WHAT ARE THE HAMMERSMITH NEUROLOGICAL EXAMINATIONS?
The Hammersmith Neonatal Neurological Examination (HNNE) is a quick, practical and easy to perform exam encompassed in 34 items assessing tone, motor patterns, observation of spontaneous movements, reflexes, visual and auditory attention and behaviour. It was initially developed by Dr Lilly Dubowitz and Prof Victor Dubowitz in 1981, and updated with Dr Eugenio Mercuri, in 1998. Many studies have been performed using it in different clinical groups of full term and preterm infants at different ages within the neonatal period.
The Hammersmith Infant Neurological Examination (HINE) is based on the same principles as the neonatal exam and consists of 26 items that assess different aspects of neurological function: cranial nerve function, movements, reflexes and protective reactions and behaviour, as well as some age-dependent items that reflect the development of gross and fine motor function. The HINE is aimed to be used for infants between 3 and 24 months of age.
Today, the HNNE and the HINE are used throughout the world in the clinic and for research. Both the HNNE and the HINE have been standardised in large cohorts of typically developing children. The exams are easily recorded on standardised proformas, simplifying the documentation of findings and comparison between sequential exams. The exams can be scored to enable classification into optimal and sub-optimal neuromotor categories. The scores of the HINE can also be used to enable detection of high risk of cerebral palsy (CP) at an early age and prediction of independent sitting and walking in children with CP.
Dr Lilly Dubowitz examining a baby
WELCOME TO THIS WEBSITE
This is an educational website where you will find all the information you need to learn how to perform, score and interpret the HNNE and the HINE. Please click below to go to each section.
In this section you will find teaching videos that show in detail how to perform and score the neonatal and infant exams.