Parent FAQ

Biting:

"One of the biggest challenges for both parents and child care providers is the toddler who bites. What advice could you give child care providers who must deal with the biter and bitee and their respective families?"

Young children bite for a whole variety of reasons. Usually it occurs because it is the most powerful strategy for getting what they want or expressing emotions when they either don't have the words or are still young and impulsive. It's the adults' job to:

        *Observe when it is most likely to happen. Then adapt environment, schedule, and staff assignments based on what you have observed.

         *Develop a strategy for use by parents and other caregivers that helps the biter develop new constructive ways of getting needs met.  For example, provide a teething ring, if the child has a need to work those teeth; acquire a second favorite toy, if the issue is often fighting over the toy; give the child extra friendly and responsive attention at non-problemmatic times, if the child seems to be using aggression to get attention, etc.

        *Use preventive or anticipatory approaches, i.e. re-arrange the room so a child who does bite can easily move away and find a safe place to de-escalate when he/she feels stressed; or redirect a toddler who is about to bite in response to a child taking away the ball he/she is playing with to a different ball and a next step might be for her to talk with the toddler about how hard it is to have a toy taken away, help him/her say "no" and "I am playing with the ball" and perhaps remind him/her to ask the teacher for help, or remind the toddler that the balls are kept in a certain container.

         *Help the child recognize that biting is not acceptable behavior without using aggressive behavior as an adult.

         *Give short clear messages such as, "No biting. That hurts." while redirecting with short clear messages. "Tell him no!" "She has the truck. We'll find you something else." Etc. Your face and voice should both convey the strong message that biting is not OK.

         *Shadow the biter more, being particularly watchful of children that may be repeated targets. It is particularly effective with biters to assign someone (may be a trainee or volunteer) to that child. Their job is to watch and redirect quickly when they see mouth opening and teeth moving toward a target.

         *Remove favorite toys and/or stop activities only if those are the only things that seem to work. Then say something like, "I'm so sorry, but I'm sad that you hurt--- so now we have to put this away." Because timeouts have been used in such punitive ways that have tended to reinforce a child's bad feelings towards himself and others, they are currently not being recommended. If you can use a short timeout (one minute per year of age) in a way that helps the child think about how sad you are and how s/he needs to stop, slow down, and think, it may be acceptable, but do this very carefully and observe what happens.

         *Give the child lots of affection and attention for positive behaviors.

         *Immediately reinforce no biting times. Example: Give a hug and exclaim," Good for you. You played so nicely with --- this morning."

         *Work hard on helping the child acquire communication skills through encouragement of expressive language and signing. There should be lots of book reading to develop vocabulary.

         *If the biting indicates that the child is struggling with aggressive feelings, provide a variety of expressive outlets: play dough, hammering, puppets, wild animals. Likewise more sensory activities such as sand and water may help children feel more mellow.

        *Communicate daily with parents to see what is happening at home, do joint problem solving, and help parents see that you are their ally in helping their child get through a challenging stage. Make sure that you focus on both parent and child strengths rather than dwell on a behavior that may make them feel inadequate, worried, on punitive toward their child.

         *Help everyone realize that biting is a normal stage for many children and that it is important that everyone work together during this period to protect and comfort bitees while helping the biter change behavior.

         *Pay equal attention to concerned parents of bitees. Empathize with their concern about their children. Discuss the developmental stage and what you are doing to help the biter gain control while you protect their child. Let them know that it is your philosophy to work with all children through difficult periods. Help them reflect on difficult periods in their own lives and the lives of those around them and what helped. Use this as an opportunity to discuss the early childhood philosophy of  guiding children toward being positive, caring, competent adults.

         *Help everyone understand that this is a process and will not change overnight. The length of time needed for each child to stop biting behavior varies.

         *Bring in mental health consultants if needed and form a supportive team with parents.

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"Would using a leash with a young child have any negative effects on the child's personality?"

Toddlers who have just learned to walk rightfully want to practice their new walking skills day and night. Parents have to figure out ways to protect them while allowing them many opportunities to move. Leashes are just one way of both allowing some freedom while protecting from danger. Many people are horrified when they see a leash and immediately think of dogs rather than children. I happen to be one who thinks that it should be a parental decision. Adult backs can get tired of bending over and short arms, tired of reaching up. Outside in a crowd, a leash may be the best solution. For me the question always is "How does it feel to parent and toddler?" If the child is happy and gets at least most of the autonomy they crave and the adult is enjoying the time with their child, I don't think it should be a problem. As toddlers grow big enough to understand safety rules and understand that they must hold an adult's hand at certain times, the leash can be put away. Likewise if there are enough older children and adults to make sure that the toddler is safe, there may be no need for a leash. Back to Top

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Exersaucers and Swings:

"Exersaucers and swings are popular with both parents and many child care providers. Could you say something about their use?"

My own feeling is that there has to be careful rationale and individualization for use of swings and xersaucers. Never should babies be left in them for long periods of time, but they may be used carefully with the following guidelines:

         * some fussy babies may benefit from the motion of swings and with special needs children, there may be a prescriptive use from a Part C (early intervention) team

         * if a child care educator has 4 babies that often demand attention at the same time (diapering, feeding, comforting), an exersaucer or swing might be used to help them wait a few minutes

         * active babies who require a lot of stimulation and variety may benefit from short stints in an exersaucer or swing, but the caregiver should be careful to limit the amount of time that this activity is used.

Perhaps it is most useful to get parents and providers to think about what is most important for babies -- that nothing substitutes for the relationship of a human being who is holding and playing with them. One of our values should be that children prefer people to material objects.

Secondly, the young infant's biggest job is to work on all the various aspects of development, a large part of which is motor.Exersaucers and swings may comfort and entertain them but they also take away from floor time where the baby gets to work on his or her own capacities.

Thirdly, we all have to learn some frustration tolerance. None of us like to hear babies cry and as much as possible, we respond quickly to ease an infant's distress.  But realistically, the world is a place that requires a little waiting. When a caregiver is busy with another baby, she may help a crying baby learn to tolerate a few minutes' wait by soothing talking. "I know. You want to eat right now. It makes you mad, but I'm coming." This is what I call emotional literacy. You intentionally empathize and name the feeling while helping the baby know that you are emotionally available and that needs will be satisfied in a short period of time.

Fourthly, these pieces of equipment take up a lot of space. It is essential that there be plenty of room to learn to crawl, walk, and climb up to things. If a center or home has small rooms, the equipment may make the room seem crowded and detract from space that is most critical for the development of motor skills.

Any time we can get people to dialogue and share their stories about individual children, their setting, and what works best while guarding the underlying values, we all learn.  People also have to learn to accept the rules of their particular organization. If the established rule is that there will be no swings or exersaucers, adults and
children will get along just fine and discover strategies for providing for care of multiple children, keeping crying to a minimum, and hopefully making the day move along smoothly.  There is no one recipe for creating healthy, happy babies.  They are all individuals as are the adults caring for them.

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"In a few days, we are scheduled to be 'introduced' to a baby at an orphanage in Bulgaria.  We need advice on how to tell you this child is OK.  We know nothing about the age of this baby, but it should be less than 12 months.  What kinds of activities, 'tests' should we do with this child to determine if she or he is OK?"

Rather than try to "test" the child, panel members recommended observing the child, preferably with a familiar caregiver.  One panel member said, "beginning at about four to six months, babies usually become wary of strangers and are not as responsive as with familiar caregivers.  So you might want to watch the baby in interaction with a familiar caregiver, rather than judge the baby based on responses to you."

Another panel member said, "I personally would try to pay attention to the eye contact of the child when approached, and whether the child seems to look at faces.  If the child would show cautiousness at age 2, I would think it would be a good sign.  I would look at the muscular tone of the child, and the quality of movements, and whether the child pays attention to things when playing.  At age 2, how much language is there?  Finally, most importantly, I would want to know if the child seemed content, happy with his/her caregivers, and seemed to trust them. If all of these ingredients were there, I would feel happy and reassured.  Of course, this does not guarantee anything, as there is no way to really 'predict' outcome, based on infant features, but these are good promonitory signs for a child who is well-regulated and emotionally warm and trusting.  "

In a similar vein, another panel member said, "watch responses to people and objects, look at emotions and whether they are appropriate, watch the baby's ability to focus attention and his or her interest in mastery of the simplest tasks.  Pay attention to alertness, whether or not the baby seems aware of someone new and different, how he or she reacts to being held, whether he or she will engage in an interactional 'dance' (smiling, making sounds, imitating).  If upset, can he or she be comforted?  Ask as many questions that you can from the people who have cared for the baby."

Another panel member said that "babies who have been in institutionalized tend to have developmental delays that are general across all areas, and they may be small for their age.  Usually, they make dramatic gains when they get into a better environment.  Unfortunately, it is not possible to tell whether the poor performance is just a transient delay or due to some sort of permanent damage.  This is a perennial problem when trying to assess infants to make predictions for the future.  That being said, if the child seems dramatically delayed (i.e., looks like a newborn but is actually eight months old), I would be very concerned.  Also, if you see any unusual postures or movements or asymmetries, this may be an indication of permanent damage."

Another panel member suggested that the parents try to "find out as much as possible the numbers of caregivers the baby has had, how long the baby has been in the orphanage, the reason why the baby is up for adoption, where the baby was before the orphanage, etc. and if the orphanage has a primary caregiver system where one person is assigned as the main person to nurture the baby.  The outcome will be better if the baby has had, from birth, a small number of consistent caregivers who have provided warm and responsive care."

Another panel member said "we know there are great risks with children who experience early neglect and maltreatment.  We also know that many children do develop serious, untreatable problems while others succeed and live happy lives.  It's entirely up to the adoptive parents as to whether or not they want to take the risk."

After visiting the orphanage, the parents said that "this particular orphanage accommodates age children from birth to three.  According to the director, they have good medical records on the pregnancy and some family history with each child.  Also, we were very impressed with the looks of the orphanage and the apparent quality of care.  It was a bright and colorful building, with lots of toys and equipment to keep the children stimulated.  Even the youngest babies had crib toys or mobiles.  There were large mirrors at  floor level and carpeting for them to lie or crawl on in the nurseries The infants lived 2 or 3 to a room and there looked to be several caregivers per unit, but we forgot to ask the ratio of how many different ones interact with one child on a typical day.  However, while we were there we saw at least two caregivers in one room, one changing the children's diapers in the other getting ready to feed them.  The children seemed healthy and alert and able to track our movement.  We caught the 1 1/2 to 2-year-old group at lunch and, while shy of strangers, they looked like normal kids.  The three-year-old group was even more so; they were talking (both among themselves  and to us) and active and not at all shy about coming over to us.  They told us (through the translator) about the games they had just been playing.  It seemed like a normal preschool setting."

The environment in the Bulgarian orphanage described by the parents sounded good compared to others in Eastern European countries that have been described in the popular press and in professional articles.   However, the parents were disappointed to find out that it takes approximately a year to finalize the adoption process for a Bulgarian child and that by the time they went through the entire adoption process, the child they adopted would be about 2 years of age.  They were trying to weigh the pros and cons of adopting an infant from another Eastern European country who may have received poorer or unknown quality care and have an unknown medical history compared with adopting a toddler with known history who had received good care in an Bulgarian orphanage.

Business Trip Question:

The mother of an 18-month-old asked how to prepare her toddler for the mother's 6-day absence to attend a professional conference. The mother had planned to take a babysitter along on the trip, but these plans had fallen through. The toddler is breastfeeding and the mother seemed concerned that the toddler might be upset by the separation and also that she might wean herself while the mother was gone.  She was also concerned that her toddler was not used to napping and falling asleep without nursing and was used to co-sleeping and nursing several times in the night.

Panel Member 1:

My answer is first that she should not go to a conference, and if she 'has " to go, could she take the little girl in some way? If this is not possible, then other alternatives could be tried  (such as the suggestions below).

Panel Member 2:

I thought that if the child was verbal enough she may be able to relate to some simple books depicting separation and reunion. Her mother thought that she might make up a book with some photos of her leaving and coming back that they could look at before her departure and that the baby could look at with her father and babysitter while the mother was away. I also thought it would be important for the child to remain in her usual routine, i.e. with her usual babysitter coming in to look after her as usual rather than having some new arrangement in the mother's absence.

Panel Member 3:

I suspect that both mother and baby will weather this. That said, it would be great if the baby could come or if Mom could do less than 6 days.

I would suggest that Mom start having brief and longer separations before hand, do lots of talking about how "Mommy always comes back," and showing that, even just when she goes out to grocery shop and Dad holds fort. Maybe also have baby practice talking to Mom on the phone while Mom is out for short times.

Before the trip I would have her give the baby a transitional object (e.g. cuddly toy or doll), perhaps with pictures of Mom and the object, and Mom and the baby and the object in this book.

You might have Mom make a video-recording of her reading bedtime stories for Dad to try out--not sure if that would make baby sadder or more comforted. Mom could make the tape with baby and then show it before she leaves a few times so baby knows it really is Mom and that the tape doesn't necessarily mean that the real Mom won't come back. Then I'd have small gifts for the kid each day that Dad would give.

With all that, I'd prepare for an angry kid when Mom was back, but I think that unless the child is very temperamentally sensitive she'd probably recoup after about a week. And I bet the breastfeeding would be ok too. I see a 2-year old with divorced parents and the kid takes up breastfeeding with a vengeance every time she comes back to Mom.

Maybe I'm off, but as I said, I see kids coping pretty well all the time.  And learning that she can weather this may not be a terrible thing. It's not like the Robertson tapes where the kid was with strangers [the Robertson tapes depicted children separated from parents and staying in the hospital or residential nurseries for varying periods of time].

Panel Member 4:

This is a tough one. I think it points out how much mothers who are trying to balance both parenting and career need to plan far ahead and have carefully thought out what they would do if.…

The period from about 8 months to 2 years is a very difficult time for babies to handle separations unless they have had experience from early infancy with overnight separations.  I would encourage mothers to either prepare infants early on for overnight separations with familiar, loving people or wait until they are verbal and able to play out what is going to happen. Particularly for a breastfed child, I would think that a 6-day separation could be traumatic (of course, taking into account that some children are quite resilient).  Before the baby is even born, it may be important for parents to understand child development and talk about their priorities. I'm sure the mother would give up the professional conference if her child were seriously ill or something happened with a family member that made a strong case for her to cancel prior engagements. The mother should ask herself the following questions.

         " If I think there is a chance that my absence may cause my baby anxiety or upset for weeks or even months, should I take the risk?"
         "Could I get abstracts, audiotapes, or talk with professional friends in lieu of attending this particular conference?"
         "Have I exhausted my list of possible replacements for the babysitter? Is there a retired friend who loves babies and might enjoy the trip if we did some good planning of things to do while I attend key meetings?"
         "Would it really jeopardize my job if I told my employer that I do consider my career as important but that family members are priority and that this is as important to my baby as being with a parent or a spouse at a time that they have told me is really critical for me to be with them?"

I guess I think that infancy is a short time in the scope of life and sometimes parents just have to make sacrifices.

Panel Member 5:

I think the idea of stories about separation is a good one. I think the photo book is also a good idea. I don't think it should be an either/or situation (I wouldn't say to the mom "don't go"). What about a short separation before the conference, say overnight on a weekend-- just mom if there is a dad and he will be home when mom goes to the conference. Do this, after reading a story and making the photo book.  In other words, try it out in real life before the larger separation has to take place. That way the baby can actually see that mom really does come home.

The mother was contacted 11 days after her return.  She reported that about 2 days before her departure, she made a book with photos of the “Daddy going bye-bye”, “Mommy going bye-bye”, and “Daddy on a plane.”  She also drew a picture of the family bed and created 3 family dolls by laminating photos of the mother, father and child.  She acted out scenarios with the dolls showing all 3 in the bed, then the mother and child, and finally the father and child.  During the mother’s absence, the father, a regular babysitter, and grandparents from out of town helped care for the child.

The father reported that the first few nights were difficult with the child asking “Where’s Mommy?” when she awoke. She cried intensely for a few minutes before falling back to sleep.  Also, during the day when she was tired or when she fell and hurt herself, she asked for her mother.  She would not drink breast milk from a cup saying “I don’t like it.”  During the mother's absence, the father formally used the book the mother had made only  once or twice but it was always available to the child.  The grandparents were surprised that things went so well because they had expected the child to be more upset.  When the mother called home, she could hear the child laughing and having fun in the background, but she did not speak to the child because her husband feared the upset this might cause.

When the mother returned, the child greeted her, was immediately happy to see her, and did not express any anger.  However, she nursed frequently for a week (nursing with a vengeance).  The mother, who works in her home, could not get any work done that first week back as the child would not stay with the in-home babysitter as she normally would.  By the 11th day home, things were getting back to normal.  Three weeks after her return, things were definitely back to normal with the toddler doing fine with the child care provider, nursing normally, and no longer clinging as she did the first week after the mother returned.  In addition, the toddler speaks fondly of things that happened when the grandparents were there, e.g. "Kissy (a horse) ran away! Mully (a dog) chased him!"

This 18-month old weathered a 6-day separation from her mother well.  There were a number of circumstances that conspired to render this happy result.  These circumstances may not obtain in all cases, which probably accounts for the varying levels of concern expressed by the panel members above.

1.  The child was not a tempermentally difficult or sensitive child – she was fairly adaptable to changes in her environment and approached new situations with a positive attitude.
2.   The child had a secure attachment with both the mother and the father.  The parents used a close contact pattern of child rearing including practicing the family bed, prolonged breastfeeding, and lots of carrying.  The child trusted that she would be taken care of and that her mother would return.
3.  A major protective factor was the advanced language ability of this child.  At 18 months, she speaks in 9 word sentences and is beginning to use grammatical morphemes which usually do not appear until 30 months of age.  Therefore, she had the symbolic ability to be able to relate to the book of photos that her mother made, and the scenarios enacted with the dolls.  She also had the representational ability to keep her mother’s image in mind through out the 6-day separation.
4. The child had not previously experienced stressful separations.
5.  She was cared for by her father and other familiar caregivers in her own familiar surroundings and kept her usual routine in her mother’s absence.
6.  The mother, upon her return, was willing to accept the child’s extra clingyness and delayed her return to a full work schedule until her child was ready for the separation.


Thus, a favorable temperament, a secure attachment, excellent language abilities, no history of stressful separations, familiar caregivers and surroundings during the mother’s absence, and the mother’s indulgence of her child’s contact needs after her return were protective factors that helped this 18-month-old cope with a potentially stressful separation. A child of this age with more typical language skills (i.e., just beginning to put 2 words together in a sentence, a vocabulary of 50-75 words) would not have been able to comprehend the separation and reunion stories that this mother carefully prepared.  A child of this age with typical language skills also might not comprehend or be comforted when told that mother would eventually return.  When some of the protective factors listed above are not present, children of this age may experience a greater degree of upset and will take longer to recover from such separation experiences.  Parents should consider whether the above protective factors exist to gauge the reaction of their own child to overnight separations that are not routine.

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Night-waking and Crying
 

Question:   Our 2 year old son has a well established routine each night and goes to bed brilliantly. Just recently, on and off over the past 2 months, his behavior has been changing. He sleeps from 9 PM until about 1-2 AM. He then gets up and cries uncontrollably at his gate. He wants milk (which a dentist told us is bad for his teeth at night) and wants my wife (33 weeks pregnant) to get in bed with him. As you would probably guess we cannot live like this. My poor wife is an emotional wreck. Just last night we let him cry for a while at his gate....she couldn't stand it and this is understandable, she is a WONDERFUL mom (very natural with good natural boundaries). So, my question is twofold.

1. What should we do?

2. What effect does not going to him when he calls to us have on building trust?

We need all he help we can get.

Panel Member Answers:

Panel Member 1:

These sleeping problems during the toddler years are so difficult for everyone. It's my belief that each family has to find the solution that feels right for them. As I understand it, these parents want to help their toddler through a difficult time showing their compassion and empathy while also helping him maintain trust and feel secure. At the same time, Mom's pregnancy and need for sleep mean that she must take care of herself.

Possible solutions: Give water instead of milk, making sure his bedtime feeding gives him enough nutrition to help him get through the night.Perhaps Daddy could do it instead of Mom, saying firmly that Mommy's sleeping. If he's in a bed, massaging his back and perhaps playing or singing a lullaby could help him return to sleep after the initial protest (which may last quite a long time the first night but diminish over time if Daddy can stay calm, firm, and consistent.

I've known at least one family who helped the child get into a more stable sleeping pattern at this stage by putting a mattress on the floor beside their bed.

I'm not opposed to the family bed but think this is totally the parents' decision. Family bed proponents say that everyone sleeps better if the child is simply allowed to come into the bed. You may put them to bed in their own bed but allow them in if they wake up. This happens in many cultures but is frowned upon in ours. Children move back to their own beds as they get older.

This is good practice for parents, who will soon have two little ones who may compete for attention. It's important that they get clear about where they will set their boundaries, how they will balance the responsibilities, and how they show each child love while caring for themselves. They may need to work on getting rid of guilt and keep telling themselves that young children have intense emotions that they display without wrecking their mental health.  When they become like the soft rock of Gibralter, the child will eventually get over the hurdle, but each child will get over hurdles at their own pace depending on their temperament.

Panel Member 2:

Each family must find their own way through this and if they find the solution that is comfortable for them it will set them on a good path through all of child rearing.  2 year olds are often masters at playing their parents' heartstrings late at night, and I think that I would only add that these parents are unlikely to do any harm to the building of trust by whatever choice they make.  In a well nurtured child, self-confidence can actually increase by parents' lovingly but firmly stating that they know the child can go back to sleep and that they will be happy to see him in the am, providing fairly minimal interaction at the time.  When the child finds out this is actually the case he not only gets more sleep, but all feel like very successful family members.  I think actually the worst choice parents make in these situations is to "sacrifice" themselves, leading to many cranky, resentful moments on the parts of all, and often to a delay in the child resolving the important developmental task of handling the night demons and learning that he can self-soothe.  In that case, the child often gets worse, fed by the parents' feelings that there really is something wrong, and eventually the solution is much harder than it would have been in the first place or the child learns that he can rule the roost, in which case things are worse after the next baby.  What you emphasize that I think is the secret here is that parents need to be quietly sure in their approach and the child will feel comforted and learn to live with it.  If the parents decide together what seems best for the whole family, they can project that sure confidence and the whole family will do well.

 I also agree that family beds are fine if that is what everyone is comfortable with, but remember the new little one coming too.   My niece recently went through a terrible postpartum period when her 3 year old, who had only ever fallen asleep in her bed with her asleep next to him (leading to some very late bedtimes and grumpy mornings), became enraged after a baby sister joined them.  His crying kept the baby awake and vice versa.  They finally had to do a modified Ferberizing of the older child, whose demands kept escalating as his sleep time fell, until they were all somewhat hysterical.  But I think that if he had not been allowed to be the decision maker about how bed time would be carried out before the new baby they could all four have coexisted quite peacefully afterwards.

That said, I once heard about a wonderful concept I have sometimes wished to emulate--a "fussy baby clinic".  There are so many reasons for fussy babies (and toddlers) and I love the idea that parents didn't have to figure out whether this was gi upset or food intolerance, or ear infections or just a normal need for calm, firm parenting, for which parents these days seem to have a paucity of role models.

Panel Member 3:

This is a tough situation. There are varying views on this and I am of the camp that thinks you shouldn't "let them cry it out" as it will undermine trust. One alternative is co-sleeping which is what most people around the world do with young children.

 A good website to look at is:
http://www.med.umich.edu/1libr/yourchild/sleep.htm

A good book also with a balanced look at 4 alternatives is:
 "The Sleep Book for Tired Parents"

To read about the benefits of co-sleeping, see:
  www.attachmentparenting.org

For strategies to deal with crying at night, see Elizabeth Pantley's excellent book titled "The No-Cry Sleep Solution."

When the new baby arrives, you may expect to see some regression in the older child's behavior. It is normal for a child to feel displaced by the new baby so try to be sensitive to your son's needs for comfort at  this time.

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