Exhibit 1 of TIP 5: Improving Treatment for Drug-Exposed Infants is not available electronically. A copy of the entire TIP containing Exhibit 1 can be ordered from the National Clearinghouse of Drug and Alcohol Information (NCADI). The order number for TIP 5: Improving Treatment for Drug-Exposed Infants is BKD110. It is free and can be ordered from NCADI's electronic catalog at http://ncadi.samhsa.gov/" or by calling 1-800-729-6686.
Exhibit 2: Neonatal Abstinence Score
Exhibit 2
Neonatal Abstinence Score
SYSTEM
SIGNS AND SYMPTOMS
SCORE
AM
PM
COMMENTS
CENTRAL NERVOUS SYSTEM DISTURBANCES
Excessive High Pitched (other) Cry
Continuous High Pitched (other) Cry
2
3
Sleeps < 1 hour after feeding
Sleeps < 2 hours after feeding
Sleeps < 3 hours after feeding
Mild Tremors Undisturbed
Moderate- Severe Tremors Undisturbed
3
4
Increased Muscle Tone
2
Excoriation (specific areas)
1
Myocionic Jerks
3
Generalized Convulsions
5
METABOLIC/ VASCOMOTOR/ RESPIRATORY DISTURBANCES
Sweating
1
Fever < 101 (99-100.8F/37.2-38.2C)
Fevers > 101 (38.4C and higher)
1
2
Frequent Yawning (>3-4 times/interval)
1
Mottling
1
Nasal Stuffiness
1
Sneezing (>304 times/interval)
1
Nasal Flaring
2
Respiratory Rate > 60/min.
Respiratory Rate > 60/min with retractions
1
2
GASTRO- INTESTINAL DISTURBANCES
Excessive Sucking
1
Poor Feeding
2
Regurgitation
Projectile Vomiting
2
3
Loose Stools
Water Stools
2
2
TOTAL SCORE
INITIALS OF SCORER
Evaluator should place a check next to each sign or symptom observed at various time intervals, then add scores for total score.
* Finnegan, L.P and K.
Kaltenbach, 1992. Neonatal Abstinence Syndrome. in Primary Pediatric Care, Edition 2, Hoekelman and Nelson (Eds.), Mosby Yearbook, Inc., St.
Louis, MO., pp. 1367-1378.
Aiken, Faren R., Aikens, Diannal., and Mace, Gillian. 1981. Parent-child separation: psychosocial effects on development: an abstracted bibliography. New York: IFI/Plenum.
Bigner, Jerry J. 1979. Parent-child relations: an introduction to parenting. New York: MacMillan.
DeRosis, Helen. 1974. Parent power/child power: a new tested method for parenting without guilt. Indianapolis: Bob-Merrill.
Levy, Stephen Jay and Rutter, Eileen. 1991. Children of drug abusers. New York: Lexington Books.
Sinanogulu, Paul A. and Malcuccio, Anthony N. 1981. Parents of children in placement: perspectives and programs. New York: University of Connecticut School of Social Work/Child Welfare League of America.
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