A 5-YEAR-OLD’S SUDDEN CHANGE OF HEART

NEW YORK TIMES COLUMN: FAMILIES TODAY:
A 5-YEAR-OLD’S SUDDEN CHANGE OF HEART
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 5-year-old granddaughter has taken ice-skating lessons for a little more than a year.

A couple of months ago she started crying before her lesson, saying she didn’t like it and didn’t want to go. She was told to give it another try because she had liked it (and the lessons were paid for).

Then she started crying before her dance lessons. But when she gets home, she says what a great time she had.

Now she’s starting crying before school and having bad days at school. She was always so excited to go to school and telling us all about her day.

What could be going on? Is she just “playing around” to see how far she can go? What can we do to help?

A. Five-year-olds who have complied with activities that their parents choose for them may suddenly realize, “I want to decide what I’m going to do – all by myself!” This wish to be in control can be a healthy sign of growing self-esteem: “I’m going to decide what I do now because I know what I’m doing!”

To help her open up, commend her for wanting to have a say. Then, if she can tell you what she doesn’t like about these activities, she may be able to focus on what she likes about them. Her parents could make an agreement with her to remind her that she says she enjoys these activities.

If a child complains about one activity, she may need help to figure out why. Is it too hard, frustrating or lonely without friends in that class? Is she too tired or hungry at that time of day? Perhaps something frightening happened there? A traumatic experience in one setting can lead a child to be fearful of others.

If you had told us that she was crying most of the time, and if you hadn’t said that after class she realizes she’s had fun there, we might have wondered if she could be depressed. If the crying is limited to these times, and if she is bright and cheerful at home and with friends during less structured activities, that’s reassuring.

It is concerning that she is also having “bad days” at school. You need more information about these bad days, about what is going on in school and her behavior there. Her parents could ask her teacher how she is handling the everyday school challenges. Her teacher may have ideas about how to help her enjoy school more. The teacher might even let her parents observe her in the classroom.

Another possible reason for the crying might be trouble with transitions. Many children this age become so absorbed in one activity that they can’t stop and switch to a different one. Reminders 15, 10 and five minutes before it is time to get ready to go can help. Another possibility is that her busy schedule may overtax her parents. If they’re frazzled, she’s bound to feel that way too.

When a child is more insistent on staying home or with a parent than avoiding a specific activity, separation may be her challenge. Such anxiety is common at this age, especially after a loss such as the death of a grandparent, or a move, or when a parent has been ill or preoccupied – by stress at work, financial worries or marital tensions. Five-year-olds may also insist on staying home after a new baby is born, as if to reassure themselves that they will not lose their place in the family.

For some children, dance and skating and other classes can just be too much. Your grandchild is only 5. Perhaps she’s trying to tell you that she needs a different pace, a few more breaks during the day, or more time for learning on her own – through play and with her friends. She may not know how to make friends yet – another reason to be miserable at school and in other group settings. Setting up play dates would then be an important first step.

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.

MOTIVATING A CHILD

NEW YORK TIMES COLUMN: FAMILIES TODAY:
MOTIVATING A CHILD
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. How can a parent help cultivate a child’s motivation in balance with complete acceptance of a child? What are the differences between “boundaries” and “unconditional acceptance”?

A. Parents can’t choose between boundaries and unconditional acceptance. The goal is to work toward balancing the two.

Children’s motivation partly depends on their feeling that they matter to others. From infancy, that feeling helps them believe in themselves. Why would any child be motivated to take on a new challenge if she sees herself as a failure?

Motivation begins at birth. Parents start the process by loving their baby, holding her, cooing, singing and rocking, setting up rhythms of smiling, vocalizing and touching that make her feel cared-about.

Within this cocoon of attachment, your baby begins to reach out for you. When you respond to her laughter with yours, she is learning – even in the first months of life – that things happen when she takes action. These exchanges are the beginning of motivation. She reaches out for others, and then for the world.

If she gets no response to her first coos and babbles, a baby doesn’t see much point to trying to make an effort.

As your baby grows into a toddler, your job gets more complicated. You have to set boundaries to be sure that her environment is safe to explore as she learns the motor skills – cruising, scooting, crawling and walking – that give her a new independence. When she’s just begun to toddle, you set the limit – no climbing up the stairs unless you’re right there to help her practice.

You can foster motivation even when you need to balance it with limits: “You can try climbing the stairs when I’m here to hold your hand.” But you also have to install safety gates, since a toddler can’t be expected to remember the limits when her own motivation tips the balance.

She tests you. She scrambles toward the stairs, then looks back to see if you really mean that she not climb them. Once you let her know you’re in earnest, you need to pick her up and stop her if she can’t stop herself.

Many parents worry that when they set limits they no longer unconditionally accept their child. Nothing could be further from the truth.

Setting limits is an act of love – it’s not always easy, and you wouldn’t bother if you didn’t really care. A child needs grown-ups who love her to clarify the rules and to protect her from hurting herself as she follows her motivation to learn about the world.

As a child becomes more independent, she finds new ways to resist your authority – temper tantrums in the second and third years, and often, at ages 3, 4 and 5, lying, cheating and stealing.

Boundaries help improve the child’s ability to achieve what she wants, as long as they are respectful and she understands the reason for them. Setting limits makes it clear that you unconditionally accept her but not all her actions.

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.

YOUNGEST IN HIS CLASS

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.

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.

CONCERN ABOUT AN UNORTHODOX CRADLE

NEW YORK TIMES COLUMN: FAMILIES TODAY:
CONCERN ABOUT AN UNORTHODOX CRADLE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. During a recent visit to a cousin’s home in another state, I was very troubled by a sleeping arrangement for a 14-week-old. Perhaps I’m not aware of common practices today for encouraging newborns to sleep through the night.

The baby is swaddled in a garment designed for newborns, then fed and put into a car seat, which is placed on the floor in a small bathroom – without windows. The fan is turned on to provide white noise, and the door is closed. A blanket outside the door blocks external noise. No monitors are used.

The baby has been sleeping for 10 to 12 hours at night. He appears to be healthy and happy.

But I’m concerned about his being in a sensory-deprived situation, unattended. The parents go to him when he cries, but the entire procedure seems wrong.

I would appreciate your input since I’m expecting a baby in a few months.

A. We share your concerns. This arrangement may interfere with the baby’s safety and development.

With all the measures to block out sound, the baby’s parents may not be able to hear him when he needs them. Adequate ventilation is another basic requirement.

Safe ways of swaddling can help babies settle for sleep and get back to sleep when they awaken during the night. But babies also need a chance to move their limbs to develop their muscle tone and strength.

We would ask whether all this protection against light and sound will interfere with the baby’s developing the capacity to filter them out on his own.

What kind of transition are the parents expecting from such a highly controlled environment to a more natural one, and when?

It would be helpful to know why the parents feel their baby needs these special measures. Was the baby hypersensitive at birth to noise or light? At birth, babies have different levels of tolerance and sensitivity to touch, sounds and sights. Some have little trouble tuning out useless information such as the sound of the dishwasher or a slice of light from a street lamp. Others may be sensitive only to sights, or to sounds, or to touch.
Such differences contribute to each individual’s unique temperament from the very beginning of life. Even infants who start out hypersensitive may become at least a little less so over the years by learning to cope.

We could imagine that without practice at shutting out unwanted stimulation, some infants could become overly sensitive. Later on they might even have trouble focusing their attention in the face of everyday distractions.

Sometimes technology can improve on nature, but there are plenty of examples, such as infant formula, where this just isn’t the case. Often we don’t fully understand the benefits of nature’s design until we’ve tried to substitute our own.

For all we know, human babies and parents may have evolved ways to communicate with each other, such as pheromones, that would require more contact than this closed-in arrangement allows – perhaps even through the night.

In any event, we see no reason why you need to follow your cousin’s example when your own baby is born.

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.