Early Intervention

I thought it might be a good idea to talk a little bit about early intervention---what it is, and why it's important. When a child's development is delayed it's best to begin supporting the child and parents to encourage that development along at the earliest age possible. This is why I currently help families of infants and toddlers in encouraging their children's development. What we know about the development and learning of young children is that it's much easier to see progression and progress early. The brain is much more "plastic" in those first 3-5 years.

Early intervention in Idaho looks like this:

• Children birth to three years old who are eligible receive home/community based early intervention services. Children that receive early intervention services birth to three years old have what's called an Individualized Family Service Plan or IFSP, which includes a lot of information about the child and the goals early intervention will address. Early intervention at this age centers around the child's home and family. As of this time, Boise (and possibly the entire State soon) is moving to a "coaching model" of early intervention. With this model one early interventionist from a team, who may be a speech language pathologist, an occupational therapist, a physical therapist, a social worker, or a child development specialist like myself, would have regular visits with the family, helping them to address goals for encouraging their child's participation and learning during everyday routines and activities. Whenever needed any of the other team members (which will include one person from each discipline) will be available to do co-visits. This model utilizes current best practice, and puts in to place our knowledge of how we know young children learn best--it's been very successful so far!
• Children three years old until Kindergarten who are eligible may receive services with their school district. Children that are eligible for early intervention 3-5 years old will have an Individualized Education Plan, or IEP. This plan address pre-academic goals, to ensure that children can become successful in the school setting. For some children this may mean developmental preschool. These preschools that are actually located within some of our elementary schools look like a typical preschool. There are different centers for child initiated learning, structured large and small group times, snack times, times to play outside, and often time for library, music or physical education. The children who attend developmental preschool, often receive speech language therapy, physical therapy or occupational therapy in the classroom based on their different needs. Some school districts include typically developing peers in their preschool classrooms as models.

Please if you ever have concerns about any aspect of your child's development (speech/language, social, motor--anything!) contact the Infant Toddler Program, or your local school district and share your concerns. I always thank parents for going ahead and letting us visit with them and their children--it's always best just to check things out and make sure there isn't any additional supports we can provide children to ensure they grow and learn to the best of their abilities.

As always there is so much I could address in this topic as well. Please feel free to ask any questions.

Choosing Quality Childcare

This is a big one. This topic is a huge passion of mine. I've decided that one of the best ways to address this topic will be to share my own story. Here it is...

As a working mother, I knew I could only return to work after my maternity leave if I felt like my daughter was being loved, well cared for, able to build an attachment with a primary caregiver and in an environment that would encourage her learning and development---this is not easy to find. Lets be honest, especially in Idaho. When I was five weeks along my husband and I toured the centers that we thought might be an option for us and we got on wait lists. We were on about five wait lists, and were only offered spots in two centers just before it was time for me to return to work. This of course was a very nerve wracking experience.

So where did we begin. First we toured all accredited centers in the area in which we live, and a few other non-accredited centers that we had heard good things about. This was easier for us because almost all the accredited centers in the Boise area are downtown. As of the last time I looked there are still no accredited centers in Meridian or Eagle. I know of one in West Boise. When I say accredited I mean that the center has voluntarily sought specialized accreditation, by holding themselves to much higher standards than the the state's. This accreditation is given though the National Association for the Education of Young Children. Please check out their website at www.naeyc.org!

Accredited centers have lower teacher to child ratios, they utilize a developmentally appropriate curriculum, and employ early childhood educators that have education in the field of early childhood (the majority of lead teachers by 2012 in accredited centers will have bachelor degrees, and at this time all lead staff must have an associates degree or a bachelor degree).

During our tours we were looking for specific things we wanted to see, such as...

Were teachers down on the floor with the children?

How were the teacher's talking to the children? Were they using positive/respectful language?

Were infants on their own routines, not forced to mold to a group routine?

Was the room set up up for open ended exploration?

Were the children assigned to a primary caregiver?

Were the children able to be with that caregiver for more than one year?

Were the children happy, content, regulated and engaged in what they were doing?

Were there any "baby containers" (you won't see any most of the time in an accredited center)?

What was the teacher's education and experience?

Did the infants gets to spend time outside each day?

Was the center and staff supportive of breastfeeding mothers?

Did the center have written policies/procedures/philosophy?

As you see there is a lot to look for in finding quality care. These are just a few of the things that were very important to me. My husband commented to me as we were in the middle of touring centers that he almost pitied those centers that had to respond to our questions. Especially those that were obviously not providing quality care, and that became evident to not only us, but them by the end of our tour. I can't even explain how frustrated I was with centers that claimed to be high quality, but apparently did not even have basic understanding of how children learn and develop.

This isn't always the fault of childcare providers. It really is a national issue. We pay people who work with young children very low pay, we set few or limited standards on how they should care for and educate the childen in their care, and we don't support or demand higher education in this field. This outrages me, and hopefully it outrages others. The more parents that speak out, that they need high quality care for their child, the more other's will hear this (the important ones being local politicians of course).

So, back to the story, finally we got that call that we had a spot in one of our top picks. We found a center that has a looping program (the same teacher remains with the same group of children for three years). My daughter's teacher is currently working on her Master's degree in Early Childhood Education, and is one of the most responsive, respectful, purposful teachers I have ever met---we lucked out!

So for all of you looking for quality childcare, here's some suggested first steps:

• Do an accredited program search on the NAEYC website
• Check out NAEYC'S and Zero to Three's information on choosing quality care at http://www.naeyc.org/academy/search/choosing.asp and http://www.zerotothree.org/site/PageServer?pagename=ter_key_childcare_selectcc&AddInterest=1152
• Set up tours at centers, and don't forget to write down the questions to ask that you don't want to forget
• Then, I'm sorry to say, but get on the waitlists and hope for the best!

Please, there is so much I could address on this topic, I'm sure there will be more questions. Feel free to post a comment, and I'll get a response back to you if I know the answer, or at least point you in the right direction on how to find your answer.

Good luck parents!

Feeding Young Children

Sorry parents, this post is way past due. I promise to try and stay on top of getting these out more frequently, but at times being a mom, a wife and a child development specialist just takes ALL my time!

Ahh mealtimes, are many of you struggling right now??

I don't know of any parent who hasn't struggled with some aspect of feeding their young child. As a parent myself now, I've felt that personal fear and anxiety over my daughter's feeding, especially because she suffers from a milk protein/soy allergy. I've continually referred back to the six principals for feeding young children that were developed by some of my professors at the University of Idaho who have done a lot of research and training on feeding young children (Janice Fletcher and Laurel Branen).

Here are the six principals for feeding young children:

1. Adults should eat with children
2. Adults choose what is served and how it is served.
3. Children choose how much to eat
4. Children need a variety of foods.
5. Children should serve themselves
6. Adults set the feeding environment.

Some basic things to remember, besides these principals, is that babies are born with internal cues of hunger and satiety, and it's important for us to read these cues and respond accordingly--they know their bodies best. Also "variety increases intake". Children have to be offered a food multiple times; an occupational therapist I work with who does a lot of work with children with feeding challenges told me that it now takes around 18 times of introducing a food to get a child to eat it. Remember that children want to feed themselves--let them. This validates that you respect their independence and their need to learn a new skill. Yes, it's messy, but learning something new often is.

Remember to have fun as a family and enjoy mealtimes. It's a wonderful opportunity for families to come together. There is so much learning that can occur during mealtimes I couldn't write a post long enough to address it all!

For more information about feeding your young child I would encourage you to check out Ellyn Satter’s book, How to Get Your Kid to Eat, But Not Too Much.

Children and Television

A lot of parents ask me about whether or not their child should be watching television and how much. This is really tough to answer because television can play an important role in a family. As an educator of course I know children learn best through play, and interactions with people and things in their environment. Here's what we know about children and television, hopefully this information will be helpful for some parents that are considering TV? and how much?...

• The American Academy of Pediatrics began urging parents in a statement from 1999 that children under two years of age not watch ANY television, or any other electronic media
• We know that studies have found a strong correlation between how much television children watch and increased rates of obesity and ADHD
• Research has demonstrated that children can learn from television after multiple viewings but that it takes much longer than interactive learning approaches
• Children in homes where the TV is always on are less likely to read
• Children are quickly spending as much or more time in front of a television than playing outside

Just Something to Think About: I heard the famous pediatrician T. Berry Brazleton speak at the National Association for the Education of Young Children Annual Conference in Chicago about a study on the impact physically to children from watching TV. I couldn't find the specifics of this study again, but I chatted with the other early childhood educators that were with me and here's what we remember: He spoke about a study in which they found children's breathing was accelerated while watching children's programs (perhaps these programs are more overstimulating than we think?). The only children's program that didn't seem to have any impact was Mr. Roger's--a very slow paced program.

So here's just a few things to think about...

• Is it possible for your child under two years of age not to watch television?
• If your child does watch television can you make sure it's only for brief periods of time, or can they watch television with you so that it's an interactive experience (plus, you can insure that the content is appropriate)?
• How often is your child playing outside?
• Is your television always running in the background?
• Does your child have multiple opportunities to look at books and listen to you read books?

For more information check the website www.screentime.org

I would also recommend that any parents seeking information about their children birth to three years of age, check out the Zero to Three website, www.zerotothree.org. Zero to Three is a very reputable organization serving early childhood professionals and parents. Some of my information from this post came from one of their research releases.

Coming Soon: Children and Television

I'm so sorry parents! My daughter has been super sick for, well we're going on eight days now! Is everyone elses little ones sick too?? I've chosen Television as the topic for my next post. I'll get it out soon--I promise!

Melissa

Infant Massage

Parents: I had a few of you ask me about infant massage, which I don't know too much about, but one of our pediatric physical therapists is a certified infant massage therapist. She gave me some information to share and her contact information in case any of you are interested in learning infant massage for you and your baby. She does individual and group lessons in your home!!

Here are some of the benefits of infant massage:

Massage can be useful for helping calm your baby. Massage can also help with relieving gas, colic and constipation. Massage can help your baby sleep better. Massage can be part of the process of building an attachment with your baby because it encourages eye to eye contact, skin to skin contact and the release of the nurturing hormone, Oxytocin. With parental responsiveness, babies can learn early communication during infant massage.

If any of you in the Boise area want to contact Sima about infant massage classes here's her info.

Sima Tavazoie MPT, CIMT

208-870-9746

Simapt@gmail.com

Thanks for the information Sima!!

Behaviors That Challenge

Parents: Here's information from a handout I created for parents about toddlers and challenging behaviors a few years ago...hope it's helpful!!

Toddlers are at a very unique stage of development because they are between complete dependence on others and becoming independent people themselves. With new skills learned such as walking and starting to talk, we often find that toddlers feel they have to over assert their independence. For this reason toddlers often present with behaviors that are challenging for us. It is important at this stage of development to remember that we must support toddlers in this transition to independence while providing boundaries for healthy growth and development. Here’s how…

Positive Language: Many parents get in the habit of saying “no, no, NO!” during the toddler years. For anyone that has spent time with a toddler before, they soon realize that this word also becomes a toddler favorite. To avoid this “no trap” use positive language instead. Redirect the child to something they can do. Avoid using the words: "no" and "don’t." Many of these words become lost on toddlers because they hear them way too often. If a child is in a dangerous situation say, “STOP” with a serious tone of voice, you can sign "stop" as well. This will give a visual and an auditory cue to the child. If you want your child to listen to you in those dangerous situations, it is very important that you only use that serious tone of voice with them when it’s needed. Again, if they hear a loud, serious tone of voice all the time they will start to ignore it.

Redirect: Tell your toddler what they can do (and, yes, there is always something they can do) instead of always telling them what they can’t do. For example: A child throws something that is not supposed to be thrown. Tell the child “I see you need to throw something, here you can throw a ball.”

Validate Children’s Feelings: Toddlers are experiencing a wide range of emotions, often on a daily basis. When your toddler is happy, sad, frustrated, excited, etc. label those emotions for them to hear. Example: “I see you are really excited right now.” This will allow them to express how they are feeling to others later on when they are able to associate specific feelings with that emotional label.

Give Warnings, Follow-Through and be Consistent: Toddlers are constantly testing their boundaries to learn what is appropriate and what is not appropriate. If a child has been redirected, and continues to present with the challenging behavior, let them know if they do it again they will be all done. If they do it again, take away the item, if there is one present, or remove the child from the situation. If you give in one time, and don’t follow-through, your child will try even harder the next time.

Descriptively Reinforce: Remember to tell toddlers what they are doing well, so the only thing they hear isn’t what they shouldn’t be doing. Instead of saying “good job” which makes you the judge of their actions, tell your child exactly what they are doing that you think is good. For example, “I see you are helping pick up all the toys and put them away”. This allows children to start feeling good about what they have done, and builds their internal cues of what is right and wrong, rather then having to be dependent on someone else to let them know if something is right or wrong.

Stay Calm: Toddler’s that have strong attachments to their parent’s or caregivers, are usually looking to those important people to learn how to act. If you are upset and yelling, your child will be upset and yell. Remember that toddlers are not acting out to make us angry; they are simply trying to learn how the world works.

Dealing with Tantrums: It is very common for a toddler to tantrum, especially if they feel a strong emotion that they do not understand yet. Toddlers need this time to release their emotion in a safe place. If a child is tantruming move them to a safe location (the middle of the floor, on the couch, etc.) and remain close, but do not talk or pay much attention to them, until they have calmed down. This way they do not learn that tantrums get you to pay attention to them. When the child is finished with tantruming, allow them to return to an appropriate activity.

Recommended Readings:

Discipline for Life: Getting it Right with Children, By Madelyn Swift

The Emotional Life of the Toddler, By Alicia F. Lieberman, Ph. D.