Abstract
Early intervention planning for infants with disabilities has conventionally been centered on the infants' disabilities, rather than the family's adjustment. There have been no prior studies designed to evaluate the effects of early intervention, based on the principles of the Brazelton Neonatal Behavioral Assessment Scale (NBAS), on infants with disabilities and their mothers.
The objective of this study is to investigate the effectiveness of an NBAS-based intervention for infants with disabilities, in enhancing infant neurobehavioral organization, maternal self-efficacy, and mother-infant interaction.
This trial consisted of a time series design two-week observation (base-line) and intervention periods to analyze the efficacy of the NBAS-based intervention on infants' neurobehavior, maternal self-efficacy and mother-infant interaction. Subjects were 13 infants with disabilities (6 cystic periventricular leukomalacia, 3 chromosomal anomaly, 1 birth asphyxia, 1 holoprosencephaly, 1 congenital multiple arthrogryposis, 1 Russell-Silver syndrome) and their mothers receiving care in the NICU at Nagasaki University Hospital. The Brazelton NBAS, Lack of Confidence in Caregiving (LCC) items of the Mother and Baby Scale, and the Nursing Child Assessment Teaching Scale (NCATS), were used to assess neonatal neurobehaviors, maternal self-efficacy, and the quality of mother-infant interaction respectively, at 3 time points: at intake, pre-intervention, and postintervention. The NBAS-based intervention consisted of parental observation of the NBAS exam conducted by the infant specialist, followed by discussion of infants behavioral characteristics and demonstration of intervention strategies to attune mothers to their infants behaviors. Intervention sessions were performed 6-8 times, 30 minutes per session, during intervention period.
The NBAS orientation and State Regulation cluster scores, the LCC score, and the NCATS Caregiver Total and Subscale scores (Sensitivity to cues and Social-Emotional Growth Fostering) were significantly improved post-intervention.
The NBAS-based intervention has beneficial effects on neonatal neurobehavioral organization and the quality of mother-infant interaction skills and maternal self-efficacy, in infants with developmental disabilities. Attunement of mothers to their infants' behaviors early on in life may promote a positive cycle of interaction between parents and infants.
