Before I start talking about my journey, I’m sure there will be plenty of you who have read the title of this blog and thought “What is a Newborn Behavioural Observation?”. So let’s begin with a brief explanation.
The Newborn Behavioural Observation (NBO for short) is a set of shared observations, designed by the Brazelton Centre, to help practitioners and parents observe the baby’s behaviour together. Since a newborn baby’s method of communicating is their behaviour, taking time to observe and understand these signs, movements and responses, means understanding what that baby is saying, who they are, what they like and what they dislike. The NBO can be used with babies from birth to 3 months old. There are 18 items in total that can be observed on the NBO. Each session is individual, because the practitioner and the parents will be guided by the baby, but it will typically cover:
• Capacity to habituate to light and sound (sleep protection)
• Motor tone and activity level
• Capacity for self-regulation (including crying and consoling)
• Response to stress (indices of the infant’s threshold for stimulation)
• Visual, auditory and social-interactive capacities.
So that’s a bit of background, but how did my journey to being a certified NBO practitioner begin?
At Dad Matters, we regularly see Dads/parents with newborn babies and in order to enhance our skills and help us to help the parents understand their babies better, myself, Nick and Dan were offered the chance to attend the two-day training course for the NBO.
This was initially offered in September 2020, with the training scheduled for the 4th & 5th November of that year. As you probably don’t need reminding, 2020 was an Annus Horribilis (as Her Majesty would say) for most of the world and therefore it was tentative as to whether the course could go ahead. Luckily, it was agreed that we could partake in the face-to-face training, provided certain social distancing and infection prevention measures were put in to place. So after many months of only seeing people over Zoom, we finally got together to begin our training.
We had been asked to do some pre-course reading and bring a doll with us to use during the training. Despite having a 2-year-old daughter, she was yet to get to her doll-phase, therefore myself and Buzz Lightyear (who brought Woody and Jessie along for moral support) set off in eager anticipation of what lay ahead. Day 1 was fascinating, learning all about the history of both the Brazelton Centre and the NBO itself, along with seeing how the NBO is conducted and learning about the different observations involved. We also heard some case studies and learnt a little about how to administer an NBO.
Now the eagle-eyed of you will have spotted the dates of the training course and will remember the announcement made around lunch time on the 4th November, that the UK was to go back in to lockdown as of midnight that night! Annus Horribilis indeed! Thankfully, due to the strict measures the organisers already had in place, we were granted a stay of execution, so myself and Barry the Sloth (Buzz was needed for an emergency in the Gamma Quadrant of deep space) and Nick and Dan (along with their dolls Donald and Sheila) were able to reconvene the following day and continue with the training. Phew!
Day 2 consisted of learning more about how to administer the NBO, along with how to record and report our findings. We were also shown the NBO in action, albeit with the trainer and a doll as opposed to a family and actual baby, and given the opportunity to perform some of the observations on our own dolls. We then had to complete a full NBO, along with the relevant reporting, on our dolls, in small groups. This really helped us to grasp how we both observe the babies and how we report this accordingly.
The final parts of the training involved learning about vulnerable families and high-risk infants, implementing the NBO in to practice and information on how to obtain our certification. In order to become a fully certified NBO practitioner, you are required to go and administer 5 NBOs and send copies of your reports and the parent questionnaires to the Brazelton Centre. Once this has been completed, you are then sent your certificate (from Harvard University!) and your practitioner pack so that you can deliver NBOs as a fully qualified practitioner. Ideally, the above is to be completed within 1 working month of completing the course. But due to the pandemic, we were assured that we could take a little longer, given the circumstances.
Little did any of us realise that almost 2 years later, I would be writing this blog having finally completed the required 5 NBOs!
Thankfully, in August 2021, I was able to get my first NBO under my belt due to a nursery friend of my daughter having a younger sibling. The delightful little lad, at just 6 weeks old, was absolutely textbook and I was able to perform the NBO with great ease and perform almost all of the 18 tests without fuss. Given that almost a year had passed since my training, I was a little bit nervous as to how the NBO would go and I was massively relived to have had such a perfect first subject.
I now had the bit between my teeth and was ready to power through to get the other 4 done as quickly as I could. Sadly, the opportunities were few and far between and the next chance I got was in October. This time, it was a little girl at almost 11 weeks old. She was again a dream and this time there wasn’t even any crying to witness. Sadly this meant not all 18 tests could be carried out, but this was not the end of the world.
I was all ready to find baby number three! Cue the tumbleweed……
Christmas came and went and we were now into 2022! As luck would have it, some close friends welcomed their new son in to the world just before Christmas and so in February, whilst he was just over 10 weeks old, I was able to perform my third NBO. Another baby who was developing well and despite being a little unsettled after waking up, he was able to complete the observations and show both myself and his mum just how much he was capable of.
And just like buses, you wait ages for one and two come along at once!
My fourth NBO was in early March, with a young baby boy who was just 1 day shy of being 6 weeks old. Although I was able to complete the observations with ease, there were a lot of tears and baby was struggling to self-soothe so relied on both Mum and Dad to soothe and reassure him. It was quite evident that the stimulation threshold had been exceeded for this young baby and he needed a break and a cuddle. Once settled, he was much happier and alert and it was a great example for me of how sometimes you can catch the baby at the wrong moment and the NBO might not go as smoothly as others.
Four down, one to go…..
Despite a couple of months wait, my fifth NBO soon came around in late May. This was with another baby boy at 10 weeks old, who was by far the most vocal of all of the babies seen in the most delightful way. As with all of the babies seen, it was wonderful to see their response to the observations and also see the parents’ reactions to just what their little one was both capable of and telling them. I was able to witness some great examples of Serve and Return between baby and Mum and highlight just much baby was responding to her when she spoke. Alas, there was no crying witnessed this time, but I was lucky that he fell asleep just as I was about to leave, so that we could complete the majority of the tasks.
And with that, I had my five NBOs completed and was able to finally obtain my certificate and Practitioner Pack! But the journey doesn’t end there, in fact, it is only just beginning! I hope to be able to deliver as many NBOs as I can in the future and would urge all new parents to ask about these either via ourselves or via their Health Visitor.
I am so glad to have been offered the chance to undertake the training and am also extremely grateful and honoured that the five families I have delivered the NBO to so far have allowed me in to their homes to do so.
If you have a baby under three months old and are interested in hearing more about or indeed receiving the NBO*, drop us a line and we can provide more details and can arrange for the NBO to be carried out Alternatively, visit Brazelton.co.uk/parents/ for lots more useful
