying the existence of deficits or difficulties in the capacities of newborns, resulting in a very detailed evaluation that allows establishing a profile of scores regarding various health aspects. And even if there is no deficit as such, it allows evaluating 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 for him than others.

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

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Main aspects evaluated

The Brazelton scale is a broad and quite complete scale, which includes a total of 53 items that allow us to get an idea of ​​the capabilities of the newborn in different areas of operation. These items are grouped into a set of large aspects, factors or modules, which include grouping different tests depending on the type of classification that is carried out.

1. Autonomic nervous system

It includes the evaluation of reflexes and the state of health linked to the functioning of the autonomic nervous system. In this sense, it takes over the basic functions of the body, including breathing and temperature regulation, variations in skin color or the presence of tremor or startles.

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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, hug response, general muscle tone or lability of the child’s condition.

3. Habituation

This test module aims to assess the child’s ability to get used to the stimulation , assessing whether he is able to inhibit his reactions and even be 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 state or response to the action of uncovering it.

4. Organization of the state

A module that aims to answer the question of how it is able to organize itself to activate and respond to stimulation . 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

This module observes and analyzes the child’s ability to manage himself and react to stimulation . It includes a series of items that assess the ability to console oneself or receive comfort from the environment, the ability to become irritated by stimulation or to strive to maintain attention or the ability to ask for help.

6. Social interactive

A set of items that can only be done when the minor is in a quiet and waking state. 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 that value animated and inanimate visual and auditory orientation are included , 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 to detect possible abnormalities in the development of newborns, which could be derived from alterations during fetal development. However, despite the fact that it is used for this purpose, it has also received great attention within the field of research.

Often these scales have also been used not only to assess difficulties but as a mechanism to approach positions 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 confidence and parental attitudes as well as to establish a communication that allows to begin to understand and learn what the minor is like.


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