Mental health articles

NEWBORN NEUROBEHAVIOURAL DEVELOPMENT
The importance of the infancy period has been clearly established and
emphasised in earlier chapters of this book. The infant’s genetic make-up,
constitutional factors and birth experience will influence early behaviour and the
caregiving received. The capacity of the parents and other caregivers to
sensitively respond to the subtle cues of the infant will in turn influence the
infant’s attempts at self-regulation and subsequent development. An explanation
of early development within this approach has been detailed by Dr Heidelese Als
(1982).
In the Synactive Theory of Development (Als, 1982; Brazelton, Als, Tronick
& Lester, 1979), Als proposed a method of conceptualising the biological basis of
newborn behaviour and a framework for organising observations of newborn
infants. Newborn behaviour is the expression of five hierarchical, sequentially
maturing and interdependent areas of function, which are: the autonomic
system, the motor system, the state organisational system, the attentional and
interaction system within the state system, and a self-regulatory and balancing
system. Autonomic homeostasis is seen as forming the core, in terms of being
the earliest system to achieve stability, and as being required as the foundation
for other behaviour. All of the systems are an integration of physiological
adaptation and maturation and the caregiving environment. For example, when
a baby is born, respiration, nutrition and temperature control are dependent on
particular physiological adaptations and also appropriate caregiving. The baby
needs maximum support to maintain homeostasis and to avoid excessive stress.
Thus, those caring for the baby modulate the timing, intensity, duration and
appropriateness of stimulation.
Infants born premature, or compromised in some anatomical manner, will
require greater assistance from the caregiving environment to establish and
maintain homeostasis and establish circadian rhythms.
Als has identified within each subsystem behaviours displayed by infants that
indicate approaching or engaging behaviours, or withdrawal from stimulation,
that is, stress and defensive behaviours. In balancing these behaviours to achieve
self-regulation, infant signals range from mild and subtle to more dramatic expressions, and are generally understood by caregivers. Under ordinary
circumstances, loving parents either intuitively or quickly learn their baby’s
signals that indicate availability and interest, or withdrawal, and respond
accordingly. When subsystems are disturbed by medical and biological
conditions, this process becomes more difficult.