Januari 17, 2017
frequently, i get askedhow i started on the path that i'm on, and the inspiration. and perhaps like many of you,there were moments where my professional workand my personal life came together. i remember this october dayas i was driving our three children from the grocery storeto the pumpkin patch. and in the back seatwere our three-year-old, our one-and-a-half year old,and our baby. and as i drove from my martha stewartmoment at the pumpkin patch,
tears were rolling down my cheeks; physically and emotionally exhaustedliving by my own standards of parenting, these three very closelyspaced children. at the time, i was working on a researchproject as a statistician for a home visiting intervention that was looking at helping women who wereusing drugs and alcohol during pregnancy improve their parenting. i remember one day watching this womanwith a three-year-old by her side push a double stroller overthe snow-covered sidewalks of minneapolis
and convince her three-year-old to walkthe two blocks to catch the bus. now, i knew my job was impossible, and i had an attached garage,a supportive spouse, an amazing community, and a phd in child development. i actually used to goto parent education classes, not telling anybodywhat my background was, just so i could havecoffee with the ladies. in fact, i was terrible duringparent-child interaction time because i did not wantto play with my children.
(laughter) one day one of the womenpulled me aside, and she says, "what do you do?you sound a little bit like my therapist." i had been outedin parent education class. we also have been on a journey in termsof policy, research, and practice. and i'd like to borrowfrom an urban legend to talk about this journey. it's a day a villager is outwalking alongside a river, and as he's looking at the currentseeing the sun glisten upon the water,
he notices somethingsomething in the river, and he realizes it's a child. and without regard for himself,he jumps into the river, he pulls that child ashore, and he calls for another villagerto come down to help him. as she walks down and wraps her sweateraround the two of them, she too notices a child in the river,and jumps in and pulls that child ashore. well, they lived in a very prosperous,very generous village, and soon they had peoplelined up on lookout
because these childrenkept coming down the river. there were folks responsiblefor taking care of the rescuers, and the children, and supplies. everyone had a job to do. one day, one of the villagers startedwalking away from her position. and they're like,"hey, where are you going?" "i'm going to find out why the childrenare in the river in the first place." that's actually the journeythat we've been on for about the last 50 years.
our first vision was that we sawchildren living in poverty, particularly those in familiesrelying on welfare, who were not as well prepared for school as children coming frommore affluent communities, and so we created head start. in the 80s, we saw the importanceof parent-child relationships, and so we started home visiting as a wayof helping improve parent to education and understandingof their children's cues and signals. in the 90s, we thought if we gotinvolved with children earlier,
before problems happened,early intervention or prevention, maybe we could keepthose problems from surfacing. and in the 90s,we got really issue-focused. so we now have literacy-based,early intervention, home visiting programs in head start. the problem is part of what we didis we took what we knew at the wide end of the river,and we just miniaturized it. a first grade classroom startedto look like a pre-school classroom, started to look like an infant classroom.
so that in this infant classroom, you have an area for climbingand an area for reading, as if a baby would know they neededto do those things in two different spots. the other thing we've done is there's beena major change in the fabric of lives of families living in poverty,and that was welfare reform. we now, all of the interventionswe've developed previously, relied on a parent being homefor most of the time, even in communities of poverty. now we've said young mothersin poverty need to be working,
and there needs to be a placefor those children to go during the day. but in most communities of poverty,there is no high quality place for those babies to be,for the families still to be nurtured. in fact, the minnesotachildren's defense fund reports that children under the age of twohave more changes in who takes care of them during a weekthan any other age group -- than a six-year-old,than a twelve-year-old. at a time where relationshipsare so critical, children are going from adultto adult to adult.
now, if you journey with meback down stream, this well-organized village,this is our special education system. we are spending all kinds of resources,everybody knows in which line to stand, which form to fill out,how many minutes to be in that line. we can't get all the childrenback to shore so we've built barges out therein the middle of the river: our juvenile justice system, our level 5 special education system - that's for the children who havebeen in the water for so long
that's it's changed the way they move,changed the way they think, changed the way they interact. the best we can hope foris to keep them dry. but we never get backto typical development. so what's the answer? what i'd like you to journeywith me today, upstream, and do something really important: turn 180 degrees and begin to look atthe river from the baby's point of view. the lovely part is that there'sthis grassy meadow of typical development
right before that child. the early experiences that that baby hasare what form the neural synapses, the connections that are madethat lay the foundation for that child's growth and development. a mom has her baby in a bouncy seatas she cooks dinner. she twirls the toy bar. the baby gets interested in it,gets a little fussy and she's like, "oh, i'm stirring the pot." baby gets a little more fussy,
she realizes the baby's not goingto be distracted, she picks him up, he calms back down. it's nothing extraordinary.it's everything ordinary. paying attention to the cues and signals, what the baby's learning about formingrelationships, regulating his emotions, and learning through playand exploration. contrast that for a minute to a babythat spends all of his day in a saucer. his mother and fatherare diagnosed with schizophrenia. the best that they can dois keep that baby safe.
but relying onhis cues and signals to get fed? no luck. has to do with when the parents remember. monitoring who interacts with that babyby virtue of their mental illness, who comes in and out of that houseis unregulated. sometimes the baby's bombarded,sometimes left alone. those everyday experiencesare forming the architecture of each of those babies' brains. now i want to pull back a little bitfrom something quite so dramatic
and talk about those babiesthat are beginning to get into the river. right on the pebbly shore. i want to tell you a story about joe. joe's parents were expectingthe birth of their second baby, and they had decided that they wantedto spend the first week just at home with the new baby --mom, dad, and the new baby. and joe would go with grandma and grandpawho he loved very much, and they had all kindsof fun things planned. he had a present a day to open
so he could rememberwhen he was going home. joe comes home after the seven days. he's home with his new baby,his mom, and dad. that night, in the middle of the nightwhile joe's asleep, the baby spikes 105 temperature. mom, dad, and the baby are air-vac'edfrom their rural community to a teaching hospital three hours away. joe wakes up in the morning to a neighbor. the next nighthe's at the aunt and uncle's house.
the next nightat another neighbor's house. the baby's diagnosedwith spinal meningitis. fortunately, the baby recovered. two-and-a-half weeks later,mom, and dad, and the baby come home. joe is cranky, irritable,not sleeping through the night, wants to be held all the time. dad's been out of work for three weeks. mom has this critically ill baby. now, if joe was running a fever,was cranky, not sleeping through the night
and pulling at his ear, she'd callher family practitioner and say, "i think joe has an ear infection.can i bring him in?" what does she do in this case,when he's showing symptoms? ideally, this has beena family practice or pediatric office that has been screeningfor social-emotional health right along with motordevelopment, with vision, so that she knows she can call and say, "i think joe is having some difficulty.can somebody get us some help?" they could be connectedwith a mental health provider
who probably would seethe family two or three times. they make a plan for joe in transitions,they'd help them understand, go ahead and hold him, because as soon as he knowsyou're not going to leave anymore, he won't want to be held anymore. he's two-and-a-half years old! could you have a baby-sittercome over one hour a day to take care of the babybecause we know you're worried about her, and you just spend an hour with joe.
a couple of times, joe's backon the path of typical development. it's much like an ear infection. unfortunately for joe and his family, they told me this storywhen he was five hears old -- he'd been kicked outof two childcare centers. there was no such help. it's interesting, with ear infections --children's anatomy changes so that they're only vulnerableto ear infections when they're very young. and we treat it because re-occurringear infections lead to later hearing loss.
but we don't treatsocial-emotional problems? the national institute of mental healthestimates that one in four adults every year has symptomsof mental health problems. hmm. we need to make surethat health is more than growth; that health includessocial-emotional development. how does that baby go aboutforming relationships? how does that baby experienceand regulate their emotion? and how do they learn?
now, we have some children who areparticularly vulnerable to something that we have been calling "toxic stress." three things make up toxic stress. the first one is deep poverty.the lack of opportunity. the second one ischild maltreatment or neglect. and the third one is trauma. trauma can be witnessing violence. it can be experiencing an environmentalevent like a hurricane or a tornado without a supportive network of adultsaround that child
to help them understand the experiencethat they're going through. the center that i started, "baby's space"is in one of these neighborhoods that has high poverty,extremely high community violence. in fact, a couple of weeks ago,we were on lock-down at noon because there was shootingin the neighborhood. we were running around the buildingtrying to find out as much information as we couldso we could tell the children. we were able to let them knowthat there were three men that were arrested and no one was shot.
we had to give them that information so they knew they were safeto go out to play. imagine being five years old,and the thing you have to worry about is if there's a shooter outside that could hurt youor somebody that you love. in the same community,a dad was murdered last year. four children in the family, but an entire community that found outthat your dad could be murdered. so what's the solution?
for us, it was about creatinga child development center from the baby's point of view that really took social-emotional healthas the critical factor. i want to tell you aboutthe second day of childcare for tamara. tamara was wheeled into the room. dad signed her in and walked out. she sat in the stroller. she's 11 months old. did she want out of the stroller?
picked her up,set her down. nothing. at 11 months old, she's telling uswhat she expects from the world. dad was telling us what he expected from tamaraand from the rest of us. couple of days later, we have a teachersitting right next to her as mom's leaving. mom's leaving the door. the teacher has the baby's arm,waving to the mom.
"bye mom.see you later," the teacher says. but tamara's head is turned this way,and mom is leaving this way. and mom walks out and goes,"she doesn't care about me." now, i have an 11-month-old baby that is showing no indicationthat her parent is important, and a parent who believes she is not. i have to tell you,in a typical childcare center, this is a dream baby. she doesn't care when she gets fed.
she never complains. she plays with whatever's in front of her. in our center, red flagsare going up all over. we have a baby who is in the water, and parents who do not knowhow to connect with that baby. we also know, based on research, that childrenin mildly stressful situations -- so they brought two-year-oldswith their parent, and they brought in a clown.
now, two-year-olds and clownsdon't go together very well. that's what researchers do. they bring in things kids don't like,and they watch and see what happens. but these researchers knewa couple of more things. they knew whether or not the childrenhad a secure reliable partner in the parent that was with them, or like tamara, had a parentthat was unavailable, inconsistently available, or not really there to supportthe child and partner.
they also wereneurobiological researchers so they were particularly interestedin stress responses. now, you may hear a lot about cortisolbecause it's so easy for us to measure. cortisol is that fight-or-flight, saber-tooth tiger,run!-extra boost that we get in emergency situations. interestingly, if children,as the clown is there -- all the children look the same. i cannot eyeball who hasa secure relationship
as we say in attachment researchor has an insecure relationship. y'all look the same. but something different is happeningon the neurobiological level. the children with a secure parent,a partner in the stress: no change. the children who do not havea reliable partner are kicking in your own cortisol system. fight or flight;saber-tooth tiger; run! you're two years old. you're not even old enough to knowsaber-tooth tigers don't exist.
but your body's reactingas though it does. interestingly, if we look atmath achievement later on, children who have secureearly relationships with their parents do better in maththan the children who did not. now there's no difference in ability,it's in achievement. why? because if i have a trusted partner, and i know that when i getstuck on a math problem, i can turn to my neighbor and say,"hey could you help me with this?"
versus, if i've never hada trusted partner, and i get stuck on a math problem, my body is going, "saber-tooth tiger!saber-tooth tiger!" and i never get the help i need. so, by bringing innovationfrom the baby's point of view, this is what it looked like for tamara. couple of months later, we're still doing waveand talk for the baby, but this time after mom left,tamara re-traced mom's steps,
put her hands up on the door,turned around, and fell completely apart. she was crying. we were thrilled. finally, what had been cappedwas able to bubble up. four months later,this was what it looks like. mom's hanging out in the childcare room because we have partnered momwith a parent educator in the same way we partneredtamara with a teacher.
we found out domestic violencewas happening in the house. now, for tamara, shutting downwas a great survival strategy, terrible developmental strategy. the family now has a safety plan in place. dad is out of the home. things are better. mom's working on her job,and the teachers know about that. now tamara brings a book over to mom. they read the book together. mom goes to leave. tamara follows her.
they give each otherthree kisses good-bye. and tamara holds her arms upfor the teacher to hold her. in four months, she wentfrom the river to the solid ground where she stays today. the distance is so short here. we have the capability of changingthe fabric of lives of families which then changesthe response of the community when we begin to look at successfrom the baby's point of view. we have the opportunity.we have the knowledge.
we just need to bring itto our most vulnerable children and invest in them early. thank you very much. (applause)
Tidak ada komentar
Posting Komentar