The Clinical Neonatal Behavioral Assessment Scale (CLNBAS) is new short form of the NBAS and is based on a structured developmental model that collapses the key clusters and concepts from the classic scale into a 7-10-minute 16-item tool. Busy clinicians can use the CLNBAS to guide parents into healthy relationships with their children from the start. Using a simple three-point scale, clinicians are able to systematically observe and measure a newborn's unique behavioral characteristics with a view to help parents to better understand and bond with their babies. Relationship building is strengthened and the risk of missing important information is reduced when time with new families is better utilized. When parents feel comfortable with their clinicians and are prompted to discuss their observations about their babies, they are more likely to share their concerns.

A public health concept, the CLNBAS when used in the immediate postpartum period offers health care professionals an opportunity to support all parents in the important phase of an evolving relationship with their child. Relationship building between clinician and parent is centered on their newborn's behavior and ultimately brings new parents closer to their child. Although all families will benefit from this model, families who are considered "at risk" are more likely to benefit when they have more actively participate in relationship building behaviors. Participation in the exam helps to reinforce new parents' instincts about their newborns while encouraging them to ask questions about important themes such as infant feeding, social issues, home and family environments, etc. When parents are more comfortable with their clinicians and more confident about interpreting their newborn's behavior, they are more likely to aid in the prevention of potentially serious complications for their newborns.

With increasing attention paid to prevention, the American Academy of Pediatrics recommends that developmental-behavioral practice begin in the newborn period. Currently, pediatric physicians are the primary focus of training in an effort to keep pace with the identified growing importance of understanding development and behavior in pediatric practice, although nurses and other pediatric clinicians are also included. Historically, medical training in pediatrics has not incorporated formal training in child development into their curricula.

Targeting pediatric physicians, the clinical version of the Classic Neonatal Behavioral Assessment Scale (NBAS, Brazelton, Nugent, 1995), the CLNBAS, got off to an enthusiastic start in early Spring at two major medical centers: Boston Medical Center and Massachusetts General Hospital. A total of 30 participants from both centers, comprised of more than 70 % pediatric physicians who are currently in practice, were the first to be formally trained to use the CLNBAS.

The daylong training consisted of lectures, case studies and CLNBAS demonstrations with families. The CLNBAS Faculty includes: Brazelton Institute Director, J. Kevin Nugent, Ph.D., along with T. Berry Brazelton, M.D., Constance H. Keefer, M.D., Sue O'Brien, M.D., and CLNBAS Project Coordinator, Cynthia M. O'Hare, S.M., R.N. All of the participants felt that the training was "worth their professional time" and felt that the session "met their expectations." While distance learning feedback is incomplete at this time, preliminary data suggest that the use of the CLNBAS model of practice with new families has a positive effect on both clinicians and the families with whom they use this model. Of the questionnaires returned, nearly 100% of the participants said they would "recommend the CLNBAS training to a colleague." Of the "Mothers' Questionnaires" returned, 90% of the mothers rated their experience with their clinician who used the CLNBAS model "very good" to "excellent."

The Brazelton Institute has been funded to extend CLNBAS training across the country, beginning this October. We will provide one day training workshops, while mentoring from CLNBAS Faculty at the Brazelton Institute will also be offered during the course of the distance learning, to ensure support. Certificates of completion from the Brazelton Institute are awarded to all participants who complete the day of training as well as the distance learning practice with two families.

All training sessions are arranged through the Brazelton Institute. For further information write: cynthia.ohare@tch.harvard.edu