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A 4-YEAR-OLD REACTS BADLY TO BABY

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From the NEW YORK TIMES COLUMN: FAMILIES TODAY

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

Q. I am writing for advice about my 4 1/2-year-old grandson. Very recently, my son and his wife welcomed their second child, a girl, to the family. They very diligently included their son in all the preparations beforehand, and he seemed to be handling everything very well. His parents even allowed him to stay at the hospital overnight with them.

Now that the baby is 3 weeks old, my grandson is beginning to act out at preschool, not even wanting to attend, but when there, has done things no one ever thought he would do. He’s even been sent out of the class because of disruptive behavior.

How can you get a 4-year-old to voice his feelings when he himself probably doesn’t know why he’s behaving negatively? What approach might his parents take in addressing this problem?

A. Your thoughtful questions show how much you and his parents have tried to do everything you could to prepare him for the new baby. The last question about “voicing his feelings when he doesn’t know why he’s behaving negatively” is so respectful of what it’s really like to be 4 years old. Knowing what he’s feeling, and knowing how to say it is a very big project – even for many adult-aged children!

You’ve prepared him in every way. I’m sure you’ve talked about the baby in mommy’s tummy, how he could help take care of his little sister when she comes (as if he asked for her, as if it were up to him). He even stayed overnight at the hospital so he wouldn’t feel abandoned by his concerned parents.
Everyone has reassured him that he’ll never be deserted because of her. You probably even brought him home a teddy bear or a truck to nurture when his mother is nurturing her new baby. This may help keep him from feeling displaced by the fascinating new baby.

So why shouldn’t he handle everything well, or even near perfectly?

Despite all best efforts, he still feels angry and displaced. Of course, you and his parents feel let down by his behavior. You feel so badly for him and may blame yourselves, wondering what else you could have done that would have made it easier for him. Yet it sounds as if you all have done everything you possibly could have to smooth over this big transition for him. Except perhaps to leave room for him to protest. To let him know that no one expects him to enjoy being a “big brother,” all the time. To allow him to be “a baby” too without feeling that he is letting anybody down. And to reassure him that sooner or later most big brothers ask about sending the new baby back to the hospital, or stowing her permanently back in the mother’s “stomach.”

He is upset; upset enough to act out at preschool. Not yet at home, although that may come yet. Over time, he may come closer to understanding his feelings, and then to controlling them, if the adults around him can identify the specific aspects of this natural catastrophe that are most disturbing to him.

Of course his parents have less time for him. Of course the baby is lavished with nurturing that stirs up longing – both embarrassing and irresistible – for such nurturing in him. Can he be encouraged to nurse and change his baby doll alongside his parents as a way of pulling together this flood of feelings? Are his parents too tired, too busy, and too preoccupied for their old games and rituals with him? Which ones does he miss the most? Are there a few rituals that they could manage to keep going while he is wondering if they even remember who he is, if they even know he’s there? Can they sit down with him and simply talk out some of the hard parts and show them that they understand and that they care? “It’s so upsetting when people come over with gifts for the baby, and they barely even say hello to you. Of course it hurts your feelings!” Or is he under so much pressure to be praised for being such a good big brother that he doesn’t dare regress – as he will need to -to ask to be your baby again?

But it sounds as if he wants to protect his parents and his baby from his feelings, so he “blows up” at pre-school where it is safer, and where the teachers will protect him from his understandable angry and naturally destructive feelings. He must feel safe with them, and I recommend that you and his parents thank his preschool teachers for the environment they have created where he can feel safe and protected from his out-of-control feelings. Their discipline must be reassuring to him at such a time.

These feelings of displacement and jealousy are inevitable. One of the most precious gifts you can give as parents to a first child is to guide him through his feelings about being displaced to the point where he can accept and control his jealousy. Then he can get on to the important job of caring for his little sister.
For competition with a sibling is one side of the same coin as caring deeply about that sibling later on. But you must be patient and wait for caring to come later.

Meanwhile, to allow him his negative feelings about her, and to face these angry feelings, can be a real gift to him. He won’t have to suppress them. In time, he can feel in control of them so he can move on. My mother always expected me to “love my little brother” so I never got a chance to face my feelings openly. I disliked him until he was 50 and then we became best friends. The pressure to be perfect instead of real was finally off.

It is interesting that he begins to be aware of and to show these feelings after she is 3 weeks old. Just at the time when she’s beginning to smile, and coo, and to fuss at the end of the day – more beguiling but also more demanding. He picks up his family’s turmoil and reacts at preschool. I would predict that he’ll “blow” in some way at each of her new developmental steps – most older siblings do. I call these developmental steps Touchpoints (See our book, “Touchpoints: Birth to Three.”).

Before each new step in her development, she will regress and be more demanding. This will throw the family into turmoil. Your grandson is likely to react at these predictable times. For example, when she begins to crawl, or to walk. Don’t be surprised, and if you and his parents can help him express himself safely (with limits on how far he can go) each Touchpoint becomes an opportunity for him to express these negative feelings. Eventually he can become aware of his protective and caring ones for her. Good for you to want to help him connect his feelings with his 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, 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 PRECOCIOUS TODDLER’S REPLY TO A PASSERBY

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From the NEW YORK TIMES COLUMN: FAMILIES TODAY

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

The topic of thumb-sucking continues to prompt responses from readers.

Q. My “children” are now 32 and 24. Your column reminded me of my favorite thumb-sucking story.

A friend and her toddler son were shopping. He was sitting in a child’s seat in the shopping cart, happily sucking his thumb, when a woman approached and said to him and his mother, “Imagine a child that age still sucking his thumb.” My friend’s child took his thumb out of his mouth, looked directly at her and replied, Hurts you?”

I’d love to meet that young man now. He was a wise soul already almost 30 years ago.

A. Your friend’s toddler’s reply to a judgmental busybody is quite a hoot! How does a child just old enough to make two word sentences come up with something like that? A toddler might have sensed this intruder’s negative emotion without fully understanding it. At 2 years or less, a child certainly wouldn’t have known that it was none of her business. And at his tender age, he may not yet have encountered the disapproval of thumb sucking that often is reserved for older children. Toddlers do already know that people have feelings, and by 2 and 1/2 years or so are already hard at work trying to understand what causes them. (This child must have been a little precocious.) Their range of understanding of feelings, and their explanations for other people’s feelings, of course, can only come from their close-at-hand experiences. This child was too young to understand the very abstract notions of persnickety value judgments, or competitive parenting. (His mother may have felt that this woman was saying, “I’d certainly do better than that!)

A child this age would be likely to think that he’d caused her emotions, and would be bound to translate “condescending” or “judgmental” into “hurt” or “mad.” Why would a lady in the store sound upset and mad while looking in the toddler’s general direction? From a toddler’s perspective, this might very well be because he hurt her! This poor child sucking his thumb might even think that he’d caused her distress by sucking too hard, or using his teeth! This may have been the best explanation he could come up with for her arching eyebrows and turned up nose, but it sounds as if it seemed a little implausible even to him!

What a wonderful story! The profound truths of young children’s words let us into their world – one that we have long since left behind, and so often fail to understand.

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 BACK-AND-FORTH ON BITING

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From the NEW YORK TIMES COLUMN: FAMILIES TODAY

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

A reader suggests a turnabout-is-fair-play solution to toddlers’ biting.

Q. I can just see your reactions to my solution to the biting problems of toddlers. Politically incorrect? Oh my yes! But as a mother of four, and grandmother of seven, I have a bit of experience on this subject. First, a child rarely tries out this bad habit on a contemporary first. Generally, a parent is the first victim. If the parent shows alarm the child quickly assumes this is a sure-fire attention getter. Instead, if the response is a quickly delivered return bite, the toddler gets the message very quickly that this does not feel good and rewards them with discomfort in return. They are not likely to try this again. On anyone. Of course, I am not speaking of injuring the child in any way. Just a gentle, “See what that feels like.”

A time-out or such might work in the home, but it cannot be applied when the child is not in the care of the parent. They learn what Mom and Dad will not allow but that does not curtail this behavior socially.

Call me old- fashioned but success is a pretty good argument for my case.

A. As you say in your letter, nearly all toddlers go through a stage of biting in the second and third years. First, as infants, they bite their parents. A parent’s first response of pain and surprise is bound to intrigue and confuse a baby. In her attempt to understand what’s going on and to connect cause and effect, she’s bound to bite again. After a few more tries, a less dramatic but unequivocal response _ “I’ll have to put you down until you can learn to stop” _ will suffice to make her stop. Later, as she’s learning to reach out to other toddlers, to attract their interest and entice them to play, or just to get some kind of response, biting is likely to emerge again.

It will also appear when a toddler is pushed over the edge by desire (for the toy she can’t have), frustration (that another child won’t pay attention), or anger (over the toy that the other child grabbed from her). Biting at these ages is a natural step in a toddler’s effort to sort out her role in interacting with others.

One pediatrician we know says that a toddler’s bite is just the flip side of a kiss – another try at communicating with her mouth! But when it stirs up hysterical responses in the adults nearby, biting is bound to take on a life of its own. A toddler’s simple effort, once again, to figure out what the fuss is all about.

When a child bites another child in a childcare center, parents and teachers are often, understandably, incensed. Even if their children have been biters in the past themselves, parents want their child buffered from the current carnivore on the loose. Perhaps they fear that their own child will go at it again.

Yet parents and teachers would be wise to use a straightforward teaching response to a toddler’s bites (stop the biter, separate the children, remind them it’s not acceptable, without overreacting to them and tempting them to try it again), not a punitive one like the one you suggest.

A parent who bites is getting down on the level of the child and is no longer a parent. Most common behavioral challenges defy the “logic” of a parent inflicting a child’s misbehavior on a child so that she’ll “know what it’s like.” Should a parent steal from a child who steals so that she’ll get the point? Should a parent lie? Cheat? Would you suggest we also scratch, hit and kick children who need to learn not to? This is not teaching. This is not problem solving. This is not parenting.

We’re happy to share your disdain for the “politically correct” if you’ll think through the issue you raise with us rather than pigeonholing our response in advance. Freedom from “political correctness” is a pretty handy posture to strike these days in defense of just about anything. But it is a distraction.

The problem is that biting back is a primitive response _ one we’d understand in animals in the wild but not one we’d want to model for our children. No doubt you’ve caused no serious harm with the little nibbles you describe, but we want to assure our readers that you wouldn’t apply your logic to the broader challenges of raising a child.

We’d like to see children to be raised into adults who can show each other enough respect to work to understand each other when they disagree rather than to just throw labels at each other. Perhaps all the pigeonholing in politics these days that shuts down healthy debate before it starts is an adult equivalent of the limited social skills of the toddler who bites, or bites back.

We certainly respect all of your experience but must differ with your conclusion that simply stopping a behavior proves your method to be successful and justified. Raising a child is not about simply stopping unwanted behaviors in the short term. It’s also about teaching the child self-control, respect for herself and others, what’s right and what’s wrong, and what it means to be human. We doubt that arguments such as “do it back so she’ll see what it’s like” and “if it stops the behavior, it works” will accomplish these fundamental goals for raising a child.

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 3-YEAR-OLD TOUCHES HERSELF TOO MUCH

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN A 3-YEAR-OLD TOUCHES HERSELF TOO MUCH
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I have a 3-year-old daughter who I believe is masturbating. I have Dr. Brazelton’s book “Touchpoints” and I read about it in “Challenges to Development” and my husband and I have used his advice.

We even took her to the pediatrician to have her checked out and we didn’t get any help as to how to handle this. I have talked to her about it and she does it in inappropriate settings. I don’t know what to do. I think it has become a pattern. I want to take her to someone to be evaluated to see if she is hypersensitive as Dr. Brazelton mentions. I am a stay-at-home mother and she has only been watched by my mom and sister so molestation I think is not the problem. I need some professional help, but I want to make sure we take the right next step.

A. There are a number of reasons why children this age repeatedly touch their genital areas. They may have a urinary tract infection, a skin rash or even pinworms (which would lead them to scratch their behinds). Presumably your child’s pediatrician checked her for these kinds of causes. Any prolonged itching or discomfort in the genital area can set off this kind of behavior.

Even more common than these is the natural inclination of young children to explore their bodies, including the sensations that touching themselves stir up. This often begins when diapers come off, and rather suddenly children have more access to their genitals. Later, at age 3 or 4, they become interested and able to identify differences between their bodies and other peoples’ bodies.

At these ages, they may also start touching their genitals as a way of checking on themselves, understanding their differences: “Is that the way my body is supposed to be? Is everything there that is supposed to be there?” This kind of touching usually occurs at the normal times for being naked – bath time, bathroom time, getting dressed and undressed. It doesn’t interfere with other normal interests and activities.

For many young children, touching their own genitals can become a way of self-soothing, for example, relaxing when feeling anxious, or when trying to fall asleep. Gentle, neutral reminders should be enough to tell them that this is a private activity for alone times in their own rooms. The frequency of such self-touching may increase when a child is under great stress – for example when a new sibling is born, or when separated from parents.

Children who touch themselves repeatedly, as if preoccupied or driven, who appear unable to respond to such reminders, and who seem so compelled by this behavior that it competes with other activities, may be signaling that there is another kind of problem.

You mention the possibility of sexual molestation. Children who have been sexually abused, that is, touched in sexual ways by adults or children who are several years older than they, or shown pornographic material, may display sexual behaviors that appear preoccupying, that interfere with their play and their peer interactions, or that are adult-like in quality.

Obviously, adult-like sexual behaviors displayed by young children are stronger evidence of sexual abuse than self-touching, which is common and normal in young children.

Children who have been sexually abused may also appear fearful when with adults who remind them of the abuser, or near the place where it happened, or simply when they are separating from the adults who they can still trust. They may also appear distressed at bedtime and bath time, when they must confront the vulnerability of their own bodies. Or their behavior may suddenly and radically change – irritability and aggression are common examples, although they certainly aren’t specific to sexual molestation.

It is possible, as you seem to be thinking, that a young child simply becomes over-focused on touching her own genitals, far more focused than children just learning about themselves, or self-soothing at limited times, in limited situations.

Some experts have termed this behavior “infantile self-stimulation” or “gratification disorder,” although little is known about it, or its causes.

In some cases, it is thought, these children may lack other kinds of stimulation. For example, such behavior may begin at the time of weaning, or with the birth of a sibling, which decreased the child’s physical contact with parents.

Certainly, engaging such a child in ordinary kinds of physical play and normal cuddling, all of which is deeply involving and rewarding, may help. Avoid emotional reactions, too, since making a big deal of the behavior may inadvertently reinforce it. It is hard to tell from your question whether your child’s touching herself is within the normal range or not. Your observation that she does it in inappropriate places, and won’t stop when you ask her, are causes for concern.

We would urge you to return to the pediatrician to reconsider the possible causes and help determine whether the behavior requires more attention, or less.

If there are no other causes for self-touching that she can’t limit to alone times and that disrupts her other activities, then a cognitive-behavioral psychologist experienced in treating small children may be able to help you see how you can avoid reinforcing this behavior, and encourage other ones instead.

The idea is not to make her stop, but to help her get this behavior under control. But she mustn’t be made to feel bad about herself or her body with any approach that you take.

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.

THE PURPOSE OF TIME-OUT

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
THE PURPOSE OF TIME-OUT
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Could you please send me guidelines for time-outs?

My son-in-law put my grandson, who is almost 5, in time-out for a couple of hours and when he ran an errand my daughter let him play and his daddy made him go back and sit.

He’s a sweet boy, and after we spank him or give him a time-out, he always apologizes.

Even the next day when we’re playing or watching a movie, out of the blue he says, “Mamaw, I’m sorry I upset you or threw a fit, etc.” He’s a very good boy. My sister and I and his grandmother tell him we love him even when he messes up. And that we have to correct him but that doesn’t mean he’s not a good kid.

A. Guidelines for time-outs? First, time-outs are not punishments, and should not be used as punishments. If they are, then of course the child will try to avoid them. This is one reason why some parents find they don’t work.

Time-outs require that a child actively cooperate to come to a quiet place to sit, calm down, think, get ready to apologize and come up with some better ways of handling himself or approaching a problem. This is an awful lot to ask a child to do if at the same time he is being made to feel that a time-out is bad, scary, uncomfortable and shameful.

Time-outs should not be presented as if the child were being banished forever to outer space. What child would ever go along with that? Instead, the child needs to be reassured that a time-out does not mean a rupture in the relationships with parents, just a quiet time to settle down and think things over before coming together again. If time-outs have come to mean punishment in your household, them it may be time to call them something different and to do them differently.

One family we know says “time to sit on the calming-down couch.” Stuffed animals and books are welcome there too.

Second, time-outs are for learning. Time-outs can be used when a child becomes overwhelmed by strong feelings – frustration, disappointment, anger, which have been expressed in misbehavior, for example yelling, hitting, talking back, being rude and disrespectful, and breaking things.

Children are not born knowing how to handle these feelings, and it is our job to help them learn. Once parents understand that time-outs are a special time in a quiet place for a child to learn to settle down and regain control, then they can help children understand their purpose.

At first, parents may need to help children calm themselves, offering them a cool washcloth to wet their faces, or their favorite stuffed animal to squeeze. These are not rewards for misbehavior. They are examples of strategies for learning how to get back in control. It can also help to remind the child of the ways he has successfully settled himself down in the past. “You might need to make a mad face and not talk to anybody for a little while. Let me know when you’re calmed down, and then we can talk.”

Once a child is calm, the next step is for him to work on recognizing his role in what went wrong. This doesn’t mean everything is always his fault. But he might be helped to see that he did have trouble controlling his strong feelings, and then did something he knows he shouldn’t have. Or that he did something he didn’t know there is a rule about – but now he does.

Now he’ll be ready to apologize, and then be forgiven, a critical step to protect self-esteem that is important to include. Forgiving does not mean that his misbehavior is acceptable, but that parents recognize his potential to learn and grow.

There seem to be a number of questions within your question.

First, about the different ways your son-in-law and daughter discipline your grandson: Time-outs don’t work when they are too long because they can’t be enforced. How can any adult get a 5-year-old to sit quietly in one place for an hour or more? (How many adults can do that themselves?)

Discipline strategies that don’t work are bound to lead to conflict between parents, which in turn undermine whatever other discipline they may try. Parents’ agreement on when to discipline and how to discipline is at least as important, if not more so, than on the specifics of what they decide. Children need parents to discipline together, although it often seems that they actively make this even more difficult than it is to do so.

Second, what, if anything, can you do, as the grandmother? Taking sides certainly won’t help. Understanding that parents usually have strong feelings about discipline, and that it is expectable for them to discipline differently – even though this causes problems – may be the key.

Then your role is not to give specific advice but simply to encourage that they share their ideas and listen to each other so that they can arrive at a shared understanding. But your children aren’t likely to listen to your advice as a grandparent. So mostly what you can do is to love and cuddle your grandchild – while trying as hard as you can to avoid turning him against either parent.

Finally, what effects is this having on the child’s image of himself, and what can be done about it? It does sound like he may be struggling with the feeling that he is a bad boy. When children feel this way, they often misbehave more and more, as if they’ve come to believe the worst about themselves.

Discipline that focuses on teaching, not punishment, and that gives a child a chance to apologize, make reparations and be forgiven, can help. Spanking won’t, since it can feel to a child like it is an attack on his “badness.” Instead, effective discipline makes the child feel that he has the potential to learn and grow and improve his behavior.

See our book “Discipline: The Brazelton Way.” Da Capo Press 2003.

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.

PARENTS AND POLITICS; BABIES AND MUSIC

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
PARENTS AND POLITICS; BABIES AND MUSIC
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

A reader adds a contribution to a column about adults’ political responsibility for children.

Q. People can be so self-centered that they forget that we are all in this boat together. Sometimes people without children or with grown children, for example, act to undermine the educational system or publicly complain about contributing to it.

A. We agree with you that we will all pay the price of shortsightedness and selfishness. We do, though, want to be clear that personal responsibility for such irresponsible attitudes is broader than you suggest: Some people without children or with grown ones may not see themselves as having a broader contribution to make to the greater good, but of course there are many who absolutely do.

The mere fact of bearing children doesn’t seem to be quite enough to help people accept the interdependence that goes along with being human. (Isn’t our need to communicate with and understand one another the reason why we humans have such elaborate languages, even if we are still stumbling in the Tower of Babel’s rubble?)

Some parents seem to be so over-focused on their own offspring that they teach them only to fend for themselves. We all know at least one parent who has taught their child that it is not how you play the game that counts, but whether you win. What happens then to the rules of good sportsmanship that will keep their child and everyone else’s safe?

We appreciate especially your comment that “we are all in this boat together.” Perhaps some of us are uncomfortable with the closeness and responsibility that your metaphor implies, and adhere instead to the notion that “each man is an island.” Yet a stranded man on an island isn’t likely to do much for perpetuating the human race until he reaches broader shores. Until then, his only hope is a message in a bottle – not much good if it never makes it way to someone who can understand it and respond.

When times are tough, and the flood waters are rising, it may not be a boat we need, but an Ark. Can’t we aspire to one in which all can be welcomed, including those without children or with grown ones? Can any of us mere mortals presume to determine who the sinners are to be left to drown? (In recent years, we’ve seen too many examples of such presumption on the part of high-handed humans with more than their fare share of human foibles.)

Tolerance and the most inclusive generosity are the best ways we know to leave that job to a higher power.

Our answer to a question about a 1-year-old who cries during brief car trips prompts another solution.

Q. The 1-year-old sounds just like the situation we had as grandparents. Once a week we had the little girls and the 40-minute trip to our home was almost constant crying from the younger one – until we discovered a set of 100 favorite children’s songs recorded on a CD. They loved the “kids”’ music, there was no more crying and they learned the classic old children’s songs. Good luck to the parents.

A. For thousands of years, long before car rides and CDs, humans have turned to music for comfort, and sung lullabies to soothe their young. Most soothing of all to infants are the songs sung by familiar voices.

Of course modern technology offers us wonderful opportunities for introducing young children a rich and wide range of musical sounds and textures – from the very simplest ones, those that make them feel ready to try out their own singing too, to more complex ones, that astonish, and prompt them to dream. But we sure hope that you all sang along too.

Recorded music will never replace the human act of singing, of listening to each other sing, of according the voices of a family and singing 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.

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.

WHEN A 2-YEAR OLD WON’T STAY IN BED

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN A 2-YEAR OLD WON’T STAY IN BED
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. How can we keep our 2-and-a-half-year-old daughter in bed? Two weeks ago she climbed out of her crib and never looked back. However, I don’t feel that she is developmentally ready to stay in bed.

We are patting her back until she falls asleep, but this goes against all the parenting I’ve done with my other kids. I would like her to rest and sleep in her own bed, by herself.

A. We’d love to know what else happened two weeks ago. Has an important change or event affected the family – a move, illness or death, a pregnancy, a parent’s job loss? When children this age experience a new stress, the first sign may be a change in sleep patterns.

Parents sometimes assume that a child is “too young” to realize that something’s up, which is appealing when a change is hard to face and parents wish they could protect a child from knowing. At such moments, though, young children need parents’ help to understand what is happening, and how the family will manage. What young children can’t put into words they may translate into actions, like refusing to stay in bed.

Another potential cause may be allergies, asthma or even a cold. Check with your pediatrician.

If your child had been sleeping through the night, she’s mastered how to settle herself down at bedtime. But going to bed means she must temporarily separate from parents and surrender to being alone – unless she is sharing a room.

Separation can be tougher when a child’s world seems less predictable. She needs to believe you will still be there, and respond as always, in the morning.

Another sleep-disrupting event can occur within the child – a developmental threshold we call a touchpoint. At age 3 or 4, children become newly aware of their emotions and of the moral judgments that go with them. They realize they can feel angry or vengeful or jealous. Such emotions may frighten them or make them feel guilty. Often this awareness surfaces as fear about monsters and witches, and in nightmares of angry, vengeful, hurtful creatures.

Parents can help to ease this stress by talking gently about the full range of emotions (their own and their children’s) and by reading children’s books that deal with them – for example, “Where the Wild Things Are” by Maurice Sendak, or “There’s a Nightmare in My Closet” by Mercer Mayer.

When children know their parents can help them handle emotions so they won’t act in scary ways, the fears and nightmares will subside.
(See our book, “Touchpoints: 3 to 6: Your Child’s Emotional and Behavioral Development.” Da Capo, 2006)

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.

DEVELOPING A SENSE OF SELF ESTEEM

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
DEVELOPING A SENSE OF SELF ESTEEM
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D

Q. I would like to hear your thoughts on how to raise a child to have a strong sense of self-esteem.

A. The word “self-esteem” has been so overused that its meaning has been lost and sometimes confused with “selfishness.” But these are entirely different. Thank you for your question and this opportunity to clear up the confusion.

Self-esteem does not refer to an inflated view of one’s self. Instead, it is the capacity to hold onto a basically hopeful view of one’s self while facing and integrating experiences that challenge this view.

The development of healthy self-esteem in a child allows her to confront her mistakes without taking apart her positive feelings about herself, so that she can mobilize these positive feelings (confidence, faith in her potential, etc.) to find the courage to learn from and overcome her mistakes. The result is not a skewed view of one’s self, but a realistic one in which both strengths and weaknesses can be acknowledged and accepted.

How to help a young child develop healthy self-esteem? Here, too, there’s been a great deal of misunderstanding.

Overpraising a child (“Yay!” for every least little utterance or gesture) can interfere with a child’s learning to motivate herself, to praise herself when she deserves it, and to face her failures so that she can work to overcome them. I have seen 5-year-olds in Kenya care competently for younger siblings without anybody cheering them on, yet radiating a quiet confidence in their own abilities.

In some upper-middle-class communities in this country, I have seen some children who seem to lack the inner motivation to challenge themselves, and who have become dependent on external sources of praise – over which they have a different kind of control.

Abundant opportunities for small successes and an environment rich with developmentally calibrated challenges are important, but total protection from small failures deprives a child of the experience of facing mistakes, feeling the feelings that go with this, getting these feelings under control, and then developing the resolve to try again.

Perhaps most important of all for the development of healthy self-esteem in a child is a parent’s unconditional acceptance – entirely independent of performance – of a child not for what she does, but for who she is. Feeling loved no matter what does not fill us with illusions about how wonderful we are, but helps us to tolerate our imperfections. When we can do this, we are more likely to learn to live with the imperfections of others. This is why self-esteem is such an important first step in learning to get along with others.

Q. I am writing to appreciate you for being such a fine pediatrician who cares as much about the parents as you do about our children … I felt you were like a friendly grandfatherly type of doctor sitting by my side as I faced each developmental phase. I’ve always felt my daughter is my teacher, and with your guidance, I learned to listen and observe her better so I could support her to develop her potential.

A. It is good to hear that I was able to get across to you what I truly believe, that parents need support at least as much as they need advice, and that their best teachers are not the “experts” but their children, if only parents can really watch and listen, as you have been able to.

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.