New parents have the challenging job of learning how to parent and how to meet the needs of their baby. The Brazelton assessment can help parents and healthcare providers to better understand the unique needs of each newborn. With a better understanding of the unique capabilities and needs of the baby, parents can nurture the baby with more ease and potency.
New parents have well-meaning advice coming from all directions. Some of the advice might work while others might not. Parent of the problem is that each child is different. What may work for one child, might not for another.
Understanding the struggles of new parents (and their well-meaning healthcare providers) Dr. T. Berry Brazelton and his colleagues developed an assessment to better understand newborns.
The Neonatal Behavioral Assessment Scale (NBAS), commonly referred to as the Brazelton scale, was developed in 1973. The NBAS assesses a wide range of behaviors common to newborns up to 2 months old. The assessment paints a picture of what the baby is able to do independently and what she needs help with.
This allows parents to gain a better understanding of the needs of their baby. It also allows healthcare providers to teach different parenting techniques that will help in specific situations.
Parents feeling like they just aren’t getting the right advice for their baby or situation may be interested in the Brazelton Assessment. It’s a perfect way to quantify baby’s needs and to be able to respond with a loving, helpful and effective response.
Make sure to check out our resources of where to get a baby assessed at the end of the article. Not all healthcare providers are trained in this assessment.
12 What Does It Assess?
The Brazelton Assessment tries to paint a clear picture of what baby is able to do and not able to do. The scale is made up of 28 behavioral items and 18 reflexive items. The Brazelton Assessment scores newborns in four areas: autonomic, motor, state and social-interactive.
Autonomic relates to the automatic body processes that are controlled by the brain and the nervous system. For newborns, regulating breathing and temperature is especially important.
Motor involves how the baby moves. This part of the assessment looks at how well the baby is able to control random movements. It also takes into consideration the baby’s muscle tone, activity level and reflexes.
State relates to the state of consciousness a baby is in. For newborns this could be sleeping, crying, active alert and more. The social-interactive portion of the assessment deals with how the baby interacts with healthcare providers or parents.
11 Why Assess The Autonomic System?
As mentioned above, it's best to assess the autonomic system for any sort of neurological issues the baby may be having. The NBAS might be able to detect an early neurological problem and give the doctors a clue as to how to treat the issue. Not to mention that early detection of neurological issues means that the baby won't have to suffer form poor growth and misdiagnosis before coming to an accurate diagnosis.
Another feature that these tests look for is a reaction to stress. This is where breathing and fight or flight responses would be tested. It's important to get an understanding of how the baby interacts with their world and how they react to it.
Doctors feel assessing this system is vital for low birth weight babies and premature babies.
10 The Importance Of Testing The Motor Control
Motor control is important for newborns because their reflexes, muscle tone and hand-to-mouth activity is essential for the future growth of babies development. Although motor function isn't completely developed in infants until they're 3 months old. A baby's motor function must be purposeful and directed, moving with a purpose.
Testing the fine motor and gross motor skills of newborns can let healthcare practitioners see if there's a problem with smooth and symmetrical movement, rather than rigid and unpredictable movement.
Head control is important at birth. Doctors will hold a newborn by their chest and measure how far the baby is able to hold up their head. Newborns should be able to hold their head at a 45 degree angle with their back straightened or in a slight arch.
Head control and baby's grasp are the most important motor skills at birth, afterward the wrist strength and ability to pull theirselves into a sitting position is important.
9 The Interactive Assessment
The importance of the interactive assessment can't be overlooked. Overall doctors are checking for how the baby relates to people through how alert they are, and how "cuddly" they are. Doctors measure the visual, auditory and the social interactions between the baby and human or non-human stimuli.
These tests can reveal which behaviors are unique to the baby, and how different their preferences are to other babies. When testing the newborn's voice, or their "signature," doctors can measure what is unique to the baby and indicates the baby's preferences and vulnerabilities.
This is also helpful for parents because it teaches them how they can help their child grow and develop socially. It may even hint at neurological issues or visual and auditory problems as well. if an infant can't hear or see their parents, they won't develop normal social interaction like their peers.
8 Testing The Baby's Physiological State
This doesn't refer to the baby's actual health of their body or organs, instead this refers to the baby's ability to self soothe, or how they react to being soothed after being upset. Under the Brazelton method, doctors assume that babies have 9 months of experience where they've learned to interact with their surroundings and their environment.
That means that babies should be capable of controlling their behavior to some extent in response to their environment. Basically this test assesses the baby's levels of consciousness. Being able to control their state or mood and transfer from one state or mood to the other is important. For example how soon they go from crying to settled after being unsettled.
This information can tell parents whether the baby needs help soothing and calming or whether they're able to do it all on their own. This test also informs doctors whether the ability to adept and react to situations is normal and warranted rather than abnormal and unexpected.
7 Who Administers The Assessment?
You may be excited to have your newborn assessed using the Brazelton scale. After all, who wouldn’t want specific guidance in how to care for their unique newborn? these assessments can help parents better understand the needs of their newborn and how certain methods will benefit their children and help them to grow.
The assessment was originally developed for researchers looking to quantify the differences between newborns. Since then, it has been used by healthcare providers and pediatric professionals. The Brazelton Institute points out that specific training is needed to be able to do the assessment as it was intended.
A pediatrician who has specialized in the Brazelton method will use it to assess a newborns abilities, behavior and their senses. Mothers can ask for this type of assessment and even discuss it with their healthcare provider to see if they're able to perform these tests, or know of someone who can.
6 How Are The Results Scored?
Sorry, this isn't a test you or your baby can prepare for!
The assessment won’t give parents a single score (unlike APGAR testing). Instead it creates a picture of what the newborn is able to do or not do. this can give parents reasons why babies aren't meeting milestones or if the abby is currently having an issue with a sense or in a developmental way.
The Brazelton scale gives a detailed analysis of the newborn baby’s abilities to control movements, transition from sleeping to awake, respond to stimuli and more.
Babies are complex beings and this assessment addresses that. It looks for what is unique for each baby. The result is a detailed analysis that tells practitioners and parents much about the baby. A rich understanding of the newborn baby’s level of development is established.
5 How Do The Results Help Healthcare Providers?
The results can help healthcare providers trying to advise parents on their newborn baby. Often times, new parents look to their pediatrician or midwife on how to help their baby. They may be concerned that the baby is crying a lot, sleeping too little, seems irritable, or is feeding poorly.
The Brazelton assessment will help to pinpoint the specific areas baby has mastered (like body temperature control or tuning out loud noises). The areas that baby is struggling with will help to indicated what strategies will help the new parents.
For example, if a baby is struggling to control his muscles and waking himself up from jerking, the practitioner may teach the parents how to swaddle the baby. The swaddled baby would then wake up less from jerking arm movements.
4 How Do The Results Help Parents?
Parents may discover many things about their baby with the Brazelton assessment. A parent may learn that baby has difficulty blocking out light while sleeping. This may mean that baby needs a completely dark room to sleep.
Another baby may not be able to block out sounds. This baby may need quiet tones and reduction of bothersome sounds in the house.
Parents will learn that their baby has unique needs and is trying to communicate those needs. They will see that some things really bother baby while others don’t. This is invaluable information for parents trying to get baby to feel safe, secure and comfortable. Many parents report that they became more aware of what was happening with their baby and were able to tune into what baby was trying to communicate.
3 What If My Doctor Doesn’t Know About The Brazelton Assessment?
Some parents may worry that they are demanding too much of their practitioner by requesting the Brazelton Assessment. They may also be concerned about whether or not it is covered by their insurance.
Each situation will differ, but an open conversation with your healthcare practitioner is key to having an open relationship with him or her. This may be a great question to ask as you're looking for a pediatrician for your baby before baby arrives. You can explain that you are interested in the Brazelton assessment to build your confidence and skills as a new parent.
Since practitioners have to go through a special training program to be certified to administer the test, your pediatrician may not be certified in it, but that doesn't mean that they don't know another professional who is qualified to do the assessment, even if they're not.
2 Is There An Alternative To Brazelton Assessment?
You may be interested in the Brazelton assessment, but might be wondering if there is an alternative to it. There is a shorter version of the NBAS which is very beneficial for practitioners helping new parents. This version just has 18 areas of assessment and is referred to as Newborn Behavior Observations (NBO) systems.
This system limits the number of assessments taken for the baby and focuses on building relationships between parents and practitioners. Some parents find this type of assessment just as helpful as the Brazelton method.
NBO was developed by Dr. J. Kevin Nugent, fellow researcher of Dr. Brazelton. Nugent had extensive practice using the NBAS with newborns for research purposes. He developed the NBO to give practitioners a more practical way to use NBAS with families. Both of these methods are basically evaluating outcomes for babies and caregivers. The outcomes determine what type of care the baby will benefit from.
1 How Do I Get My Baby Assessed?
If you want to get your baby assessed, you can begin by asking your pediatrician about using the Brazelton assessment on your newborn (up to 2 months old). If your pediatrician is not familiar with the assessment, you can contact the Brazelton Institute directly for recommendations.
If you're not sure you want to go through the rigour of the Brazelton method, you might find you'd rather have a practitioner certified in NBAS conducting assessments on your newborn. To find a qualified healthcare practitioner, contact the Brazelton Institute at 1295 Boylston Street, Suite 320, Boston, MA 02115 USA. Phone: 1-617-355-4959.
Have you had a Brazelton assessment done on your baby? Comment below to tell us the results. Are you interested in having one done? Comment below to tell us the main reason you want it.
Source: Brazelton Institute