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A 3 page term paper on Dr. Thomas Berry Brazleton Theory

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     Dr. Thomas Berry Brazelton is one of the most famous children child-development experts in the world. Brazelton looks at the practice of healthcare, he uses the eye of a man who has spent his life studying the development of children. He does not see cases, or even individual patients, he sees families, growing together.

     He has turned this point of view into serious medical tools, including the widely-used Brazelton Neonatal Behavioral Assessment Scale, and into a great range of scholarly publications. At the same time he has popularized it in a syndicated newspaper column, in Family Circle where he is a contributing editor, on National Public Radio, on the "What Every Baby Knows" series on the Lifetime cable channel, and in a series of books such as Working and Caring, To Listen To A Child, and On Becoming A Family all geared at helping parents understand what their children are going through, helping them see the growth and see how they can help.

     “Obviously written by talented therapists, Raising Resilient Children is such a well-written, easy-to-read, and helpful book for parents. It is timely, for all parents are hungry for such advice and guidance in raising resilient children. All families live with stress, but children who learn resilience from their parents' handling of these stresses are fortunate indeed. This book should help parents guide their children toward this necessary resilience." (T. Berry Brazleton, M.D., The Healthcare Forum Journal, November-December 1992, Vol. 35, pg 6.)

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     The Neonatal Behavioral Assessment Scale (NBAS) was developed by Dr. T. Berry Brazelton and his colleagues in 1973. The scale represents a guide that helps parents, health care providers and researchers understand the newborn's language.

     "The Scale gives us the chance to see what the baby's behavior will tell us," says Dr. Brazelton, professor emeritus. It gives us a window into what it will take to nurture the baby." (Brazelton, T. B., & Nugent, J. K. The Neonatal Behavioral Assessment Scale. Mac Keith Press, Cambridge. (1995), pg 79)

     The Scale, looks at a wide range of behaviors and is suitable for examining newborns and infants up to two months old. If a baby is examined by NBAS his/her strengths, adaptive responses and possible vulnerabilities can be portrayed. This helps the parents to develop appropriate care giving strategies aimed at enhancing the earliest relationship between babies and parents.

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     When the Scale was published in the early 1970s, people were started to know the infant's full breadth of capabilities with the help of NBAS. Previously the only tests available were designed to detect abnormalities. The Scale was designed to go beyond available assessments by revealing the infant's strengths and range of individuality, while still providing a health screen. The NBAS is based on several key conjectures. First, infants, even ones that seem weak, are highly capable when they are born.

     "A newborn already has nine months of experience when she is born, notes. She is capable of controlling her behavior in order to respond to her new environment."

     Second, babies can communicate through their behavior, which, although it may not always seem like it, is a rational language. Not only do infants respond to cues around them, like their parents' face, but they also take steps to control their environment, such as crying to get a response from their caregivers.

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     Third, infants are social organisms, individuals with their own individuality, ready to shape as well as be shaped by the care giving environment.

Assessing the baby's capabilities

     In an effort to reveal everything the infant has to say, the Scale was built to 28 behavioral and 18 reflex items. The exam does not yield a single score but instead assesses the baby's capabilities across different developmental areas and describes how the baby integrates these areas as she deals with her new environment.

     When infants are born they face four developmental tasks vital to their growth. The Scale examines how well the infant manages these interrelated tasks and sees if the baby may need extra care giving support in some areas.

     The basic challenge facing newborns is to regulate their breathing, their temperature and the rest of their autonomic system, which needs to be functioning properly before infants can concentrate on other developmental areas. High-risk infants may spend most of their energy trying to maintain their autonomic systems, so they cannot focus on other areas of growth. Sights and sounds may overburden them, so looking at their mother's face may disturb their breathing or noise may set off shiver, startles or color changes, signals that are assessed by the Scale.

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     Next, infants strive to control their motor system. Inhibiting random movements and controlling activity levels lets the newborn focus her energy on other developmental tasks vital to growth. If the baby is having difficulty in this area, caregivers can help her by providing as much tactile support as necessary to help her settle down, such as holding or swaddling her. The Scale assesses the quality of the baby's tone, activity level and reflexes.

     Once the baby can manage motor behavior, she will be ready to tackle the next sphere in her developmental agenda: "state" regulation. State is a key developmental concept that describes levels of consciousness, which range from quiet sleep to full cry. The infant's ability to control her states enables her to process and respond to information from her care giving environment. The NBAS examiner looks at how an infant controls her states and at the transition from one state to another.

     Finally, when an infant's autonomic, motor and state systems are in equilibrium, she is ready to interact socially, the ultimate developmental task. The Scale shows how babies are ready to be engaged in their new world from the first moments of life. In this portion of the assessment, the examiner looks to see how a baby follows a red ball, a face and a voice. It is a powerful experience for parents to see their new child respond to their voices or study their faces.

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     Examiners have to take training for using NBAS. This training would help them to do everything possible to support the infant in "succeeding." For example, one part of the exam looks at an infant's ability to self-console when they are upset. Some infants console themselves easily, while others have a more difficult time. If the infant cannot console herself, the examiner takes measured steps to help her. Not only do we learn how much support the infant may need at home, but also how far along the child is at completing her developmental agenda.

     By the end of the test, the examiner has developed a vibrant portrait of the newborn, which can be used to tailor care giving to the baby's specific physical needs and behavioral style. We can solve various questions like; does the baby like to be handled? Is the baby receptive to social interaction? Does the baby easily calm himself?

     "One of the important things about the Scale is that it parallels what parents are looking for," Dr. Brazelton says. "It puts health care providers on the same wavelength as parents."(Zigler, Edward F. and Matia Finn-Stevensen, Yale University. Children, Development and Social Issues, D.C. Heath and Company, Lexington, MA & Toronto, 1987, pg 144)

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     T. Berry Brazleton, M.D., The Healthcare Forum Journal, November-December 1992, Vol. 35, pg 6.

     Zigler, Edward F. and Matia Finn-Stevensen, Children, Development and Social Issues, D.C. Heath and Company, Lexington, MA & Toronto, 1987, pg 144)

     Brazelton, T. B., & Nugent, J. K. The Neonatal Behavioral Assessment Scale. Mac Keith Press, Cambridge, 1995, pg 79.


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