As visiting nurses from a small home health agency in East Harlem, New York City, we are confronted with the challenge of trying to find a connection with young families from various backgrounds within the context of their own homes. From the teen parents in public housing who learned from an early age to be wary of the "system", to new immigrants, often from indigenous, rural Mexico now living in overcrowded tenements and speaking little Spanish, let alone English. It is often a challenge to find a connection from which to build a trusting relationship. In our maternal-newborn home visiting program, the Newborn Behavioral Observation (NBO) system has provided us nurses with the approach and skills with which to develop relationships with and between parents and infants from diverse backgrounds.

From our preliminary integration of the NBO into our maternal newborn home visits, nurses have reported increased participation of mothers, fathers and other family members in the infant assessment. The focus on concrete, observable behaviors in the infant has often produced enthusiasm that would otherwise be difficult to ascertain ("Look what my baby can do!"). The nurses found that using the infant"s behavior to emphasize the child"s strengths and to help describe his or her personality not only seem to give parents a sense of pride and connection with their child, but also a framework for understanding infant actions. One mother reported feeling that she was better able to deal with prolonged crying spells because she understood his behavior better after the nurse"s visit.