Letter to Berry Brazelton (May 10, 1918 – March 13, 2018)

Noah e Vovo


Dear Berry,

I sure wish you were here to help us with this Coronavirus epidemic. You were practical. You stuck with what was in your power to do, and in ours. You inspired us, as you did parents, to do the most good we could by finding that good in ourselves.

You would have reminded us of everything we can do to avoid infection, and that most people who get sick will recover. You would have been obsessed about helping the people at greatest risk – our elders, people with pre-existing illness without health insurance, without paid sick leave, in low wage service jobs, in overcrowded housing, detention centers, or without homes.  You would have insisted that we help the helpers risking their own health, the nursing home workers and health care providers caring for the medically fragile, and those donning masks and goggles to treat one baby or child after another with fever and cough – all day long.

You really knew how to get people to listen. Just as you helped Congress understand why we needed a Family Medical Leave Act (still unpaid), you would have been helping people across the political spectrum understand why, in order to heal and be strong again, our country needs to fund – at the very least – free coronavirus testing, medical treatment, time off from work and unemployment insurance for everyone who needs it in the U.S. who is dealing with this viral illness. You would have kept it simple: any one left untreated or unfunded to stay out of work when potentially contagious becomes one more chance for this virus to spread itself. But you would never have let the physical distance from others we need to stop the spread turn into emotional distance.

Carrying on your good work in these hard times is daunting. Yet one strange twist on the coronavirus epidemic is that, for many of us, the best first thing we can do for ourselves as individuals turns out to be what we are most able to do right now to help others. For many of us, doing everything we can to protect ourselves from the coronavirus may be the first most powerful thing we can do to protect others – and to be ready to continue on with your good hard work as soon as we can.

Thank you for still showing me – and so many – the way. We miss you.


A Three Generation Approach to the Opioid Epidemic

Every 15 minutes a baby is born in the U.S. with symptoms of opioid withdrawal (view full report here). These newborns are often irritable, difficult to soothe, to settle down to sleep and to feed. These predictable challenges can be draining for already exhausted parents and undermine their sense of effectiveness and competence.  Newborns’ withdrawal symptoms may interfere with their earliest contributions to the attachment process, just as a mother’s struggle with substance use may complicate hers.

Research on the long-term effects of exposure to opioids during pregnancy suggests long term developmental impacts, but it is fraught with the confounding factors associated with substance use disorders (SUD), especially other poverty-related adversities, and trauma, which affects half or more of women of childbearing age with SUDs. The research is, however, clear that the single most important way to mitigate the effects of in utero exposure on children’s development is the quality of the primary caregiving relationship.

Yet many children are placed in foster care by state child protective service agencies, even though foster care systems in many communities are too overwhelmed to provide the kind of quality caregiving that these infants need. Whenever possible, strengthening families – including grandparents who step in to help – and the quality of these caregiving relationships is the best hope for children’s recovery, and for parents’. Tragically, many parents who lose custody of a child exposed in utero to substances will deal with this loss by continuing to use substances and go on to bear more children who are exposed. Aplomb

Stigma often prevents these adults from recognizing that they deserve and need help. It also often infiltrates health and mental health professional attitudes toward them, further alienating families from otherwise effective treatments. Parents and expecting parents are often subject to particularly harsh judgment as healthcare providers struggle to deal with their frustration about treating newborns whose distress could have been prevented. Yet the perinatal period and the first years of life offer uniquely powerful opportunities for prevention, healing and recovery. Expectant and new parents may find powerful new motivation to seek treatment for their new baby’s sake, even when they don’t feel that they themselves deserve it. These Touchpoints in a family’s development are times of heightened vulnerability and opportunity when we can touch into the family system to bring hope for families so that they can dare to hope for themselves.

BTC’s work on prenatal exposure to substances can be traced back to the use of Brazelton’s Neonatal Behavioral Assessment Scale to detect behavioral effects at birth of in utero exposure to medications, illicit substances, and environmental toxins. In 2007, BTC began partnering with HRSA/MCHB-funded First 5 Santa Clara County grant to use the Touchpoints approach to create a shared vision and common language for 28 agencies across the county, including the courts, that served families in which an infant had been born exposed in utero to methamphetamine. Since then, BTC has continued to expand its activities in this area in many ways, including a congressional briefing on Capitol Hill on the opioid epidemic, grand rounds and other presentations around the country on a whole family approach to opioid use disorder, consultations to Tribal communities on preventing and treating SUDs, and adapted Touchpoints and NBO trainings.

Through programs and tools like the Touchpoints professional development series and the Newborn Behavioral Observations system (NBO), the BTC and BI are helping families and children overcome the opioid epidemic and helping family-facing professionals battle stigma.  These providers learn to explore together with parents each individual newborn’s competencies.  Practitioners and parents learn together to help infants born exposed in utero thrive by cultivating strong parent-child attachments, building parental confidence as well as motivation for their own recovery process.  Family-facing practitioners learn together with peer recovery coaches who have lived experience of SUD and substance exposures for their own children. This silo-busting approach tackles the implicit biases that can undermine professionals’ relationships with families and children, and, as a result, the effectiveness of the treatments they provide.

Just one result of these joint trainings is a mindset shift toward deeper understanding of SUD as a disease process – opioids can rewire the brain – and greater empathy for parents living with SUD.  Evidence of this mindset shift within the Touchpoints and NBO professional development training and reflective practice activities abounds.  Take, for example, the peer-recovery coach who appreciated what she learned about newborns experiencing effects of exposure but did not think that the direct hands-on use of the NBO would be a natural part of her work with parents in recovery.  Yet, when a new father expressed to her concerns about what to do if his baby cried during an upcoming supervised visitation, she was ready to offer what she’d learned in the NBO training about the challenges with soothing that babies with exposures face, and the strategies for overcoming them.  The father later recounted that not only did he successfully soothe his baby with the specific technique taught to him by his recovery coach, he showed the other fathers in the visitation group how to soothe and console their babies as well.

We can support the attachment process when parent and infant are both struggling with challenges to self-regulation. We can boost parental self-confidence and self-efficacy and help family-facing professionals recover their own sense of effectiveness and overcome the frustration that leads to blame and reinforces stigma. To do so, we need strengths-based approaches like the Touchpoints approach and the Newborn Behavioral Observation that focus not only on the baby or the adult in recovery, but on parent-infant-provider relationships, that build skills for understanding infant behavior as communication, and for self-reflection, so that providers can surface and move beyond bias, and so that parents can dare to believe in themselves and to have hope for their family’s future.

Dr. T. Berry Brazelton, A Memorial Minute

Read The Faculty of Medicine, Harvard University’s memorial minute in honor of Dr. T. Berry Brazelton.

Census 2020 – Every Child Counts: Remembering Betty Bardige

It is with deep sadness that I share with you the unexpected passing of Betty Bardige, a long-time Touchpoints board member and a tireless advocate for children and families. The Brazelton Touchpoints Center has been asked by several partner organizations about what family-facing nonprofit organizations can do to help ensure an accurate census.  As Betty reminded me just a few weeks before her death, it is vital that all children and families be counted, and, she insisted, all childcare providers too.

The people counted this spring -or not – will determine your local community’s share of nearly $900 billion per year in federal funding for schools, roads, public health, SNAP, CHIP, school breakfast and lunch, and other services.  The data collected by the census will also shape political representation in Congress and state legislatures.

It has never been more important for organizations that care about children and families to ensure every child and family is counted.  For most of the past decade, Congress and the Administration have cut Census Bureau budgets.  Inadequate funding, combined with increased reliance on online data collection, and fears over how census data may be used, are driving deep concerns that the Census Bureau may undercount children and families that are economically disadvantaged, residents who speak English as a second language, immigrants, and others that may be unable or unwilling to share information.

In your nonprofit organization roles, you can assist in providing information to families about the census, helping them understand what it is, how the information collected will be used, and why it is so important to be sure they are counted.  Some families may be afraid to provide information or to interact with census workers.  It is important to know that the census does not include any questions about immigration status, that data collected through the census cannot be shared with immigration enforcement agencies or law enforcement agencies, and cannot be used when determining any individual’s or family’s eligibility for government benefits. The census is also quick and easy to fill out.

The Brazelton Touchpoints Center is pleased to provide the following resources to help you help the families you work with feel as safe and confident as possible so that they and their children are properly counted.  Census Day takes place on April 1, but most households can start participating around mid-March, when letters with instructions are scheduled to be sent to 95 percent of homes around the country.  Data collection will be continue over the course of about six weeks, at which point the data inputting phase of the 2020 Census will be completed.


Census Advocacy:  What Your Nonprofit Needs to Know

This brief from Bolder Advocacy is a great place to start for nonprofits interested in improving the accuracy of the 2020 census, providing additional background on the serious problems caused by undercounting disadvantaged communities, and offering introductory steps that nonprofits can take to help ensure complete counts in their communities.

Mapping Families that the Census or Your Non-Profit May Find Hard to Count

What is the likelihood of an undercount in the communities you work in?  Mapping Hard to Count (HTC) Communities for a Fair and Accurate 2020 Census has an interactive map highlighting how much of an area’s population may be at risk of an undercount based on prior community response rates.  The map also shows how people in different areas will be contacted by the Census Bureau.

Community Outreach Toolkit and Targeted PSAs

The official United States Census 2020 website has a partner toolkit focused on community outreach that is designed to help organizations identify the barriers to participation in local communities and apply evidence-based practices to better connect with individuals facing common challenges.  The toolkit includes shareable graphics highlighting the fact that data collected through the census cannot be shared with immigration enforcement agencies or law enforcement agencies, and cannot be used when determining eligibility for government benefits.

Looking for video resources?  The official PSA toolkit has several short, informational videos covering how to take the census, how census data will be secured and used, and more, along with PSAs appealing directly to immigrants, American Indian and Alaskan Natives, and Native Hawaiian Pacific Islanders.  A complete list of official census materials can be found here.

Get Out the Count Toolkit

The Get Out the Count Toolkit from Census Counts 2020 is meant to provide community-based organizations and other stakeholders with information on the importance of the census and tools to help ensure its accuracy.  Included in the background materials are fact sheets examining the risks and adverse outcomes of undercounting the following hard-to-count communities:  Middle Eastern and North African Americans, American Indians and Alaska Natives, African Americans, Asian Americans and Native Hawaiians and Pacific Islanders, Latinos, and young children and their families.

Language Guides

The Census Bureau recently released census guides in 59 different languages with instructions on how to complete the census.  These guides include a brief overview of the purpose of the census and the confidential nature of the data collected before providing step by step directions for respondents.  Video language guides will be made available soon.

We hope this information is helpful to you and the communities in which you work.  Thank you for all you do to help lift up the voice of children and families.

Remembering the Baby Inside Each of Us

Noah, Age 2

Berry Brazelton liked to say he played with babies. His fellow Texan, pediatrician Sally Provence, danced with them. “Sally,” he asked, “how do you get inside a baby’s head?”  “Well,” she replied, “isn’t there a baby inside each of us?”

It can be difficult to remember that baby. Yet those early experiences – what we are grateful for, needed, wish we hadn’t missed out on, or wish we’d been protected from – are a guide to what the world needs now.

We witness children harmed by the decisions that adults make – whether at the border, in far off countries, just down the road, or in our own homes. Not knowing what to do, or knowing we are not doing enough to protect all our children, can also make it hard to remember the baby each of us once was. But beginning with the way we use self-understanding to understand, care about and act on behalf of others, our human capacities evolved precisely so that we could ensure that all our children would thrive. To find hope in this may sound dreamy, but dreams help us see beyond reality to possibility.

Every newborn baby is possibility become reality. Birth may be one of the only universally revered miracles, whether we celebrate it in December, the spring, or every day. Each new life reminds us of why we are here, and why we keep on going. 25 years ago, in war torn Sarajevo, a traumatized young psychologist asked Berry Brazelton how to keep helping in the midst of the hate and destruction. “Play with a baby,” he said. Or dance with one. To heal the baby inside, ourselves, and each other.

Thank you for all you do to protect babies and children, to help them flourish, and restore hope for all of us.

Joshua Sparrow, MD

BTC December Newsletter

In this issue, we pay tribute to our dear friend and colleague, Betty Bardige, a lifetime advocate for ALL children and families, share plans of BTC’s new program innovation, recap the Fall 2019 Learning to Listen conversation series, and share resources, podcasts, and information about upcoming trainings. Check it out here! 

Brazelton Touchpoints Center and Horizons for Homeless Children Partner to Promote Healthy Child and Family Development

The Brazelton Touchpoints Center (BTC), a non-profit organization focused on ensuring that every child will be healthy, succeed as early learners and have the opportunity to thrive, is pleased to welcome Horizons for Homeless Children (Horizons) to the BTC Site Network, a national learning community of organizations, practitioners, and systems of care actively using the Touchpoints Approach in their family engagement strategies.

Horizons for Homeless Children improves the lives of young homeless children and their families through high quality early education, comprehensive family support services, opportunities for play, and advocacy work.  In delivering these services, Horizons reaches more than 2,000 young homeless children each week in Massachusetts through three early education centers and more than 120 shelter-based Playspaces.

The experience of homelessness is a traumatic one, particularly for young children experiencing family homelessness.  Through its work with homeless children and families, Horizons has learned firsthand how important an understanding of early childhood development is in helping young children overcome the impact of their negative experiences.

In recognizing the need for its staff to have a deeper understanding of early childhood development, BTC is delivering Touchpoints professional development to Horizons staff.  Touchpoints is an evidence-based approach and training program for family-facing professionals that facilitates a strengths-based mindset to more effectively engage families, giving Horizons staff a toolkit of strategies, tactics, principles and perspectives that helps them engage families and support positive developmental outcomes.

Learn more about our partnership here!

New Paper Published by Dr. Catherine Ayoub on the Effects of Maltreatment on Children’s Communications

Read the Full Paper Here!

Remembering Marlies Zammuto

The Brazelton Touchpoints community mourns the loss of Marlies Zammuto, a colleague, mentor, friend, and lifetime advocate for children and families.

“The key to life is truly living, not just existing. Please take the time for self-care and make room for fun and joy every day. It can sustain you over the most difficult challenges. Thanks to all my family and friends who bring so much sweetness and joy into my life.” – Marlies Zammuto

You can follow this link to see pictures of Marlies enjoying every moment of the life she lived: https://tinyurl.com/1RememberingMarliesZammuto
If you would like to share your own memories of Marlies, please follow this link and include your stories and pictures if you like. The link takes you to a Google Doc that will include everyone’s memories from across the network. https://tinyurl.com/ShareaMemoryofMarlies

Brazelton Touchpoints Center is Hiring for a New Managing Director – Join Our Team Today and Make a Difference!

The Brazelton Touchpoints Center (BTC) seeks a Managing Director with passionate commitment to BTC’s mission, to oversee and manage key aspects of operations and programs, including data driven operationalization and implementation of strategic plans and priorities, and cross-learning and integration across BTC’s rich and varied professional development, organizational learning and change, research and evaluation, and communications and marketing programs.

See full job description here.