What's on your toddler's mind?

 UNDERSTANDING INFANTS AND TODDLERS AND YOURSELF
  
How can we understand the amazing changes that take place so rapidly in infants and toddlers during the first few years of life—and in their parents who raise them? The best way is to understand the fascinating subject of human development. In other words, how do babies, who are programmed from birth, indeed, from the nine months in utero; to become healthy, productive adults as they pass through infancy, childhood and adolescence?  Even though adults don’t have accurate memories of these early years, their experiences in the first few years of life lay the foundation for what they become as adults, and consciously and unconsciously influence the way they raise their infants and toddlers. So, with this awareness in mind, let’s begin to understand with a definition of development.

 
 
    Development may be defined as the emergence and evolution of the human mind from birth until death as the result of the constant interplay of biological, psychological, and environmental influences.

This definition suggests several critically important ideas. First, development, which focuses on the study of the mind, is not synonymous with growth and physical aging; these are terms that refer to the changes that occur in the body over time.  However, mental development is profoundly influenced by the body. Conversely, neither is development the study of the effect of environment, alone. Environment refers to all external influences, particularly the interaction with other human beings. Both biological and environmental influences must be understood within the context of the third factor in this confluence of forces that shape the developmental process; namely, the mind itself, as it exists at a particular point in the life cycle; be it one of relatively immaturity in infancy and early childhood or one of sophistication and complexity in midlife. Thus, in attempting to understand mental functioning at any age, we must consider biological, environmental, and intra-psychic influences as they exist at that moment in time.
 
     The lifelong course of development has been broken down into blocks of time called developmental phases. One of the most commonly used divisions is as follows:
 
     First Phase          Infancy and toddlerhood     Ages 0-3
     Second Phase     Preschool years                      Ages 3-6
     Third Phase        Elementary school years     Ages 6-12
     Fourth Phase      Adolescence                            Ages 12-20
     Fifth Phase          Young adulthood                   Ages 20-40
     Sixth Phase         Middle Adulthood                  Ages 40-65
     Seventh Phase    Late Adulthood                      Ages 65-85
     Eighth Phase     Late, Late Adulthood             Ages 85 and beyond
       
These artificially determined divisions are organized around basic themes and issues that are specific for any particular phase, called developmental tasks. Engagement and mastery of each of the tasks at the appropriate time strengthens and expands mental capabilities and provides the tools needed to engage the next set of developmental tasks—and so it goes, throughout life. Later in this book we will focus on the developmental tasks of the first three years of life.
 
     So what do parents need in order to facilitate the developmental processes in their very young child? A modicum of maturity, which is a reference to a mental state, not an age, would certainly help. Webster suggests that maturity refers to “complete and finished in natural growth or development. . .the state or quality of being fully grown.” A developmental definition of maturity contains some of the same elements. Maturity refers to that mental state found in healthy adults which is characterized by a detailed knowledge of the parameters of human existence; a sophisticated level of self-awareness based on an honest appraisal of one’s own experience within those basic parameters; and the ability to use this intellectual and emotional knowledge and insight caringly in relationship to one’s self and others. In regard to child rearing, to use your knowledge of early child development and an understanding of your own developmental experience as a child and adult to treat your infant and toddler with the utmost in understanding, love and empathy; thus facilitating, to the maximum degree possible, his or her course through the critically important first few years of life.
 
SOME GENERAL CONCEPTS
 
    The Importance of Childhood Experience: All roads to happiness and fulfillment in adulthood begin in childhood. Some are as smooth as the Indianapolis Motor Speedway, others are as rough as a pothole-scarred street. Most individuals experience some of both as they traverse childhood and adolescence. Indeed, it is the enormous variety of human experience that adds texture to the broad expanses of daily living and sparkle and uniqueness to the individual personality.
 
    Misconceptions about Childhood: Prior to the twentieth century, children were thought of as miniature adults, physically smaller and asexual but mentally the same as adults. Over the centuries this misconception became the rational for the misunderstanding and maltreatment of children. We now understand that children are qualitatively different than adults. Indeed, infants and toddlers are very different from older children and adolescents. Understanding those differences, and how and when they become apparent, is essential knowledge for raising children.
 

   The Importance of Mothering: As strange as it may seem today, because the idea is so completely accepted, the importance of the mother-child relationship for normal infant and early child development was not fully recognized before the 1940s and the 1950s. Then psychoanalyst Rene Spitz’s work on “hospitalism” revolutionized contemporary thought. In orphanages and foundling homes around the world he was shocked to find row after row of listless, hollow-eyes infants. Although fed and clothed, they received little stimulation and love from their starchly-dressed nurses. They spent nearly all of their time lying in their cribs, clean and dressed but nearly always alone. Doomed by the ignorance of their well-intentioned caregivers, they failed to develop and many died before they were a year old. In startling contrast were the happy babies cared for on a continuous basis by their unwed mothers who were relegated to institutions because of their disreputable status.

     After fleeing to England in the 1930s with her famous father to escape Nazi persecution, Anna Freud studies the effects of trauma and separation on children who were caught in the London blitz. Those who remained with their parents, huddled night after night in the cramped, womb-like security of the subways, were less affected by the traumatic situation than those who were sent away to the physically safe but emotionally barren countryside.

Similar to the World War II experience, we are currently dealing with US immigration policy that includes separation of immigrant children from parents at the US border.
 

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   Children are Different at Different Ages: Children differ at different ages because mind and body evolve so rapidly in childhood. This seemingly simplistic idea has far-reaching consequences for understanding children because it suggests that similar behaviors have different meanings at different ages. The ubiquitous temper tantrums of the two-year-old are normal, but the unbridled thrashing about of a six-year-old is not. The terrified response of a four-year-old (to a frightening nightmare) is an age-appropriate response to an intense struggle with feelings of anger and competition, but the presence of frequent nightmares in a ten-year-old is a likely indication of pathology.
 
   The Length of Childhood vs. Adulthood: At first glance, nature’s division of life into childhood and adulthood appears capricious and inequitable, since we have but twenty years in which to crowd the experiences of childhood, but three times as long to struggle with the great issues of adulthood. However, a more studied consideration suggests that the temporal distribution may be just right. The passion of youth must recede before the unhurried contemplation of adulthood and the human condition can begin.
 
   Parenthood: The Power of the Potter’s Wheel: When they are very young, children are amorphous and unformed, responsive to the touch of their parents who shape and mold them like wet clay. But as time passes and the clay hardens, children become less malleable but still responsive to the potter’s wheel. Once fired in the kiln of adolescence, the artist’s influence diminishes, reduced to the role of connoisseur admiring his or her creation.

Parents are nature’s substitutes for the instincts that provide newborns in the animal kingdom with the survival skills needed to evade predators. Human infants are not so equipped; they do not survive in life’s jungle without caretakers.

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Marilyn and Bob decided to go out to dinner. It was a warm summer evening and they thought that an hour in the park with some Subway sandwiches sounded just great. They bounded down the steps of their second floor apartment and were about to get in the car when Bob said, “Oh my god, we forgot about Jim!” Jim was their one-month-old first-born who was asleep upstairs in his crib. With great embarrassment they bounded up the stairs and assumed the mantel of their new roles.
 
   Healthy parents recognize their awesome power and exercise it judiciously, remaining steadfast and firm when necessary. Then gradually, joyfully, they relinquish control to the toddler’s messy demand to feed him or herself, to the seven-year-old’s insistence on bathing in private while undoubtedly forgetting to wash behind the ears, and to the impetuous adolescent who wants it all—now! After all, active parenthood is meant to be a time-limited activity.

The successful practitioner of the art is out of business when the young ones reach eighteen or so, but not out of the role of parent. Fortunately or unfortunately, as the case may be, the relationship between parent and child continues. Their lives remain tightly intertwined as they march through the second half of life, anxiously anticipating the arrival of the next generation, who will assign them the new roles of parents and grandparents and further transform their lives.
 
   The Egocentricity of Childhood: During infancy, mother is not perceived by the child as having an existence of her own. Rather, she is an extension of the child’s needs and wishes, the source of satisfaction and frustration. Every preoccupation of the mother—her concerns with other family members, with work or outside interests, illnesses and absences, even her death—is transformed into an experience of rejection and desertion. This means that the infant and toddler must misinterpret the actions of significant adults. Under normal circumstances, these repeated inevitable slights are compensated for by innumerable interactions of assurance and pleasure.

     As parents help the young child engage the developmental tasks of early life such as weaning and toilet training, and accept the frustrations involved therein, he or she gradually develops the capacity to control raging wants and desires. Then, too, as intellect develops, the toddler begins to understand that he or she is not the center of the universe and that all actions that frustrate wishes are not intentional. Slowly, ever so slowly, as adulthood approaches, the egocentricity of childhood is partially transformed into enlightened self-interest and a growing concern for others.

But as muted as infantile egocentricity may be in the mature adult, it is never totally absent; constantly lurking beneath a face of civility, ready to reassert itself at a weak moment’s notice. The mature person recognizes, accepts, and occasionally  be-friends the beast within, thus satisfying the wish to be special.
 
   Five-year-old Rebecca knew that mother had to take care of her two year old brother but she certainly didn’t like it. “You like Ralph more than me. Why do we need to stop reading my book because he’s crying. Stay here with me. He’ll stop soon.”

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 The Irrationality of Childhood:
The ability of young children to think in logical, rational terms does not exist in infancy and increases slowly over the first decade of life. Even the adolescent will be discovered to harbor infantile misconceptions beneath a veneer of rational thought (masturbation causes pimples and girls can get pregnant from toilet seats). This qualitative difference in the nature of thinking between children and adults means the former must, will, misinterpret events and adult intentions, creating considerable frustration in those grown-ups who do not understand.
 
For example, I was asked to do an emergency consultation on a four-year-old boy who had been admitted to a pediatric ward with a broken arm. When awakening from surgery, he began to cry and could not be consoled by the increasingly anxious and frustrated nursing staff. When I asked him why he was crying, he sobbed in mini-phrases, watered by alligator tears, that his arm was gone. He wanted it back. What he couldn’t see wasn’t there, creating a hole in his body image similar to that caused by a missing piece in a puzzle. After he and I wrapped, unwrapped, and reapplied a “cast” to the arm of his favorite GI Joe, our wounded warrior began to calm down, reassured that his arm was “safe” inside the cast, now decorated by us with images of Tony the Tiger, his favorite cartoon character.
 
The wise parent feels compassion for the child’s inability to understand the world. This empathy is heightened by the mature recognition that the child is not alone in the inability to understand; both adult and child are constantly in touch with the unknown and the incomprehensible, as the older imperfectly shield the younger from life’s uncertainties.
 
A Different Sense of Time:
To the one-year-old left by his or her parents for a much -needed weekend of R & R, time stretches out endlessly. For the parents, the time away is all too short. This is so because of the limited cognitive understanding of time which exists during infancy and early childhood and even more important, the manner in which it is experienced subjectively. Possessing little ability to tolerate frustration and delay gratification, the child experiences time in relationship to basic needs.
     These are the factors which determine whether the intervals set for feeding, the absence of the mother, and the duration of nursery school attendance will seem to the child short or long, tolerable or intolerable, and as a result prove harmless or harmful in their consequences.

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In addition, young children are not yet equipped with the ability to maintain memories and mental images of the needed and desired person in their absence. Without the internal organization of experience provided by the primary caretakers, the passage of time is often associated with pain and frustration. Like all other capacities, the ability to understand and organize temporal experience increases gradually as the child grows.

Different needs and a lack of knowledge about time sense in childhood create painful dilemmas for adults. “My husband and I want to take a two week vacation. We plan to leave Sharon with her grandparents. What do you think? The determined tone in Sharon’s mother’s voice indicated that there was only one correct answer. Screwing up my courage, I explained why Sharon might have difficulty tolerating such a long absence. “Oh,” said her mother with resignation, “you’re telling me that at this point in her life, I have to put her needs before mine. Her response had the ring of maturity. Unspoken but understood was the recognition of the qualitative difference in cognitive development, time sense, and frustration tolerance between adult and child. “Lucky girl,” I thought.
 
Regression as a Normal Phenomenon: Regression is the abandonment of recently acquired functions and abilities for patterns and behaviors from earlier phases of development. It is a ubiquitous phenomenon in childhood. Normally, such behavior is temporary and self-limiting, related to some identifiable stress such as fatigue, illness, jealousy, parental absence, or facing a daunting new challenge such as riding the school bus for the first time or going out on a date with the most popular boy or girl in the class. When pathological processes dominate, however, regressions become pronounced, long lasting, and involves more mental functions and behaviors, sometimes resulting in an inability to bounce back to more age appropriate behavior. This is called fixation.

Backward moves accompany all developmental progression in childhood including control of bowels and bladder, the growth of frustration tolerance, language acquisition, and conscience formation. Indeed, the ability to achieve a higher level of functioning is no guarantee that such performance will be stable or continuous.

In fact, occasional returns to more infantile behavior is a normal sign. Thus, nonsense talk or even babbling has a rightful place in the child’s life, alongside rational speech. Clean toilet habits are not acquired instantly, but take the long,  back-and-forth way through an interminable series of successes, relapses, and accidents.
 
Three and one half year old Jamie had just about mastered toilet training. He used the potty all of the time and was only wetting the bed approximately once per month. The process had not been an easy one and his parents were greatly relieved and pleased with his progress and their efforts. But wouldn’t you know it, just about this time, Jamie’s sister was born. He was definitely not happy about the new addition to the family and make his feelings clear by kisses that turned into head butts and questions about why she had to be part of the family. He also began to wet the bed nightly and occasionally have BMs in his pants. After repeated explanations that Susie was here to stay and he had to be a big brother and take care of her, and a reinstitution of parental involvement in toilet training, the bedwetting and misplaced BMs gradually diminished and eventually disappeared.
 
Adults regress, too, although not as frequently as children. The middle finger pointing temper tantrum on the freeway when cut off by another driver or the second martini after a tough day at work are somewhat problematic examples. Mature adults legitimize the need to regress and pepper their work time with vacations, play, and free intervals, thus creating a balance that promotes mental and physical health and infuses life with the qualities of richness and variety.

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