Determining the reliability of the Withdrawal Assessment Tool-1 in comparison to the Neonatal Drug Withdrawal Scoring System

Allie Hardesty, Lisa Letzkus, Joy Miller, Lauren Turner, Mark Conaway


Background: Children that receive opioids and/or benzodiazepines can develop dependence and demonstrate withdrawal symptoms if the medication is abruptly discontinued. In addition, neonates that are exposed to intrauterine drugs can also manifest symptoms of withdrawal. Due to the limited research, reliability and validity remains unclear among clinical conditions and instruments.
Objective: The purpose of this study was to determine the reliability of the Withdrawal Assessment Tool-Version 1 (WAT-1), in comparison to the Lipsitz Neonatal Drug Withdrawal Scoring System (NDWSS).
Methods: A prospective cross sectional study was conducted at a University-affiliated academic Children’s Hospital. An Advanced Practice Nurse (APN) and a nursing student were trained on the use of both instruments. The student nurse and APN independently filled out both the NDWSS and the WAT-1 based on reports of symptoms and direct observation. Results were analyzed using descriptive statistics and correlations.
Results: One hundred assessments were completed. The correlations between the WAT-1 and the NDWSS scores were high (correlation > 0.8 and p < .001). There was a significant difference between the NDWSS scores based on diagnosis (p ≤ .01). Cardiac and neurologic diagnoses tended to score higher when the NDWSS was used.
Conclusions: The NDWSS instrument should be used cautiously in children with varying diagnoses especially cardiac and neurological diagnoses.

Full Text:




  • There are currently no refbacks.

Clinical Nursing Studies
ISSN 2324-7940(Print)   ISSN 2324-7959(Online)

Copyright © Sciedu Press

To make sure that you can receive messages from us, please add the '' domain to your e-mail 'safe list'. If you do not receive e-mail in your 'inbox', check your 'bulk mail' or 'junk mail' folders.