​TEACHING CHILDREN TO BE SAFE
As we all live through this pandemic of Covid-19, we need to be wise about our continuing need to protect ourselves and our children from exposure. We can do this by simply following the CDC Protection Guidelines when away from home:

• Wear a mask
• Physically distance yourself 6 feet away from those you do not live with
• Wash your hands frequently

However, gaining the cooperation of our children to do those 3 protective steps may be difficult, especially wearing a mask. To gain a child’s compliance, the child will need to be taught these behaviors with continuing reinforcement until they become habit.
Here are some suggestions for teaching children to wear a mask:

• Whenever your children leave the house, have them wear a mask. At first they may resist keeping it on because they are not accustomed to wearing it and their sense of touch will alert them to the mask being on their face. However, if consistently worn, they will become desensitized and will adjust to wearing it just like they did to wearing a hat
• Role model wearing a mask and following all other recommended safety guidelines
• Try not to call attention to the fact your children are wearing masks. The object is for them to not notice the mask
• Use distraction to help your children not to think about the mask
• If they remove the mask, gently and positively put it back on them and then distract their attention on to something fun or interesting. Do not use a bribe in the moment because your children will then learn to take off their masks to receive a bribe.
• Speak only positively about wearing a mask even though you would prefer not to wear one
• At the end of each day, give a little prize, special treat, or do a fun activity with your children as positive reinforcement for wearing their masks even if it was difficult for them to keep it on
• Be consistent and recognize that wearing a mask does not feel natural and will take a month for the habit to form.

Wearing masks, washing hands, and physically distancing will be with us for the months ahead and will play an important role in controlling this crisis and returning us to work and our children to school and child care. Until there is a proven vaccine, what other options do we have? Our job as parents is to teach our children how to survive. They will then have the opportunity to live a happy and productive life!

​       If you recall, last week we described several behaviors that are present in newborn infants and their mothers from the earliest of their shared experiences. For example, newborn infants and their mothers are driven to initiate and sustain face to face contact. A mothers’ request to “see the baby” is concurrent with the infants’ primary interest in gazing at faces above than anything else. It is only later that the infant’s principle interest transitions from gazing at faces to gazing at objects. With those considerations in mind, let’s take a look at several additional developmental activities that mothers and infants engage in, from the earliest of their interactions.
       Prior to 4-7 months of age, the infant is the primary initiator of face to face contact. If you doubt that, simply try to get an infant to gaze at you if he does not want to. However, although the baby is the primary initiator of face to face contact, the adult can prolong it by responding to and encouraging the lengthening of mutual gaze. After 4-7 months of age, the child and the adult can both initiate and sustain interactions. This is an important development because it is at the 4-7 month mark when the infant’s primary interest shifts from faces to objects. This shift is generally observed as soon as the child develops independent reach and grasp.  So, once the child is interested more in “things” than “faces” adults are encouraged to facilitate mutual interest in objects that are familiar to the child and which will likely become part of his future play activities and routines. 
       In addition, if we carefully study the content and manner of how mothers speak to their children, we will find several interesting characteristics. The first to note is that a mother’s vocalizations with her baby consist primarily of 3-5 words, spoken in a very even cadence and characterized by a wide inflectional pattern. 
Thus, statements such as, “pretty baby” or “ma-ma loves you” or “you’re a good girl” or “time for bed” are quite common. As a side note, no one instructed mothers to use 3-5 word utterances spoken with an even cadence and wide inflectional pattern. This is something mothers are naturally “wired” to do, and it is something your child is naturally “wired to respond to. 
       As a way of demonstrating the reality of this, let me encourage you to pay particular attention to your child’s eyes, hands, and breathing patterns as you speak to them in this manner. It would not be at all unusual for your child to synchronize her eye, hand, or finger movements in cadence with your speech. She may even demonstrate awareness of your rate of speech via breathing patterns. The consistency of her responses will amaze you and make you particularly aware of how social infants are from their earliest of weeks. And although his response patterns may be limited by a lack of understanding of what is said, the rate and pattern of your speech catches the child’s interest and is accompanied by wonderful responses on her part. 
These thoughts represent just a few of the things adult caregivers can be alert to during the early months of a child’s life. As we continue, additional patterns of interaction will be discussed. 
I never tire of watching mothers and infants learn to interact during the early months. I trust that you will come to be as amazed as I am at the incredible process our children engage in as new members of our world.

Over the past three weeks, we have laid the groundwork for understanding how important early experience is relative to a child's cognitive development. We have stressed the importance of opportunity and ability as foundational for a child to begin and sustain the process of making sense of the world. With those considerations in mind, in the weeks ahead we will discuss the developmental milestones that suggest typical skill development and mastery, with particular emphasis on the emergence of communication skills.
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Now as it relates to communication skills, it is important to note that a child's communication skills are highly related to his success in the early elementary grades. Said differently, children that possess and utilize age-appropriate communication skills, by school age, generally do well in kindergarten and beyond. Conversely, if a child does not possess age-appropriate speech and language skills, the risk for school difficulties is increased. Thus, our awareness and promotion of speech and language development is an important component for school success. Please keep those considerations in mind as we describe some of the earliest milestones of communication development in infants and toddlers.

There are two things worth considering as it relates to the earliest of experiences a newborn has. First is the response of the mother, almost immediately following the birth of her child. Now it is worth noting that mothers throughout the world say virtually the same thing after delivering their child. Once they know that their child is healthy and have asked the appropriate questions, mothers universally utter a simple request. This is their first utterance directed toward the child as opposed to statements about the child. Further, not only does the professional literature support this but I have witnessed this as part of my professional activities in birth contexts throughout the world, even though I did not know the language that was being spoken.

Mothers throughout the world say something like; "come see me, let me look at you, let me see your eyes, let me see your face." Hence from a biological standpoint, mothers appear driven to facilitate face to face contact with their newborns shortly after birth. Thus it is reasonable to assume that a mother's requests to make face to face contact with her newborn are part of her biological makeup.

Now combine that with another significant fact regarding newborns. It is a developmental reality that infants under four months of age are primarily interested in gazing at faces above anything else. When given a choice, a child will voluntarily direct his visual attention toward faces as opposed to objects. This preference is noted from the earliest of newborn experiences, and is present in infants throughout the world, regardless of the birthing practices into which they are born.

Can you see the connection? Both mothers and infants are biologically driven and drawn to initiate and mutually engage in face to face interactions. This behavioral pattern is where the earliest communication development begins? And further, if anything impedes such interactions, the risk for communication delay increases?
Indeed, mothers and infant are compelled to make and sustain face to face contact, thus initiating the process of communication development. Quite amazing, don't you think?
As we continue this discussion in the weeks ahead, we will explore several of the common events that characterize how mothers and infants interact. The process is incredible and complex. It has a significant impact on how our children make sense of and become important participants in their world.
 

Week 3
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 Based on our discussion over the previous two weeks, it is instructive to recall that there are two things that are essential for a child to begin the process of making sense of the world. Certainly, one of these relates to the child's ability to do so. As we noted, anything that restricts a child's ability can serve as a contributing factor to the presence of developmental delay. Several of these factors were discussed last week.

        The second issue relates to a child’s early exposure to the world. In that light, if a child has a limited or deficient early experience or is not afforded ample environmental exposure, the potential for developmental delays is increased. This relates to several things, not the least of which is the actual caregiving environment and routine the child is exposed to.

       It should be kept in mind that children come into the world uniquely predisposed to begin the process of making sense of it. In order for the process to unfold, a child needs auditory, visual, and tactile experiences that are provided in the context of a stable and nurturing caregiving routine. During the early weeks of life, the child's system is geared toward his basic survival needs. The infant's earliest behaviors and responses are biologically driven, thus reflecting her need for nutrition, sleep, physical comfort, and contact with caregivers. Any undue or prolonged deprivation in one or more of these basic areas predisposes a child to less than optimal opportunities. At this stage of development, a child has very limited intentional means to express their needs. Yet as the child grows and becomes a greater participant in its world, his ability to make an increasing sense of it improves. Thus, in many ways, these early weeks serve as a developmental foundation thereby enabling the child to put his world together in an increasingly purposeful manner over time.

    Neglect, lack of routine, limited face to face time with caregivers, social deprivation, minimal nurturing touch, or an over stimulating daily routine can further the risk of the child's withdrawal into a "survival" mode and reduce its benefit from exposure to the world.
In the presence of adequate environmental exposure and opportunity, it is truly a wondrous thing to note, from week to week, the subtle changes that take place as visible proof that a child has begun and will sustain a rapidly expanding set of skills that equips him/her for optimal success during the infant, toddler, preschool years and beyond. I encourage parents to be intentional about keeping a record of developmental changes, some quite subtle, that are constantly taking place. You will be amazed at how perfectly ready your child is to grow, learn, and change. 

          Last week, if you recall, we began this discussion by emphasizing the unbelievable process whereby children enter the world and immediately begin making sense of it. I made the point that children learn more in the first five years of their lives than they do for the rest of their lives. It is an incredibly complex process, and it is dependent on two primary things; first, the opportunities provided for the child; and second, normal ability, from birth, to begin and sustain cognitive development. As such, anything that impedes the child's ability or inhibits their exposure to the world presents an increased risk for developmental delay. Keep those thoughts in mind as we consider some of the "ability" factors that can impact, in a negative manner, a child's developmental progress.

        It is helpful to acknowledge that there are many factors, prior to a child’s birth, that equip a child for typical skill mastery. Now, keep in mind that for the most part, a healthy mother brings a healthy child into the world. However,  good prenatal care is not a 100% guarantee that a child will possess the ability to begin the process of skill mastery. There are numerous factors, some genetic, some related to problematic choices made by the mother and some as a result of a disease process in the mother and or the child, that enhance the potential for developmental problems.
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          The presence of a genetic anomaly, particularly one known to include developmental delay, must be kept in mind. Prenatal exposure to drugs and alcohol is surely on the list of risk factors for atypical development. Another important consideration is prematurity. Premature and low birth weight infants are at enhanced risk for developmental delay, pending the degree of prematurity, birth weight, and other complicating medical factors. Birth injuries that include any degree of cranial bleeding, lack of oxygen, or head trauma must likewise be considered as risk factors. Frankly, the list of potential factors that relate to impeding the child's ability to make sense of the world is extensive. However, please note that the presence of any of these factors increases risk. Their presence does not guarantee problems in development.

All of these considerations have a potential impact on a child’s ability to make sense of the world. 
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Should there be questions as it relates to these factors (and others) a developmental specialist should be consulted as soon as possible. Please feel free to contact the Achieve Center if you have any questions.