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Archive for August, 2013

Essentials Skills in Preschool as Predictors for Success

We all know that early learning includes the development of the pre-reading and math skills that children will need for school.  However, preschoolers need to learn more than how to recite the alphabet and count; children also need to develop executive function skills.

Executive functions help us control our thoughts, behavior and emotions, including our abilities to concentrate, focus, transition between activities, reason and plan. Other executive functions include working memory, organizational skills and cognitive flexibility.  Children who develop these executive skills are more likely to do well in school.

The Goddard SchoolGoddard School teachers focus on helping children develop executive function skills throughout each day in purposeful and fun learning activities.  We do this by encouraging play through dramatizations, stories and games that help young children to develop self-regulation, cognitive and social-emotional skills.

Here are some activities that you can do at home to help your children develop these core skills:

  • Play simple games like Candy Land or Chutes and Ladders.  These help children practice self-regulation by learning rules and following directions;
  • Solve puzzles with them, and introduce harder ones with more pieces as your children improve their skills;
  • Learn a simple dance and create new steps together. Take turns following each other’s movements;
  • Sing your favorite songs together to practice the words and music;
  • Assign your children simple daily chores, and praise your children when they complete the tasks;
  • Turn off your tablet or smartphone, and bring out toys that encourage imaginative play, such as blocks and clay.

Pica: When Kids Eat (and Eat!) Non-Foods

Jack Maypole, MD
Contributing Writer and Goddard School Educational Advisory Board Member

Infants and toddlers are like wobbly ninjas, focused maniacally on tasting and mouthing items from coins to blocks to the odd flotsam and jetsam that lives on living room floors. Parents know to beware, to police an area well…as you never know what they’ll pop in their mouth next.  Infant  and toddler oral fixation is considered developmentally appropriate (if not entirely healthy) behavior.  Fortunately, most children outgrow this item-to-mouth impulse by the time they are closing in on their second birthday.

And then, there are those children with pica.

Pica, of course, refers to the old typewriting term of 12 points of line space equal to 1/6 of an inch. However, that has nothing to do with the more intriguing medical definition we’ll discuss here: Children with pica (estimated to be about 10-20% of kids at some point) demonstrate a persistent tendency to ingest or mouth non-food items for more than a month, at an age for which it is not considered developmentally appropriate.

What are we talking about here? The items children and adults with pica may consume range from the everyday (ice, fingernails, batting from stuffed animals, pebbles, and chips of wood), to the unusual (erasers, talcum powder, coins, cigarette butts) to off-putting or dangerous menu items (feces, pins, lightbulbs, batteries, and burnt matches).

In some cultures and communities, family members may promote eating non-food items for health, well-being, or enjoyment.  For example, in Turkey and Rwanda, geophagia–the practice of eating soil–occurs in huge segments of the population. Dirt can be bought in marketplaces expressly for eating. In parts of the American South, particularly in African American communities, pregnant women may eat laundry starch, or bits of clay to allay the symptoms of morning sickness.  Children or parents who consume these items report it works, and pass it on down the generations.  But is it ok? More on that in a minute.

Even  after documenting this phenomena for centuries, we don’t have a full explanation for pica, and the compulsion to consume non-food items  in otherwise healthy individuals.   The pre-eminent  theory explains pica as a compensation for nutritional deficiencies–such as iron, zinc, or other minerals– in an individual’s or community’s diet.  Ironically, the consumption of clay and starch block the body’s absorption of iron, and can create or exacerbate a  low iron problem for a woman (not a good thing in pregnancy).

Even in a child who is progressing normally developmentally, pica may be associated with other complex factors. Children with histories of stress, economic hardship, trauma, depression, parental deprivation or frank hunger may consume non food items. Distraction? Boredom? Soothing? Perhaps.  In other situations, pica strongly correlates (for reasons unclear)  with certain mental disorders, such as schizophrenia, or developmental conditions, such as mental retardation or pervasive developmental delay (PDD ).  This can be an important heads up for caretakers, and another challenge in managing these kids as they go through their day.

Pica  behaviors in children and families may go on for years, undisclosed but in plain sight or in secret. For some children and families, shame or embarrassment may hinder discussion with their health care provider. Families may not perceive pica as a health issue, or consider the matter worth mentioning.  For the primary care doc, if there is a suspicion or mention of pica, this is a matter best approached with awareness, sensitivity, and the right questions.

The medical problems from pica derive from what gets eaten. Kids with damaged  or missing teeth from chewing or mouthing unusual materials may arouse suspicion and herald an unrecognized case of pica. Consumed items may exert poisoning effects when swallowed over days or weeks. Lead toxicity is most common, and may be subtle (anemia) or devastating (encephalopathy and brain damage).   Pica behaviors around eating paint chips or contaminated soil may be the source, and observations by parents or astute history taking by health care providers may prove critical in helping manage the acute symptoms and preventing recurrences.

Other children and teens with pica may present with GI discomfort caused by items they’ve eaten. Constipation, ulcers, perforations, and bezoars (wads of undigestible items, such as hair, that are unable to pass out of the stomach) may require special imaging, ER visits, or surgical intervention.

The ingestion of soil or fecal matter in some individuals can also cause bacterial or parasitic infections.   Toxoplasmosis, toxocariasis,  and worm parasites like ascaris can occur, cause havoc, and require prompt treatment and evaluation.  And, they are unpleasant.

Treatment of children and teens with pica requires a team effort.  When the diagnosis is made, the first priority is to determine the health status of the child in question.  Clinicians will perform complete physical and neurological examinations, with  laboratory  or imaging studies, or specialist consultation done as needed.  Medical treatment for pica will be tailored to address any acute problems (infection, GI issues, or toxicity) and longer term, applying a comprehensive and collaborative approach to the family.

Primary care providers, social workers, and mental health experts need to partner with a family to understand their cultural attitudes and health beliefs around pica behaviors to develop trust, communication, and a workabole plan. Ideally, family members learn about the potential risks of pica, and to recognized potential symptoms of ingestion.  With time, families can apply  individualized strategies to redirect and distract from unhealthy mouthing or munching. In most cases, the prognosis is good: healthy children will often outgrow pica by school age, while children with mental or developmental disorders respond well to intervention, but may relapse into the behaviors into their adolescence, and beyond.

So then, while kids may gnaw on this or nibble on that, be mindful. If you are concerned, be careful. And if necessary, talk to your child’s primary doc.


What Is STEM?


The Goddard SchoolSTEM is the acronym for the subjects science, technology, engineering and math. According to Dr. Sherri Killins at the Boston Children’s Museum, “What STEM does is give a label to what you (parents and educators) are already doing… helping children to explore, observe, ask questions, predict, integrate their learning.”

At The Goddard School®, we encourage children to use their inquisitive natures to explore, build and question. Through hands-on activities, children learn to ask questions, draw upon their existing knowledge, design experiments, make predictions about what might happen and draw conclusions, which is the scientific process. Lessons and play use math and technology every day. Children are natural engineers, and we encourage their creativity in our block, art and outside play areas.  

“There are no greater natural scientists and engineers then young children. Inquisitive learners who learn STEM concepts through play. Once again, it comes down to letting the children play!” – J. D. Chesloff, 2012, Chair of the Board of Education and Care, State of Massachusetts

The Effect of Art on Learning

The Goddard SchoolThe walls of our classrooms are covered with the children’s art. But how does art affect learning? According to the 2009 Neuro-Education Initiative of The Johns Hopkins University School of Education, “researchers found ‘tight correlations’ between arts training and improvements in cognition, attention and learning.”

Creative art motivates and engages children in learning, stimulates memory, facilitates understanding, enhances symbolic communication, promotes relationships and provides an avenue for building competence.

Encourage art at home as a family activity.

  • Get out the art materials and create projects together;
  • Create drawings on the computer with one of the many fun early learning art applications online, and share the drawings with the children’s grandparents;
  • Be creative with recycled materials. You can build a bird house from boxes and wood or a robot from cardboard, leaves and twigs.

The children will be learning a lot and you will be creating wonderful family memories. Goddard Schools tested all of the activities for Susan Magsamen’s book The Classic Treasury of Childhood Wonders (2010) in our classrooms. The children and families had fun and loved being involved.