The Effects of the Newborn Behavioral Observations (NBO) System in Early Intervention: a Multi-Site Randomized Controlled Trial.

Beth M. McManus, Yvette Blanchard, Natalie J. Murphy and J. Kevin Nugent (2020). The Effects of the Newborn Behavioral Observations (NBO) System in Early Intervention: a Multi-Site Randomized Controlled Trial. Infant Mental Health Journal. 2020; 41, 6, 757-769: https://onlinelibrary.wiley.com/doi/10.1002/imhj.21882

Abstract

Objective: To evaluate the effect of an infant mental health intervention, the Newborn Behavioral Observations system (NBO), versus usual care (UC) on infant neurodevelopment and maternal depressive symptoms in Early Intervention (EI). 

Methods: This multi-site randomized trial enrolled newborns into the NBO (n=16) or UC group (n=22) and followed them for 6 months. Outcome measures included the Battelle Developmental Inventory (BDI-2), Bayley Scales of Infants Development (BSID-III), and Center for Epidemiologic Studies Depression Scale (CES-D). The CES-D and BSID-III were collected at 3- and 6-months post EI entry and the BDI-2 was collected at EI entry and 6-months post-EI entry. We estimated group differences [95% CI], adjusting for program characteristics. 

Results: At 6-months, the NBO group had greater gains in Communication (b=1.0 [0.2, 1.8]), Self-Care (b=2.0 [0.1, 3.9]), Perception & Concepts (b=2.0 [0.4, 3.6]), and Attention & Memory (b=3.0 [0.4, 6.0]) than the UC group. The NBO group also had greater decline in maternal postnatal depressive symptoms (b=-2.0 [-3.7, -0.3]) than the UC group.

Conclusions: Infants receiving the NBO infant mental health intervention had greater gains in cognitive and adaptive function at 6-months than infants receiving UC. Caregivers receiving NBO care had greater improvements in maternal depressive symptoms than caregivers receiving UC.