Understanding Newborn Behavior & Early Relationships: The Newborn Behavioral Obsrvations (NBO) System Handbook / Edition 1

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Overview

Giving babies a "voice" helps parents understand their baby's unique strengths and needs. This observational tool and handbook, complete with beautiful four-color photographs by a Pulitzer prize-winning photographer, gives professionals a systematic way to help parents respond with confidence to their baby's individual needs-and build positive parent-professional relationships in the process. Flexible, easy to integrate into everyday practice, and based on more than 25 years of research, this system includes A short, easy-to-use, interactive observational tool. With the Newborn Behavioral Observations (NBO) system, professionals will have a structured set of 18 observations (see sidebar) for infants from birth to approximately 3 months. Including parents as partners, professionals guide the observation, discuss the baby's abilities and behaviors with parents, encourage parent insights and questions, and suggest specific ways to support the child's development. (Appropriate use of the NBO tool in clinical practice requires training through the NBO training program.) A complete guide to the NBO system. Through realistic case studies, step-by-step how-to instructions, and color photos illustrating each NBO item, professionals will understand how to use the NBO effectively with a wide variety of families. Invaluable professional guidance. More than a tool, the handbook helps professionals improve their daily work with in-depth information on infant and parent development, cultural competence, premature and at-risk infants, family-centered care, and more. An essential resource from the co-author of the highly regarded Neonatal Behavioral Assessment Scale (NBAS) and his colleagues, this system is just what clinicians in hospital, clinic, or home settings need to help new mothers and fathers get to know their baby, increase their confidence and competence as parents, and support their child's growth and development.

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Editorial Reviews

Leslie Sanders

"A valuable resource for any clinician seeking to enhance the engagement of new parents with their infants."
Professor Emeritus and Founding Director, Center on Infant Mental Health and Development, University of Washington - Kathryn E. Barnard
"A valuable collection of information for all professionals working with parents and infants . . . a promising preventive intervention."
Associate Professor of Occupational Therapy, Boston University - Elsie Vergara
"At last —a truly unique family–centered perspective to the assessment of the newborn infant."
Boston Institute for the Development of Infants and Parents (BIDIP) Newsletter
"The richness and complexity of the thinking that led to the [Neonatal Behavioral Assessment Scale, NBAS] re-appears now."
American Psychological Association PsycCRITIQUES
"Accessible to a wide range of professionals who work with young infants . . . provides for the most information transmission possible outside of a hands-on training session."
From The Critics
Reviewer: Jay P. Goldsmith, MD (Tulane University School of Medicine)
Description: This handbook for neonatal clinicians details the application and use of the Newborn Behavioral Observation (NBO) tool to help parents respond to the needs of their newborn infants. The book provides a guide to the administration and interpretation of the NBO, including case studies and color photographs, and then directs clinicians on how to give parents anticipatory guidance to respond to their babies' needs.
Purpose: The purpose is to introduce healthcare professionals to the NBO, to emphasize the importance of behavior in both well and sick newborns, and to guide clinicians in helping parents understand and respond to these behaviors. Fostering parental development is a worthy goal and is met well by this book.
Audience: According to the authors, the book is written for "professionals who work directly with new parents and their infants" and for faculty who teach these clinicians. However, the book is written at a level that would not exclude interested parents from reading it themselves and gaining great insight into newborn behavior without having to understand medical terminology. The authors are leaders in the research and application of newborn behavioral observations to clinical practice.
Features: The first chapters describe the NBO as a tool and provide principles that guide its use. The actual NBO manual for the administration and recording of behavioral observations follows with color photographs, interpretive material, and guidelines for anticipatory guidance for parents. The last five chapters deal with the application of the NBO in different clinical and cultural settings and with different types of babies (e.g. preterm and medically fragile infants). The handbook is complete and offers new perspectives to clinicians on how to help parents interact with their newborns.
Assessment: Although the Neonatal Behavioral Assessment Scale (NBAS) has been used since 1978 by trained professionals, it remained remote to most bedside professionals who cared for newborn infants. This new handbook finally brings the NBO to the mainstream of professionals to truly help parents understand, bond with, and promote development of their infants. This is especially true for the medically fragile and premature infants who are often separated for prolonged periods of time from their families in hospital settings. This handbook will help clinicians improve their daily work by making them better observers and become active intermediaries between their newborn patients and their parents. It should be required reading for every professional who deals with infants from 0 to 3 months of age.
Doody's Review Service
Reviewer: Jay P. Goldsmith, MD (Tulane University School of Medicine)
Description: This handbook for neonatal clinicians details the application and use of the Newborn Behavioral Observation (NBO) tool to help parents respond to the needs of their newborn infants. The book provides a guide to the administration and interpretation of the NBO, including case studies and color photographs, and then directs clinicians on how to give parents anticipatory guidance to respond to their babies' needs.
Purpose: The purpose is to introduce healthcare professionals to the NBO, to emphasize the importance of behavior in both well and sick newborns, and to guide clinicians in helping parents understand and respond to these behaviors. Fostering parental development is a worthy goal and is met well by this book.
Audience: According to the authors, the book is written for "professionals who work directly with new parents and their infants" and for faculty who teach these clinicians. However, the book is written at a level that would not exclude interested parents from reading it themselves and gaining great insight into newborn behavior without having to understand medical terminology. The authors are leaders in the research and application of newborn behavioral observations to clinical practice.
Features: The first chapters describe the NBO as a tool and provide principles that guide its use. The actual NBO manual for the administration and recording of behavioral observations follows with color photographs, interpretive material, and guidelines for anticipatory guidance for parents. The last five chapters deal with the application of the NBO in different clinical and cultural settings and with different types of babies (e.g. preterm and medically fragile infants). The handbook is complete and offers new perspectives to clinicians on how to help parents interact with their newborns.
Assessment: Although the Neonatal Behavioral Assessment Scale (NBAS) has been used since 1978 by trained professionals, it remained remote to most bedside professionals who cared for newborn infants. This new handbook finally brings the NBO to the mainstream of professionals to truly help parents understand, bond with, and promote development of their infants. This is especially true for the medically fragile and premature infants who are often separated for prolonged periods of time from their families in hospital settings. This handbook will help clinicians improve their daily work by making them better observers and become active intermediaries between their newborn patients and their parents. It should be required reading for every professional who deals with infants from 0 to 3 months of age.
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Product Details

  • ISBN-13: 9781557668837
  • Publisher: Brookes, Paul H. Publishing Company
  • Publication date: 5/1/2007
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 256
  • Sales rank: 716,175
  • Product dimensions: 7.00 (w) x 10.00 (h) x 0.50 (d)

Meet the Author

Dr. Blanchard teaches the pediatric curriculum of the physical therapy program at the University of Hartford and is a faculty member of The Brazelton Institute where she is the lead NBAS trainer and an NBO trainer. She is also an early intervention provider for the East Hartford Birth to Three Program in Connecticut. Dr. Blanchard has published more than 15 articles and 4 book chapters relating to the field of pediatric physical therapy and early intervention with high-risk infants.

Lise C. Johnson is Director of Well Newborn Nurseries at Brigham and Women's Hospital. She is also an instructor in Pediatrics at Harvard Medical School, and a faculty member at The Brazelton Institute.

Dr. Johnson is a board-certified pediatrician. Prior to focusing her clinical work and teaching on newborns, she worked for 10 years as a primary pediatrician in the greater Boston area. She integrates the NBO into her practice with newborns and their families and into her training of residents and medical students.

Dr. Keefer is a faculty member of The Brazelton Institute at Children’s Hospital Boston, and Assistant Professor at Harvard Medical School.

Dr. Keefer, a board-certified pediatrician, has worked as a researcher and teacher in the field of infant–parent relations for 30 years. She has conducted research on newborns and young children in Kenya, has worked as a community physician, and was Director of the Newborn Nursery in the Brigham and Women's Hospital (BWH) in Boston, where she developed a curriculum in primary care neonatology for residents and the PEBE (the combined physical and behavioral neonatal examination) to help promote a more parent-centered approach to newborn care. Currently, Dr. Keefer is an attending pediatrician in the BWH Newborn Nursery and is also on the faculty of The Brazelton Touchpoints Center at Children's Hospital Boston, where she trains providers in aspects of early childhood development.

Susan Minear, M.D., is Director of the Birth to Three Program at Boston Medical Center; She is also Assistant Professor of Pediatrics at Boston University School of Medicine,.

Dr. Minear (formerly O'Brien) practices primary care pediatrics and is a board-certified behavioral and developmental pediatrician and a graduate fellow of the Zero to Three Leadership Development Initiative. From 1997 to 2005, Dr. Minear served as Medical Director of the Newborn Nursery at Boston Medical Center, where she worked to transform a traditional newborn nursery practice into a developmentally rich service for newborns and families. Dr. Minear incorporated the NBO into newborn care and into medical student and resident education. She implemented an infant massage program and was a cochairperson of the Baby Friendly task force through which Boston Medical Center achieved the World Health Organization's Baby Friendly status, a designation for hospital organizations that successfully follow the Ten Steps program to provide support for breast-feeding mothers.

J. Kevin Nugent is Director of The Brazelton Institute at Children's Hospital Boston, and Lecturer at Harvard Medical School. Dr. Nugent is a developmental psychologist and Founder and Director of The Brazelton Institute at Children's Hospital Boston. He is co-author with Dr. Berry Brazelton of the Neonatal Behavioral Assessment Scale (NBAS) and has directed the NBAS training program since 1978. Dr. Nugent has conducted research on newborn behavior and parent–child relations in different cultural settings around the world and has published extensively on topics in infant and child development. In addition, he has written the manual Using the NBAS with Infants and Parents (March of Dimes Foundation, 1985) and is senior author of the series The Cultural Context of Infancy (Vols. 1 and 2; Ablex 1989, 1991). Dr. Nugent is editor of Ab Initio, the international journal for profe

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Read an Excerpt

Excerpted from Chapter 5 of Understanding Newborn Behavior and Early Relationships: The Newborn Behavioral Observations (NBO) System Handbook, by J. Kevin Nugent, Ph.D., Constance H. Keefer, M.D., Susan Minear, M.D., Lise C. Johnson, M.D., Yvette Blanchard, Sc.D., PT, with invited contributors.

Copyright © 2007 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Use of the NBO During Common Pediatric Encounters in the Early Newborn Period

For convenience, the role of the NBO for clinicians in the early newborn period is outlined somewhat chronologically. Although every interaction differs, common themes do emerge from one family to the next, providing a framework for discussion. Although this is to some extent an artificial organization of concepts, the following themes are discussed as a “rounding” pediatrician or nurse practitioner might encounter them:

Day 1: The first encounter—strengths and needs within the family system

Day 1/Day 2: Feeding support and easing transition

Day 2/Day 3: Crying and soothability

Day 2 and beyond: Individualized caregiving guidelines

The reader will see how concepts from one theme weave throughout other themes and how the NBO adapts itself to a variety of professionals. As is discussed in the latter part of this chapter, the NBO is most powerful when it is used by all of the clinicians the family encounters; it helps if everyone is using the same language.

Day 1: First Encounter—Strengths and Needs within the Family System

The first pediatric physical assessment often is the first meeting between the clinician and the family. The pretext of the visit is to complete the physical examination of the infant and discuss newborn health maintenance issues. Its richness, however, comes from clinician and parents looking together at the new infant as a person. Therefore, as discussed earlier, this examination should be done, whenever possible, in the presence of the family. Although each provider builds relationships in his or her own style and there are cultural differences in the ways in which such an introduction may be presented, a useful first question is, “How did you choose his name?” Most parents care deeply about the name they have chosen for their infant; usually much thought has gone into their decision. There often are stories that spring from the parents as they begin to recount their story of the infant’s name. Listening carefully to the answer, the clinician can elicit important social and family history without asking uncomfortable or intrusive questions (e.g., the father’s involvement, key support people who participated in choosing the name, religious and cultural traditions, hopes and dreams for the new infant). Using the infant’s name throughout the subsequent examination gives parents one of their first opportunities to hear their infant addressed by his or her name—an intimate joy to share.

Early in this first encounter, the clinician can invite the parents to bring their concerns to the fore: “What questions do you have about your infant so far?” Typical concerns may revolve around unresolved worries or fears from the pregnancy, prenatal testing findings, medication exposure, effects of maternal illness on the infant, delivery room events, transitional difficulties that the infant may have experienced, or physical findings that were noticed by a parent or other family member. Many of these issues, of course, may not be raised at first. Nevertheless, the question should be posed at the start of the visit as a standing invitation for parents to raise concerns when they feel comfortable doing so. Indeed, in a study by Wolke, Dave, Hayes, Townsend, & Tomlin (2002), the opportunity to discuss health care

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