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Archive for the ‘Toddlers’ Category

Potty Training

Potty training is a major milestone in a child’s life and can be difficult for many parents.

Most children begin to show signs that they are ready for potty training between 18 and 24 months. However, instead of using age as an indicator, look for other signs that your child may be ready to start the process, such as these:twenty20_f33fc0a5-02b6-4782-90db-35bd62a89cda

  • She orally expresses a need to go;
  • She keeps her diaper dry for over two hours;
  • She goes to the potty, sits on it and then gets off the potty;
  • She pulls down her diaper, her disposable training pants or her underpants;
  • She shows an interest in using the potty or in wearing underpants.

During the potty training process, remember that teaching a toddler to use the potty is not an overnight experience. It requires a lot of time, patience and a willingness to accept setbacks. Remember that accidents will happen. Recognizing all the little successes during the process is important. Be sure to praise her each time she attempts to use the toilet, even if nothing happens. If you show disappointment when she wets or soils herself, it can result in a step backward. Instead, offer your support and reassure her that she is close to using the potty like a big girl.

10 Training Tips

Once you see that your child is ready to start learning how to use the potty, these tips may help.

  1. Do not make your child sit on the toilet against her will. Instead, show her how you sit on the toilet and explain to her what you’re doing. Children learn by watching. You can also have her sit on the potty seat and watch while you or one of her siblings uses the toilet.
  2. Establish a routine. For example, you can begin by having her sit on the potty after waking up with a dry diaper or by having her sit on the potty an hour after drinking lots of fluid. Only have her sit on the potty for a few minutes a couple of times a day. Let her get off the potty as soon as she wants.
  3. Try catching her in the act of pooping. Children often give clear cues that they need to use the bathroom: their faces turn red and they may grunt or squat. Many children tend to have a bowel movement around the same time every day.
  4. Have your child sit on the potty 15 to 30 minutes after meals to take advantage of the body’s natural tendency to have a bowel movement after eating. This is called the gastro-colic reflex.
  5. Remove a bowel movement from your child’s diaper, put it in the toilet and tell your child that poop goes in the potty.
  6. Make sure your child’s wardrobe is suitable for potty training. Avoid overalls and onesies. Simple clothes are necessary at this stage of training, and children who are potty training need to be able to undress themselves.
  7. Some parents like to let their child spend some time during the day without a diaper. If she urinates without wearing a diaper, she may be more likely to feel what’s happening and express discomfort. If you opt to keep your child’s bottom bare for a little while, keep the potty close by, protect your rugs and be ready to clean up the mess.
  8. When your son is ready to start urinating standing up, have him play target practice. Show him how to stand so that he can aim his urine stream into the toilet. Some parents use things like cereal pieces as a target for their little guys to hit.
  9. Offer your child small rewards, such as stickers or time reading with Mommy, every time he uses the toilet. You can also let him pick out a few new pairs of big-boy underwear.
  10. Make sure all of your child’s caregivers, including babysitters, grandparents and teachers, follow the same routine and use the same names for body parts and bathroom acts. Let them know how you’re handling the issue and ask them to use the same approaches so your child won’t become confused.

There are some times in which it might be awkward for you to start the toilet-training process. During these periods it may be better to wait until your child’s environment is stable and secure. For example you might want to postpone toilet training:

Just remember that toddlers will let you know when they’re ready. If you’re torn about when to start the potty training process, let your child be your guide.

Teaching Children a Foreign Language

Learning language is a natural process when children are young. Introducing them to second languages such as Spanish, SigningFrench and American Sign Language (ASL) encourages brain development. The earlier a child is exposed to another language, the greater the likelihood is that the child will become fluent in the language.

Second languages also help celebrate cultural diversity and create an understanding of the written word. A second language can unleash a child’s curiosity.

The sooner a child is introduced to a second language, the more success he will have in learning the language. Following are some age-appropriate activities to help you incorporate a second language into your baby’s daily routine.

Infant to 12 months

  • Sign as you say words;
  • Use one-word signs, like more, mom, dad, ball or cup;
  • Gently move your child’s hands to make a sign;
  • Play music in the target language.

12 to 18 months

  • Add to your child’s signing vocabulary;
  • Use signs with verbal cues;
  • Say both the English word and the target language word for an object;
  • Practice the target language while playing ball. As you roll the ball to your child, you could say, “Here comes the red ball, la pelota roja”;
  • Use the target language words interchangeably in your own speech;
  • Name body parts, animals and colors in the target language.

Five Tips for Developing Healthy Learning Habits

  • Encourage play. Playing alone and with others not only builds brain development, it also helps children develop social skills and a sense of ethics. The most effective play is free of evaluation and correction (after all, throwing a ball shouldn’t be “right” or “wrong”), while promoting autonomy.
  • Play together. In addition to their ABCs and 123s, preschool children are learning and developing life skills that will shape who they grow into as adults.  One of these building blocks is learning to play well with others and accepting one another’s differences.
  • Get adequate sleep and proper nutrition. Your child will do their best if they get to sleep early and eat a healthy breakfast each day before school. A daily diet of junk food is not compatible with learning. It can cause listlessness and hyperactivity, which can impair a child’s ability to learn. Skipping breakfast, especially, is a detriment to a child’s education.
  • Continue year-long education. Routine provides structure, which is often lacking during the summer months when children all too quickly become detached from the lessons they learned throughout the school year.  Maintaining a schedule throughout the summer supports an environment that is less of a contrast to the classroom and provides a healthy balance between building skills, play and rest.
  • Turn off the screens. The American Academy of Pediatrics urges parents to avoid television and other electronic media for children two years of age and younger. Time spent in front of a computer, TV, video game or other similar devices can interfere with schoolwork, physical activity, curious exploration, social interaction and play.

How to Raise Emotionally Healthy Children: Meeting the Five Critical Needs of Children…and Parents Too!

by Dr. Gerald Newmark
The Children’s Project
Developing Emotionally Healthy Children, Families, Schools and Communities

Everyone, including babies, toddlers, teenagers, parents and grandparents, has similar emotional needs. Meeting your child’s needs in childhood provides the foundation for success in school, work, relationships, marriage and life.

In his book How to Raise Emotionally Healthy Children: Meeting the Five Critical Needs of Children…and Parents Too!, Dr. Gerald Newmark shows parents and teachers how to nourish children’s emotional health at home and at school. The book helps parents and teachers recognize and satisfy children’s critical emotional needs, which are to feel respected, important, accepted, included and secure. Parents and teachers can benefit from this process, too.

In the coming weeks, we will share a series of articles on this blog with tips, activities and more information about meeting each of these five emotional needs. We’ll also address hurtful and helpful behaviors and how to become an effective parent. These simple, powerful ideas can enhance the lives of children, parents and families.

The goal is to raise self-confident, independent, responsible, thinking, caring and civic-minded individuals.

In the next article in this series, Dr. Newmark will discuss children’s need to feel respected. Until then, consider the following.

When you were a child and someone asked you a question, did your mother or father ever jump in and answer it for you?

Have you ever interrupted a conversation with your child to answer the phone, and then found yourself saying to your child, “Don’t be rude. Can’t you see I’m talking?”

Preventing Bullying from an Early Age

To ensure our children treat others fairly and speak up when they see a peer being bullied, we should start teaching them these behaviors while they are young and build on their natural ability to show empathy. Empathy, a key tool in dealing with and preventing bullying, shows up as early as the toddler years (picture a toddler offering a hug or a stuffed animal to a friend who feels sad).

Recently, a Harris poll found that two-thirds of parents worry about their young children being bullied. This result should inspire us to have deeper conversations on this subject and develop new and creative ways to educate and inform our youngsters about what bullying really is, how they can prevent it and how to find the appropriate channels for reporting it if or when it occurs.

Bullying Versus Typical Behavior

Bullying differs from typical day-to-day conflicts. Toddlers are starting to explore their independence and using their new vocabulary to assert it. If a peer tries to play with a toy they want, the back-and-forth “mine!” game begins. This is typical toddler behavior. Bullying involves behavior that is aggressive, intentional and intended to intimidate a specific peer. Determining what is bullying and what normal behavior is for toddlers is difficult because young children are still learning right from wrong and acceptable play behavior.

Fostering Empathy and Teaching Children to Speak Up

As parents, our duty is to foster empathy in our children. We can pay close attention to small acts of kindness our children display, praise them for being considerate and encourage them to speak up when someone is being mistreated. Since bullying is fueled by silence, we can help stop it by teaching our children to treat others kindly and speak up at appropriate times.

Concussions in Infants & Toddlers: Sung to the tune of “Five Little Monkeys Jumpin’ on the Bed”

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

Gravity sucks (well, actually, it pulls). If you are an infant or toddler, The Goddard Schoolanyway, it remains one of the greatest challenges you face. One does not need to be a phrenologist to know that the noggins of our littlest children get bumpy as they are knocked and bonked with zillions of pratfalls and tumbles each day. The question is: when is it serious? When should these kids be seen by a doctor?

To truly gain insight into this phenomenon, let us turn to the celebrated case study of the “Five Little Monkeys Jumping on the Bed.”

To the less initiated, this case presented as follows. Five infant and toddler primates were performing gymnastics in a bedroom. In succession, each individual was observed to fall, striking some aspect of his or her brainpan.

Their parents wisely and serially put the question to the on-call clinician: how will I know if my child has a concussion?

Five little monkeys jumping on the bed,
One four-year-old fell off and bumped his head
Momma called the doctor and the doctor said:
“Look at the bump: is it bleeding, swollen or red?
As for the kiddo, check STAT for these signs
(as a pediatrician and dad who’s done this a few hundred times):
Most worrisome is a child who is unconscious or seizes
Or who oozes blood or fluid from their nose, mouth or earses.
If that happens, it suggests urgency,
Call 911, or get the to a room of Emergency…
Or — think right away, did he cry right after?
Was he quickly recovering with grinning and laughter?
That’d be reassuring, to see a smiling squirt-
Headbonked, perhaps, but likely not badly hurt.
There are some things in which you can trust,
That’ll manifest sooner or later, in a littlun concussed.
But then four little monkeys were jumping on the bed,
The 3-year-old fell off and bumped her head. Papa called the NP and she said:
“Cried right away! Good, she’s awake, and again busy?
Ask her if she feels a headache, pukey, or dizzy.
She might feel funky, get crabby, or throw up in your flowers.
These symptoms usually show up in the first six to eight hours.
For toddlers and up a mild headache or single throw-up can be par for the course;
I’d consider a callback to the doc if you think it gets worse.
These could herald a mild brain injury, or concussion;
To the ER or clinic you’d best go, to have that discussion.
And soon three little monkeys were jumping on the bed,
Then the 2-year-old fell off and bumped her head. Zen-like, Momma called the on-call doc and he said:
“Thanks for calling, now ask me your questions.
I’ll ponder the story, and make some suggestions.
Can she sleep? Sure. That the concussed can’t is a myth. (Lethargy is the concern, and is hard to miss!)
Might she be crabby? Somewhat is okay,
but unceasing crankiness get check’d, forthwith!
Most kids should respond to “supportive care”-
Hugs, chilling out and Motrin work there.
And, on cue, two little monkeys were left on the bed,
and the yearling old rolled off and bumped his head.
Papa called the clinic and the care provider said:
“For these kids who cannot talk yet,
Our approach is as much doctor as it is vet.
Fortunately, we consider lower risk for the kids with lesser falls,
Like sliding off a couch, stumbling over their feet, or careening off walls.
These tend to be a bit more tame;
(though we take ’em all seriously in the head injury game!)
But folks should check ’em out, just the same.
And for all kids who fell farther, or with a ’worse mechanism of injury’
Like a car crash or sledding accident when do you worry?
We’re extra cautious for them, as for babies of six months or less.
Consulting a doc for all these may be best.
And do a headcheck as a part of routine:
Kids with scalp dents or babies with big bumps may need to be seen.
Ditto for headaches, copious vomiting, or confusion;
Your clinic’s contact info might need using!
And then there was a six-month-old monkey snoozing on the bed
While stirring, she slipped, and down to earth she sped.
Momma called the doctor and then Momma said:
“I have successfully prevented an injury to her head!
Carseats, bike helmets, and childproofing our homes
Will lower the rate of bonks to lil monkey’s dome.
Not leaving babies unattended up on high places,
Closing my windows against where they press faces,
Are steps on the road to safety, a trip I’m starting,
To avert the dangers of head injury, as research is imparting…
Concussions happen, and can be treated, ’nuff said.
Oh, and there’d best be no more monkeys jumpin’ on the bed!

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

All Fun and Games

The Goddard SchoolVery young children don’t have the abstract thinking ability or emotional development to understand competitive sports. They generally prefer motor activities and games with simple rules instead. As children get older, they become more interested in organized sports. At The Goddard School®, we understand that sportsmanship includes giving your best effort, accepting defeat gracefully, playing fairly and compromising.

We live in a competitive culture, and it’s easy for children to develop a winner-takes-all mindset. This attitude isn’t good for a child’s character development or mental health. Sooner or later we all fail, and it’s important for children to learn early on that making mistakes and coming in last are okay. Children who learn these ideas early are more likely to show positive leadership skills at school and in the community. Goddard School teachers recommend you start with simple things like the following:

  •  Playing games like catch, hide and seek or tag, which require everyone to take turns;
  • Encouraging your children to try again when they are having trouble mastering a skill;
  • Choosing teams and coaches carefully. Coaches should teach good sportsmanship and use a patient, calm approach;
  • Being a good sport yourself. Show good sportsmanship at your child’s games;
  • Congratulating others on their successes.

Rainy Summer Day

Before you put on the children’s favorite movie for the eleventh time on a rainy summer afternoon, use the opportunity to star in your own production. Dramatic play is an important part of early learning and can be a lot of fun. When children engage in dramatic play, they adopt and manipulate identities, playing out the ideas of the world around them and fantasy worlds. This critical component of the developmental learning process helps children develop abstract thinking, literacy, math, scientific thinking and communication skills naturally.

Dramatic play is part of the everyday curriculum in all Goddard School classrooms. Parents can join in the fun by getting down on the floor and playing with the children. You and your children can make costumes of their favorite story characters using old clothes, paper and crayons and then act out the scenes. If your children love Goldilocks and the Three Bears, let them assign you a character to play and let them lead the way. With very young children, dramatic or pretend play can be as simple as drumming with pots and pans or pretending to make a meal. It may feel like play, but it is your child’s work and it helps children learn.Before you know it, the rain will stop and you can go play outside.