Neurobehavioral organization describes infants’ abilities to organize themselves within their central nervous system maturation and environment. As part of infants’ environment, caregivers can structure the environment to support infants’ development. Care of the high-risk infant emphasizes support of infants’ emerging neurobehavioral organization. This article describes the theoretical rationale of neurobehavioral organization, effect on the infant and family, and assessments available to the neonatal occupational therapist for use with high-risk infants. Information gained via neurobehavioral assessment can be used to engage parents in better understanding their infant’s behaviors and interact at a level appropriate with their infant.