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MODULE 2 – NEWBORN, 1 MONTH AND 2 MONTH VISITS
SECURE ATTACHMENT What Caregivers Can Do Why
• Hold, hug, kiss, and cuddle their baby often.
• Learn and respond sensitively to the baby’s cues
• This helps the baby feel loved and safe. Parents cannot spoil a baby at this age
• This makes the baby feel safe, heard, and
understood and lets them know that they can rely on their caregivers.
AUTONOMY
What Caregivers Can Do Why • Start tummy time everyday
• Tummy time will strengthen head and neck muscles to help with crawling, which allows babies to explore and learn from their environment.
SELF-REGULATION
What Caregivers Can Do Why • Soothe the baby by letting them suck, swinging or
gently bouncing them, and by talking, singing, or shushing.
• Finding out what soothes their baby will help parents to teach them strategies to calm down in the future.
PERSPECTIVE TAKING
What Caregivers Can Do Why • Label the baby’s emotions. “You must be cold...
You seem hungry… That noise was surprising…”
• Naming a child’s emotions will help them to understand their feelings as they grow.
PROBLEM SOLVING
What Caregivers Can Do Why
Coming soon!! This skill is
developed as babies age
ACADEMIC KNOWLEDGE
What Caregivers Can Do Why • Talk with the baby face to face as much as
possible. Great opportunities include diaper changes, feeding, and baths.
• Use parentese, an exaggerated, sing-song voice, with real words
• Label and sportscast throughout the day
• Babies love to watch and learn from facial expressions and can see best up close while their eyesight is developing.
• Research shows that a baby’s brain lights up when they hear familiar and excited voices.
• This increases the amount of words children
hear, which helps with language development.
MODULE 3 – 4 MONTH, 6 MONTH AND 9 MONTH VISITS
SECURE ATTACHMENT What Caregivers Can Do Why
• Match their expression to their child’s
• Always say goodbye when leaving
• By matching the behavior and emotional state of their child (synchrony), parents can build a stronger connection with their child.
• Sneaking out can make children feel that adults are unreliable. Saying goodbye helps children to manage separation anxiety.
AUTONOMY
What Caregivers Can Do Why • Allow children to start feeding themselves
• Babyproof
• Eating independently allows children to make choices about what they want to eat.
• Babyproofing allows children greater independence in exploration and creates a YES environment. This helps children to play and develop interests safely and on their own.
SELF-REGULATION
What Caregivers Can Do Why • Develop regular routines
• Put children down drowsy, but awake
• Consistency helps children understand what to expect and makes them feel safe.
• Falling asleep on their own helps children learn how to soothe themselves.
PERSPECTIVE TAKING
What Caregivers Can Do Why • Keep calm during difficult moments
• Look, point, and talk about things with their children
• Children look to their parents to interpret whether or not something is safe. If parents look worried or scared, children are likely to feel that way too.
• This teaches children to share attention, which is an important aspect of communication and connecting with others.
PROBLEM SOLVING
What Caregivers Can Do Why • Play peek-a-boo
• Learning that objects and people continue to exist, even when they cannot be seen, heard, or felt, will help with separation anxiety.
ACADEMIC KNOWLEDGE
What Caregivers Can Do Why • Offer finger foods
• Engage in back and forth conversations
• Practicing fine motor skills leads to the development of the pincer grasp, a precursor to the tripod grasp that is used for writing.
• Responding to a child’s early sounds and taking turns when speaking, teaches children how
conversation works and lets them know that what they say is important.
MODULE 4 – 12 MONTH, 15 MONTH AND 18 MONTH VISITS
SECURE ATTACHMENT What Caregivers Can Do Why
• Eat meals together often
• Offer love, attention, and praise
• Family meals promote bonding while also increasing language skills and healthy eating habits.
• Having a close bond with the primary caregiver sets the foundation for future relationships.
AUTONOMY
What Caregivers Can Do Why • Follow the child’s lead in play
• Involve children in daily activities
• Children learn best when they are interested in what they are exploring.
• Encouraging children to help feed themselves, brush their teeth, and get dressed promotes independence and confidence.
SELF-REGULATION
What Caregivers Can Do Why • Use positive opposites and redirection
• Offer new items for comfort, instead of the pacifier
• Redirection is an effective way to help a toddler when they are upset by shifting their attention. Positive opposites help teach children how to behave by providing clear expectations and not relying on the word no.
• By providing items, like a blanket, that help a child calm down, caregivers can promote self-regulation skills.
PERSPECTIVE TAKING
What Caregivers Can Do Why • Label feelings
• By identifying what they think their child is feeling, caregivers help children to understand their own reactions and the reactions of others.
PROBLEM SOLVING
What Caregivers Can Do Why • Let children practice “cause and effect” • Allowing children to “experiment”–like dropping
different objects on the floor and seeing what sounds they make - helps promote curiosity and creativity..
ACADEMIC KNOWLEDGE
What Caregivers Can Do Why • Read with children
• Expand on vocalizations with words and gestures
• Reading and telling stories with caregivers improves children’s’ language development and school readiness.
• This enhances communication skills and engagement and helps to decrease frustration.
MODULE 5 – 2 YEAR, 2.5 YEAR AND 3 YEAR VISITS
SECURE ATTACHMENT What Caregivers Can Do Why
• Provide comfort during difficult moments
• Offer praise
• Children still need support and affection from caregivers to feel safe and calm.
• When children hear regular and specific praise from their caregivers, it helps their development, behavior, and self-esteem.
AUTONOMY
What Caregivers Can Do Why • Let children practice making choices
• Start toilet training
• Allowing children to make age-appropriate choices whenever possible helps them to feel powerful and in control.
• Helping children to use the toilet independently is an important part of promoting autonomy.
SELF-REGULATION
What Caregivers Can Do Why • Tell children what to expect next
• Model how to handle emotions
• Use visualization
• Anticipating what comes next can help children to prepare and regulate their behavior.
• Children learn how to handle emotions by observing those around them.
• In difficult moments, visualization can help children regulate their emotions.
PERSPECTIVE TAKING
What Caregivers Can Do Why • Play pretend
• Pretend play helps children to imagine how others are feeling and what they are thinking. Developing good Perspective Taking can help to reduce conflicts with peers and improve relationships.
PROBLEM SOLVING
What Caregivers Can Do Why • Be creative and playful
• Play fill-in-the-blank games
• Being silly and playing creatively with children helps them to discover new ideas and think outside the box.
• Fill-in-the-blank games help children to improve their memory and attention – both important components of problem solving.
ACADEMIC KNOWLEDGE
What Caregivers Can Do Why • Sort, count, and categorize • Early math skills can be promoted with
discussions about categories and amounts. Everyday activities, such as snack time or laundry, are great opportunities to boost numeracy.
MODULE 6 – 4 YEAR AND 5 YEAR VISITS
SECURE ATTACHMENT What Caregivers Can Do Why
• Read together as often as possible
• Avoid shaming
• Reading is a great time to build the bond between caregivers and children.
• Shaming can negatively impact the relationship between a caregiver and child.
AUTONOMY
What Caregivers Can Do Why • Give children age appropriate responsibilities
• Praise hard work and strategies, not intelligence
• Giving children responsibilities helps them gain confidence and feel capable.
• Teaching children to value hard work, persistence, and perseverance (a growth mindset) promotes problem solving skills and taking on challenges in the future.
SELF-REGULATION
What Caregivers Can Do Why • Play games like Freeze Dance, Simon Says, and
Red Light/Green Light
• Teach children to “pause and think” before they act
• Playing games where children practice following rules, paying attention and bodily control are great for developing self-regulation skills.
• Taking a moment to think before acting is a great way to manage strong emotions.
PERSPECTIVE TAKING
What Caregivers Can Do Why • Talk about how other people feel
• Taking about how a child hurt someone’s feelings
or made someone’s day, helps them to connect what they do to the response that it produces in others.
PROBLEM SOLVING
What Caregivers Can Do Why • Ask your child to help generate ideas for solving
problems
• Reframe mistakes as opportunities to learn
• When children take part in creating the solution, they learn important skills in gaining autonomy and control over their world.
• Helping children understand that things won’t always go according to plan helps them to turn mistakes or failures into opportunities to grow.
ACADEMIC KNOWLEDGE
What Caregivers Can Do Why • Talk about size, quantity, and volume • Continuing to promote early math skills – by
measuring and comparing items, conducting experiments, and understanding scale – helps stimulate academic achievement.
Secure Attachment Summary Sheet
What it is… Definition: “A child is securely attached when they view the caregiver as safe, reliable, nurturing, and caring and as someone with whom the child feels a sense of belonging.”
- Develops over time - Allows the child to explore - View caregiver as a safe base
There are four decades of research on attachment revealing that children in secure child-parent relationships are more likely to experience better social, emotional, cognitive outcomes as they become adults.
Ø Parenting behaviors associated with a Secure Attachment relationship: - Sensitive and responsive caregiving - Warmth, affection and nurturance
Ø Parenting behaviors associated with more negative outcomes and insecure attachment relationships: - Controlling, persistent harshness - Insensitivity, non-responsiveness - Inconsistency
Ø Other factors that may impact the attachment relationship: - The temperaments of both child and parent may impact how the pair can connect/attune - Culture and tradition
Examples of how to promote Secure Attachment in the well child visit…
❖ Discuss: ➢ Skin to skin- “Remember, your touch teaches a baby” ➢ Responding to cries, “At this age, you can’t spoil a baby” ➢ Importance of noticing cues and responding to them ➢ Avoiding shaming
❖ Model: ➢ Warm, positive affect ➢ Back and forth interactions
❖ Praise what you observe... ➢ He calms down so nicely when he snuggles with you ➢ Those kisses are so great for his development
Autonomy Summary Sheet
What it is…
Definition: “A child’s sense that they are able to use their own skills in thinking and behaving”
Helps children to:
- Explore and learn from the environment - Gain confidence to take appropriate risks - Grow ability to discover on their own
Children who have the opportunity to make choices and act on them exercise autonomy. By contrast, children who are not allowed to make choices and/or do not feel a sense of ownership over their actions experience a lack of autonomy.
Ø Autonomy is important for child development because: - It fulfills a basic human need to feel choice over ones behaviors and actions (self-determination
theory) - Is necessary to maintain intrinsic motivation - Children who experience parenting that supports their autonomy are likely to have better
academic achievement, social-emotional-cognitive development and executive function skills
Ø Autonomy supportive parenting: - Is important in helping a child feel that their interests CAN be met and are WORTH being met - Helps child be more likely to explore their environment and learn new things; take on challenges;
maintain their motivation and effort; and express their wants and needs to adults and peers.
Ø Supporting a parents Autonomy: - Makes it more likely that parents will adopt these supportive practices with their child
Examples of how to promote Autonomy in the well child visit…
❖ Discuss: ➢ Tummy time ➢ Creating a “yes” environment ➢ Using the word “explore,” ➢ Allowing child directed play ➢ Encouraging the child to help with routines (put on coat)
❖ Model: ➢ Asking patient questions ➢ Giving choices ➢ Asking patients for their thoughts on how to do things (i.e. how do you think you could be
healthier in your eating?) ➢ Asking parents questions about what they think works best for their child
❖ Praise what you observe... ➢ “It is so great how you allow her to explore the room” ➢ “Thank you for letting her answer my questions”
Self Regulation Summary Sheet
What it is…
Definition: “A child’s increasing ability to manage their emotions, behaviors, and attention in order to achieve their goals”
Helps children to:
- Sustain attention - Resist distraction - Refrain from responding immediately - Tolerate frustration
In infancy, babies rely on relationships with caregivers to assist with soothing as they do not have the ability to have intentional self-regulation. Though infants have some involuntary ways of regulating themselves, Self-Regulation becomes increasingly intentional as children age. When it is intentional, Self-Regulation draws on what are known as executive function skills.
Ø Self Regulation has important implications for individual trajectories of health and well-being across the life span: - Children with better self control in early childhood have better health and wealth in adulthood,
regardless of their intelligence and social class at birth - Behavior regulation and inhibitory control are correlated with school readiness, vocabulary,
literacy and math skills - Children with better attention span persistence at age 4 are more likely to have graduated from
college by age 25 - Poor Self Regulation has been linked to high rates of expulsion, most dramatically in preschool
classrooms
Examples of how to promote Self Regulation in the well child visit…
❖ Discuss: ➢ Soothing and responding to distress
■ Including transitional objects and self-soothing ➢ Creating routines ➢ Using positive discipline strategies ➢ Playing games like Freeze Dance or Simon Says
❖ Model: ➢ Soothing (suck my finger) ➢ “Be still like a statue” game ➢ Mindfulness practices
❖ Praise: ➢ Good routines, sleep habits ➢ Parents efforts to soothe or calm their child - “You are doing such nice rocking and bouncing,
she really seems to like that.”
Perspective Taking Summary Sheet
What it is…
Definition: “A child’s ability to understand and communicate their thoughts and feelings as well as those of others.”
Helps children to:
- Learn to get along with others - Form meaningful relationships - Succeed in school - Decrease aggression and conflict
Perspective Taking requires recognizing and understanding one’s own thoughts and feelings, recognizing and understanding others’ thoughts and feelings, and knowing that they may not be the same. Perspective Taking draws on the three basic components of executive function: working memory, cognitive flexibility, and inhibitory control.
Ø Perspective Taking enables a variety of prosocial behaviors, such as: - Making and keeping friendships - Helping and comforting others - Resolving conflicts without aggression
Ø Perspective Taking depends on several key developmental milestones:
- Object permanence: the understanding that objects and people don’t disappear when they leave a child’s view
- Recognizing self: conceiving of oneself as distinct from other individuals - Theory of mind: the knowledge that others have different beliefs, desires, and intentions than
one’s own
Examples of how to promote Perspective Taking in the well child visit…
❖ Discuss: ➢ Labeling emotions ➢ Object permanence, separation anxiety, and “Peek-a-boo” ➢ Playing “I spy” with emotions ➢ Sibling issues and friend issues ➢ Anything that explains your thinking or their thinking!!
❖ Model: ➢ Engaging in joint attention ➢ Memory - “I know you are scared because you remember your last visit.” ➢ Pretend play - “Do you want to be the doctor?”
❖ Praise: ➢ Parents labeling and/or explaining emotions to their child ➢ Parents empathizing with their child’s experience
Problem Solving Summary Sheet
What it is…
Definition: “A child’s skill in stepping back and reflecting on what has been learned, making connections, and using critical thinking to help solve problems that are important in his or her life.”
It requires that you:
- Step back and reflect
- Make connections
- Weigh alternative options
- Inhibit first responses
- Persist when challenged
Effective problem-solving is key to forming positive peer relationships and succeeding in school and can impact learning and motivation.
Ø Problem Solving calls on Executive Function Skills:
- Thinking flexibly/cognitive flexibility
- Keeping more than one thing in mind/working memory
- Not going on auto-pilot/inhibitory control
Ø Essential components of Problem Solving include:
- Reflection: stepping back, considering alternatives, and then determining how to respond
- Making connections: understanding the relationship between a symbol and what it represents
- Critical thinking: the search for accurate information
- Taking on challenges
Ø Children with a fixed mindset:
- View intelligence as a fixed trait
- Reluctant to undertake challenges that “stretch” them
Ø Children with a growth mindset:
- Believe that traits such as intelligence can be improved over time through practice and good strategies
- Are more likely to take on challenges
- Have better outcomes in school and life
Examples of how to promote Problem Solving in the well child visit…
❖ Discuss:
➢ Using different strategies when solving problems or playing games
➢ Growth mindset
❖ Model:
➢ Silliness (disrupting typical patterns of thought/behavior)
➢ Fill in the blank games “now I am going to listen to your…”
❖ Praise:
➢ Scaffolding - when parents help the child support learning instead of solving problems for their child
➢ Asking questions that expand - what do you think that is used for?
Academic Knowledge Summary Sheet
What it is…
Definition: “A child’s increasing and meaningful understanding of language, literacy, numeracy, and sciences as foundational to the acquisition of future knowledge.”
This includes the development of:
- Language - Literacy - Numeracy
Research shows that children’s foundational knowledge at the beginning of school can have a lasting impact on their academic trajectory. Children who enter kindergarten with more knowledge are better equipped to incorporate new information over time. Addressing gaps in language, numeracy and spatial skills in the early years is more effective than waiting until school entry, when catching up is harder.
Ø Children learn Academic Knowledge best through: - Every day play - First-hand experiences
Ø Vocabulary/language acquisition:
- Is related to competency in reading and school in the future - Varies between children from higher and lower SES households - Involves not only the number of words heard by a child, but the way in which they are communicated
(through back and forth conversations) - Is also impacted by the tone and expressions with which we communicate
Ø Early math competency in Kindergarten:
- Is AS predictive as literacy of later academic achievement - Predicted not only later math achievement in elementary school but also later reading achievement
Examples of how to promote Academic Knowledge in the well child visit…
❖ Discuss: ➢ Language: Fill children’s days with words!
■ Parentese, sportscasting, back and forth conversations ■ Labeling objects, expand word approximations
➢ Using “math talk” by discussing quantities, shapes, comparisons ❖ Model:
➢ Grouping/comparing sizes/shapes ■ What vegetables do you like? How many cups of milk?
➢ Narrating throughout the exam using big words (otoscope) ➢ Using books to ask questions beyond the page
❖ Praise: ➢ I love that you are reading with her… ➢ When you’re talking about sizes and shapes with her like that, it builds her math skills...
