Terrie Rose
Founder of Baby’s Space
Founder of Baby’s Space
I have been waiting for this opportunity to link early childhood mental health to issues of the achievement gap. My hope is that by the end of our time together, it will be crystal clear how what happens for a young child in laying that basic foundation has everything to do with first grade math success or high school graduation.
Video lesson #1, Ethan: Rose plays a video clip of a father playing with Ethan, his infant child. (It is available on You Tube. ) Ethan enjoys ripping paper, a game he plays with his father. Audience analyzes what Ethan does to show his social emotional development (his mental health). Examples include:
- He recognizes the person who is there.
- He reaches out to grab the paper
- When he falls down, it is not a catastrophe. He bounces right back
- He is laughing because he is engaged in this relationship
- What did dad do to support Ethan and help him develop these skills?
- Laughed with him. And the laughter sounded similar
- He pre-tore the paper to make it easier
- Dad responds to a baby’s need for repetition
- He is lying on the ground at child’s level, being fully present.
Three key elements to early childhood mental health: Each of these descriptions defines early childhood mental health. Zero to three has an official definition. It has to do with the child’s capacity to do three things.
- Form and maintain a relationship
- Experience, express and regulate emotion.
- Learn and explore the environment
The River: (A metaphor for early childhood mental health) It’s a beautiful day. A villager is out walking along the grass and sees something unusual in the river. It is a child. She jumps in the river, saves the child and calls another villager to help. That villager looks in the river and sees another child. He jumps in to save the second child and calls for more help. The villagers soon see more and more children coming down the river. The prosperous village sets up a system to watch for children and rescue and feed them. One day, a villager walks away from his post. Others say, “Hey, why are you going?” The person says, “I am going to find out why the children are in the river in the first place.” This is where we have been going for the past 30 years. We have been slowly moving up stream in terms of research and best practice, to better understand why children are in the river.
Metaphor continued: Special Education/Juvenile Justice: Come back downstream to this well-organized village. This is our special education system. We have all kinds of resources going into this. We also have all kinds of regulations. We can’t get all the children onto the shore. We build barges out in the middle of the river. It is called Level 5 services or juvenile justice. For those children, the river’s current has come against their skin for so long, it has changed the way they move in their everyday life.
Taking the child’s perspective: Child Protection: Today, think not only about moving upstream, but turn 180 degrees and start looking from the baby’s perspective. How we would we go about building programs? How would we pay attention to baby’s everyday moments? Almost all of our services have been developed down stream. Take Child Protection. It is developed for an eight-year old who understands home visits and foster parents, and who has school and a peer group. It is not set up for an eight-month old, who doesn’t understand what it means to be in one house without their crib or blanket for a week, then transfer to a different house with unfamiliar people.
Video lesson #2, Manipulator baby, from AMERICA’S FUNNIEST HOME VIDEOS, (a video with laugh track.) A baby looks for the camera. When he sees the camera he falls down and starts screaming. The camera holder walks away. The baby stops screaming, gets up and looks for the camera. When he sees the camera, he falls down and starts screaming again. Analysis: Why is it called baby manipulator? Because he can stop and start crying. He only cries when he is in front of an adult. He cries to get what he wants. If you move to the baby’s point of view, what do you see? We see a baby who has limited strategies for getting his needs met. Why does he stop crying? The fear of abandonment is overwhelming. His fists are clenched. His mouth is square. That is a typical fear response in a very young child. (This video won the contest.)
Genetics, maltreatment and depression: There is a gene related to serotonin. Researchers looked at two variables in 26 years olds: the gene structure and whether the individual had experienced maltreatment when they were young. If they never had maltreatment, the genes didn’t matter. But it mattered if they had aberrant care giving early on. If they had two long alleles, their chances for depression were no greater—even with significant maltreatment—than if they were not abused. If their genes have two short alleles, their incidence of depression went up 70 percent. Consider two siblings with similar maltreatment. One becomes a professor. One struggles with depression. What do we think from the wide end of the river? One tried harder and pulled himself up by the bootstraps. What it has to do with is that one of them got really crappy genes.
PTSD and maltreatment: We have a lot of interest in returning service personnel with Post Traumatic Stress Disorder. Soldiers are trained for the kind of stress they experience. Given that training, why are they coming back with debilitating symptoms? One of the clues looks like it has to do with whether or not the service personnel experienced child maltreatment. They developed a pattern to reacting, so that put in another stressful situation it is re-charged.
Neurons to Neighborhoods: Published in 2000 by NSF. It says there are two things that happen when a child is very young that have significant consequence for getting that child in the river and keeping that child in the river. The first is aberrant care giving/child maltreatment and the second is significant economic hardship.
Trusting strangers: Researchers found that half the children 3-5 in foster care would leave with a complete stranger who came to the door and asked nicely, compared to none of the children who were in their biological families. Something about reaching out for anyone who will take care of you has lasting power. The child is in survivor mode.
Learning relationship skills: One of the things that children learn in the first year of life, particularly the second half of the first year, is to form an important relationship with at least one person. For children taken out of their home because they are abused or neglected, they don’t learn that. You see a growing inability to trust people. Or think of a mom suffering from post partum depression and home with the baby. She can’t take care of they baby. How does that baby learn to build and maintain a relationship? On the day mom feels better and decides to play with the baby, the baby doesn’t react. It doesn’t have consistent experience. The baby needs to have everyday moments.
Example from Baby’s Space: Dad walks in and signs in his 11-month-old daughter and walks out. Neither react. She is telling us what she expects from a relationship. Nothing. Dad told her what he expected from a relationship with his daughter. This is a dream baby in a typical childcare center. We describer her as easy going. She will sit and play by herself. Yet when she is 3, she will get kicked out of childcare. If a child has a toy and she wants it, she will blow him over. She doesn’t have any empathy.
How Baby’s Space worked in this case: A teacher is assigned as a primary caregiver for this child. She greets her. Changes her diaper. Sits next to her when she has her bottle so that the baby can begin to identify with the same person with these intimate, everyday activities. We do “talk for the baby” (that is, what the baby should be thinking.) Saying “Bye Mom, see you later” when mom leaves. (Even though the baby doesn’t react at first.) We also assign someone to work with the mom and the dad. In this family, domestic violence is present. For the baby: shutting down is a great survival strategy, but a terrible developmental strategy. Our job is to get back to trusting relationships. Within two months the separation looks like this. “By mom, see you later.” The child still is not paying a whole lot of attention. But this time, she retraced mom’s steps, put her hands on the door, turned around and felt completely apart. YEAH, she’s crying! We were so excited. On another occasion, dad is hanging out in the childcare room. The now-toddler brings dad a book. He gets down and they look at it together. He gets up to go. The toddler follows him. They give each other three kisses good-bye. She holds her arms up for the teacher to hold her. From ankle deep in the water onto the grassy shore. We helped her develop skills at forming relationships.
Emotional regulation and cortisol: Children learn emotional regulation through relationship that are consistent and through routines. Stress responses (fight or flight) can be measured through the hormone cortisol, present in saliva. Researchers looked at two stressful situations: a well child visit for children who are 12 months old, and two year olds meeting a clown. Researchers compared children with secure versus insecure attachment. The children had similar behaviors to the stressful environment. But if you couldn’t count on your parent, the cortisol (fight or flight system) kicked in. This has real significance. A longitudinal study shows that security of attachment predicts achievement. (It does not predict IQ; it predicts achievement.) Say a first grader who has never been able to rely on a parent gets stuck on a math problem. The cortisol kicks in. We know if children start on this path, what it takes to kick in the cortisol system gets lower and lower and lower.
More on cortisol and childcare: Toddlers have a lovely pattern of cortisol; it rises in the morning and goes down at night. What happens to toddlers in group care, it rises in the morning, levels off at naptime and goes up after naptime. Why? In group care, if I am an adult, I have seven toddlers, what do I need them to do? Stand in line, wait their turn, use their inside voice. What are the challenges of being a toddler but exactly that? By creating this system from the wide end of river, we have lost the essential ingredients of very young children in their development.
Q: Does exceptional quality care offset experience in the home?
A: That is what we created at Baby’s Space. There was a fight on the playground. Child had to meet with the Director. He said, “On the weekends, I forget to use my words. I have to come back to Baby’s Space to remember.” What we see is kids develop two models, the neighborhood model and the Baby’s Space model.
Q: But you also work with families?
A: It has to be a combination of working with the parents and working with the child. Our goal with parents is that they can support the success of their children. It is not that we lower life stress, not decreasing depression, we are not enhancing parenting skills. We want parents to support the success of their children.
Success possible in spite of trauma: American Indian urban children have experienced extraordinary historical and current trauma, not by virtue of their culture but circumstance. Every one of our kindergarten children has seen somebody shot. All of our kindergartners are academically on target at the same time. It is possible to build the opportunity, even thought the trauma keeps coming.
Why child care ratios matter: Increasing student-adult ratios might be OK for keeping kids safe, but if you want to ensure they have solid foundation in forming relationships, to experience, express and regulate their emotions, one adult to seven children is not adequate and certainly not developmentally appropriate for toddlers. If we don’t’ want toddlers stressed in childcare, we shouldn’t have seven to one ratios. The other thing, we have good screening measures now, Ages and Stages for Social Emotional, a questionnaire. Every parent should want to know, is my child on track? Families should request screening. Parents should know the benchmarks.
Welfare reform. The program has money for childcare, but the program’s goal is to keep parents employed. It is not about predictable, consistent high-quality childcare. A parent works three weeks and gets childcare. Ooops, you are not working this week, you don’t get childcare this week. What happens to the child? They change from childcare to a friend, family or neighbor, back to a childcare. How does an eight-month old understand that? What happens to his ability to form relationships? We have to look at the collateral damage of policy changes.
Q&A
Q: Is there an ideal progression? Should children be home with a parent for the first 18 months, then into a quality care setting?
A: It has to do with the child’s ability to form consistent, available, sensitive relationships, through which that child will learn about emotional regulation and learning—no matter where the setting is. A mom who is depressed is no better than an understaffed childcare setting. The setting for me is not as important as how the child goes about developing the things we know are critical to keeping them on the course.
Q: It seems the answer is supportive pre-birth and post-birth services for parents, teaching them how to tune into their child.
A: I don’t think it can only be parent services. It has to be that parallel path, working with the child simultaneously. You need to get that baby turned around, too, to help the parents rebuild that relationship. It makes it easier for that parent to be successful.
Q: One of the detriments to the wide river view is Ann Geddes, who ensures us that babies are happy in tall flowerpots. I think that is pretty dangerous. She is making a mint on cute, and missing the things you talk about.
A: That is a great example from the wide end of the river.
Q: I live in a neighborhood with stay at home moms When they take their children for walks, they are on cell phones talking and children are completely ignored. I wonder about the influence of technology?
A: The good news is that kids have a wide range of what typical can be. If every moment is plugged into something else and mom is not available, it is a problem.
Q: Should what you are presenting to us becomes part of the standard curriculum in high school? When kids are taught about how they learn, they can figure out a lot of things.
A: Two points. I have been in sessions with counties about how they can move on infant mental health. The idea of high school classes comes up often. The research doesn’t support that this is the moment at which people best learn about parenting. People parent the way they learned it, unless they have another model. We see those significant changes happen in the moment, an observation, an aha moment.
Regarding intervention. I have been around the state, training mental health providers on how to diagnose toddlers. We could spend a whole session on what the diagnose are. It is not ADHD, bipolar disorder or autism spectrum disorder, which are the three diagnoses most parents know. We have ways of understanding how do young children get off track in forming relationships, regulating emotions and learning. We are teaching providers to correctly identify the symptoms, diagnose and intervene. It is about specifically understanding the story of the child in the community.
Q: What do you say to those policy makers who say it is all about literacy.
A: Children need to learn to read, we all know the mantra. Is literacy important? Absolutely. How do children learn to be literate? By their ability to engage in relationships, their ability to manage their feelings and their ability to learn. If a child is confident in the relationship in which they are begin taught, those skills can develop. In Baby’s Space, we have highly stressed kids, but they are on target for their literacy development. They have secure relationships. Literacy is important. It happens in the context of a child’s ability to manage these three important skills.
Q: Are you following kids through the school system?
A: We started as an infant toddler center, then added preschool, then added kindergarten and now we have become a contract school. Soon, we will have 3rd grade MCA on children we have had since birth.
Q: What is the data we should be collecting to look at that system?
A: A lot of the data was collected was through Abecedarian and Perry Preschool, and that all occurred before welfare reform. They occurred with families where parents were at home. As we collect the data, it has to be clear that it is in the context of our current social-political environment, and we begin to look at achievement and begin to look at the impact of stress and how they do over time, if they are in consistent environment.
Q: Is Ages and Stages Social Emotional the right tool?
A: A great opportunity for us to begin to look at that.
Q: What about the increase in out-of-wedlock births? The high percentage of men in prison whose father rejected them? Should we go further up stream, is that a concern?
A: Every day I thank my husband. There are days that tag your it. I can’t imagine raising children this without a partner. We know that domestic violence s not in the best interest of the child. The question is how do we raise children that are able to have committed relationships and give back to the community? That is the key. I don’t think it is about literacy training. I think it is about paying attention to relationships and emotions and learning.
Thank you, Terrie. See you in August. Amy Donnan, LLBO Mental health
Posted by: Amy Donnan | 06/21/2011 at 02:13 PM