children

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.

STORM FEARS; AND TREATING A CHILD LIKE A BABY

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From the NEW YORK TIMES COLUMN: FAMILIES TODAY

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

The aftermath of Hurricane Katrina continues to inspire readers to share their experiences about children’s fear of storms. We can’t resist sharing one more letter:

Q. When my boy was about 4 years old, I recall there was a sudden thunderstorm, so I picked him up and went to our enclosed front porch. I told him that the clouds were rolling around in the sky and when they bumped into each other they made a lot of noise, which is the thunder. When the clouds collided really hard, they made sparks, which we call lightning.

When my boy was 12, we left for vacation before sunrise. He was riding in the front seat with his dad, and I was in the back. In the distance, lightning appeared. The boy and his father were pointing out the sharp, jagged lightning strikes. At one particularly spectacular strike, my son said, “Mom, did you see that one?” I replied, “No, my eyes are closed.” “Are you afraid of lightning?” he asked. “Yes,” I replied. After a moment he said, “Thanks for not making me afraid.”

A. As a parent, who could ask for a more rewarding outcome? Our children mostly tell us about our mistakes. Rarely do we receive their approval. What a nice kid, and how appreciative of you! Your success shows how important rituals and stories — even if untrue — can be.

Although even as a young child he may have seen through your fanciful explanation, the fact that you shared your story with him let him know that you were not afraid. You showed him that you understood his fear, and took him seriously enough to reassure him that you were there to protect him.

Frightening events are more disturbing when they are out of our control, and beyond our understanding. Any explanation for events like these, no matter how far-fetched, seems better than the unknown. All 4-year-olds are prone to fears – being alone at night, loud sounds, dogs who may bite. But giving your child an explanation for his fear rather than pooh-poohing it must have been very comforting. What an example of great communication with a child at a vulnerable time! No wonder he has never forgotten it.

Q. I share custody of my 5-year-old daughter with her father. When he is at work, his mother watches her. My daughter is potty-trained and doesn’t wet the bed at my house. But her grandmother still gives my daughter a spill proof cup and puts diapers on her. I feel she is stunting my child’s progress toward independence.

On the first day of school her grandmother even wanted to follow the school bus. When I protested, she called me out in front of my daughter. And the father won’t listen to me. He just follows his mother’s orders.

Am I wrong to be annoyed? What can I do to fix this situation?
Frazzled and annoyed

A. Of course you are annoyed. You know your child has grown beyond spill proof cups and diapers. And you know that no child likes to be treated as a baby. From what you say it sounds as if the infantilizing you describe hasn’t led the child to regress. But the tension in the adult relationships in this situation could make it harder for her to stand her ground. Can you manage to control your feelings and present a calm, neutral approach to her grandmother’s behavior?

If she doesn’t feel caught between her loyalties to each of the adults, or pressured to protect one from the other, you daughter is more likely to be freed up to make her own decisions about it.

I can almost promise you then that she will resist her grandmother’s babying of her. If you and her father are not stirred up to get into the act, she will put up her own resistance. This will work better with her grandmother than just about anything else you can do.

If the child begins to show persistent, delayed problem behavior you may have to enlist a court advocate (for example, a court appointed guardian ad litem for the child) to try to intervene with the grandmother, but it would certainly be better if your daughter could handle it herself.

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.