Factor Analysis of the Einstein Neonatal Neurobehavioral Assessment Scale in Infants with Congenital Heart Disease and Healthy Controls

Nhu N. Tran; Jay Desai; Jodie K. Votava-Smith; Mary Lynn Brecht; Douglas L. Vanderbilt; Ashok Panigrahy; Liza Mackintosh; Kenneth M. Brady; Bradley S. Peterson

doi:10.1177/08830738221115982

Factor Analysis of the Einstein Neonatal Neurobehavioral Assessment Scale in Infants with Congenital Heart Disease and Healthy Controls

Nhu N. Tran^*, Jay Desai, Jodie K. Votava-Smith, Mary Lynn Brecht, Douglas L. Vanderbilt, Ashok Panigrahy, Liza Mackintosh, Kenneth M. Brady, Bradley S. Peterson

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Administration of the Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS) can be time-consuming, and items can be highly correlated. We aimed to determine: (1) its factor analytic structure; (2) the validity of the factor structure; and (3) the associations of physiologic measures with factor scores. Methods: A factor analysis reduced 21 ENNAS items into 5 factors in 57 congenital heart disease (CHD) and 35 healthy infants. Multiple linear regressions examined the association of factor scores with group, gestational age, and physiologic variables. Results: 5-factor solution: 1 (Orienting Reflex), 2 (Extensor Axial Tone), 3 (Primitive Reflexes), 4 (Flexor Tone), 5 (Reflexive Tone Around Extremity Joints). Moderate to strong evidence supported: face, discriminant, and construct validity of these factors, with Factor 2 having the strongest. Conclusions: Components of Factor 2 may provide similar information about neonatal development, thus reducing the time for and burden of administration for researchers and clinicians.

Original language	English (US)
Pages (from-to)	851-863
Number of pages	13
Journal	Journal of child neurology
Volume	37
Issue number	10-11
DOIs	https://doi.org/10.1177/08830738221115982
State	Published - Oct 2022

Keywords

congenital heart disease
developmental outcomes
Einstein Neonatal Neurobehavioral Assessment Scale
factor analytic structure
infants

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Clinical Neurology

Access to Document

10.1177/08830738221115982

Cite this

Tran, N. N., Desai, J., Votava-Smith, J. K., Brecht, M. L., Vanderbilt, D. L., Panigrahy, A., Mackintosh, L., Brady, K. M., & Peterson, B. S. (2022). Factor Analysis of the Einstein Neonatal Neurobehavioral Assessment Scale in Infants with Congenital Heart Disease and Healthy Controls. Journal of child neurology, 37(10-11), 851-863. https://doi.org/10.1177/08830738221115982

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title = "Factor Analysis of the Einstein Neonatal Neurobehavioral Assessment Scale in Infants with Congenital Heart Disease and Healthy Controls",

abstract = "Background: Administration of the Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS) can be time-consuming, and items can be highly correlated. We aimed to determine: (1) its factor analytic structure; (2) the validity of the factor structure; and (3) the associations of physiologic measures with factor scores. Methods: A factor analysis reduced 21 ENNAS items into 5 factors in 57 congenital heart disease (CHD) and 35 healthy infants. Multiple linear regressions examined the association of factor scores with group, gestational age, and physiologic variables. Results: 5-factor solution: 1 (Orienting Reflex), 2 (Extensor Axial Tone), 3 (Primitive Reflexes), 4 (Flexor Tone), 5 (Reflexive Tone Around Extremity Joints). Moderate to strong evidence supported: face, discriminant, and construct validity of these factors, with Factor 2 having the strongest. Conclusions: Components of Factor 2 may provide similar information about neonatal development, thus reducing the time for and burden of administration for researchers and clinicians.",

keywords = "congenital heart disease, developmental outcomes, Einstein Neonatal Neurobehavioral Assessment Scale, factor analytic structure, infants",

author = "Tran, {Nhu N.} and Jay Desai and Votava-Smith, {Jodie K.} and Brecht, {Mary Lynn} and Vanderbilt, {Douglas L.} and Ashok Panigrahy and Liza Mackintosh and Brady, {Kenneth M.} and Peterson, {Bradley S.}",

note = "Funding Information: We thank all of the families who participated in this study, as well as staff at the Heart Institute, Fetal Maternal Center, Brain Imaging Lab, and Brain Development Lab of Children's Hospital Los Angeles for their invaluable assistance. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by Children's Hospital Los Angeles Clinical Services Research Grant, SC CTSI (NCATS) through Grant UL1TR0001855, and the NINR K23 Grant 1K23NR019121-01A1. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Funding Information: All authors, except JD, have no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. JD has funding from Novartis, UCB, Aquestive, Neurelis, Ovid. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by Children's Hospital Los Angeles Clinical Services Research Grant, SC CTSI (NCATS) through Grant UL1TR0001855, and the NINR K23 Grant 1K23NR019121-01A1. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Publisher Copyright: {\textcopyright} The Author(s) 2022.",

year = "2022",

month = oct,

doi = "10.1177/08830738221115982",

language = "English (US)",

volume = "37",

pages = "851--863",

journal = "Journal of Child Neurology",

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T1 - Factor Analysis of the Einstein Neonatal Neurobehavioral Assessment Scale in Infants with Congenital Heart Disease and Healthy Controls

AU - Tran, Nhu N.

AU - Desai, Jay

AU - Votava-Smith, Jodie K.

AU - Brecht, Mary Lynn

AU - Vanderbilt, Douglas L.

AU - Panigrahy, Ashok

AU - Mackintosh, Liza

AU - Brady, Kenneth M.

AU - Peterson, Bradley S.

N1 - Funding Information: We thank all of the families who participated in this study, as well as staff at the Heart Institute, Fetal Maternal Center, Brain Imaging Lab, and Brain Development Lab of Children's Hospital Los Angeles for their invaluable assistance. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by Children's Hospital Los Angeles Clinical Services Research Grant, SC CTSI (NCATS) through Grant UL1TR0001855, and the NINR K23 Grant 1K23NR019121-01A1. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Funding Information: All authors, except JD, have no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. JD has funding from Novartis, UCB, Aquestive, Neurelis, Ovid. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by Children's Hospital Los Angeles Clinical Services Research Grant, SC CTSI (NCATS) through Grant UL1TR0001855, and the NINR K23 Grant 1K23NR019121-01A1. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Publisher Copyright: © The Author(s) 2022.

PY - 2022/10

Y1 - 2022/10

N2 - Background: Administration of the Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS) can be time-consuming, and items can be highly correlated. We aimed to determine: (1) its factor analytic structure; (2) the validity of the factor structure; and (3) the associations of physiologic measures with factor scores. Methods: A factor analysis reduced 21 ENNAS items into 5 factors in 57 congenital heart disease (CHD) and 35 healthy infants. Multiple linear regressions examined the association of factor scores with group, gestational age, and physiologic variables. Results: 5-factor solution: 1 (Orienting Reflex), 2 (Extensor Axial Tone), 3 (Primitive Reflexes), 4 (Flexor Tone), 5 (Reflexive Tone Around Extremity Joints). Moderate to strong evidence supported: face, discriminant, and construct validity of these factors, with Factor 2 having the strongest. Conclusions: Components of Factor 2 may provide similar information about neonatal development, thus reducing the time for and burden of administration for researchers and clinicians.

AB - Background: Administration of the Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS) can be time-consuming, and items can be highly correlated. We aimed to determine: (1) its factor analytic structure; (2) the validity of the factor structure; and (3) the associations of physiologic measures with factor scores. Methods: A factor analysis reduced 21 ENNAS items into 5 factors in 57 congenital heart disease (CHD) and 35 healthy infants. Multiple linear regressions examined the association of factor scores with group, gestational age, and physiologic variables. Results: 5-factor solution: 1 (Orienting Reflex), 2 (Extensor Axial Tone), 3 (Primitive Reflexes), 4 (Flexor Tone), 5 (Reflexive Tone Around Extremity Joints). Moderate to strong evidence supported: face, discriminant, and construct validity of these factors, with Factor 2 having the strongest. Conclusions: Components of Factor 2 may provide similar information about neonatal development, thus reducing the time for and burden of administration for researchers and clinicians.

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ER -

Factor Analysis of the Einstein Neonatal Neurobehavioral Assessment Scale in Infants with Congenital Heart Disease and Healthy Controls

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