T. Berry Brazelton

PREVENTIVE INTERVENTION WITH INFANTS AND FAMILIES - THE NBAS MODEL

A model for preventive intervention based on the use of the Neonatal Behavioral Assessment Scale (NBAS) is presented, and the conceptual framework underlying this approach is made explicit. The approach is based on the assumption that the neonatal period presents clinicians with a unique opportunity to influence parent-infant relations positively from the beginning. It is argued that especially under conditions of stress, this infant-centered but family-focused form of intervention can serve to prevent the compounding of problems that may occur when the caregiving environment is unable to adjust to the needs of the young infant. The aim of the NBAS-based approach is to sensitize parents to the communication cues and the unique adaptive capacities of their infants. It is the individualized nature of the NBAS-based approach that places it outside the domain of main-effects treatment modalities and renders it responsive to the particular needs of individual infants and their families. The model of intervention described herein is based on the development of a supportive therapeutic relationship between clinicians and parents and as such may serve as the first stage in a comprehensive follow-up program of support for infants and families. Guidelines for clinicians using the NBAS in clinical settings that follow from these assumptions are provided.

Affective Reciprocity and the Development of Autonomy: The Study of a Blind Infant

Abstract This study describes the development of affect and the system of communication evolving between a congenitally blind infant and her resourceful parents. The study is based on systematic videotaped observations from birth through age 15½ months. The organizing principle of the study lies in the tracing of the evolution of dyadic reciprocity and the accompanying unfolding of ever-increasing competence of the infant. The study demonstrates that this infants development proceeds largely along normal lines, with occasional regression preceding new accomplishments. It is hypothesized that with support, resourceful parents can from the beginning understand the distorted signals their infant displays as part of his grappling to realize normal developmental goals. This, it seems, prevents the commonly observed stereotypic rigidities and restrictions of blind infants and leads to a mutually energizing process of rich and modulated development for infant and parent.

Early Infant Social Interaction with Parents and Strangers

Abstract This paper extends the observations of early mother-infant face-to-face interaction to situations in which infants 1 to 6 months of age interact with fathers and strangers. Videotaped records of these laboratory interactions were scored second by second. We saw differences in the behavior of both infants and adults in these interactions. Even infants less than 2 months of age behaved distinctively with the different adults in these settings. Infants showed more positive affective displays with both parents than with strangers. The implications of these findings for the theoretical understanding of the infants affective development as well as for public health concerns are discussed.

The Infant as a Focus for Family Reciprocity

The human infant, from birth onward, exhibits predictable behavioral patterns with an adult conspecific. Within the first few weeks, he establishes differentiated behavioral sets for interaction with objects and with persons (Brazelton, Koslowski, & Main, 1974).

The development of social reciprocity between a sighted infant and her blind parents. A case study.

Abstract Affective reciprocity between an infant and his caregiver is the matrix in which the infant develops physically, emotionally, socially, and cognitively. The case study of a sighted infant of two blind parents highlights the complexity of the infant-adult interaction. It brings out the fact that the human infant shows great adaptability to communication in the absence of a communicative channel as important as the parents eyes. The development of a mutually satisfying infant-parent relationship is thus not tied to a particular sensory modality in a fixed manner, but is based on the success of establishing emotional reciprocity.

Working With Families: Opportunities for Early Intervention

The birth or arrival of a baby is a defining event for families. Most infants progress through predictable, yet individual, patterns of development. All families want the opportunity to optimize their childrens futures, yet each spurt of development is a transition that can stress the child and the entire family system. These biobehavioral shifts, or touchpoints, provide opportunities for the pediatrician to help the family understand, adapt, enhance, and promote the childs outcome. This family level approach serves as a form of anticipatory guidance that helps both parent and child successfully manage the challenging phases of development: motor, cognitive, social, and emotional. The touchpoints concept can be adapted for the pediatrician to help older children and their families.

Stress for families today

Rapid changes in family life have created enormous challenges and pressures on developing families - divorce, two working parents, disappearance of the extended family, unclear cultural values for our childrens future, poorly defined support systems for stressed families, inadequate substitute care when both parents work-all contribute to an anxious atmosphere for young families. Parents who must return to work „too early” (and we have no established standards yet for what this means to either child or adult development) seem to grieve about the loss of the relationship with the developing child. They may even set up defenses against making a strong and painful attachment. They may not become involved in the childs development in a way that will foster their own development as nurturing adults. The grieving and the necessary defenses against it are predictable and must be mitigated in order to foster nurturing adults within the family. Children must be provided with caring, intensely involved adults in order to assure their optimal future development. We must provide them and their parents with adequate substitute care. This paper suggests adjustments at the industrial level that must be made to foster parental involvement and to assure positive outcomes for future generations.

Child care and Culture: Infant care: Cultural norms and interpersonal environment

This chapter concerns how Gusii mothers define infant care – their shared assumptions about the tasks and standards involved – and examines the infants interpersonal environment over the first 30 months of life. Age trends in the infants social ecology are analyzed in relation to family characteristics and to developmental patterns measured by the Bayley Infant Scales. THE CULTURAL MODEL OF INFANT CARE Despite their socioeconomic and religious differences, our sample families in Morongo varied little in how they defined the maternal role and its primary responsibilities. Their model of infant care largely replicated that of the preceding generation, whose norms and practices were recorded in the 1950s. The practices of mothers had been affected by new scarcities as well as new resources. The new resources included blankets, which made it unnecessary to keep the cooking fire going all night, thus reducing the risks of burns; more clothing, keeping children warmer during the rainy season; bottles with nipples, making it unnecessary for child caregivers to force-feed babies from a calabash when the mother was absent; and the use of water from wells instead of streams. In other words, greater access to cash, imported consumer goods, and household improvements had brought a higher level of material welfare that reduced some of the risks to infants observable in the earlier study. Novel scarcities included firewood, still used for cooking but more difficult to obtain in densely inhabited settlements, and children to look after babies, now attending school during the years they formerly spent at home.