Nurturing Children in Early Childhood

Family as unit for Developing Person

Families teach values & appropriate behavior, foster self concept/self esteem

Each critical period in a child’s life reactivates a critical period in the parent

Culture, family structure/style strongly influence how children develop

Boundaries between parent/child & caretaker/child important

Variables ~ adult/child interactions

responses to learning styles and opportunities

spontaneity of child

ordinal position and sex of child

how parents were parented

type of family

single parent, traditional, blended, same sex parent

‘good’ families...

Provide for physical, emotional, social and spiritual needs

Listen and communicate effectively

Provide trust, support, security, affirmation, encouragement

Demonstrate mutual respect for family and others

Able to grow with as well as through children

Perform roles flexibly and share responsibility

Murray & Zentner (7th ed) , p. 201

Factors ~ G&D...

biology, genetics, environment, biochemical & neurophysiological factors, sex differences

predictable, sequential patterns but variable timing

behavioral

S-R bonding, readiness, conditioning, behavior mod

ego adaptive/defense mechanisms

psychoanalytic focus, developmental ‘tasks’

cognition & morality

staged levels not always related to chronology

crisis

developmental vs accidental

expected vs unexpected

a state where existing coping mechanisms do not work

human do not tolerate crisis, so must develop new coping mechanisms

Selye, Gerald Caplan, Holmes & Rahe Betty Neuman

"Childbearing,"

Childbearing, childrearing, marriage, aging, retirement, loss of spouse/partner, grandparenthood - all examples of developmental crises

how people cope depends on various factors

perception of event, physical and emotional status, level of maturity, previous experience with similar situations, culture, realistic aspects of current crisis, availability and response of support systems : family, friends, community

Getting started on a positive pathway : everybody needs a buddy...

Important components for positive outcomes

prenatal care

childbirth education

‘normal’ birth experience

strong relationship with pediatric provider

support systems

Prenatal care...

EVIDENCE BASED!!!!

Huge number of ‘old wives tales’ and biased assumptions even among those who are not ‘old wives’

Childbirth education

Eclectic

present range of possible/acceptable behaviors

support of process of pregnancy & childbirth

management of uncontrollable interventions

include information about becoming parents and nurturing infants

‘normal birth’

as ‘non-interventive’ as possible

pregnancy, labor and delivery are not an illness

tailor to individual preferences

Relationship with pediatric provider

establish prenatally if possible

need level of comfort that allows free access

strong sense of trust

willingness to seek and adhere to anticipatory guidance, especially in first year

support

Everybody needs it, especially first time parents…

Variables that affect nurturant behaviors

In parent

stress/emotional state, method of delivery, resolution of birth that was, degree of maturity, finances

In child

anoxia/LBW, nutrition, environment, vulnerability, ability of caretaker to understand ‘normal’ bizarre behaviors

In both

culture, separation

Nurturing needs in Infancy

Nurturing/parenting is learned behavior

ALL new parents need to be nurtured to be able to nurture

I need….

a consistent caretaker - ? Mom ? Dad ?Nannie

touch, cuddling, comforting, ‘unconditional love’

bonding (not intuitive, develops over time)

to be fed - breast is best but I can tolerate bottles…

to have my growth and development progress understood, especially in my first year

risks, problems

consistent difficulty providing basics

no signs of attachment

doesn’t call by name, no joy in caring for child

not concerned for or aware of safety issues

disgusted by infant’s bodily functions

not responsive to infant’s non-verbal communication

doesn’t hold baby

Nursing interventions

talk to parents and baby by name

ask about well-being of parent before asking about child

positively reinforce good/safe parenting behaviors

comment on how baby ‘knows’ parents

provide anticipatory guidance

After infancy - months 2-6 +/-

neuromuscular development

cephalocaudal, midline to periphery; myelinization; ‘top half’ of body

teething

solid foods

immunizations

increased social interests

safety issues

6 months - 12 +/- months

neuromuscular development continues…

mylinization continues to lower part of body - sitting, creeping, crawling, standing, cruising, walking

eye-hand coordination becomes more precise

development of 3 dimensional vision

watch out for anything on the floor….

increasing vocalization

language acquisition

may exhibit ‘stranger anxiety’

prefers primary caretakers

Stimulating development

Gradual replacement of reflexive behavior with voluntary

providing an environment which allows infant opportunity to ‘learn’ new skills

capitalize on behaviors that evolve together

encourage vocalization

appropriate toys

danger signs in caretaker/parent

ignores baby

can’t talk about feelings or concerns

little effort to learn how to care for baby

reluctant to hold/comfort/talk to baby

refers to baby as ‘it’ or does not give name

no support system

refuses or won’t accept help

misinterprets or exaggerates information about baby

Raising SuperChild

belief that ‘better than anyone else’ is best

earlier is better

time should be programmed and organized from the very beginning - idleness is bad

more is better

NOT!!!

Competitiveness, materialism and brutality lead to burnt out adolescents...

The Abercrombies

The Abercrombies…?

Toddlerhood

Are you ready???

Toddlers...

somewhere after infancy and before preschool

first experience with autonomy, ‘me’

attachment and separation

slowing of rapid neuromuscular growth; increase in refinement and further development

language - begins ‘meaningful social control,’ expresses wishes

intense interest in world around him/herself

but absolutely no judgment...

Risks

parents/caretaker will not understand normal behavior

increased physicality, temper tantrums, decreased appetite, definitive likes and dislikes, dawdling, ritualistic, ‘me do it’

safety needs - very prone to accidents

not only falls/auto accidents but also poisoning

‘forced’ cognitive development

can create an environment where children can learn but can’t ‘make’ them learn

Needs

opportunity for safe exploration of environment

doesn’t understand cause and effect - yet - ‘does’ to learn

free play options

will play ‘next to’ but not necessarily ‘with’ other kids

play is the work of little children

regular routine

provides a sense of structure, appeals to ritualism

‘loving firmness’

somebody better be in charge here or it’s too scary

Slide 32

anticipatory guidance

look and listen : tune into child’s cues

have realistic expectations for behavior

provide a safe environment where the child can explore, talk, learn, play

handle temper tantrums with compassion

food doesn’t have to be an issue - s/he won’t starve

punishment vs. discipline

this too will pass...

Special issues for toddlers

toilet training

can’t do physically until can walk well

act of ‘supreme love’

sexuality

exploration does not mean perversion

identifying differences does not mean understanding

body image

an important part of self esteem

easy to foster ‘shame and doubt’

Danger signs

passive, apathetic

overly aggressive and/or impulsive

sneaky

hoarding

super messy or super neat

calls self ‘bad

Preschoolers...

Preschoolers are

‘more’ than toddlers

coordinated, verbal, participatory

roughly 3-5 years old

‘preddlers’

look like ‘little adults’ but aren’t

proportion changes, about 1/2 adult height

can’t distinguish fact from fantasy accurately

Needs

‘healthful’ daily routine

opportunity to continue to master and develop neuromuscular skills

be a participating member of a family

communicate effectively

initiative tempered with conscience

begin to understand ethical, spiritual and philosophical concepts and ideas

Risks

siblings

regression

change in family structure

divorce, moves

abuse

physical and especially sexual

negative self image

emerging conscience extremely ‘strict’ - self blame

illness

increased group contacts

Slide 40

Special issues for preschoolers

language

very verbal but ‘logic’ isn’t really : don’t laugh

sexuality

intensely interested in; more than ‘haves’ and ‘have nots’ - answer what’s asked

differing sources of authority

home vs. day care/nursery school

play

acts out how s/he feels

Danger signs

excessive regression

changes in eating and elimination patterns

excessive fears

temper tantrums, irritability

lack of interest in play, peers

inability to separate from primary caretaker

‘defeated,’ guilty about self

Anticipatory guidance

Listen!

realistic expectations of behavior

recognize the importance of play and what it reveals about how child thinks

encourage initiative - praise for successful attempts

emerging sexuality is positive

teach safe behaviors

The Donovans

The Donovans…?

Take home message

ALL children need to be loved and nurtured

successful nurturing comes from having experienced it personally

successful nurturing comes from understanding specific developmental characteristics, especially in early childhood

simple interventions make a big difference in a crisis situation

Slide 48


	Families teach values & appropriate behavior, foster self concept/self esteem
	Each critical period in a child’s life reactivates a critical period in the parent
	Culture, family structure/style strongly influence how children develop
	Boundaries between parent/child & caretaker/child important


	responses to learning styles and opportunities
	spontaneity of child
	ordinal position and sex of child
	how parents were parented
	type of family
		single parent, traditional, blended, same sex parent


	Provide for physical, emotional, social and spiritual needs
	Listen and communicate effectively
	Provide trust, support, security, affirmation, encouragement
	Demonstrate mutual respect for family and others
	Able to grow with as well as through children
	Perform roles flexibly and share responsibility

	Murray & Zentner (7th ed) , p. 201


	biology, genetics, environment, biochemical & neurophysiological factors, sex differences
		predictable, sequential patterns but variable timing
	behavioral
		S-R bonding, readiness, conditioning, behavior mod
	ego adaptive/defense mechanisms
		psychoanalytic focus, developmental ‘tasks’
	cognition & morality
		staged levels not always related to chronology


	developmental vs accidental
		expected vs unexpected
	a state where existing coping mechanisms do not work
	human do not tolerate crisis, so must develop new coping mechanisms
	Selye, Gerald Caplan, Holmes & Rahe Betty Neuman


	Childbearing, childrearing, marriage, aging, retirement, loss of spouse/partner, grandparenthood - all examples of developmental crises
	how people cope depends on various factors
		perception of event, physical and emotional status, level of maturity, previous experience with similar situations, culture, realistic aspects of current crisis, availability and response of support systems : family, friends, community


	prenatal care
	childbirth education
	‘normal’ birth experience
	strong relationship with pediatric provider
	support systems


	EVIDENCE BASED!!!!

	Huge number of ‘old wives tales’ and biased assumptions even among those who are not ‘old wives’


	Eclectic
		present range of possible/acceptable behaviors
	support of process of pregnancy & childbirth
		management of uncontrollable interventions
	include information about becoming parents and nurturing infants


	as ‘non-interventive’ as possible
	pregnancy, labor and delivery are not an illness
	tailor to individual preferences


	establish prenatally if possible
	need level of comfort that allows free access
	strong sense of trust
	willingness to seek and adhere to anticipatory guidance, especially in first year


	In parent
		stress/emotional state, method of delivery, resolution of birth that was, degree of maturity, finances
	In child
		anoxia/LBW, nutrition, environment, vulnerability, ability of caretaker to understand ‘normal’ bizarre behaviors
	In both
		culture, separation


	Nurturing/parenting is learned behavior
	ALL new parents need to be nurtured to be able to nurture


	a consistent caretaker - ? Mom ? Dad ?Nannie
	touch, cuddling, comforting, ‘unconditional love’
	bonding (not intuitive, develops over time)
	to be fed - breast is best but I can tolerate bottles…
	to have my growth and development progress understood, especially in my first year


	consistent difficulty providing basics
	no signs of attachment
		doesn’t call by name, no joy in caring for child
		not concerned for or aware of safety issues
		disgusted by infant’s bodily functions
		not responsive to infant’s non-verbal communication
		doesn’t hold baby


	talk to parents and baby by name
	ask about well-being of parent before asking about child
	positively reinforce good/safe parenting behaviors
	comment on how baby ‘knows’ parents
	provide anticipatory guidance


	neuromuscular development
		cephalocaudal, midline to periphery; myelinization; ‘top half’ of body
	teething
	solid foods
	immunizations
	increased social interests
	safety issues


	neuromuscular development continues…
		mylinization continues to lower part of body - sitting, creeping, crawling, standing, cruising, walking
		eye-hand coordination becomes more precise
	development of 3 dimensional vision
		watch out for anything on the floor….
	increasing vocalization
		language acquisition
	may exhibit ‘stranger anxiety’
		prefers primary caretakers


	Gradual replacement of reflexive behavior with voluntary
	providing an environment which allows infant opportunity to ‘learn’ new skills
		capitalize on behaviors that evolve together
		encourage vocalization
		appropriate toys


	ignores baby
	can’t talk about feelings or concerns
	little effort to learn how to care for baby
	reluctant to hold/comfort/talk to baby
	refers to baby as ‘it’ or does not give name
	no support system
	refuses or won’t accept help
	misinterprets or exaggerates information about baby


	belief that ‘better than anyone else’ is best
	earlier is better
	time should be programmed and organized from the very beginning - idleness is bad
	more is better
	NOT!!!
	Competitiveness, materialism and brutality lead to burnt out adolescents...


	somewhere after infancy and before preschool
	first experience with autonomy, ‘me’
		attachment and separation
	slowing of rapid neuromuscular growth; increase in refinement and further development
	language - begins ‘meaningful social control,’ expresses wishes
	intense interest in world around him/herself
		but absolutely no judgment...


	parents/caretaker will not understand normal behavior
		increased physicality, temper tantrums, decreased appetite, definitive likes and dislikes, dawdling, ritualistic, ‘me do it’
	safety needs - very prone to accidents
		not only falls/auto accidents but also poisoning
	‘forced’ cognitive development
		can create an environment where children can learn but can’t ‘make’ them learn


	opportunity for safe exploration of environment
		doesn’t understand cause and effect - yet - ‘does’ to learn
	free play options
		will play ‘next to’ but not necessarily ‘with’ other kids
		play is the work of little children
	regular routine
		provides a sense of structure, appeals to ritualism
	‘loving firmness’
		somebody better be in charge here or it’s too scary


	look and listen : tune into child’s cues
	have realistic expectations for behavior
	provide a safe environment where the child can explore, talk, learn, play
	handle temper tantrums with compassion
	food doesn’t have to be an issue - s/he won’t starve
	punishment vs. discipline
	this too will pass...


	toilet training
		can’t do physically until can walk well
		act of ‘supreme love’
	sexuality
		exploration does not mean perversion
		identifying differences does not mean understanding
	body image
		an important part of self esteem
		easy to foster ‘shame and doubt’


	passive, apathetic
	overly aggressive and/or impulsive
	sneaky
	hoarding
	super messy or super neat
	calls self ‘bad


	‘more’ than toddlers
		coordinated, verbal, participatory
	roughly 3-5 years old
		‘preddlers’
	look like ‘little adults’ but aren’t
		proportion changes, about 1/2 adult height
	can’t distinguish fact from fantasy accurately


	‘healthful’ daily routine
	opportunity to continue to master and develop neuromuscular skills
	be a participating member of a family
	communicate effectively
	initiative tempered with conscience
	begin to understand ethical, spiritual and philosophical concepts and ideas


	siblings
		regression
	change in family structure
		divorce, moves
	abuse
		physical and especially sexual
	negative self image
		emerging conscience extremely ‘strict’ - self blame
	illness
		increased group contacts