RISK FOR DISORGANIZED INFANT BEHAVIOR
Risk for alteration in integration and modulation of the physiologi-
cal and behavioral systems of functioning (such as autonomic,
motor, state-organizational, self-regulatory, and attentional–interac-
• Environmental overstimulation
• Oral or motor problems
• Invasive or painful procedures
• Lack of containment or
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Physical regulation
The parents will
• Identify factors that place infant at risk for behavioral disturbance.
• Identify potential signs of behavioral disturbance in infant.
• Identify appropriate ways to interact with infant.
• Identify their reactions to infant (including ways of coping with
occasional frustration and anger).
• Express positive feelings about their ability to care for infant.
• Identify resources for help with infant.
The infant will
• Maintain physiologic stability.
• Maintain an organized motor system.
• Respond to sensory information in an adaptive way.
SUGGESTED NOC OUTCOMES
Knowledge: Child Development: 1 Month, 2 Months, 4 Months,
6 Months, and 12 Months; Infant Care; Neurological Status;
Knowledge: Parent–Infant Attachment; Parenting; Preterm Infant
INTERVENTIONS AND RATIONALES
Determine: Monitor infant’s responses to ensure effectiveness of pre-
Perform: Demonstrate appropriate ways of interacting with the
infant to help parents identify and interpret the infant’s behavioral
cues and respond appropriately. For example, help them recognize
when the infant is awake and alert, and help them understand
when the infant needs more stimulation, such as being spoken to
Inform: Explain to parents that infant maturation is a developmental
process and that their participation is crucial to their understanding
of the importance of nurturing the infant. Participation in the
process by the parents will both stimulate the developmental process
and alert to delays in development.
Explain to parents that their actions can help modify some of
their infant’s behavior; however, make it clear that infant maturation
isn’t completely within their control. This explanation may decrease
the parent’s feelings of incompetence.
Explain to parents that certain risk factors may interfere with the
infant’s ability to achieve optimal development. These risk factors
include overstimulation, lack of stimulation, lack of physical contact,
and painful medical procedures. Educating the parents will help
them understand their role in interpreting the infant’s behavioral
cues and providing appropriate stimulation.
Describe for the parents the potential signs of a behavioral distur-
bance in the infant: inappropriate responses to stimuli, such as the
failure to respond to human contact or tendency to become agitated
with human contact; physiologic regulatory problems, such as a
breathing disturbance in a premature infant; and apparent inability
to interact with the environment. Education will help the parents
recognize if the infant has a problem in behavioral development.
Attend: Explore with parents ways to cope with the stress imposed
by the infant’s behavior to increase their coping skills. Help parents
identify their emotional responses to the infant’s behavior to help
them recognize and adjust their response patterns. Explain that it is
normal for parents to experience feelings of inadequacy, frustration,
or anger if the infant does not respond positively to them.
Praise the parents when they demonstrate appropriate methods of
interacting with the infant to provide positive reinforcement.
Manage: Provide the parents with information on sources of support
and special infant services to help them cope with the infant’s long-
SUGGESTED NIC INTERVENTIONS
Attachment Process, Infant Care; Newborn Monitoring; Parent
Education: Infant; Positioning; Surveillance
Swartz, M. K. (2005, March–April). Parenting preterm infants: A meta-
synthesis. The American Journal of Maternal Child Nursing, 30(2),