Ab Initio International Spring 2009
Notes from the Field

Notes from the Field

Submitted by Kathleen Belliveau, OTR/L
Massachusetts

I had an initial visit with a 7-week old little boy who was brought into our program several days ago. He has been through a lot in the past week... his mother has issues with post-partum depression, leading to a conflict during which the baby was cut with a knife several times. Most were surface wounds, although one punctured his lung. He had surgery this past Friday and is now in the custody of his maternal great-aunt.

When we arrived at the home, his aunt told us about how he doesn't sleep very well and needs his pacifier all day and night to remain calm. She also expressed concern that he does not look at her, is not tracking, and doesn't appear to be connecting with her (she believes he is still in a traumatized state). At first I hesitated to administer the NBO as she was in and out of the room, and many items would probably not be able to be administered (I worried about putting him in prone secondary to the wounds healing on his stomach and chest.). Despite that, I decided this was the perfect opportunity...

At first, his aunt remained in the doorway of the room, appearing eager to leave us alone. As the NBO session progressed, however, she joined us fully, and became an active participant. This baby would not visually focus on faces or objects, nor would he turn to voices. He would immediately cry when the pacifier would fall out. No amount of visual stimulation, voices or confinement would calm him, although he did immediately calm when the pacifier was placed back in his mouth. When lost again, I tired some movement (holding him, bouncing), which he responded to beautifully and consistently. I also remembered that you said many babies respond well to the rattle, and parents often ask where they can find one... This was certainly the case today! It was amazing how calm and focused he became when he heard that rattle. In fact, listening to the rattle kept him in the perfect state of arousal to be able to do some focusing and tracking on my face (the first time his aunt had ever seen him do this!).

By the end of the session, his aunt was holding him saying that he looks like a completely different baby to her- very calm, organized, and finally not afraid. I will never forget her excitement as she was able to say for the first time, "Oh my God, he's looking at me!"


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