Lassen County Behavioral Health-Youth Information

Early Newborn Observations (ENO)


The ENO is a structured set of observations designed to help the clinician and parent together, to observe the infant's behavioral capacities and identify the kind of support the infant needs for his successful growth and development. It is a relationship-based tool designed to foster the parent-infant relationship. The ENO system consists of a set of 18 neurobehavioral observations, which describe the newborn's capacities and behavioral adaptation from birth to the third month of life. While it describes the infant's capacities, the ENO provides parents with individualized information about their infant's behavior, so that they can appreciate their baby's unique competencies and vulnerabilities and thereby understand and respond to their baby, in a way that meets her/his developmental needs. The 18 ENO items include observations of the infant's

  • capacity to habituate to external light and sound stimuli (sleep protection)
  • the quality of motor tone and activity level
  • capacity for self-regulation (including crying and consolability)
  • response to stress (indices of the infant's threshold for stimulation)
  • visual, auditory and social-interactive capacities (degree of alertness and response to both human and non-human stimuli)


While the ENO attempts to reveal the full richness of the newborn's behavioral repertoire, the clinical focus is on the infant's individuality, on the aspects of behavior that make the baby unique and different. In other words, the ENO provides the baby with a "voice", with a "signature". It gives the baby an opportunity to tell the caregiver who he or she is, if you will, what her preferences are and what her vulnerabilities might be and in what areas she may need support. By providing this behavioral profile of the infant's strengths and challenges, the ENO can provide clinicians with the kind of individualized guidance that can help parents meet their baby's needs. This, in turn, will help the parents develop the kind of confidence they need to support their baby's development and enjoy the experience of being a new parent.


While the ENO was developed to meet the needs of parents, it is designed in its ease of use to be a helpful tool for professionals who work with parents during the perinatal period. It is flexible and can easily integrated into routine home visits. The ENO, therefore, was designed as a relationship-building method that can be flexibly administered and that offers individualized information to parents about their baby, with a view to promoting a positive bond between parent and child and between themselves and the parents and family. For that reason, the ENO is best understood as a relationship-building tool. It is inherently interactive and family-centered, because parents are involved as partners in the ENO session throughout.

Contact Information: 

Contact Information

Lassen County Behavioral Health
555 Hospital Lane
96130 Susanville , CA
Substance Use Disorder Program
1400 Chestnut Street Suite A
96130 Susanville , CA
Mon - Fri:
8:00 am-5:00 pm
Sat - Sun:
Crisis Line: Toll free 24-Hour
(530) 251-8394