Brazelton, T. Berry 1918-

BIBLIOGRAPHY

In his roles as researcher, clinician, and advocate for parents, T. Berry Brazelton has been one of the formative influences on pediatrics in the United States for over fifty years. For much of the earlier part of the twentieth century, it was assumed that the newborn infant was a “blank slate,” operating at a brain-stem level, and the care of the newborn seemed to reflect this assumption. It can be argued that one of the most important advances in the study and treatment of the newborn infant was the development and publication of the Neonatal Behavioral Assessment Scale (NBAS) by Brazelton and his colleagues in 1973. Unlike the classic neurological scales, which were designed to identify abnormalities in newborn functioning, the NBAS examines the competencies of the newborn infant while at the same time identifying areas of concern. It has been used in hundreds of research studies to assess the effects of a wide range of prenatal and perinatal influences on newborn behavior, including prematurity and low birthweight and prenatal substance abuse. From the time it was first published, the NBAS has been used to document cultural variation in newborn behavior across a wide range of cultures. In recent years, it has also been successfully used as a method of helping parents understand and relate to their infants.

Critics acknowledge that whereas the NBAS provides the most comprehensive description of the newborn’s current level of neurobehavioral functioning, and although a number of studies have reported a relationship between patterns of change in newborn behavior and future parent-child relations and developmental outcome, the NBAS’s predictive validity has not been convincingly established. Moreover, although many population studies have been conducted with the NBAS, it has never been standardized. Because of its emphasis on “examiner flexibility” and the importance of eliciting the infant’s “best performance,” the scale does not have a standard order of item administration and thus is judged by some researchers to lack the objectivity required by the classic psychometric assessment tradition. Brazelton and his colleagues maintain that careful training of examiners to the 90 percent inter-rater agreement level ensures the reliability of the results across settings.

Brazelton was born in Waco, Texas, on May 10, 1918, and graduated from Princeton in 1940. In 1943 he graduated from the Columbia University College of Physicians and Surgeons in New York City, where he accepted a medical internship. In 1945 he moved to Boston to serve his medical residency at Massachusetts General Hospital, before undertaking pediatric training at Children’s Hospital. His interest in child development led to training in child psychiatry at Massachusetts General Hospital and the James Jackson Putnam Children’s Center. With Professor Jerome Bruner, he was a Fellow at the Center for Cognitive Studies at Harvard University. The process of integrating his dual interests—primary care pediatrics and child psychiatry—culminated in 1972, when he established the Child Development Unit, a pediatric training and research center at Children’s Hospital in Boston.

Like Benjamin Spock, to whom he has been compared, Brazelton has written books for parents that have influenced the beliefs and practices of parents everywhere. What characterizes Brazelton’s writings for parents is his focus on the nature of individual differences in behavior. Indeed, in the preface to Brazelton’s classic book Infants and Mothers, Jerome Bruner remarks, “What delights me most is Dr. Brazelton’s unflagging sense of human individuality.” Brazelton has published many other books for parents, including the Touchpoints and Brazelton Way books, and his work also includes the development of a fourth edition of the Neonatal Behavioral Assessment Scale with his colleague J. Kevin Nugent.

Brazelton is a professor emeritus of clinical pediatrics at Harvard Medical School and a professor of psychiatry and human development at Brown University. In 1995 Harvard University Medical School established the T. Berry Brazelton Chair in Pediatrics. Brazelton is founder of the Brazelton Touchpoints Center at Children’s Hospital, Boston. Established in 1993, Touchpoints is a preventative outreach program that trains professionals to better serve families of infants and toddlers.

SEE ALSO Child Development; Developmental Psychology; Motherhood; Parent-Child Relationships; Parenthood, Transition to; Parenting Styles; Psychoanalytic Theory; Spock, Benjamin

BIBLIOGRAPHY

Brazelton, T. Berry, and J. Kevin Nugent. 1995. The Neonatal Behavioral Assessment Scale. 3rd ed. London: McKeith Press.

Brazelton, T. Berry, with Joshua Sparrow. 2006. Touchpoints: Birth to Three: Your Child’s Emotional and Behavioral Development. 2nd rev. ed. Cambridge, MA.: Perseus Publishing.

J. Kevin Nugent

T. Berry Brazelton

1918-
Well-known pediatrician, writer, researcher, and educator.

Like Dr. Benjamin Spock (1903-) before him, T. Berry Brazelton has earned a nationwide reputation as a trusted expert on child care, reaching a mass audience through books, personal appearances, newspaper columns, videos, and a cable-TV program. His research on infant behavior and development led him to formulate the Neonatal Behavioral Assessment Scale (NBAS), a series of clinical tests used in hospitals worldwide. Brazelton's efforts on behalf of children have also been extended to the public policy arena through congressional appearances and lobbying efforts.

Thomas Berry Brazelton II was born in Waco, Texas, in 1918. By the sixth grade he had decided on a career in pediatrics. He earned his undergraduate degree from Princeton in 1940 and his M.D. from Columbia in 1943. He remained there another year as an intern and then served for a year in the Naval Reserves. His residency was served at Massachusetts General Hospital in Boston, where he completed an additional residency in child psychiatry at the James Jackson Putnam Children's Center in Roxbury. Brazelton opened his own private practice in Cambridge, Massachusetts, in 1950 and became an instructor at Harvard Medical School the following year. He also began research on newborns, toddlers, and parents with the goal of helping parents better understand and interact with their children. Among other areas, he has focused on individual differences among newborns; parent-infant attachment during the first four months of life; and the effects of early intervention on at-risk infants. Based on his research, Brazelton developed the NBAS, first published in 1973. The test, popularly called "the Brazelton," uses visual, auditory, and tactile stimuli to assess how newborns respond to their environment . It is widely used both clinically and as a research tool.

Brazelton's interest in shifting the focus of pediatric study from disease to infant development led him to found the Child Development Unit at Children's Hospital Medical Center in Boston in 1972, together with Edward Tronick. The unit provides medical students and other professionals the opportunity to research early child development and also prepare for clinical work with parents and children. Brazelton's first book, Infants and Mothers (1969), has sold more than a million copies and has been translated into 18 languages. It has been followed by a dozen more, including Toddlers and Parents (1974), On Becoming a Family (1981), and Working and Caring (1984), as well as a series of videotapes on child development. Brazelton also writes a syndicated newspaper advice column and since 1984 has had his own program, What Every Baby Knows, on cable television.

Rosalie Wieder