Mental health articles

Infant developmental assessment A developmental assessment, for example, using the Neonatal Behavioural Assessment Scale (Brazelton & Nugent, 1995), shared with the parents at the time of taking their baby home gives important information to the clinician and the family. The assessment allows the parents to observe their baby’s unique characteristics, response to handling, and strengths, and where the baby needs extra support. The clinician obtains a clear picture of the baby’s tolerance of handling, signs of stress and availability, and how much support the infant requires to return to a calm state after stimulation. The information gained from the assessment forms the basis of the intervention with the family to address the
developmental needs of the baby.
Once a careful history has been taken and an assessment of the infant has
been obtained, an agreement is made between the clinician and the family as to ongoing involvement by the clinician or other agencies.
At the very least, these parents usually need to have the opportunity to
debrief the experience of the previous weeks and sometimes months. They also frequently require some information as to the developmental needs of their particular infant. For example:
• how their premature infant has two birthdays, the day on which she was born and the day on which the baby was due to be born
• that for developmental purposes, for at least the first three years, it is the day on which she was due to be born that is significant
• the importance of sleep and a rhythm of light sleep, deep sleep, quiet alertness
and active awake time to their infant’s development
• that premature babies and babies who are ill or have developmental delay
often require assistance to get to sleep, assistance in the form of wrapping
and/or holding until the baby’s body is relaxed before placing her in a
bassinette or carrying her in a sling (to allow the infant to feel human
closeness and relax to sleep, as infants prefer to sleep in the company of
others)
• that many premature, ill, or infants with developmental delay are inclined to
be extended in their bodies and thus benefit from being carried in a sling to
enable them to maintain a curled posture, which assists them in getting to
sleep
• that their particular baby has been denied the normal closeness experienced
by healthy full-term infants and will require extra holding and body-to-body
contact in the first few months of their time together and that infants cannot
be spoilt when their needs are met in this way
• that the more extreme forms of behavioural techniques to get infants to sleep through the night are completely inappropriate for their baby, given the
baby’s history to date. A more appropriate approach would be to find respite
for the parents to enable them to get uninterrupted sleep.
Most families with a premature or sick infant will have ongoing
appointments with medical services, either at specialists’ rooms or at the
hospital, and with a follow-up clinic with allied health services. Very often these parents require someone who can monitor their baby’s progress and their wellbeing
in a holistic way, with whom they can share their ongoing concerns and
often their stages of grieving as they adjust to the baby they have, rather than
the baby of their dreams.
Often the clinician will recommend referral to additional services as the need
arises.

Tags: infant