United States

NBO and NBAS training: There was an increase in the demand for NBO training in the United States this year. Seventeen NBO trainings were offered over the course of 12 months and 309 trainees attended these sessions. Seven of the training sessions were conducted in Boston and the remaining 10 across the country at the following venues:

  • The University of California Davis Extension's Infant-Parent Mental Health Fellowship Program in Napa, CA, which is directed by Dr.Kristie Brandt. The training was led by Drs. Keefer and Nugent. The first NBO training in the Napa-based Fellowship program, led by Kristie Brandt, was offered over 12 years ago and the multidisciplinary program now draws participants from all over California and from all over the US and abroad (Napa training photo below). 
  • NBO training, with Keefer and Nugent, took place as part of the Infant-Parent Mental Health Postgraduate Fellowship/Certificate Program at the University of Massachusetts. The program is led by Professor Ed Tronick and Dorothy Richardson is the Program Director. Participants from many countries include psychologists, physicians, social workers, marriage-family therapists, educators, occupational therapists, physical therapists, nurses, speech/language & communication therapists, and other professionals attended.
  • NBO training was presented at the University of New Mexico School of Nursing by Connie Keefer and Ann Stadtler on June 21-22nd.
  • Connie Keefer and Yvette Blanchard presented NBO training to the Kootenai tribe in Montana.
  • The Little Company of Mary Hospital in Chicago hosted NBO training, which was conducted by Ann Stadtler on Sept 20th—21st.
  • NBO training was presented at Russell Child Development Center, Garden City, Kansas on September 13-14, 2016. Yvette Blanchard and Aditi Subramaniam taught the course.
  • The University of Wisconsin Capstone Certificate Program in Infant, Early Childhood and Family Mental Health hosted NBO training in October 2016.NBO training has been an integral part of the program since it was inaugurated seven years ago. The program, founded in 2009 by Roseanne Clark, Associate Professor in the Department of Psychiatry, University of Wisconsin School of Medicine and Public Health and by Dr. Linda Tuchman-Ginsberg, who has contributed to early childhood professional development for almost 35 years, continues to flourish. This year, NBO training was presented to the Capstone fellows and a group of home visitors by Dr. Constance Keefer and Kevin Nugent,

An added element to the Boston-based NBO training offerings this year was the Advanced Level Training for experienced NBO Early Intervention providers. Jayne Singer took the lead in facilitating the reflective practice emphasis in the program. 2017 will see the introduction of an Advanced Level II NBO training, for experienced NBO practitioners.

In 2016, we bade goodbye to NBO Trainer, Gaylen Plant, who contributed so much to our NBO training and practice, but has now relocated to Germany. We offer her our best wishes and hope our paths meet again. Fortunately, the NBO training team was enhanced by the addition of Nancy Deacon and Aditi Subramaniam and Trainers-in-training Claudia Gold and Carmen Noruña. Yvette Blanchard continues to be the lead NBAS Trainer in the United States. The US NBO Trainers Team is made up of the following:

Yvette Blanchard, Sc.D., P.T., Professor, Sacred Heart University, Hartford, Conn.

Kristie Brandt, CNM, MSN, DNP, Director of the Parent-Infant & Child Institute, Napa, CA.

Nancy S. Deacon, D.O., F.A.A.P, Shore Touch Pediatrics, Toms River, NJ

Claudia M. Gold, M.D. Austen Riggs Center, Stockbridge, MA.

Lise Johnson, M.D., Director, Well Newborn Nurseries, Brigham and Women's Hospital, Boston and Harvard Medical School

Constance Keefer, M.D., Boston Children's Hospital and Harvard Medical School

Beth McManus, P.T., M.P.H., Sc.D. Department of Health Systems, Management & Policy, School of Public Health, University of Colorado.

Susan Minear, M.D., Boston Medical Center and Boston University School of Medicine.

Carmen Noruña, LCSW, MS.Ed.,CEIS, (NBO Trainer–in-Training) Boston Medical Center, Developmental and Behavioral Pediatrics. The Child Witness to Violence Project

Kevin Nugent, Ph.D., Director, Brazelton Institute, Boston Children's Hospital and Harvard Medical School

Claudia Quigg, B.A., M. Ed., Director, Baby TALK, Decatur, ILL.

Jayne Singer, Ph.D., Boston Children's Hospital and Harvard Medical School.

Ann C. Stadtler, RN, CPNP, DNP, Director, Touchpoints Site Development and Training, Boston Children's Hospital

Aditi Subramaniam, LMHC, R-DMT, The Trauma Informed Collaborations for Families with Young Children, Boston Public Health Commission

Research: In terms of research, Kevin Nugent, Beth McManus and Yvette Blanchard received a research grant from the Deborah Munroe Noonan Memorial Research Fund to test the effectiveness of the NBO as a model of care in a large sample of infants served by Early Intervention programs for infants with developmental disabilities or delays in the State of Massachusetts. The purpose of this randomized trail is to determine the effects of the NBO on infant cognitive and social-emotional function and maternal depression. NBO Trainer Jayne Singer is involved in the training and mentoring of the EI practitioners in the study. Data collection will continue until late 20i7.

The following are reports by individual NBO/NBASinternational members:

Using the NBO to introduce relationship-based care to an entire community

By Claudia M. Gold, MD, Pediatrician, Consultant in Human Development, Austen Riggs Center; Author, The Developmental Science of Early Childhood, The Silenced Child, and Keeping Your Child in Mind.

In rural western MA, under the sponsorship of the Austen Riggs Center, we are developing a model of community intervention with the NBO as its centerpiece. Our project has three parts. In April of 2017 we will conduct an NBO training for all professionals who interface with parents and newborns. This includes maternity nurses at our local hospital, pediatricians, home visitors, and early intervention workers. The maternity nurses will then integrate the NBO into care of the approximately 150 families per year who deliver there. The third part is a research project. We will first assess, among other measures, baseline levels of parenting stress, co-parenting and postpartum depression in the community. We will continue to collect data- both prenatally and postpartum- following the training, thus allowing us to study the effects of the NBO both within an individual family as well as in the community as a whole.




Using the NBO in different cultural settings

by Alex Harrison

In 2016 I have used the NBO in India, El Salvador, and China. In India, our team demonstrated the NBO with about 10 infants and consider it the “heart” of the infant mental health mini course we gave in the nursing school (see photo above). Josh Sparrow and I used the NBO with 9 or 10 families in China in order to obtain videos of Asian families to illustrate the training we taught in Shanghai. The child psychiatrist who was our host at the university and who translated for us during the NBO, said that this experience inspired her to become more interested in infant development. In El Salvador, I also used the NBO on about 6 newborns in order to generate videos for future mini course trainings in El Salvador. 

Next month, in February, 2017, I am traveling with a small team back to India to teach the mini course to a new group of nursing students. In the future, we hope to do a modest outcome study to demonstrate the effectiveness of our training, using the NBO to assess the change in the students’ behavior towards parents and infants. We will also travel to the south, where we will explore the possibility of teaching the mini course to a different group of caregivers. In July, I am taking another team to Peru to give the mini course training to caregivers in two different institutions. The NBO will again be central in the training. Finally, in August, I am also traveling to Grenada to give a training.

Opiate Exposed newborns and the NBO

by Sue Minear, NBAS Trainer

Drs. Cathleen Dehn and I are using the Newborn Behavior Observation (NBO) to develop the consolability aspect of a new tool which will be standardized as part of a research project at Boston Medical Center (BMC). Opiate abuse has become epidemic in Massachusetts and other states within the US. There is little consensus around the management of newborns who were opiate-exposed prenatally and there is no standardization around use of opiates to treat withdrawal in newborns. In 2016 Boston Medical Center was awarded funding from the Massachusetts Health Policy Commission to create a standardized approach for treatment of infants exposed to opiates during pregnancy. Drs. Dehn and Minear helped create a new tool, which is designed to objectively assess opiate-exposed newborns and determine which newborns require treatment for drug withdrawal. Using this tool, the observer (parent, clinician or nurse) observes the infant’s eating, sleeping and ability to console. The tool, (called ESC), will be standardized as part of the research study.

Report by Carmen Rosa Noroña LCSW, MS.Ed.,CEIS, (NBO Trainer–in-Training) Boston Medical Center, Developmental and Behavioral Pediatrics. The Child Witness to Violence Project

In collaboration with Cathleen Dehn I introduced the NBO to a group of 4 social work interns. This training was designed to increase the interns’ awareness about infant development and attachment and to increase their observational skills. They will not be using the tool yet but some of them were interested in getting fully trained in the NBO. The trainees work with a diverse population of young children and their caregivers who have been affected by traumatic events. The training helped the trainees reflecting on opportunities for intervention with some of their client families where a caregiver was pregnant or recently gave birth. It created an interest in some of the staff and trainees to get fully trained in the NBO

I plan to continue my training as a NBO trainer; I began my training in the summer of 2016 and would like to have opportunities for more structured observation, mentorship and practice. My hope is to start training as an associate trainer whenever my mentor considers I am ready, and also to bring the NBO to Ecuador and/or other countries in Latin America. I would also like to help translating the training materials into Spanish using a Translations Review Committee Approach.

2016 NBO Report

by Claudia Quigg, Baby TALK, Decatur, Illinois, NBO Trainer

Reflective Practice calls with trainees. Through the early months of 2016, I was still conducting mentoring calls with the 17 NBO trainees from a training held at Little Company of Mary Hospital in Chicago in September 2015.

Mentoring of local Baby TALK staff. Because Baby TALK serves every family who gives birth in our county, we have a real commitment to having staff learn the NBO. To date, we have had 35 staff go through NBO training. NBO training is required for our staff that conduct Newborn Encounters at local hospitals. We also have 3 staff who are certified reliable on the NBAS (including myself). It is my pleasure to mentor these staff who are using the NBO in their practice, often attending their monthly meetings to practice specific maneuvers or to discuss challenging situations.

Leadership of Illinois Newborn Practice Roundtable. In 2015, we convened a group of Illinois professionals from a variety of disciplines who have experience in and commitment to working with Newborns and their families. This group identified the need for a guidance document for home visitors and others working with Newborn families without the benefit of much specialized training. Working with input from this group, I wrote and published a small book entitled Professionals Partnering with Newborns and their Families, with the publication costs supported by the Illinois State Board of Education. This book was disseminated throughout many program funding streams and professional groups.

NBO Presentation to the 20th Anniversary Forum of the Brazelton Touchpoints Center. At this special assembly in Providence in July, I was given the opportunity to present about the NBO to this group for approximately 140 Touchpoints trainers. The purpose was to acquaint trainers with the NBO and also to depict how the NBO is truly the “quintessential Touchpoint,” serving as a model for the strategy of “using the child’s behavior as our language” when working with families.

Organization and promotion of 2016 Chicago NBO training. I organized and promoted another Chicago NBO training at Little Company of Mary Hospital. While I had been scheduled to serve as faculty, in the end the 13 participants registered did not support a second trainer so Ann Stadtler led this training solo and I did not train.

At the end of 2016, I am retiring as Executive Director of Baby TALK, but will stay involved in my role as “Founder.” I plan to continue to be supportive of NBO efforts, and in fact hope to be more available as needed.