Category: Development

Myth Busting- Babies and Depression

Baby sad.

Today is  National Children’s Mental Health Awareness Day, so I thought it might be appropriate to do some myth-busting around babies and mental health issues:

Myth: Infants and Toddlers aren’t at risk for developing mental health problems such as depression.

Fact: In February of this year,  the American Psychological Association published research indicating that infants and toddlers can suffer serious mental health disorders, such as depression, yet they are unlikely to receive treatment that could prevent lasting problems.

Myth: Young children are naturally resilient, and usually grow out of behavioral problems and emotional difficulties.

Fact: According to Joy D. Osofsky, Ph.D., of Louisiana State University, and Alicia F. Lieberman, Ph.D., of the University of California, San Francisco, “Mental health risks to infants are magnified by the fact that “the youngest children, from birth to age 5, suffer disproportionately high rates of maltreatment with long-term consequences for mental and physical health, but pediatric health and child care providers seldom identify or refer children under 5 years old to mental health services.”

Myth: Infants cannot have mental health problems “because they lack a mental life.”

Fact: Even young infants can react to the meaning of others’ intentions and emotions because they have their own rudimentary intentions and motivating emotions, according to an article by Ed Tronick, Ph.D., of the University of Massachusetts, Boston,  and Marjorie Beeghly, Ph.D., of Wayne State University.

Myth: Trauma is the main cause of mental illness in babies and toddlers.

Fact: The everyday life and ongoing interactions between infants and parents or other caregivers, has a huge impact on the development of mental health issues in babies because,  “Infants make meaning about themselves and their relation to the world of people and things, and when that “meaning-making” goes wrong, it can lead to the development of mental health problems. Some infants may come to make meaning of themselves as helpless and hopeless and may become apathetic, depressed, and withdrawn. Others seem to feel threatened by the world and may become hyper-vigilant and anxious. Apparent sadness, anger, withdrawal, and disengagement can occur “when infants have difficulty gaining meaning in the context of relationships.” (Tronick and Beeghly)

 

In recent years, there has been a huge focus on understanding and optimizing the development of children, but often the emphasis is on developing their cognitive (thinking or reasoning) skills. While strong cognitive abilities are necessary for academic success, there is a growing awareness of how crucial it is for young children to develop social–emotional competence in order for them to thrive in school and in life.

Awareness and education are the keys to making a positive difference in the lives of all young children. It is imperative that both parents and caregivers be aware of the need, and learn strategies for fostering the nurturing adult–child relationships that lead to social competence, mental health, and resilience in young children.

Magda Gerber’s approach to child care nurtures the development of resilient, emotionally healthy babies, and their ability to develop social competence through mutual respect, trust, and acceptance. It is “like preventative medicine, and it’s therapeutic for both parent and child.”

This year, the 22 Annual RIE Infant/Toddler Conference to be held on Saturday, May 14, 2011, in Los Angeles, will feature a keynote address by Alicia F. Lieberman Ph.D., entitled “Helping Young Children Cope with Stress and Trauma.”

Please see Amy Webb’s post at The Thoughtful Parent for further information and reading about National Children’s Mental Health Awareness Day.

The best gift

On Crying and Fussiness

Fussy babies are either annoying or “poor little thing” depending on if they are related to you.

My friend Kaylia (proud Auntie) made this astute observation and posted it on Facebook the other day, which resulted in a number of interesting and (some) humorous comments.

It’s common and understandable that loving and caring adults (both parents and others) often react to a baby’s cries and/or fussiness in one of the above ways, depending on the circumstances. Underneath the expression of “poor little thing”, or the expression of irritation and perplexity, as the case may be, often exists the desire to soothe or “help” the baby in some way, in order to stop the crying, and make the baby feel better. But I don’t think it’s always possible or desirable to try to soothe or distract a crying or fussy baby.

My response to Kaylia’s observation:

Can’t help it. Let me offer another point of view regarding a fussy baby! When a baby is fussy or crying, I don’t think, “Annoying” OR “Poor little thing.” Instead, I wonder about what the baby might be trying to express, and I try to “listen” very closely to understand what she might be trying to say, in order to be able to respond to her in a helpful way. Sometimes there is nothing we can do to ease the fussing, and it’s just a matter of being present with a baby, and letting them know we hear them.

Little babies have feelings, and things to say, and can also have bad days,  just like us. We wouldn’t like to be responded to in a condescending or patronizing way if we were having a hard time, so why respond to a baby as if they are either completely helpless, and in need of rescuing or pity, or on the other hand, as if they are a bother because we are frustrated by not being able to understand their way of communicating, and are unable to make them stop fussing?

Maybe the best any of us can do for babies (or for each other) is to be willing to listen,  try to understand, and offer help IF we can. I wonder if parents and caregivers would feel less frustration as well, if they let go of the idea that it was somehow up to them to solve the problem for the baby, or make the baby happy?

Just some food for thought.Smile

“Maybe She Was Just Practicing”

We were all at the dinner table the other night, when the conversation turned to the subject of “truth telling.” S. who is now 5 years old, has been known to experiment with stretching the truth a bit at times in recent months, which prompted her Dad to tell her the story of “The Little Shepherd Girl Who Cried Wolf.” Now, her Dad asked her if she remembered the story, and if she could tell us what happened. S. said “Well, the little shepherd girl kept calling “Wolf” when there wasn’t really a wolf, and then when there really was a wolf, and she called for help, no-one believed her, and no-one came to help, and that was big trouble for the sheep.” S. was quiet for a moment, and her Dad asked what she thought the story meant. Without missing a beat, S. replied, “Well, I think maybe the shepherd girl was just practicing.” I love this child, and the way she thinks!

What A Toddler Knows: There Are No Mistakes

Last week as I listened to my business coaching call, I found myself rushing to scribble down some words of wisdom that particularly spoke to me. Ryan was talking about the fact that all highly successful business people and leaders have some traits in common: namely that they are unafraid to take bold action, and they see taking imperfect action as better than taking no action at all.

Successful people don’t view mistakes as failure, but rather as information and learning opportunities.There is an element of playfulness to their approach, and a willingness to keep moving forward in the face of obstacles.

For some reason, this made me think of J., probably because at 21 months of age, he is the embodiment of these principles in action. Have you ever noticed that toddlers seem to approach most everything in life with gusto? They just live full out, and go for what they want. They don’t let inexperience or lack of knowing how stop them. They may encounter obstacles along the way, and they may literally run into walls and experience frustration, but most of the time they don’t give up. The difference between a lot of adults and most toddlers is that adults have often forgotten what they used to know as young children- which is that mistakes don’t equal failure.

Let me paint you a word picture that illustrates: J. literally spent hours last week trying to conquer climbing up onto the coach by himself, which is no small feat for someone who is barely taller than the 18 inches he had to scale to make it up on his own.

Now, what was interesting to me was that this was a self chosen challenge, and one he could have achieved easily by moving his small plastic step stool close to the couch and using it as a tool to boost him up, which he knows how to do, and had done many times before.Nope, that would be far too easy. He wanted a new challenge.

So I stood patiently by, and refrained from giving direction, suggestions, or a hand up, while he struggled valiantly to figure out how to conquer the climb up to the coach. He tried several techniques that just didn’t work. There was a lot of grunting, and sometimes he stopped and turned to me to complain. I acknowledged that he seemed to be working hard, and that it wasn’t easy. This seemed to be all he needed to carry on.

Eventually, he achieved his goal. I wish you could have seen the look of joy in his eyes when he turned to me with a big grin, as if to say, “Look, I did it.” Was he content to have achieved his goal? Yes, but he wasn’t content to rest on his laurels. No sooner had I returned his smile than he went scrabbling down to try again, and again, and again, and again, and…. until he had perfected his technique. I could only marvel at his determination and perseverance.

This is why I love being in the company of toddlers. My wish for J. is that he will always be so self motivated and persistent and take such pleasure in his learning. And my wish for myself and any adult that may have forgotten that mistakes are just opportunities to try again, is that we always have a toddler around to remind us of this truth!

NO Tummy Time Necessary

Allowing babies to move freely, according to their own inner schedules and dictates,  is a hallmark of Magda Gerber’s RIE philosophy. When babies are allowed to develop naturally, in their own time and their own way, they learn to move with ease and grace. They tend to have excellent body awareness and posture, and a good sense of where their bodies are in space.

Allowing a baby’s gross motor development to unfold naturally means avoiding placing babies into positions they can’t get into or out of on their own. Ideally, young babies are set on their backs not just for sleep, but for playtime as well, because this is the position that most supports their bodies, and in which they are most relaxed and free to move. What this means is no tummy time for babies until they spontaneously begin to roll first to their sides, and then unto their tummies. It means not pulling or propping a baby with pillows into a sitting position until he can move into this position on his own. It means avoiding all baby “containers” like bouncy seats, exersaucers, and baby swings, and using car seats judiciously. It means not lifting a toddler onto a piece of play equipment, like a slide, that she can’t yet scale herself.

There are many advantages for babies who are allowed to develop their ability to move on their own without adult assistance or interference. For instance, they are safer and less likely to fall from playground equipment and injure themselves, because they develop good judgment. As Magda Gerber said, “If they can climb up by themselves, we can trust that they can climb down safely.” (For an excellent description of how children learn to sense where their bodies are in space, see: Learning to “Sense” Space: Why Kids May Fall Out of Bed,  at Moving Smart.)

It turns out nature has a plan, and it’s a good one. All children develop gross motor skills in the same sequence, and all that varies is the timing. If children are given the opportunity to practice moving freely, they will be in tune with and strengthen their ability to listen to their innate body wisdom. At every stage, in every way, they will be doing exactly what they need to do to prepare themselves to achieve the next milestone. Their gross motor abilities will unfold before our eyes- no adult help or intervention is necessary. They will not attempt to use equipment or take risks they are not yet ready for.

When we place babies in positions that they are not yet able to achieve on their own, we may put them at risk of injury, of developing poor coordination and posture, and equally importantly, we risk cutting off their inner agenda, and their self-initiated exploration. There are recent studies that show that babies placed in baby walkers and exersaucers, actually develop their ability to walk at a later date than babies who have not been exposed to such devices.

Magda suggested that babies know best how to be babies, and there are just some things we should not rush. The message babies might get when we “help” them, by pulling them to sitting before they can do it on their own for instance, might be this one: “I don’t value and appreciate what you can do, but I expect you to do what you can not yet do.” Is this the message we want our babies to get? What implications do you think this has for a baby’s developing sense of self, his ability to learn, or her ability to trust herself?

Another thing to consider is that when we put babies into positions that they can’t yet achieve on their own, we make them dependent on us, because they have limited mobility, and are stuck until we come to rescue them.

Most young babies are very uncomfortable, and loudly protest when they are placed on their tummies to “play”. They can’t yet lift their heads or hold them up for very long, so they can’t see much. The ways in which they can move their arms and legs are limited. All they can do is learn to endure the discomfort they feel, or cry, and hope someone will come to move them into a more comfortable position.

I learned from infant specialist Magda Gerber, who learned from her friend and mentor, Hungarian pediatrician Emmi Pikler, who learned from carefully observing and documenting the development of hundreds of babies over many years.

And if seeing is believing, all you need to do is watch this short video montage of baby Liv, which follows her development throughout her first year. This four-minute video, produced by Irene Gutteridge, as part of a project called The Next 25 Years speaks volumes about how babies learn to move easefully and gracefully, from back to side, to tummy, and back again. Just look at Liv’s face when she achieves her goal of turning onto her tummy. Priceless!

Listening

The following are quotes from Joyce Maynard’s novel Labor Day about what babies know, and what they need, and how we might listen to, and be with them. I found these passages to be inspiring and wise, and wanted to share them here:

One thing he would tell me, though, he said, had to do with babies.Not that he was any kind of expert, but for a brief while, long ago, he had cared for his son, and that experienece more than any other had taught him the importance of following your instincts. Tuning in to the situation with all your five senses, and your body, not your brain.A baby cries in the night, and you go to pick him up. Maybe he’s screaming so hard his face is the color of a radish, or he’s gasping for breath, he’s got himself so worked up. What are you going to do, take a book off the shelf , and read what some expert has to say?

You lay your hand against his skin and just rub his back.Blow into his ear. Press the baby up against your own skin and walk outside with him, where the night wind will surround him, and moonlight fall on his face. Whistle, maybe.Dance. Hum. Pray.

Sometimes a cool breeze might be just what the doctor ordered. Sometimes a warm hand on the belly.Sometimes doing absolutely nothing is the best. You have to pay attention. Slow things way down. Tune out the rest of the world that doesn’t really matter. Feel what the moment calls for.

What I have found is that a baby-though she doesn’t know words yet, or information, or the rules of life- is the most reliable judge of feelings. All a baby has with which to take in the world are her five senses.

…And it has been my experience when you do this-slow down, pay attention, follow the simple instincts of love- a person is likely to respond favorably. It is generally true of babies, and most other people too, perhaps.Also dogs. Hamsters even.And people so damaged by life in the world that there might seem no hope for them, only there may be.

Learning

I read and read, and every once in a while, I come across something that resonates deeply and I feel is worth passing on. The following is a quote about learning written by Dawna Markova:

Learning is so much more than a transfer of information. It can mean wholeness, empowerment, actualization, liberation. Observe any young child anyplace in the world and you will find a seeker of excellence built into their DNA. They embody this inherent impulse in their rampant curiosity about themselves and their world, the way they naturally follow their interests and rhythms, seek out and risk experimentation, honor their dreams and daydreams, consider mistakes as information rather than something wrong. Children have taught me that learning is discovering something is possible.

The question for me as a caregiver and an advocate for children becomes “How do I allow, support, and protect the child’s natural ability to engage in her own learning in this deep way, and how do I support parents in being able to see the miracle of what their child is capable of from birth ? ”

I’ll tell you I earned a Master’s degree in Education, and worked with children for many years before being introduced to Magda Gerber and her RIE philosophy, which finally provided me a meaningful way to begin to answer this question. Magda’s philosophy is both simple and profound, and beautiful in that it allows parents and other adults who care for children a way to honor and nurture a child’s essence from the very beginning. I remain in awe and gratitude to this wise woman for her work with children and families, her teachings and insights, and her way of teaching…

Tummy Time- Report From the Trenches

Click on the link below for an excellent blog post and discussion of tummy time (or in this case no tummy time) by a Mom who is raising her babies utilizing Maria Montessori (and Magda Gerber’s) philosophies.

I love this blog because it is well written, thoughtful, and honest! Interesting side note here: Maria Montessori wrote very little about the care and teaching of infants and toddlers- her interests, her work and the methods she developed were primarily focused on children age three and older. But Montessori and Gerber shared many similar beliefs and ways of seeing and thinking about children and their development and needs. In recent years, Magda Gerber’s ideas and work have highly influenced modern Montessori practice with regard to infants and toddlers.

Now go read some more! Be sure to read the comments following the blog post- the discussion adds to the post…

http://mommybahn.blogspot.com/2006/04/motomontessori.html

Meeting In The Middle

I attended the 20th annual RIE Conference held at San Francisco State University this past weekend, and I had the honor of presenting a workshop on Toddlers to a wonderfully responsive group of parents and caregivers.

I talked a lot about the importance of observing, and listening to the children we are caring for, as well as the absolute necessity of meeting the child or children where they are – as opposed to pushing our adult expectations and agendas upon them before they are ready.

All learning is a process, it can’t be rushed, and it starts with the child, and the child’s readiness to participate with us in moving to the next level of mastery or maturation.

Toddlers are working on mastering many new skills in all areas, and we as adults are often anxious to help them along. But we can save the little ones in our care a lot of misery and frustration, not to mention ourselves, if we are willing to slow down, and cooperate with the child in their own process.

Sometimes, all the best advice from all the best experts in the world will be of little use if we forget to include the unique child in the equation, which is why I constantly encourage parents and teachers to go back and really take a look at the child and what’s happening for that child in the context of the question the adult is raising.

The workshop participants contributed many excellent and pointed questions around this topic, which started me thinking that it might be helpful if I shared an example from my own experience, to illustrate these principles more clearly.

To that end, here’s a story about how S. learned to sleep.

I started working with S. and her family when S. was 11 months old. Her parents had developed a good bed time routine, and S. went to sleep in her crib in her own room, and slept through most nights to wake happy and refreshed in the morning.

Naps were another story. It was clear S. needed to nap, as evidenced by her behavior, but no rhythm or routine had evolved around naps, and each day a struggle ensued with S.’s parents and caregivers resorting to ever desperate measures to help S. get to sleep. Walking, singing, carrying, rocking, stroller rides, milk, stories, car rides, and on and on. If S. went to sleep, after an adult had spent at least an hour assisting her, she’d often wake 20-30 minutes later, more tired and cranky than before her rest.

So the adults had a question and an agenda, which was how to help S. to get the rest she needed, without being dependent upon them.

I began as always, by observing S.,-looking at her environment, and her daily rhythms and routines. This is vital, because environment, and routines all work together- it’s impossible to try to solve a problem in one area without looking at what may be underlying and contributing to the disruption.

Moving slowly, we began to make some small changes to S.’s daily routines, and to note if the changes were having a positive or negative impact. A journal was a useful tool for both her parents and me at this stage.

Through observation, we learned that it was important for S. to be outside and active, early in the morning. I helped her parents begin to notice and observe S.’s particular signs of tiredness- what Magda Gerber called the “soft signs of tiredness.” We also began to create some simple rituals around day time resting- a diaper change, a story, a song we always sang, but we stopped strolling, carrying, rocking, driving etc. We included S. in the process by talking to her about what was happening. “I see that you are rubbing your eyes. You are starting to feel tired. Soon it will be time to rest. Your crib is a safe cozy, place to rest.”

This process took about two weeks. S. protested somewhat- as was to be expected. Why? Because she had been used to falling asleep for naps in one way, and now we were changing all the rules. We were asking something new and different from her. She had not learned to be able to recognize her own signs of tiredness, allow her body to relax, and to fall asleep in her crib unassisted.

She needed a lot of support, and we as her adults had to be willing to listen to her crying, and be available to reassure her. “Yes this is hard for you, but you can do it. We will help you.” “You will feel so much better, when you are able to get the rest you need.”

Over the course of a month we got it down- together! And all was well – for awhile.

At about 15 months, S. moved from taking two one hour naps a day to taking one longer nap, in the mid afternoon. Except that the transition didn’t happen easily, and suddenly she absolutely refused to go to sleep in her crib for her naps.

We went back to observing closely, keeping a journal, making small adjustments to our daily routine. I consulted Dr. Weissbluth’s book- Healthy Sleep Habits Happy Child. I consulted with my teachers and mentors. We remained consistent and hopeful. Nothing was working.

S. was exhausted and miserable. I was exhausted and miserable, and out of ideas! One day, after she’d spent half an hour sobbing in her crib, calling my name, and I’d done my level best to soothe and reassure her, I just gave up!

I took S. out of her crib, and sat her next to me on the couch, and said to her, “I don’t know what to do. I don’t know how to help. You need to rest, and I need to rest, but nothing is working. I am going to sit here on the couch with you, and maybe we can rest together.”

At which point S. put her head down in my lap, went to sleep, and slept for two hours. I kid you not!

To this day, S., who is now almost four years old, naps for one to two hours every day. She goes to sleep easily, and wakes up well rested and happy, and I don’t have to lay down with her, or even be in the same room with her. She still doesn’t sleep in her bed for her naps, however. She sleeps on the futon in the office area. Go figure!

We may never know why S. can’t/won’t take a nap in her crib/bed, but the important thing is that she now gets the rest she needs. First, we had to learn to co-operate with S. as much as we were asking her to co-operate with us.

Every child is unique. Every situation is different, and no adult – not even an “expert” can hope to impose a “formula” that will work for every child. The best we can do is to be willing to really look at the child, listen to the child, ask, and allow the child to participate with us in the lofty goals that we sometimes hold for them. In their own time, in their own way- “on their own, with our help,” as Magda Gerber often said, we will get where we want to be – together!