children

WHERE DO PRESCHOOLERS LEARN MOST?

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHERE DO PRESCHOOLERS LEARN MOST?
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. What are your thoughts on preschool? Are very young children better off constantly interacting with a dedicated adult parent to stimulate their brain growth, or is there a benefit to socializing them with their peers at an early age? What’s the optimum balance of this for raising an intelligent yet independent and socially adept child?

A. How fortunate you are if you have a choice! And yet what a sense of responsibility!
Most parents in the United States today have no choice, and must work in order to be able to provide for their families. Because of the decline in real wages over the past decade, most single and two-parent families need all adults to bring in paychecks. While quality child care is hard to find and harder to pay for, it may be harder still to do without a parent’s salary. Some families find, though, that with two or more children under age 4, there’s no choice but for a parent to stay home. For others, friends and relatives are the only solution.

Early Head Start (for infants and children to age 3) and Head Start have been the salvation of many families, although for decades there have been no openings for the vast majority of eligible families. Finally new funding is on its way to make room for more children in these high-quality and proven programs.

To our knowledge, there are no actual studies that compare the brain development of children in preschool to children who spend their days at home with a dedicated adult parent. Such a study would be difficult to conduct both because the specific experiences in individual homes and preschools can vary so much and because there are so many other variables that influence brain development, including pregnancy, health, nutrition, air and water quality, and genetics.

What we do know is that high-quality early childhood education has been proven to save up to $17 for every dollar it costs because it leads to better academic success, fewer special education expenditures, greater chances for employment and productivity, and less risk of ending up in jail.

Quality criteria include a low child-teacher ratio, a high level of formal training in child development and education for teachers, positive relationships between teachers and parents, and meaningful parent involvement.

There is no evidence that such high-quality experiences can’t also be provided by dedicated and caring parents for children at home. Positive learning and growing may occur in either setting.

Since most parents don’t have a choice, and are either at home or at work because they must be, we’d hate to make them feel guilty about either option. What matters most is the quality of the child’s experience. Whether the child is at home or at preschool, parents and children need enough time together to continue to grow closer and to deepen their understanding and appreciation of one another. And children at home will still need abundant opportunities to be with peers to learn from them, with them and through their interactions.

Parents may feel overwhelmed by the responsibility that the “new brain science” may seem to impose on them to stimulate their children’s brain development – quick, in a hurry – before it is too late. The reality is that while the human brain never grows and develops more rapidly and dramatically than in the first three years of life, children’s most important learning experience will not come from videos or computer programs but from interactions with those who care about them most – parents, teachers, siblings and peers.

Parents are children’s first and most important teachers not because they teach the alphabet, shapes and colors but because they encourage and motivate children’s curiosity and enthusiasm to learn. Parents help children to take in as much as they can learn from their environment by gently buffering them from more stimulation than they can handle. Early on, children teach their parents how to read their cues so that together they can work toward this balance.

The foundations for learning are laid down before kindergarten in the context of children’s interactions with adults and with each other. We have known for decades that the key to school readiness and becoming a lifelong learner lies in the early experiences that help develop important qualities such as persistence, perseverance, curiosity, the capacity to tolerate frustration and the self-esteem to keep on trying even after making a mistake.

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 TODDLER SUDDENLY DEVELOPS SLEEP PROBLEMS

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN A TODDLER SUDDENLY DEVELOPS SLEEP PROBLEMS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. We have read “Touchoints” cover to cover. We keep our tattered and torn copy on the coffee table for easy access, but we are at a loss.

Up until a week ago, our 25-month-old daughter was the “perfect child” – our pediatrician often asks to adopt her if we tire of her! She has always has been able to self-soothe and go to sleep on her own. She is not having any problems at nap time (noon-2 p.m.) She eats fairly well, is active and well ahead of the curve in her language skills.

Last week, she started a pattern of not being able to/wanting to go to sleep in the evening (7:45-8 p.m.). We keep a very regular schedule and bedtime routine (bath, brush teeth, books in the rocking chair and then bed).

Now, we are having to actually get her into a sound sleep and when we finally get her to sleep, she experiences long spells of night waking – anywhere from one to four hours of screaming, crying, pleading with us to rock her, hold her, take her to our bed, stay in her room, rub her back, etc.

She’s not waking regularly at 10 p.m., 2 a.m. and 6 a.m., but rather wakes once and can not/will not go back to sleep. She repeatedly is crawling out of her crib. It is almost more than we can take to allow her to be in such a state.

A. At what time of night do these awakenings occur? Night terrors usually occur during the first few hours of sleep, while nightmares tend to occur in the last hours of sleep, in the early morning.

During night terrors, children are not really awake or conscious. They’ll suddenly sit bolt upright in bed and let out blood-curdling shrieks. Inconsolable, they often become more agitated when parents try to talk to them or comfort them. The best bet is to stay out of their way, if they are safe, and let them fall back to sleep on their own. They’ll have no memory for the event, since they never really were awake, even though it seems as if they are.

Nightmares, on the other hand, really are dreams, and children usually can remember them, and when they’re old enough to speak, talk about them.

Does your child really keep screaming for 4 hours even if you do hold her, stay with her, or bring her into your bed? It does sound as if she is conscious – not having night terrors – if she is pleading with you to stay with her and comfort her.

At 25 months, she is a little young to be having the kinds of nightmares that 3- and 4-year olds have when they begin to become aware of their own aggressive feelings and begin to scare themselves.

It sounds as if this has only been going on for about a week, but if it has persisted, we would suggest you consult with your pediatrician, who might refer you to a pediatric sleep expert.

Have there been any recent changes or stressors for your family? Her new resistance to going to bed, and her new demands for you to stay close during the night, raise the possibility that something has happened that has frightened her and makes her more hesitant to separate from you.

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.

THE CHALLENGES OF TOILET TRAINING

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
THE CHALLENGES OF TOILET TRAINING
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Our 2-year-9-month-old son was potty trained relatively easy during the day at 2 and 1/2 years old. However, he is still in a diaper at night. He wet his bed for several days in a row when we tried to put him in underwear at night, and now he awakes with a very wet diaper since we’ve switched him back into a diaper at night. How do we try to help him stay dry at night, or wake up to go to the bathroom at night?

A. He may not be ready – yet. Patience and time may be what he needs most for now. But the “very wet diaper” makes us wonder how much he is drinking in the evening before going to bed. As long as he is getting enough fluids during the day, you can cut back on fluids after supper. If he doesn’t mind, ask him to try urinating once at bedtime and then one extra time before going to bed. If he does mind, don’t bother – the struggle will do more harm than good. In my practice, I found that some children would stop wetting at night if their parents roused them at about 10 p.m. just enough to urinate before returning immediately back to bed.

The most important thing you can do right now, though, is to back off, avoid making a big deal of it (which includes holding off on any unwelcome “help”) and let him know that when he’s ready, he’ll manage just fine. (See our book, “Toilet Training: The Brazelton Way,” Da Capo Press, 2004, for more information.)

Q. My 5 and 1/2 year old daughter constantly forgets to wipe, wash, and flush. What advice do you have?

A. Is this a new problem, or is this something she’s never yet mastered? If this is a change in her behavior, we would wonder about what might have prompted it – for example, some physical condition such as a rash or infection that might make wiping painful, or some experience that has frightened her and led her to try to avoid this area as much as possible. In this case, we would encourage you to bring this up with your child’s pediatrician.

If this is the way it’s always been, and otherwise her development has been entirely typical, our guess would be that she will learn to master this – when she is ready and when this really begins to matter to her. In the meantime, if this is one small expression of her overall temperament – a little girl who is under a head of steam, often in a rush, only halfway through one activity and then she’s on to the next before – you’re likely to do better by accepting this and helping her to accept her own temperament. This will help her to know she can turn to you to understand herself and for help when she begins to be bothered by some of her own shortcomings and is ready to work on them. (If she has difficulty following through with a much wider range of tasks in a number of different settings, it might be worth looking into what might be distracting her. Your pediatrician could help.)

She’s already shown you that reminders won’t work. Do they feel like nagging to her? They’re bound to if she hasn’t asked for them. And she won’t until she is able to recognize and accept that she needs help, and that you can offer it to her without embarrassing her. Of course you don’t mean to. But she’ll be more comfortable with your help when she’s ready for it. You might try sitting down with her in a calm moment when this isn’t the immediate issue. Let her know that you know you’ve been bugging her with your reminders and that they haven’t helped. Ask her if she would like your help. If she says no, then let her know you’ll be ready to offer it when she’s ready to ask for it. Then, drop it. If she says yes, then ask her what kind of help would work better for her than your reminders.

Some parents may feel that this approach gives a child too much control – but in areas where no parent can control a child, the best a parent can do is to help a child discover her own motivation, and to harness that motivation for her to be in control of herself. Others might suggest a reward system – some little token for every flush. There’s probably not much harm in that, except that it could still easily become your issue, rather than hers – a setup for struggles that might just reinforce the problem.

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.

FAMILIES READY FOR CHANGE

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
FAMILIES READY FOR CHANGE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Things are so tough these days that most of us are ready to do our part to make our country strong again.

Everyone’s worried about the economy, health care, the environment, and safety in a dangerous world. With unemployment and the economic crisis in our homes and around the corner, we can’t hide adult fears and struggles from our children, but we can show them what we can do, what they can do to help.

THE ECONOMY: Our current problems are complicated, but we know that greed, selfishness, irresponsibility and wasteful self-indulgence have not helped.

Young children struggle with conflicting wishes to hoard all the goodies for themselves, and to share them with those they care about. We adults can model a different set of values and behaviors: being thankful for what we have and for being able to share it with those who have less; spending a little less now to save a little more; going along with what’s fair even if there’s no one to catch us if we don’t. Opportunities for learning these simple but important lessons occur every day and in family rituals:

Once a week, each family member can give something to someone who needs it more, by helping out an elderly neighbor, inviting a family going through unemployment over for dinner, volunteering in a shelter or soup kitchen, or putting a dime or quarter in a jar to save up for a cause the whole family cares about. (See donorschoose.org or habitat.org for ways your family can make a difference in your community, or around the country.)

Allowances: Even though money is tight, a regular allowance – no matter how small (a nickel a week gives the same message as a dollar) – can help children learn to make smart decisions about limited resources, and to save now and be glad they did later.

THE ENVIRONMENT: It’s bigger than all of us, and may seem too big to a child to be able to doing anything about. Yet there are small ways that each of us can help.

As a family, start saving up now for a tree to plant. Learn about the kind of trees that are best suited for your neighborhood, those that absorb the most excess carbon in the air while using the least amount of water. When it’s time, you can pick it out and plant it together.

Help your children remember that they can save water by turning off the faucet each time that they brush their teeth. (See charitywater.org for other ways you can help.)

HEALTH CARE: Our nation’s health care crisis is also too big for any of us to solve alone. But each of us can do our part by doing our best to stay healthy, the earlier the better. A healthy diet, plenty of exercise, simple safety precautions (like seat belts and bike helmets), and balancing out stress with family times to laugh and relax together can make a big difference.

Healthy nutrition can be simple:

  • Eat more vegetables.
  • Eat less processed food, fried food, fast food, and soft drinks.
  • Enjoy what you eat, and take the time to savor it slowly while enjoying being together as a family.
  • Keep the TV off at mealtimes.
  • No grazing between meals, no eating in cars or on your feet.

EXERCISE: Limit TV to an hour a day, and computer time to an hour a day (except for homework). Walk or bike whenever you can, or use public transportation. This can be your family’s contribution to saving our planet’s health too.

SAFETY PRECAUTIONS: See the safekids.org to help keep your children safe, and to protect yourselves, for their sake and yours.

Safety in a dangerous world is another challenge that may seem too big for children to tackle. But adults may have something to learn from them.

Recently, a preschool teacher asked each child at circle time what he or she had done for winter vacation, but skipped the child sitting closest to her. The children took this seriously, and reminded her not to leave anybody out. One child asked, “What about Remy? He’s sick today. We’ll have to ask him too.”

Very young children naturally work to include each other, to help children with special challenges find their roles, and belong.

Much violence comes from hatred passed across generations, and fear that scarce survival resources like food and water will not be fairly shared. What can parents and children do?

Look at a globe and pick out one country, one your children have never heard of. Go to the library or on the Internet to learn about its people. Is there some small way that you all can get to know them? Is there a school, hospital, or orphanage that you can get to know?

See if you can find a trustworthy organization that you can support to provide clean water, food, medical care, teachers. (You might want to check out Amigos de las Americas, Mil Milagros, Oxfam, Partners in Health, Peace is Loud, Save the Children, Unicef and others. We’re sure many of our readers are involved with terrific organizations that help other families here and abroad. We’d love to hear about them.)

Children can become pen pals, or send drawings when language is a barrier. They can help bring peace one friendship at a time.

All of these problems and solutions are interconnected. What each of us can do may seem small, but when we act together as a nation, we are powerful. We can model values that will endure through the bubbles and bursts. We can keep ourselves healthy and strong, saving health care resources for illness that can’t be prevented. We can protect our planet so that we can be sure to have enough energy, water, and food for all of us.

Times are tough, but we can teach our children to do their part for 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.

WHEN A PARENT IS CALLED TO WAR

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From the NEW YORK TIMES COLUMN: FAMILIES TODAY

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

Q. My soldier son has just deployed to Iraq for his second tour of duty. His wife and three sons, ages 9 to 2 1/2, live at Ft. Hood, Texas. I want to add something that has helped our family: Web cams and computer speakers. We gave them to our daughter-in-law and our son during his last tour of duty and we have sent him a new set for this deployment. As soon as our son has his set up and running, they will be able to see and talk to each other via the Internet.

This makes a tremendous difference for spouses and children caught up in this war. The 2 1/2 year-old cries more for his dad that the others because he doesn’t understand what has happened. He just knows that his dad flew away in a plane with other soldiers. We tell him that his dad will come back. He does understand that.

A. Thank you for your great ideas and for the help they will be for all families with loved ones deployed overseas. Certainly Web cams and the Internet can be a great help in keeping families in touch. Maybe you can even record some of these special moments so that the children can go over and over them.

I have recommended leaving several DVDs or videotapes of parents reading bedtime stories so that children can be lulled to sleep by parents who are too far away to tuck them in. Your youngest grandchild may find comfort in a piece of Daddy’s clothing as a “lovey” to cuddle and to fall back on when he’s upset or frightened. Even his smell may be comforting at such a time. He is certainly old enough to sense the distress his mother must feel — another reason for his tears.

Of course a worried family member can’t hide such feelings. Instead they can be explained simply in terms that very young children can understand: “Mommy misses Daddy. I know you do too.”

The older children can be suffering because they do understand too well the separation issues as well as the dangers. Although they may seem under control on the surface, they deserve special times with their mother to unload their feelings, their questions, and to share her sadness. They also certainly need to have a chance for their own concerns to be heard. They will be relieved to speak openly but may also feel proud that through this sharing they are helping her. For the most mature children, and for adults, the terror of losing a military family member is all the worse with the current uncertainty about what this war could possibly accomplish and how it will ever end.

Family meals become even more important now. The family can pray together for their father’s safety and quick return. Then, too, they can share their feelings as a family, “We all miss him terribly and need to see his face and hear his voice.” Meanwhile, each of the boys will learn most from the mother’s strengths and her ability to share those — and her moments of vulnerability — with them.

If we can give anything to children who must suffer in this dreadful war, it will be the sense of having made it through the trauma of separation and loss and of learning how to be resilient. We pray with you that your son returns safely, and wish that all of our brave men and women could.

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.

Supporting the Development of Self-Regulation in Children

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Maine Association for Infant Mental Health

Supporting the Development of Self-Regulation in Children
By C. Michael Sandberg, MA

Recently the world of early childhood education has once again been echoing with terms like self-regulation, executive functioning, and social skills. This is a welcome moment! Not that STEM (Science, Technology, Engineering, and Mathematics) and literacy are not important, but, rather, that it is once again being realized that success academically, socially, and personally is more dependent on these “soft skills” than it is on the content of the knowledge being taught and learned!

Flavell in 1977 called these skills “one of the really central and significant cognitive-developmental hallmarks of the early childhood period.” Their importance has been well demonstrated by several recent studies that followed children over time. In one, done in New Zealand, 1037 kids were followed birth to 32 years. They were looking specifically at what they call self control, certainly one of what might today be called the executive functions. They defined self control as being willing to delay gratification, able to control your impulses, and able to modulate your emotional expression. Even though some of the study’s participants improved their ability to control themselves over the period of the study, they did find that self control at older ages could be largely predicted by self control at 5. Children were first measured at 3-5 with a 90-minute scored observation. They were scored again in their preteen years. In adulthood they were evaluated for several social, health, and financial outcomes. Their heath score was a composite of their cardiovascular health, respiratory system health, dental health, sexual health, and their inflammation status. They found that self control at 5 was highly predictive of improved finances, better physical health, lessened levels of substance dependency and fewer interactions with the justice system. They also found it to be predictive of better decision making in the teen years. Higher self control children were less likely to become pregnant as teenagers or to leave school early. They also had significantly fewer interactions with the authorities. They were also able to do an analysis comparing the differences using social situation as a child and IQ with those found using self control and they found that self control was a much better predictor.1

These kinds of results have been found by several other long-term studies.2 Interestingly these findings echo the findings of studies of the impact of quality early childhood programming such as that done of the High Scope programming evaluated by the Perry Preschool Project. There, even though the initial finding of improved IQ washed out over time, the children still had improved outcomes in terms of social, academic, and financial success. It could easily be argued that what they had gained was improved executive function. 3 For me, these are important findings because the children failing and being expelled by our schools and preschools are mostly being excluded because of poor self-regulation skills. 4 At the same time most researchers and educators agree that most executive function skills can be taught.

While most evaluators use teacher reporting to assess self-regulation skills, (the most responsible researchers recognize that there may be bias included in these ratings and evaluate the ratings across different ethnicities and SES (Socioeconomic Status) to guard against as much as they can), there is interestingly one evaluation method in relatively common use. It evaluates cognitive flexibility in 3-5 year olds by using cards featuring different attributes. There are different shapes, such as bunnies and turtles, and among each shape there are also two different colors. Children are asked to sort the cards by shape and then to switch and redo the sort by color. What is being evaluated is their ability to let go of the old references and switch to the new one. Most 3 year olds struggle with this change, while most 5-6 year olds can easily shift. This method, known as the dimensional change card sort, can separate the age at which children are able to succeed and show that cognitive flexibility is used as an indicator of emerging self-regulatory skills. 5 For me, this is reminiscent of Piaget’s work with classification and it may demonstrate a link between cognitive and social skills!

For a while, people also thought the marshmallow experiment conducted at Stanford could become an assessment tool. The method tried to evaluate the ability to delay gratification by tempting children with a marshmallow, while promising them a second one if they could wait about 15 minutes before eating it. While the researchers reported good predictive power of later success, when people tried to replicate the experiment controlling for SES, they found SES had a higher impact than any maturity measure. The kids, who could wait, were those who had not experienced scarcity!

In order to decide what we need to be teaching and come up with teaching methods, we need a more specific definition of these executive or self-regulation skills. They include the ability to monitor and manage emotions, thoughts and behavior via impulse control, maintaining attention and focus, filtering distractions, emotional regulation, problem solving, and prosocial behavior. When we know what we are trying to promote we can both appreciate and protect it when it is happening and know more about how to create situations that will enhance the learning of those skills.

Interestingly, even fetuses have some self regulation skills. We know that because their activity level often varies dependent on the mother’s activity and mood. After birth, many newborns also illustrate their ability by turning away to take a break after an intense social interaction. They know how to shut down in the face of too much stimulation! So we are not starting with a blank slate. Reading last month’s piece on perinatal psychology might give you some ideas on how to support higher skill levels even before a baby is born!

Once they are born, what can we be doing! We can help children learn that their emotions can be regulated. We do that by allowing them to become upset, and then intervening when they are no longer able to regulate and coregulating them through our calmness and nurturance. We do it by honoring when a child needs a break and waiting for them to come back online before proceeding. We do it by recognizing when they are losing focus or becoming too frustrated to continue and then supporting their efforts and directing their attention back to what they were working with. We do it by scaffolding their explorations (Tools of the Mind, a Vygotsky based curriculum has been shown to be very effective at building self-regulation skills for those children who are starting further behind. It was less effective for those who already had higher skill levels6).

The first key to all of this is that if we expect children to learn self regulation skills, we as the adults must model those skills and remain centered and calm. It is only when we are calm that we can use our support to calm children. How can we give teachers and caregivers the supports that allow them to be present and listening most of the time? When teachers become stressed by their jobs, they may react with frustration and anger to misbehavior in the room, leaving the children who are acting out feeling alone, without an ally. As allies we are engaged in trying to assist children in meeting their goals for themselves, while doing so in socially acceptable ways. When you see yourself getting that kind of support it is easier to let go of the emotionality of the moment and to begin to use and improve the functioning of your thinking brain. Mark Rains, a board member of the Maine Association for Infant Mental Health and a psychologist, suggests that when children lose it (Flip their lids to use Dan Siegel’s expression), they need us to help them feel safe, connected to others, help them learn language to talk about feelings, gradually support their ability to see the patterns in behavior, before we can expect them to be ready to plan better actions.7

In general, we have to ask, how can I support the child’s autonomy and self-regulation rather than working to control them. As one example, if we have a child who is struggling with entering groups and tends to charge in and destroy things, what method can we come up with that might help them learn the skills needed. Could we ask them to try something new and then sit down with them to play alongside the group they want to join, without ever asking to join (the child who has poor executive functioning will often be told no if she or he asks to join a group)? Soon the child will be playing with the other children, and depending on their play skills you may have to remain and continue to support their involvement, or you may be able to leave. Later we could talk about what had worked and give them another tool (By the way, this may have to be repeated multiple times before it begins to take).

How can I help them learn to evaluate risk and make decisions? Instead of saying, “No that isn’t safe!” could we ask about where they would be landing the jump and do they want to land on that? That can be followed with, “well how could we make it safer.”

Executive functioning can be built better, and if it is, children are likely to be better citizens and parents when their time comes. Join me in trying to learn more about how to do this every day.

References:

  1. Moffitt, T. E., Arseneault, L., Belsky, D., Dickson, N., Hancox, R. J., Harrington, H., Houts, R., Poulton, R., Roberts, B. W., Ross, S., Sears, M. R., Thomson, W. M., & Caspi, A. (2011). A gradient of childhood self-control predicts health, wealth, and public safety. Proceedings of the National Academy of Sciences of the United States of America, 108(7), 2693–2698. https://doi.org/10.1073/pnas.1010076108
  2. Jones, D. E., Greenberg, M., & Crowley, M. (2015). Early Social-Emotional Functioning and Public Health: The Relationship Between Kindergarten Social Competence and Future Wellness. American journal of public health, 105(11), 2283–2290. https://doi.org/10.2105/AJPH.2015.302630
  3. Heckman, J., Pinto, R., & Savelyev, P. (2013). Understanding the Mechanisms Through Which an Influential Early Childhood Program Boosted Adult Outcomes. The American economic review, 103(6), 2052–2086. https://doi.org/10.1257/aer.103.6.2052
  4. Gilliam, W. S. & Shahar, G. (2006). Preschool and child care expulsion and suspension; Rates and predictors in one state. Infants and Young Children, vol. 19, No. 3 p. 228.
  5. Zelazo P. D. (2006). The Dimensional Change Card Sort (DCCS): a method of assessing executive function in children. Nature protocols, 1(1), 297–301. https://doi.org/10.1038/nprot.2006.46
  6. Blair C. (2016). Executive function and early childhood education. Current opinion in behavioral sciences, 10, 102–107. https://doi.org/10.1016/j.cobeha.2016.05.009
  7. Rains, Mark. “‘Getting It Together’ Healthy Start Community Forum.” YouTube, YouTube, 21 Oct. 2009, http://www.youtube.com/watch?v=evikiqovSVw.

 

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.