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Updated: Jun 24, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
The newborn behavioural observations system: A relationship-building intervention to support families in the neonatal
Lise C Johnson1,2, Beth McManus3,4, Yvette Blanchard1
1Division of Developmental Medicine, Boston Children's Hospital, Brazelton Institute, Boston, Massachusetts, USA.
Aim:
Relationship-based interventions for neonatal intensive care unit families have potential to improve parent and infant outcomes; yet, their implementation has been modest within systems of care for high-risk newborns. The purpose of this paper is to describe a relationship-building intervention, the newborn behavioural observation system, summarise the evidence supporting its use, and address its clinical application for high-risk parent-infant dyads in the neonatal intensive care unit.
Methods:
We summarise the extant literature describing the use of the newborn behavioural observation system in high-risk populations.
Results:
While the body of literature supporting the use of the newborn behavioural observation system is modest, several randomised controlled studies have highlighted statistically significant and clinically meaningful gains in infant development and parental mental health. In these studies, the intervention was often integrated into existing systems of care and included high-risk parent-infant dyads.
Conclusion:
The newborn behavioural observation system is a promising intervention designed to support the early challenges of high-risk infants and their parents. Future research should examine its effects in diverse neonatal intensive care unit populations and professionals, strive for continuity of care from inpatient to post-discharge follow-up and developmental support services, and include more longitudinal studies.
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