FamiliesToday

A TODDLER WHO BANGS HIS HEAD

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
A TODDLER WHO BANGS HIS HEAD
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 21-month-old son head-butts. He has been doing this since about 13 months. He bangs his head on the wall or ceramic floor and doesn’t cry. When told no, he does it again. Sometimes he bangs his head so hard he bruises his forehead.

My pediatrician says this is normal. My mother thinks this is abnormal and he should be checked out.

A. Many children bang their heads in the second year when they begin to have temper tantrums or meltdowns. Some also rock themselves forcefully in their cribs or on the floor.

These actions seem to be a child’s way to handle uncomfortable feelings – frustration, disappointment, tension, anger, boredom. But of course such behavior frightens parents.

Even though toddlers bang their heads hard, I have never heard of one who hurt himself. As a precaution, though, I recommend putting carpet or other “shock absorbers” on concrete floors, cinder block walls and other unyielding surfaces – without making a big deal of it.

I don’t think that telling him no will help. If he could stop himself, he probably would. Struggling with him over the issue might give him another reason to bang his head: It not only helps him soothe himself but also gets your attention.

Look for opportunities to engage him before he bangs his head. When he is playing quietly by himself, you can help him learn how to prolong his play so he wards off boredom.

Try to protect this quiet time by avoiding interruptions and cutting down on distractions. When he starts to lose interest or to become bored or frustrated, you can move in briefly to help him with what he’s doing or to introduce a different activity.

When he’s ready for a break, cuddle him before he gets to the point of head-banging. Look for sources of tension that you can control and try to minimize them. If you or other family members are under stress, take a break and let off steam.

Help your son focus on his other ways of calming himself, and teach him new ones. Does he like to cuddle with and talk to a stuffed animal? Look at a storybook? Scribble with crayons? Listen to calming music? Or suck his thumb?

At the first warning signs for head-banging, offer an alternative like cuddling or singing with you. If all else fails, you can’t do much more than sit nearby and say soothingly, “I am here and I would like to help but I can’t.”

If a child is otherwise healthy and developing on track, he’s likely to outgrow head-banging. If the behavior persists, there may be a more serious problem. If a parent is concerned that a child’s development is not on pace, it is important to alert the pediatrician as soon as possible. Early intervention can make a big difference for developmental delays and disabilities.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

WHEN A CHILD FIRST USES DIRTY WORDS

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
WHEN A CHILD FIRST USES DIRTY WORDS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

(This article is updated from “Touchpoints: Three to Six,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)

Children first hear “dirty words” at age 3 and 4. Their understanding of language at these ages is sophisticated enough for them take note of the special intonations and contexts associated with such words.

But if they are to understand what is different about dirty words, they need to experiment, to try them out. No one takes them too seriously: “Mommy, you’re a poo-poo face.” “Daddy is a fat bum-bum.”

At most, each parent reacts with a cringe, then a laugh.

“Where did you hear that?”

“From you.”

Parents are usually not satisfied with that, even when it’s true: Whom did he play with yesterday? Did he learn it from him, or did he hear it on that television show?

Parents do need to be concerned because they must teach their children about language, its uses and its power. Their job is to model behavior and create an environment in which children can learn how their words and actions affect others.

Parents’ work is harder than ever as offensive sexual talk (not all talk about sex need be) becomes ubiquitous on television, radio and the Internet.

But overreactions just make the swearing and dirty words more intriguing to children and give them a power they will want to try out.

Some parents have threatened a taste of soap or hot sauce for these offenses. But bodily harm is unacceptable under any circumstances. If discipline is teaching and the goal is self-discipline, such punishments are counterproductive.

Why do parents overreact? A child who swears challenges a parent’s desire for him to fit in and please others. Dirty words may seem like another sign of growing up and that parents are losing their control; they may appear to signify loss of innocence – so hard for parents to face.

Already parents have fears about how a child will fare in a dangerous world. It may frighten them to see their child so vulnerable to imitating peers.

Everyone in the family knows it will get worse. Kids from down the street will become models, and a young child is bound to imitate their dirty words and bring them home to try out on parents. Sexual curiosity and four-letter words are right around the corner.

By age 6, a child will have segregated himself into a group with his own gender. He will already be learning to swagger and stride, to swear and to use dirty words, to engage in gender-linked play. The strong identifications with parents from 4 and 5 are now beginning to be played out in peer groups.

At 4 or 5, a child’s way to discover the limits of a taboo is by testing his parents over and over after an initial overreaction.

Innocence has now turned into outright provocative behavior. A parent worries, “Will he use it in public? What does it mean? Could he have been molested?”

All these fears may run through parents’ minds as they respond: “We don’t say words like that! We don’t swear in this family!”

But often it’s not that simple. Parents who sometimes say swear words themselves may now wish they hadn’t. How confusing for a child to understand that what comes out of his mouth is treated differently!

Instead of being offended when a child swears, a parent might try to discover the reason for it.

When you can damp down your response, the offensive words will begin to lose their interest and you will hear them less often. If your child uses them too freely in public, use such an incident as a teaching opportunity: “When you say these words, people are upset. Those are words we don’t say unless we want to bother other people. Is that what you mean to do – or does it just slip out?”

In saying this, you are attempting to place your negative view of swearing and dirty words in context – that of sensitivity to other’s feelings.

In the relative hierarchy of offensive behavior, swearing is more innocuous than most, especially if ignored, and thereby eventually extinguished. Children aren’t likely to become chronically foul-mouthed in an environment that doesn’t value swearing and dirty words.

HOW TO HELP CLEAN UP A CHILD’S ACT

If you are concerned about your child’s use of swear words, and if you or other adults also use them, trying to cut back can help. Try substituting benign substitutes such as “darn” or “shoot.”

Moderate your reaction to a child’s use of naughty words because the reaction may only encourage a repeat performance.

Try to fathom why a child says the words and use the occasion to teach that language, good and bad, really matters in how you are perceived.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

A 9 WEEK OLD AND HIS MOTHER, BOTH SLEEPLESS

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
A 9 WEEK OLD AND HIS MOTHER, BOTH SLEEPLESS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 9-week-old son cannot get to sleep. He only sleeps for two- to three-hour spans before crying and feeding at night. During the day he hardly naps unless we go for a drive.

I also can’t seem to get him to fall asleep without my nursing him or rocking him. He has fallen asleep on me a lot lately and when I put him down he wakes up and cries.I am beyond exhaustion and I worry that I am teaching him bad techniques for sleep by letting him fall asleep on my breast and rocking him.

A. At 9 weeks, many infants wake up every two to three hours – a major strain on parents. Until four months, most babies’ brains aren’t ready to organize their sleep cycles to sleep through the night.

But even by 12 weeks, your baby’s schedule should begin to follow a more predictable day-night routine. You are doing the right thing by rocking him, holding him and putting him to the breast.

Your husband can help by taking turns with you to get the baby at night. For now, he may feel he can’t do much. But you might fall back to sleep more easily if he got up to bring the baby to you and returned him to the crib after feeding. (On occasion a sleepover relative or friend can spell you, too.)

You might consider pumping some breast milk so that your husband could use it at night in a bottle to feed the baby. At 9 weeks, your baby may be comfortable enough with the breast that he won’t to give it up because of a few nighttime bottles.

You may not yet feel you know what your baby is telling you with his cries and other behavior. Sometimes you may think he is saying he is hungry when instead he is sleepy, and vice versa, which may explain why he’s falling asleep when you feed him.

Babies show they’re hungry in several ways before bursting into tears. They become alert and begin to root around, bobbing their head, thrusting it forward or turning it from side to side as if looking for the breast. They may even begin to flail with their hands.

Little by little, you will “read” your baby’s behavior. You’ll both feel less exhausted.You needn’t worry that you are teaching him “bad techniques for sleep.” Sooner or later he will no longer need to fall asleep on your breast.

Meanwhile you can help him learn to soothe himself. When he fusses during the day, don’t rush to pick him up. Wait for a short while, then go to him and talk gently to him. If he is still fussing, of course you can pick him up and hug him. You can bring his hand to his mouth and help him learn to comfort himself by sucking his thumb. He will learn to put himself to sleep and to wait until it is time for his next feeding.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

2-YEAR-OLD PINES FOR LOST BLANKET

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
2-YEAR-OLD PINES FOR LOST BLANKET
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. On a recent car trip, my nearly 2-year-old son threw “blankie” out the window. He has cried for it. Demanded it. Blankie is his most trusted companion.

A roadside search was fruitless. I ordered a replacement. He saw it, dropped it on the floor and walked away as if to say, “I don’t think so.”

Every time we have put him down to sleep for the past week, he has fought us off. He has been going to sleep at least 90 minutes after his scheduled bedtime. He is tired, cranky, loving and clingy all at once.

Now I have located an identical blanket. We are moving and he needs something to soothe himself.

I plan to stain the replacement with chocolate milk and spaghetti sauce before washing it and putting it somewhere for my son to discover on his own.

With blankie his world seems complete. Without it, he is a different child. He went away a little boy and came home a baby. I want my little boy back.

A. A child uses a “blankie” as a kind of stand-in for parents. It represents love and care. By holding tight to the blankie (I call it a “lovey”), a child learns to manage and control himself.

A scrap of cloth or stuffed animal, no matter how tattered, can become a small child’s irreplaceable best friend, something to cuddle – or to throw out the window.

Why did he do that? Nobody knows. But the wonderful thing about a child’s blankie or teddy bear is that it can handle his full range of emotions – from love to hate.

A toddler, like the rest of us, may also have mixed feelings about the things or the people he most depends on.

Good luck with making the replacement like the original, with all the familiar stains and smells. Many parents learn too late that they should never wash a child’s lovey. It’s not the same when it comes out of the washing machine.

If he rejects the replacement, offer him the chance to choose his own. Say, “I’m sorry you lost it and I wish I could help you, but you won’t let me. Now you’ll have to help yourself. You choose your new blankie.”

A child in the midst of a transition like a move deserves extra attention and comforting. As parents, we can’t always protect our children from misfortunes. But we can prepare them to cope with challenges. For a toddler, everyday frustrations and disappointments can become opportunities to begin to learn to live with what we can’t change.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center.  Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

YOUNGEST IN HIS CLASS

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
YOUNGEST IN HIS CLASS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Our only son was born in August, which means that in most schools he will be the youngest or nearly the youngest in classes. Many teachers and schools imply that always being the youngest will make things harder for him throughout the school years. True?

A. Chronological age doesn’t do justice to individual differences in development. Children of the same age show a wide range in height, weight and abilities.

Even within a single child, some kinds of development may move more rapidly than others. For example, a child may be bigger and taller than other children of the same age but clumsier and no more mature. I call this situation the “big child” syndrome – a problem because everyone expects more than is reasonable and the child suffers because of inappropriate developmental expectations.

While you can’t know the outcome for sure, taking a look at your child’s development and pace of growth may help guide your decision about whether to hold him back until the next school year.

If he is smaller than children his age, that may be an added disadvantage for him as the youngest child in the class. Height and weight are easy information to obtain, and growth curves over time are fairly predictable, at least until puberty.

It would be helpful to know about your son’s social maturity relative to his peers’. The preschool teacher should have a good perspective, using the other children in his class as points of reference.

If he is immature when compared with children with similar birthdays, that might affect your decision – even though a child can rather suddenly catch up in this area.

Also, you’ll want to consider how the school and the parents in your community handle this issue. If all the other parents of the youngest children retain them so that they can be the oldest in the following year, then your child is likelier to be isolated as the youngest unless you do the same.

Recently more parents have delayed their children’s entry into kindergarten, often with the hope that they are giving them a competitive edge, particularly in later years.

Many children have little to lose and perhaps much to gain from such a delay. In response to standardized statewide testing, many schools are introducing academic curricula originally designed for older grades that are inappropriate for younger children. These may turn them off from learning and interfere with how younger children learn.

Yet for truly gifted children – children who are cognitively ahead of their own chronological age – delaying entry to kindergarten may exact a price.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Prior to his passing, Dr. Brazelton was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

MANAGING A TEMPER TANTRUM

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
MANAGING A TEMPER TANTRUM
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

By the time a child is 15 months old, temper tantrums have usually made their unwelcome appearance.

Although parents’ behavior or requests may well trigger them, tantrums come from the child’s inner turmoil. It’s the toddler’s basic struggle to master the intensity of his own feelings. Only he can resolve the indecision that’s behind them – though he can learn to settle himself by modeling on his parents’ unruffled response to the tantrums.

When distressed parents report the first tantrum to me, I reassure them that a feisty child is bound to have these episodes. After the child has learned to handle this struggle, he’ll be stronger and more secure.

I remind parents of some steps to take:

  1. Remember your options, all directed at leaving the resolution up to the child.
  2. Hold him quietly or carry him to a spot where he can work it out himself.
  3. If you’re in a safe place, walk out of sight momentarily. When he can’t see you, the tantrum will lose force. Then quickly return to say, “I’m sorry I can’t help you more. I’m still here, and I love you, but this tantrum is your job.”

Giving the child the space to resolve his turmoil is not the same as deserting him. Do it in a way that lets him know you wish you could help. But you and he know that your efforts to help will just prolong the tantrum. Firm limits will reassure him that he won’t be dangerously out of control.

Many years ago, I spent a week in Oregon with some quintuplets. One of them had a rip-roaring tantrum. The other four crowded around to try to stop it. Their efforts made him more violent. One tried to hold his arms, another lay down beside him to croon to him and soothe him. Another yelled at him. The fourth threw cold water on him. Nothing worked, so they all gave up.

As soon as they did, he stopped crying. He got up quickly and started to play with them, as if nothing had happened.

This experience vividly showed me that tantrums reflect inner turmoil that only the child can master. Support, but not interference, is the only help. After the tantrum is over, parents can find ways to convey that they understand how important this struggle is for him, and how hard it is to handle such strong feelings.

Later in the second year, you can try timeouts – for calming down, not as punishment. Firmly hold the child briefly and then put him in his crib or room. Thus you can break the buildup of teasing behavior before the toddler loses control.

When the child has regained control, parents should make clear that a certain behavior made them act, and then they can offer plenty of hugs.

Tantrums in Public

Tantrums are especially inconvenient and embarrassing to parents when they happen in public. Everyone gathers around, looking at the parents as if they were certified child abusers.

In such a situation, parents might turn to the onlookers and suggest that they handle him themselves: “Anybody want to help?” They’ll melt away quickly after that.

Parents sometimes ask why the toddlers have tantrums in public places. For one thing, they’re overloaded by the excitement. They realize that their parents’ attention is diverted from them, and they want it back. Also, they know they can fluster their parents. Parental consternation and attempts to smooth over a tantrum are likely to prolong it.

(This article is adapted from “Touchpoints: Birth to Three,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Prior to his passing, Dr. Brazelton was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center.  Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

EXTREMELY BOSSY

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
EXTREMELY BOSSY
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q: I have an almost 4-year-old daughter who is extremely bossy – to me, to our family, to other children. Any advice?

A: A young child’s behavior is her way of letting the world know how she feels before she has developed the ability to put her feelings into words.

To understand what her bossiness is “saying,” watch and listen carefully.

If she wants everyone to go along with her ideas about what and how to play, she may need guidance about cooperation.

If she expects everyone to cater to her whims, you can set limits to teach her that she can’t always have her way.

If she seems bossier at specific times, there may be triggers to such behavior – like hunger, fatigue or overstimulation. Watch for these cues and help her to avoid them. If her bossiness seems a bid for attention, schedule regular times to play together so you won’t find yourself pulled in to play whenever she demands it.

When she gets bossy, tell her it’s no fun for you when she acts that way. Then remind her of the great time you had during your last play date. Let her know you’re looking forward to the next one. A child may be bossy before she has learned how her behavior affects other people. Let her know that no one likes being pushed around.

How do you and others respond when she can’t do as she pleases? Giving in won’t help, though it may be tempting if she throws tantrums. Instead, help her learn to control herself. Ask how you can help – with a hug or some quiet time to herself.

Some children who feel that their world is out of control may try to control other people. In this case, ease the pressures on her. Look for times and places when she can have her way – such as choosing her cereal or the color of the clothes she wants to wear.

At 4, the social skill to monitor and change behavior in response to others is a work in progress. Four-year-olds are learning to share, to take turns, to invite other children into their play, to follow another child’s lead – the back-and-forth of communication. Is anyone bossing or bullying her? Often children who are rough on others have been victims of such treatment themselves.

If your daughter is in preschool, talk to the teachers about how she gets along with her peers. They can help her learn how to compromise and get along. In the classroom she will have plenty of opportunities to practice.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

TOUGH TIMES, RESILIENT FAMILIES

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
TOUGH TIMES, RESILIENT FAMILIES
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

(This article is updated from “Touchpoints: Three to Six,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)

These times of economic insecurity challenge parents who already feel strapped to find enough time, any time, for their young children. Parents everywhere may take comfort from knowing that they are hardly alone in this period of foreclosures, layoffs, dislocations and worries about today and tomorrow.

Many parents cling desperately to the jobs they have, no matter how much time is now demanded, and bring home even more stress than ever – doing double time to make up for staff cuts and worried about looming layoffs.

Children feel the impact. But parents and children may also find that facing adversity together can strengthen the family – and the community, too, when families share what they have. During this holiday season especially, giving and sharing take on new meaning.

In most U.S. families today, both parents are in the workforce; 63 percent of mothers (of children under 18) work outside the home. Despite massive layoffs, the demands of the workplace on families aren’t likely to change all that much. We still need to find ways to adjust to them that will put children’s best interests first.

Today, parents are asked to split themselves in two – for the workplace and for nurturing at home. Increasingly, parents also are “on call” at home via work-linked cell phones, computers and all manner of hand-held devices that can compete for a family’s time.

Children must adjust to the pressures on their parents and participate in all the efforts to “make it” in a working family.

More time is the universal need of working parents. For most families, there simply is not enough time to just be together. No time for just dreaming and thinking. No time for oneself. No time for one’s spouse. No time for the children.

Children feel the stress their parents are under. Some turn away, as if to prevent themselves from causing their parents further stress. They seem to have given up on moments when they might have their parents to themselves. Others lobby hard to keep their parents tuned in to them, even if it means behavior that wrecks the little time they have together.

Children benefit, though, when parents can strike a reasonable balance between work and family.

Ellen Galinsky, director of Work Family Directions in New York, asked children what they thought about their mothers’ working outside the home. Most children quickly stood up for their mothers: “Even if she hates her job, we need the money and we all know it.”

These children felt that their mothers were “the most important person for me. She’s always there when I’m sick or I need her.” Their mothers’ working or not was not their issue. They wanted “focus time” with their mothers, time in which they were uppermost in her thoughts. The most satisfied children valued the “hanging out” time they had with their mothers. Rather than so-called quality time spent on planned excursions or planned togetherness, these children preferred just hanging out with their parents.

For the many parents who must spend the bulk of their time at work, there are ways to turn the priority of work into a positive for the children.

It became apparent from Galinsky’s study that children want to be a part of the family’s efforts; they want to understand their parents’ jobs, to be included in the family’s efforts to “make it.” If the family is working together, children do not feel shortchanged. “School is kids’ workplace. My mom and dad have theirs. But we have each other to help us.”

In planning solutions for families in which both parents must work, each parent needs to share in decisions about family priorities. If their children are old enough, they may be included in the decision-making, too.

Then, when the questions arise, “Did you see Joey’s flashy new car? Are we ever going to get rid of our old junk heap?” or “She gets an allowance to buy her own toys. Why can’t I have one? You don’t ever buy me anything,” the parent can point to the family’s decisions, trade-offs and the values behind them.

The current economic downturn is a time to re-examine values, and to model more altruistic and less materialistic ones for children.

Many parents will now need to be ready to make extra efforts just to try to hold onto their jobs – and their children will again need to adapt. A shift of values toward pulling together, looking out for each other, making sacrifices for each other, and having fun just being together rather than buying together may help many families make the transition to having less.

Still, this can’t make up for basic necessities such as food and shelter that more and more families can no longer take for granted. Some may find that they can stretch what they have a little farther by sharing their resources with neighbors – carpooling to school or for grocery shopping, or sharing childcare arrangements.

At the same time, they’ll be modeling the kind of values that have made this country strong and always pulled us through tough times. This is a time to pull together, to help each other out, and it will last well beyond this holiday season.

How to balance working and caring:

  1. Openly discuss the need to work and the necessary adjustments to the two jobs – at home and in the workplace.
  2. Share the work at home. Children can help as they grow up.
  3. Be aware of feelings of grief over being away.
  4. Learn to separate office worries and home concerns. Leave work at the job, non-critical home problems at home.
  5. Stay in contact regularly with each child and his caregiver.
  6. Prepare each child for separation in the morning and yourself for reunion at night.
  7. Learn to “cheat” on the workplace. Save up energy during the day for close family times at the end of the day.
  8. Recognize that all children will be tired and fall apart when you return. They’ll save up their protests for you. Be prepared and save energy for them.
  9. Tend to children and their needs first.
  10. When you arrive home, gather everyone up in a big rocking chair to rock and catch up together. “How was your day?” “I missed you so.”
  11. As soon as you are close again, then, and only then, attend to household chores.
  12. Plan regular celebrations for the family that works together!

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

A BACK-AND-FORTH ON BITING (follow up)

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From the NEW YORK TIMES COLUMN: FAMILIES TODAY

By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

In a recent column a grandmother recommended her solution to the problem of children biting: Bite back. We demurred. Now another mother lobbies for the fight-fire-with-fire approach.

Q. This is in support of the politically incorrect biting mother and grandmother. There is nothing like experience to teach us, and I’m talking about biting toddlers. We can talk a blue streak, and it’s all abstract to a toddler; they need to learn that if they cause pain, it comes back at them.

These are my biting stories from the trenches. I was nursing my baby and his teeth were starting to come in. After having toyed with the idea for some time, he finally bit me while nursing. I let out a very loud bellow out of proportion to the pain, because I was not going to have that happen again. The poor baby got quite traumatized by my loud scream, but he never bit me again.

When he was a toddler, I took him to a day care where there was a hyperactive boy who was a frequent biter. Nothing the parents or day-care provider tried changed anything. Finally the day-care provider’s toddler took matters into his own hands and bit him back. End of biting.

When my boy was a toddler, he kicked my leg. Like the politically incorrect grandma, I very carefully placed a kick on his leg (I was so scared of hurting him that the first attempts were air kicks). He never kicked anybody again. I must add that this boy is now 14 and a joy (besides the fact that, being a teenager, he counters everything his parents say).

A. Small children’s biting certainly creates a red flag for everyone. Yet it is such a universal response in late infancy and toddlerhood that it deserves all its eminence.

Starting out as an exploratory and often loving response when a nursing baby bites the breast of his mother, it gathers drama from the surprised, angry and even frightened response, “Have I lost my baby? Do I deserve this negative hurtful response when I’m giving him everything I can? Will he turn out to be a monster?”

For him, it is likely to mean that when he suddenly raised such a dramatic response, “Should I try it again when I need to get her attention?” Then, he may begin to fall back on it when he is tired or overwhelmed or doesn’t know any other way to get the attention of someone he craves. He tries it out on a peer toddler. The world blows up. Everyone overreacts. “Wow! This is more important than I thought. I’d better shove this behavior way down underneath. I’ve learned there are certain behaviors that I don’t dare to express. They mean something terrible to other people, even though that’s not what I meant when I tried them. I’d better be more inhibited than I was.”

Inhibitions can be expensive in the long run. Your method of retaliation has surely worked. But what has it meant to the baby or toddler? “I’m bad, or she wouldn’t have hurt me, and I’m not sure why. But I guess I’m just a bad kid.” Is that what you meant to teach him by your response?

Meanwhile, seeing it from the standpoint of the baby’s development, it has been a missed opportunity. Each behavior which becomes an intrusive or painful one presents the child the chance for him to learn about how to control himself.

A child who learns self-control is already way ahead of a child who must rely on an adult’s presence to be controlled by force or by retaliation. Learning self-control is a major goal for childhood in our present out-of-control society. Discipline (teaching) is the second most important gift we as parents can give a child. Love first, but discipline that says, “I shall have to stop you until you can stop yourself.” That’s a much longer goal in time than just teaching him to suppress his responses and his feelings.

Everything we know from research in child development demonstrates that suppressing angry, hurt feelings just postpones them. For a parent or a teacher or any caring adult, each episode needs to be understood from the child’s standpoint. We can use his hurtful behavior, share the idea of self-control rather than just shutting it off. “I can’t let you bite. It hurts and no one likes to be hurt. Let’s find another way for you to say what you’re trying to say.”

The story you tell of the child’s learning from another child how biting hurts and how necessary it was to control himself was on a different level. Children learn so much more from each other than they do from an adult. It’s fascinating to watch two toddlers as they reproduce by imitation hunks of behavior from each other.

I have recommended putting two 2-year-old biters together. One would bite the other. They’d look at each other with a startled look. “That hurt.” And they wouldn’t bite again. This is an almost sure cure, but maybe one to be used sparingly, in case it could get out of hand. When it works, one can see on the biter’s face that he recognizes the fact that he’d hurt him. “I never knew what I was doing could hurt someone. I can’t do that again.” He will have learned (at 2) how to experience what another is feeling – a major step toward empathy for others.

When an adult bites him back, his reactions are hurt and anger. He may not have meant to be aggressive in the first place. Now, biting could become loaded with angry feelings. Certainly, it has not been a learning experience except to stop the biting – but not the anger that being bitten has generated.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

IN TOILET TRAINING, A PREMIUM ON PATIENCE

by

NEW YORK TIMES COLUMN: FAMILIES TODAY:
IN TOILET TRAINING, A PREMIUM ON PATIENCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Problems in toilet training nearly always arise because of an imbalance in the parent-child relationship. Children usually show signs of readiness between age 2 and 3. When parents can’t wait until then, and impose toilet training as their idea, the child will feel the pressure as an invasion.

All parents, of course, want their child to grow up and cross this threshold. Preschools often insist that a child be “trained” before he comes to school.

Other parents may offer advice and condescending comfort when their children are already trained. Grandparents may imply that toilet training is a measure of effective parenting and of a child’s overall competence. Some families may see the child’s entire second year as preparation for success in this area.

A toddler for whom independence is a passionate issue anyway will have his own struggles. He may stand in front of a potty, screaming with indecision. Or, he may crawl into a corner to hide as he performs a bowel movement, watching his parents out of the corner of his eye.

It’s a rare parent who won’t feel that such a child needs help to get his priorities straight.

When a parent steps in to sort out the guilt and confusion, the child’s yearning for autonomy becomes a power struggle between them. Then the scene is set for failure.

In bedwetting, as in many of the problems encountered with toilet training, a child’s need to become independent at his own speed is at stake. When a child’s need for control is neglected, he may see himself as a failure: immature, guilty and hopeless. The effect of this damaged self-image on his future will be greater than the symptoms themselves.

Given that toilet training is a developmental process that the child will ultimately master at his own speed, why do parents feel they must control it? My experience has led me to the conclusion that it’s very hard for parents to be objective about toilet training.

The child becomes a pawn – to be “trained.” It may take us another generation before we can see toilet training as the child’s own learning process – to be achieved by him in accord with the maturation of his own bladder and central nervous system.

When Problems Exist:

A.) Discuss the problem openly with your child. Apologize and admit you’ve been too involved.

B.) Remember your own struggles, and your eventual successes, so that you can let the child see that there is hope ahead.

C.) State clearly that toilet training is up to the child. “We’ll stay out of it. You’re just great, and you’ll do it when you’re ready.”

D.) Let the child know that many children are late in gaining control, for good reasons. Then, let him alone. Don’t mention it again.

E.) Keep the child in diapers or protective clothing, not as a punishment, but to take away the fuss and anxiety.

F.) Don’t have a child under age 5 tested unless the pediatrician sees signs of a physical problem. A urinalysis can be done harmlessly, but invasive tests and procedures – enemas, catheters, X-rays and so on – should be reserved for children who clearly need them.

G.) Make clear to the child that when he achieves control, it will be his own success and not yours.

(This article is adapted from “Touchpoints: Birth to Three,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Prior to Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.