Toward a Research Instrument for the Assessment of Preterm Infants’ Behavior (APIB)

  • Heidelise Als
  • Barry M. Lester
  • Edward Z. Tronick
  • T. Berry Brazelton


Recent advances in the care of premature infants have led to rapid increases in survival rates. This in turn has led to a growing demand for intervention at earlier and earlier stages aimed at preventing developmental dysfunction and supporting optimal development. The demand for support and intervention necessitates early assessment procedures on which to base appropriate intervention and with which to assess individual progress. This demand, as Thoman and Becker (1979) point out, reflects a profound change in the assumptions about early infancy, namely that assessment and support at this early stage of life can effect significant changes in the developmental course of the infant. This assumption is confronted at present with a remarkable lack of predictive success associated with many of the present assessment procedures (see McCall’s review, 1976; Lewis’s review, 1973). As one might expect, prediction at the extreme low end of the continuum is most reliable (Honzik, 1976); yet even with complex statistical procedures applied to comprehensive and cumulative batteries of assessments the diagnostic measures at best have been able to account for one tenth of the variance in the major outcome measures at two years, as, for instance, reported in the UCLA Infant Project (Sigman & Parmelee, 1979). Sigman and Parmelee conclude from their extensive study of preterm infants that the “nature of the outcome measurements should be broadened to include social, motivational, and personal qualities of the infant as well as more stable intellectual assessment” (p. 215), and they conclude that predictions which do not take into account the ongoing transactions between child and environment are bound to be weak, since early diagnosis is complicated by the responsiveness of the environment and the adaptability of the human infant.


Preterm Infant Sleep State Stimulus Sequence Awake State Alert State 
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Copyright information

© Springer Science+Business Media New York 1982

Authors and Affiliations

  • Heidelise Als
    • 1
    • 2
  • Barry M. Lester
    • 1
    • 2
  • Edward Z. Tronick
    • 3
  • T. Berry Brazelton
    • 1
    • 2
  1. 1.Child Development UnitChildren’s Hospital Medical CenterBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Department of PsychologyUniversity of MassachusettsAmherstUSA

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