Validation of infant behavior identified by neonatal nurses

Nurses observe that the behavior of an occasional full-term healthy newborn is "unusual," "different," "funny," or "not like the others." This study was designed to determine whether infants identified by nurses as suspect behaved differently from those identified as normal. Suspect infants scored significantly lower on the Brazelton Neonatal Behavior Assessment Scale than their matched controls. No dysfunction was common across the entire suspect group. Although nurses accurately predicted suspect infant behavior, they did not identify the specific Brazelton dimensions on which infants demonstrated worrisome behavior. The results indicated that nurses are reliable sources of information about infant behavior and can be valuable aids in screening infants in need of further assessment. In addition, the data provided tentative insight into the methods nurses use to make clinical judgments. Finally, the results pointed to the possible limitations of the medical model of infant assessment and demonstrated that nurses' empirical knowledge is amenable to measurement and testing. Additional research is necessary to determine if and under what circumstances infants who behave suspiciously are at risk.