Category Archives: Infants

Child Care Options

Just the other day, I was talking to a soon-to-be father!  In the excitement of the new baby news we discussed the gender of the baby, the due date, and whether or not they were going to tell the baby’s name.  Very basic, “so you are having a baby” conversation.  And like most soon-to-be parents, they had figured out their doctor, birthing plan, and were now at the stage of figuring out childcare.  Yes, in America, it seems that planning for childcare is something that many parents do well before the baby is born and often times well before the baby is even conceived!

Sadly, that is the state of affairs for American families.  Before you have a baby you need to figure out who the heck is going to take care of that baby, likely for up to 50 hours a week!  So what are the options for new parents? Good public schools? Yes but unfortunately, public kindergarten doesn’t start for about 5 more years, if you are lucky to live in one of the few states with a universal Pre-K program you may have only 4 years to worry about… So what are parents to do for the first 4 years?

Best Option:.  Win the lottery, quit your job, and get a PhD in child development and an MD in pediatrics and stay at home with your baby.

If that doesn’t work out for you here are your alternatives to consider and evaluate in  your area:

1.  Center Based Care.  An expert in child care Beth Meloy posted about the details of childcare on PlayLearnParent back in February of 2011.  There are a lot of options and a lot of resources out there for helping you to pick a quality child care program.  Child care programs can introduce your children to other kids, teach lessons about sharing, encourage social-emotional development, etc.  But with very little ones be sure to ask what the teacher to infant ratio is.  At  under 1 year of age, love, comfort, attention, and interaction by a caring adult is crucial for healthy development, so make sure the center can offer lots of one-on-one time for your baby.

2.  At Home Child Care.  These programs can range dramatically so be sure to spend time to learn as much as possible about the specific family center that you are interested in.  Generally at home child care is offered at someone’s home.  Usually, the provider has fewer children in her care than a center based program but there is often a larger range of ages of children in her care.  Many programs will have 1 infant, a couple toddlers, and a few preschool-aged children all in the same room for the day.  Whereas center based program usually break kids into classrooms based on their age or developmentally ability.  Most at home child care centers will only take 1 or 2 infants at a time whereas centers can have upwards of 15 infants.  Again, ask about adult to child ratios and be aware that infants and toddlers need more one-on-one attention.  At home child care centers are usually at someone’s home so it is important to ask about the facilities available.  Are there separate rooms for sleeping? What type of outdoor area is there for playing?  Remember that children of different ages have different needs.  Ask how the program maintains safety for each of the different children (for example, infants and toddlers can easily fall down stairs where as 4 year olds are much more capable of maneuvering around these obstacles).

3.  Nanny.  If staying at home full-time with your baby is not an option for you, consider hiring a nanny to spend that time with your child.  Your child will become attached and comfortable with a nanny (don’t worry your child will not love the nanny more than you!) and the nanny can offer many of the affordances that you would have if you stayed at home with your child.  Some benefits include: more individual attention, interaction, and care as well as keeping your child in your home so they can sleep in their own crib and play with their own toys.  Nanny’s of course can be quite expensive depending on where you live, between $15 and $25 an hour is not unheard of (that can cost more than $600 per week!).

4.  Nanny Share.  This is the new hot thing in many metropolitan areas and is exactly what it sounds like- families with babies will share a nanny. Rather than each family paying $600 a week for a nanny, two families get together, generally with children of similar ages, and hire a nanny to watch both kids.  Prices vary for the nanny but this can often save families up to 50% on childcare costs.  Nanny shares can offer benefits beyond just monetary ones.  By sharing a nanny you can rotate who’s house the nanny comes to, which increases your child’s access to new toys, parks, and experiences.  Of course sharing a nanny with another kid can also help your child develop their social emotional skills like sharing and patience like they would get in childcare but with a 1 adult to 2 kid ratio which provides lots of interaction and time for hugs and kisses!

5.  Get Creative.  Yes, babies do well when they have routines but that doesn’t mean you cannot be creative with your child care schedule.  Some creative things I have recently heard about. A friend of mine did a different kind of nanny share, she only needed childcare for 2 days while her friend needed child care for 3 days, so they split the nanny that way and kept the nanny busy 5 days a week but still got one-on-one care for their babies.  My mom nanny’s for twins in the middle of the day during the week, the mom goes into work early and comes home early, and the dad goes into work late and comes home late, to decrease the amount of child care time/costs.  Another friend is a dentist and is going to opt to work Saturdays instead of a workday so she can be with the baby at home one day a week and the father can stay with the baby on Saturday.  Share child care time with friends and family.  Offer to watch a friend’s kids on Tuesday evenings when they have late meetings in exchange for them watching your kids monday mornings when you have to teach a class, etc.  Bring on the family members!  If you have family in the area (especially retired grandparents) see if they want to participate in child care responsibilities (but please do not drop this expectation on them!).

 *REMEMBER* In all cases be sure to ask for multiple references! You want to ask a range of parents about their experiences leaving their children in this person’s or center’s care.

Resources:

Day Care: Choosing a Good Center FamilyDoctor.org

Choosing a Day Care Provider ivillage

Nannies

How to Hire a Baby Nanny

Nannies4Hire

SitterCity

About Nanny Shares:

BabyCenter Nanny Shares

Nanny Network Nanny Share

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Infant Memory

 

Babies are so incredibly impressive.  They come into this overwhelming and overstimulating world with a “lets figure this out” attitude.  Without fear they just jump right to it.  They begin to explore the world and people around them using whatever capabilities they have at those young ages. Through their explorations they learn all sorts of things and remember many things as well!

Most people, and many researchers, were convinced that infants went through something called infantile amnesia, meaning that they couldn’t remember experiences that occurred prior to the toddler years.  More recent research has begun to show that infants, even very young infants, do store memories (Peterson, 2011) and that most likely their memory capabilities are very similar to those of older children and adults (See Rovee-Collier, 1999).

How in the world do we know that infants have memories?  A series of great studies by Carolyn Rovee-Collier  has demonstrated that infants as young as 2 months are able to remember and that with age their ability to remember increases (Rovee-Collier, 1999).  So, for example, kids at 2 months will remember something but for a much shorter amount of time than 18-month-olds.  How does she test something like this?  Well, one way is to use a behavioral test of memory (since you can’t ask a 6-month-old what they remember).  Rovee-Collier used a mobile in a crib (similar to the one in the picture above) and she tied a ribbon to the baby’s foot and connected the ribbon to the mobile.  This way, if the baby kicks his legs the mobile moves-teaching the baby that this movements can control the movement of the mobile.  The child is trained (training is just repeatedly letting the child do this until she learns) that kicking causes the mobile to move.  Once the child has learned this the child leaves the lab setting for a period of time.  To test the child’s memory, the child returns a few days later (or longer depending on the age of the child) and is returned to the crib, but this time the ribbon is not tied to the mobile, so the baby has no control of the mobile’s movement.  If the child kicks when placed back in the crib (more than he did prior to being attached to the original mobile a few days before) the experimenter determines that the child remembers and is attempting to move the mobile by kicking his feet. (See Rovee-Collier, 1999).

So what does this mean for parents?  Does it mean if you slip-up once and a you swear in front of your infant that she will remember forever and it will be the first word out of her mouth?  Luckily, probably not.  But it does mean that infants and toddlers are remembering from experiences they have at very young ages.  Once your child is verbal it’s amazing to see how much their remember.  If they were started by a firetruck when at an aunt’s house, the next time you go over there the child may be saying “fire truck” more often than usual.  Since your infant is learning, imitating, and remembering, you can try to test them out at home too.  Bring out a novel, age-appropriate toy and demonstrate how to use it with your infant, put it away for a few days and bring it back out and see what she does with it.  Don’t panic if they don’t remember, some things are more memorable than others and just like adults children will forget or won’t be interested enough initially to process and remember what you are doing.  Keep trying and just take note of times when your child imitates something you did a few days ago -it’s impressive to see what they do remember!

Resources:

Faull, J. & Oliver, J. M.  (2010).  Amazing Minds: The Science of Nurturing Your Child’s Developing Mind with Games, Activities, and More.  Berkley Books: NY.

Peterson, C. Warren, K. L., & Short, M. M. (2011) Infantile Amnesia Across the Years: A 2-year follow-up of children’s earliest memories.  Child Development, 82, 1092-1105.DOI: 10.1111/j.1467-8624.2011.01597.x

Rovee-Collier, C. (1999).  The Development of Infant Memory.  Current Directions in Psychological Science, 8, 80-85.

 

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AAP Media Recommendation

On Monday Oct 17th, 2011 the American Academy of Pediatrics came out with their most recent policy statement featuring recommendations regarding media use and children under age 2.  Click here for a video from the statement release and click here for a copy of the actual Policy Statement published in Pediatrics on Oct 18, 2011.

Before I go too far, what is the American Academy of Pediatrics?  According to their website, the American Academy of Pediatrics is “an organization of 60,000 pediatricians committed to the attainment of optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults.”  The American Academy of Pediatrics (AAP for short) comes out with many recommendations related to child health and development in a variety of areas including: Sudden Infant Death SyndromeADHD, and of course Media (all links are to their press releases regarding their recommendations).

In 1999, the American Academy of Pediatrics came out with their first recommendation regarding children’s media use (focusing appropriately for that time, on television and videos).  For those who need a quick recap of what the world was like in 1999 when this statement came out here you go. Who Wants To Be a MillionaireFriends, and ER ranked in the top 3 most watched television shows (see Nielsen Ratings and The Classic TV Show Database). As for children’s television shows: Teletubbies first aired in 1997 and The  Baby Einstein Company was founded in 1996 by a stay-at-home mom and former school teacher.   In 1998, Nickelodeon first aired SpongBob SquarepantsBlues Clues first aired  in 1996, and Dora the Explorer became a regular series on NickJr in 2000.  (Just for as a reference point Sesame Street began in 1969).

This 1999 Media Education statement provided pediatricians with 9 recommendations including recommendations for what pediatricians should recommend for parents. Among the recommendations, pediatricians were urged to “become educated about public health risks of media exposure” and to “urge parents to avoid television viewing for children under the age of 2 years” (AAP 1999, page 342).  A dozen years later, the AAP has released a statement focusing on recommendations specifically for children under age 2.

The release of this statement has caught the attention of quite a few large media outlets, many academics, and a considerable number of parents.  In reaction to the press and parent comments I have seen, I want to address a few key points from this new Policy Statement.

First, I want to comment on what these policy statements are.  The AAP makes these recommendations primarily for pediatricians (and of course parents too).  These statements attempt to recap all of the scientific studies related to the topic.  Note, these statements are NOT the findings from one study conducted by the AAP, these statements are compiled based on a search of related research conducted by a range of researchers.  I keep seeing parents comment about the “AAP’s study”, this document is NOT a study, it’s a policy statement based on some research.

Second, while many research studies are included in this document, many of the studies referenced are correlational, not experimentally controlled studies which would be necessary to determine causation (See previous post Science: Cause and Correlation).  When research finds a positive correlation between two things that means they just change in the same way. For example, height and weight are often correlated: the taller you the more you weigh and often times the more you weigh the taller you are. Does that mean that if I am currently 5’3” and want to 5’8″ that I should start gaining weight?  Nope- that would only work if there was a CAUSAL direction between weight and height.  Get it?  This is an IMPORTANT distinction to understand when reading the research that was used to back up this AAP recommendation.  There may be fundamental differences between children who watch a lot of television compared to children who don’t and those differences may actually be the forces that are driving the findings like language delays, etc.  Importantly, one study that the AAP statement references by Linebarger and Walker (2005) explicitly states that lower language scores were RELATED to viewing certain programs at young ages, meaning that it could be that kids who had lower language scores were more attracted to or interested in these types of programs.

Third, the world infants and toddlers live in today is very different from the pre-DVR, pre-Ipad, and pre-iphone days infants and toddlers were born into 12 years ago (when the 1999 statement was released).  It’s shocking that the AAP failed to recognize or discuss the media of today when the number of infants and toddlers using newer media technology like iPads continues to grow.  Recent research by PlayScience reports almost 80% of children age 2-5 have access to smartphones and 19% to tablet computers.  The entire policy statement focuses on the same media from 1999: television and videos and fails to discuss the realities of the media children are using today which are increasingly interactive and increasingly present in their daily lives.

Finally, the news needs to be careful with how they report this and the potential fear factor they are causing in parents.  Media is a part of almost all Americans lives.  Televisions and screens are everywhere from restaurants to gas stations, from taxis to new cars, and in classrooms and homes.  We live in a screen-filled world. Absolutely, parents should be careful of EVERYTHING their children are exposed to including but not limited to: media, music, unhealthy foods, unsafe playgrounds, germs and diseases… the list goes on.  Media is a part of that and parents should be concerned to some extent and they should be aware of the research that has been conducted, but unfortunately, this policy statement and the media’s reaction and reporting of it are failing to give parents complete, accurate information that allows them to make the best decisions for their children.

Example of a toddler's art created on an iPad

My last comment is probably the most important.  Clearly, parent interaction and real-world experiences are key to healthy child development. No one is advocating that children should only learn from screens or interactive digital devices.  But most of research that has been done today has been conducted on a small group of children and with very little regard to the context in which children are watching/using screens.  We don’t know much about infants use of newer interactive media like tablets or touchscreens.  We do not know the influence of media for all types of children.  I could imagine that for a single mom working two jobs the benefit of having her child sit in front of Sesame Street or play an educational ipad game for 20 minutes while she calms down after an emotionally exhausting day at work could have benefits well beyond the potential consequences discussed in this AAP policy statement.  I could also imagine that technology could be used to enhance learning by providing pictorial examples of things children don’t have access to (like images or videos of Lions in the wild), etc.

At the end of the day parents need to make smart decisions for their families based on the information that is available to them.  Knowing the potential consequence of media exposure is important but so is being able to understand where it can be potentially beneficial even for very young children.

References:

American Academy of Pediatrics (1999).  Committee on Public Education. Media Education.  Pediatrics, 104, 341-343.  http://aappolicy.aappublications.org/cgi/reprint/pediatrics;104/2/341.pdf

American Academy of Pediatrics (2011).  Policy Statement: Media use by Children younger than 2 years.  Council on Communications and Media.  Pediatrics, 128, 1-6.  As of October 19, 2011 available for free form this link: http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-1753.full.pdf+html

Linebarger D.L, Walker D. (2005).  Infants’ and toddlers’ television viewing and language outcomes. American Behavioral Scientist, 48(5):624 – 64. http://abs.sagepub.com/content/48/5/624.abstract

New York Times Comments by Parents regarding the AAP’s new recommendation http://community.nytimes.com/comments/www.nytimes.com/2011/10/19/health/19babies.html?sort=oldest&offset=2

PlayScience http://playsciencelab.com/LabReport/MobilePlaygrounds_LabReport.pdf

Related Resources/Blogposts

Children’s Technology Review Hey Doc, What About My Child’s iPad?

Moms With Apps Updated Policy Statement from the American Academy of Pediatrics

The Washington Post The AAP reaffirms no screen time for young children even though few parents listen

New York Time Parents Urged Again to Limit TV for Youngest

New York Times Comments to Parents Urged Again to Limit TV for Youngest

Boston Globe Trying to Gauge the Impact of Growing Up Digital

Huffington Post David Kleeman Children and Media: Pediatricians’ Monolithic Myth 

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Everyone Needs Friends

Everyone needs friends.  As adults our friends help to celebrate birthdays and support us when we have a bad day at work.  As children, friends and relationships with peers are monumentally important for the development of self-identity, confidence, emotional intelligence, social skills, sharing skills,etc.  But what about babies?  Do babies need friends? Turns out they do!

A great article in Early Childhood Research & Practice talks about the importance of relationship building in infancy and toddler years.  This particular article provides descriptive analyses of one laboratory child care setting in which infants and toddlers were in open classroom settings and allowed to interact with each other.  While this doesn’t statistically test the importance of friendships in early infancy years, it does provide evidence for the success of peer-to-peer interaction even during very early years.

The authors of this study observed a childcare setting of children focusing primarily on the children in the infant and toddler classrooms.  The researchers changed the classroom environments so that the children in the infant and toddler classrooms were in one large room that was separated by transparent barriers so that infants and toddlers could interact.  They also encouraged teachers to help the infants and toddlers interact by bringing non-mobile infants into the toddler classroom for lunch and other activities.

The major findings were as follows:

Environment: Creating a space where infants and toddlers could see and interact with each other as well as time in which they were all together was crucial for interaction and relationship development.

Toys:  Toddlers were particularly interested in interacting and playing with the infant toys, so infant toys and and play space was shared with toddlers.  Also adding additional dolls to the toddler playroom allowed toddlers to practice caregiving behaviors that they saw the teachers exhibit toward the infants.

Modeling:  Toddlers wanted to be involved in the care-taking of the younger children.  Toddlers would watch as an adult changed a baby’s diaper or help to read a story to a younger child.

Joint Experiences:  Toddlers and infants were provided with activities that they could do together, like finger painting or sand play.  These activities allowed the toddlers and infants to interact and play together at an appropriate developmental level for each child.

Spontaneous Interactions:  Toddlers and infants benefited from these interactions.  Over time the infants began to model behaviors they saw demonstrated by the toddlers, like washing their hands before lunch. Toddlers adapted their interactions to the appropriate developmental level of the infants and would bring and share toys with the younger children without being prompted.

Lessons Learned:

Infants and toddlers enjoy friendships and forming relationships.  Even though infants and toddlers are still learning how to control their bodies and emotions, being around other children, even children of different ages can be beneficial for social emotional development and relationship building.

Future research should continue to examine the specifics of infant and toddler friendships and the ways in which they may positively influence development.

References:

McGaha, C. G., Cummings, R., Lippard, B., & Dallas, K. (2011).  Relationship building: Infants, toddlers, and 2-year-olds.  Early Childhood Research & Practice, 13, 1.  

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Early Screening of Autism

Today in the New York Times there was a very brief article about the use of a Questionnaire to detect Autism earlier.  The New York Times did a very nice job summarizing the findings of the research.

The questionnaire used in this study was the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSVS-DPIT-Checklist).  Despite the focus on Autism in this article, the questionnaire is actually used to assess a range of disorders including language delays, Autism, and global developmental delays.  In the study, pediatricians had parents complete the questionnaire for their child at the child’s 1 year pediatric check-up.  The staff at the pediatrician’s office then scored the questionnaire and reported to the doctor whether or not the child “failed” the questionnaire (indicating some sort of delay). If the child failed the parent was given a flyer referring them for treatment at the Autism Center of Excellence.

The main point from this study was that while there were some false-positives (meaning children “failed” the screening and did not end up being diagnosed with Autism later) the use of this questionnaire and screening did identify children as early as 12 months with developmental delays and got them into treatment programs earlier!   Generally, children are not diagnosed with Autism until they are over 2 years and therefore do not receive treatment until then, but with this screening tool children more children may be able to start treatment for disorders at earlier ages.  Also important to  note, the pediatricians that participated in this study are continuing to use the screening tool at the children’s 1 year old check-up.

The Autism Center of Excellence has wonderful resources including Early Warning Signs of Autism, Treatment, and general Toddler Development information.

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Sharing

As a daycare teacher I felt like I spent all day everyday telling young kids to “share”.  Sharing is an important skill for children to learn and one that takes repeated practice and reminders and time before young children begin to grasp the concept.   Beyond practice and reminders, young children actually need time to develop a sense of theory of mind-the idea that other people have feelings/intentions/thoughts that are different from the child’s own.  (Eventually I will post on Theory of Mind).  Sharing is a tough lesson to learn and while most adults understand the concept, sharing can be hard for people of all ages.

Since this is a blog for parents, I thought that I would post about a study that was presented at SRCD about the importance of parents SHARING the responsibilities of parenting.  Unfortunately, most research still focuses on the mom as the primary caregiver to the child but in general findings can be reversed and still be accurate for both parents.

Clearly marriage and relationships are never easy and when you add in children and the amount of love, time, and attention they need parental relationships can go down the tubes faster than you can imagine which can have negative effects on the kids. I’m not a marriage expert so I will quit there on the marriage talk.  But, like everything in life, sharing the workload makes it easier-and that goes for child care at home as well! And when parents share the workload this can have positive impacts on the child.

A study by researchers at the University of California, Irvine examined the relationships between father’s  involvement (with child care and household labor) with mother’s and infants’ behaviors.  When fathers are more involved in household and childcare responsibilities, mothers tend to have higher leves of sensitivity when they interact with their infant.  Infant behaviors seem to be influenced by parenting.  When fathers are more involved their infants show more positive behaviors.

While this study is slightly more complicated, the take home message is that it is important for fathers (or whomever is non-primary caregiver for the child) to be involved in childcare and household responsibilities, both for the sake of the marriage and the young child’s development and behavior.

Books on sharing parenting responsibilities:

Parenting Together: Men and Women Sharing the Care of Their Children by Diane Ehrensaft

How to Avoid the Mommy Trap: A Roadmap for Sharing the Parenting and Making it Work By Julie Shield

References:

Ly, A. R., Lucas-Thompson, R., Goldberg, W.A., Glynn, L. M., Sandman, C. A., & Davis, E. P. (March, 2011).  When mommy feels daddy shares the care: Links between marital equality, maternal sensitivity, & infant behavior.  Poster presented at the Society for Research on Child Development, Montreal, CA.

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Video Chat

The other day I video-chatted with a friend’s daughters.  At first, the older daughter (age 5) thought it was cool to see me and talk to me, but then she quickly preferred to look at herself making funny faces in the camera.  Her sister (age 21 months), really loved the video chat and came right up to the computer and said, “hi”.  She lost interest after a few minutes but she clearly understood that she was speaking to me and came back over to say good-bye before we got off.  It seemed clear that even though this was her first video chat experience and she was less than 2 years old, she understood the concept that I was real and was speaking and interacting with her through the computer.

New research is beginning to examine video chatting and it seems that it is a new fast growing phenomenon especially with very young children.  Parents in Washington, DC use video chat to introduce their new babies to their grandparents in New Zealand.  Sisters (one in New York one in Chicago) use video chat to let their infant sons see each other.  Mom’s watch their children on live video feeds at their daycares.  And toddlers in child care use video chat to stay in touch with a former student who recently moved out of the country. Video chat is popular and it’s changing the way adults communicate and the ways infants and toddlers understand screens and 2D presentations.

Most research has shown that until children are about 2.5 years old learn better from a live demonstration compared to a video demonstration1.  That means, if I wanted to teach a young child to stack blocks in a certain way, it would be easier for the child to learn if I was sitting in the room with him teaching him how to stack the blocks than if I showed him a video of me stacking the blocks. But learning from a video chat seems to be entirely different from learning from other screens.  In a study recently presented at SRCD, 24- and 30-month old children learned words from video chats and live demonstrations  better than children that watched a video that presented the new words.  So why can children learn from video chat but not from a video?

It seems the true interaction that occurs during a live video chat is more “real” and acts in many of the same ways as a live interaction.  The person on the screen can ask questions, pause for answers, point to different objects, just like they can in “real life.”  On a TV show or video, even in programs like Dora the Explorer where they producers tried to create an interactive feel (Dora will ask a question to the audience and stop and wait for a response), young children still struggle to learn. So, for young children all screens are not the same.  Learning from a video screen in which live interaction can occur, like on video chat, is much easier for young children than learning from even a computer than has only programmed responses.

Not only can young children learn from these video chat experiences, research has demonstrated that relationships can actually be maintained through such video chat sessions (even with children as young as 17 months old)3.   A study conducted in Australia demonstrated that children were much more comfortable in a room alone when their mother was present on a live video chat than when they were entirely alone in the room without the mother3 similarly children were more comfortable in the room alone when their mother was on video chat than when she was on a speaker phone4. Results from these studies suggest that video chats may offer both learning and emotional development opportunities for very young children and that they can be used to keep children in contact with family members that live far away.

References:

1Anderson, D. A., & Pempek, T. A. (2005).  Television and very young children.  American Behavioral Scientist, 48, 505-522.

2Roseberry, S., Hirsh-Pasek, K., Richie, R., & Golinkoff, R. M. (April 2011).  Blicking through video chats: Contingent interactions help toddlers learn language.  Poster presented at the Society for Research on Child Development, Montreal, CA

3Tarasuik, J., Galligan, R., & Kaufman, J. (April 2011).  Maintaining familial relationships via video communication. Poster presented at the Society for Research on Child Development, Montreal, CA

4Tarasuik, J., & Kaufman, J. (April 2011).  Almost like being there: Social interactions via video link between parents and young children. Paper presented at the Society for Research on Child Development, Montreal, CA

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