Partners in Parenting

Q&A: Are We Putting Our Baby Out?

[It's Saturday, but here's this week's Friday Q&A.  Better late than never!]

Joanna sent us this question:

We have an 11 1/2 month-old who we've been rocking to sleep for naps twice a day and at bedtime for the past 9 months or so.  She now would rather not take the time to lay in our laps except to take her bottle before sleeping.  Now, she wants down to go play (she indicates this by wiggling around, etc.).  I have been holding her at nap and bedtime for the bottle feeding, but when she finishes, I lay her in her crib.  Now, of course, she cries but no longer than 6-7 minutes.  My husband says this is cruel and unkind, and he feels like we're "putting our baby out."  When he says this, I feel like he's right, and I should run and pick her up.  But a big part of me says, "you have to do this to train her to fall asleep on her own."  I have also changed her bedtime routine so that after she finishes her bottle, I read her a book and then lay her down. 

I have a 7-year-old who I rocked religiously for almost 3 years at bedtime, and I don't want our baby to be the same way.  Am I right or is my husband?  Are we putting our baby out when we do this?

I'm not sure what you mean by "putting our baby out," but if you mean that you're being cruel and unkind to her, then I have to say no, you're not being cruel and unkind.  She's probably crying because she wants to play and be with you, yet it's obvious she's tired because she's only crying for 6-7 minutes.  I know it's unpleasant to hear her cry, but it doesn't sound like she's crying because she's scared.  It sounds like she's crying because she's not getting what she wants (to play with you).  Instead, she's getting what she needs: sleep. 

Think of it this way: when you're trying to feed your child broccoli and she cries because she wants a cookie instead, do you give her the cookie and not give her the broccoli so you don't have to hear her cry?  I would guess (and hope!) that you don't because you know she needs the broccoli and she's just crying because she wants the cookie.  What we want is not always what we need, and that will cause us to protest.

Children need sleep, and they need to learn to sleep on their own because they'll have to do it eventually anyway.  We may think we'll help them for several years to fall asleep and then they'll somehow magically learn to do it on their own, but it often doesn't happen that way.  When you have a long-standing routine with a child (or even an adult -- I can't sleep when my husband is out of town!), it is almost always difficult to wean them from it.  That's why child development specialists (at least the one's I have spoken to) suggest weaning children from bottles and pacifiers before 18 months.  After that age, they're so much more aware, and the weaning process can be far more difficult on them than when they were younger. 

Alternatively, if you don't want to rock her to sleep for two more years, but you also don't want to hear her cry at all, then have your husband rock her!

That's not a Diaper, that's my White Flag Waving...

Date: 9.28.06
From: Laura S.
Subject: Sleep Post
To: Mary P

Sooo... how's the next installment of the sleep series coming along?

Now why's she sending me that? It's only... SHIT! It's THURSDAY! How'd it get to be THURSDAY already? The baby in my arms jumps a bit. Oops. Did I say that out loud? No, I just jumped. It's not easy to read your email with a baby in your arms, but it's possible. Anna has been in my care three days so far. She's a little uncertain just yet. Needs a lot of comfort and reassurance. Only to be expected.

"Shhhh, sweetie, it's okay." Mary only thought "shit", she didn't say it. "Shhhh."

But I really do need to pull together that post. Okay. Topic, modified CIO. That means I'll need Weissbluth, Ferber... and maybe that new Douglas book I've found so sensible and even-handed.  Let's see...if they're in the shelves in the living room, I can at least bookmark the bits I might use. If they're in the basement, it'll have to wait till nap time.

But they're probably in the -- "Timmy! Timmy honey, the kitty doesn't like it when -- Timmy, let go of -- Okay, baby Anna, I'm just going to set you down now, so I can rescue the kit--"

"AAAAAAAAAAAAAAAAAAAAAAAAAAAA"

"It's okay, Anna. I'm just going to help the kitty. Poor kitty. How's your tail? How about we put you in the kitchen, safe on the other side of the babyga--"

"AAAAAAAAAAAAAAAAAAAAAAAAAAAAA"

"It's okay, Anna, I'm just going to the kitchen for a sec." Kitten deposited in the kitchen with a ball of tin foil, I return to the baby, who is still--

"AAAAAAAAAAAAAAAAAAAAAAAAAAA"

"Hey! Weissbluth and Ferber are BOTH in the living room! What are the odds of that?" It's not easy to check the bottom shelf of the bookshelves with a baby on your hip, but it's possible.

Baby Anna makes a grab for the books. I'm way too skilled. She misses.

"Weissbluth and Ferber, and... where is Douglas?" It's no simple matter to rummage through piles of books with one hand and a baby on your hip, but it's possible. The Douglas book isn't there, though. Nuts.

"Mah-wee!" Nigel tugs on my leg. "Gotsa kitty! Baby gotsa kitty!" Gah. So he does. Again!

"Timmy, come out from under the couch. Drat you, kitten. Can't you stay out of harm's way for five minutes?" It's awkward, fishing one baby out from under the couch while holding another on your hip, but it's possible. "Timmy, let go of -- oh, good BOY, Timmy! That's just what I was looking for!"

I blow a dustball off Ann's cover. Perfect. My source material, all gathered. I'll just set it by the laptop, so I can finish that task off during naptime. If I can get an hour to focus during nap time, I should be able to bang out something presentable. Right now, though, I need to make lunch.

"All right, little Anna, I'm going to have to set you down to make lunch. How about we all have some nice--"

"AAAAAAAAAAAAAAAAAAAAAAAAA"

"Yeesh. How about you watch me from the high chair?" It's not easy, lifting a high chair over a baby gate with a baby on your hip, but it's possible. "We'll just put you in the high chair, and you can watch me--"

"AAAAAAAAAAAAAAAAAAA"

"Sorry, baby girl. You watch from here or you can be alone in the other room. I have to make lunch now."

"AAAAAAAAAAAAAAAAAAAAAAAAAAA"

The other room it is, then. Not that an open doorway really muffles the sounds. Thankfully, she's an enthusiastic eater. Macaroni and cheese and peas and cucumber magically restore silence. Silence continues through diaper changes. Did you know that you can change one child's diaper on the floor while holding another child on your knee? Not easy, but possible! And then naptime. Up the stairs, three times. Once with Timmy AND Anna both, one on each hip. That's easy. (Me strong voman.) Return down with Anna. Back up with Nigel and Anna. Nigel, bless him, can manage the stairs on his own. And then Anna.

Silence. Blessed, blessed silence. Now to that post. Only first, I'll just throw in that load of laundry. Oh and do the lunch dishes, scrub down the dining table, sweep the dining room floor. Oh, and let's toss the toys back into the bins, sweep under the couch. Hey, and now the washer's finished, so throw the laundry in the dryer, take the garbage out, feed the kitten. Okay, now. I'll gather up my notes, get my cup of tea, find that section in the first book, and I'm all set to start that sleep pos--

"AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA"

Oh, it couldn't be an hour and a half already! Oh, yes it could. Same way as it's Thursday already. And you know what?

It's not easy to write a post with a baby on your lap --

IT'S IMPOSSIBLE!

Date: Sept. 28
From: MaryP
Subject: Re: Sleep Post
To: Laura S

Monday. Don't ask.

Helping Our Children Achieve Academic Success

There was an article in this morning's Los Angeles Times about the rising demand for private tutoring for children as young as 3 years-old.  These days, parents aren't just concerned about whether or not little Susie's going to get into Harvard.  Now, they're worried about whether not she'll get accepted to the "right" kindergarten. 

To ensure acceptance to the "right" elementary school, preschoolers are being sent to learning centers where they sit at desks and complete worksheets.  They're taught to count dots on a page, name body parts and animals, and write their name, skills usually expected of a first-grader.  Thanks to acts like No Child Left Behind, academic standards have "elevated" to the point where, kindergarten, at least according to this article, is now "the new first grade." 

Personally, it makes me sad and angry that children so young are trading in time at the park for sitting behind a desk.  Don't get me wrong.  I'm all for academic achievement.  I'd be thrilled if my kids went to Harvard because they'd have more opportunities.  But is private tutoring really the way to help them achieve the academic success necessary to gain more career opportunities?  I don't think so.

As parents, we're proud when our little ones can count and recite their ABC's.  We beam with pride when they suddenly speak new words and correctly name objects.  But sometimes I think it's good to remember that monkeys can be taught these things as well.  Just because a child can recite her ABC's, count to 30, and identify a baboon doesn't mean she's smart.  It doesn't mean she'll develop critical thinking skills.  And it certainly doesn't mean she'll make good life choices. 

This is why we really need to think consciously about what we want for our children.  What does "success" mean?

To me, success is being emotionally, not just academically, intelligent.  I've known people who have the best education money can buy, yet they're estranged from their children, they've had several horrible marriages, their employees despise them because they're mercurial and incapable of controlling their emotional outbursts, and if you ask them if they're happy, they're not.  Yet, if you were to meet them at a cocktail party, you'd judge them as being successful because they're a lawyer with a good trial record at a well-renowned law firm, making a ton of money, and they own a large house on the expensive side of town.  Frankly, I want more for my kids than cocktail party success. 

Having a high EQ (as opposed to IQ) provides a good foundation for academic and overall life success.  It involves, according to Daniel Goleman, "self-control, zeal and persistence, and the ability to motivate oneself," requirements for high academic achievement.  Self-control, as I understand it, is not just about impulse-control, it's about being able to recognize our own emotions and manage them effectively.  Knowing how to manage our emotions and use them wisely in our rational decision-making process leads to better choices in life, and, as I've said before, better problem-solving skills. 

How do we help our children achieve higher EQ's?  We spend time with them, offer them empathy, and coach them through their frustration, anger, sadness, fear, and even excitement (see Gottman's book on our recommended reading list).  Not only does this teach self-control, it also promotes zeal and persistence.   They may feel excited about doing something, but the frustration of successfully completing the task may be too overwhelming if we don't emotionally coach them through it.  And, their eventual success with that and other tasks promotes further internal motivation to try and accomplish new things. 

How else can we help prepare our children for academic success?

The LA Times article suggests playing with our children.  As I've mentioned before, when we play with our children, their level of play becomes more complex.  Plus, play is an opportunity to do emotion coaching as described above.  But there are other things we can do, and may even already be doing, in our everyday interactions with them.

One of my favorite longitudinal studies was conducted by a Standford linguistic anthropologist, Shirley Brice Heath (1982).  She examined the use of bedtime stories and interactions between children and parents in three different communities: "Maintown," a mixed middle class town, "Roadville" a primarily white working class town, and "Trackton," an African American rural community.  Maintown and Roadville children were at an advantage academically because these communities had more literary traditions than Trackton, which engaged in a more oral tradition.  (Keep in mind one tradition is not better than another, they're just different.  The differences, however, do contribute to one's ability to sit in a classroom, which is a very particular type of environment.  For the purposes of this post, I will not be discussing Trackton because my point only involves comparing the two communities with more literary traditions.) 

However, Heath also found that the Maintown kids were at an even bigger advantage because of how their parents spoke with them.  Maintown parents asked their kids a lot "rehearsal questions," questions where the mother knew the answer.  They asked questions that were genuine requests for new information (where the mother didn't know the answer).  And they asked a lot of open-ended questions, where the child was allowed to relate experiences.  Additionally, Maintown parents verbalized connections between what the child saw in the real world with what they read about in their bedtime stories.  They also allowed their children to read the book as he or she wished.  If the child wanted to skip pages, move ahead, or read from back to front, the parents acquiesced.  Finally, when Heath looked at the reading materials of the Maintown parents, she found they had far more critical and educational sources than Roadville parents.  In other words, Maintown parents were more interested in gaining new perspectives through reading and didn't only read books reinforcing their already held beliefs.

The Roadville parents, on the other hand, insisted the children read books from beginning to end, with no skipping ahead.  Rather than rehearsal questions, the number one communication parents had "with" their children was "running commentary" involving "rhetorical questions."  Parents would comment on their own behavior or tasks and would ask questions like, "where are my keys?" without expecting any kind of answer from their kids.  Essentially, their main communication wasn't really an interaction.  Parents did ask rehearsal questions but far fewer than Maintown parents.  The third most common communication was a "question directive," where the parent gave an order in the form of a question.  The least type of question Roadville parents asked was that which involved requests for new information.  Finally, Roadville parents rarely made connections between what the child saw or experienced in real life and what was read at story-time.

Are you seeing a pattern here? 

In a nutshell, Maintown parents promoted critical thinking in their children.  True, they gave them rehearsal questions to practice learning new facts or new words, but they also wanted to know what their children thought beyond the "right" answer.  They got their kids in the habit of thinking about connections between different things, which promotes thinking beyond the information given and developing more sophisticated inferences.  Teaching critical thinking at home, I think, is what prepares our children for academic achievement, not sitting behind a desk doing worksheets.  Remember, they're not little adults.  They're very young kids.

If you really want your child to achieve academically, don't spend a couple hundred dollars a month on some learning center.  Put that money towards maybe working an hour or two less a week and spending some interactive time with your kids.

-----

Heath, Shirley Brice (1982).  What no bedtime story means: Narrative skills at home and school.  Language and Society, 11, 49-76

I'm Calling Yoooooou...

What to do when your child appears to be deaf - and you know that's not the issue?? A reader gave us this dilemma a little while back:

My 21-month-old daughter ignores me when I call her name. Usually, I am trying to get her attention on me to ask her a question, or make a request, or get her to come over to me to, for example, give her a sippy cup or change her diaper. I usually have to say her name a number of times. Obviously, I am not asking how to get her attention when she is deeply involved in something (building blocks, or watching TV  -- I know better than that). Just general "look at me please" attention. Also, I worry because sometimes when I have to get her to stop doing something (for example, walking too far in our yard, which ends in a rocky hillside), I call out, "Stop!" and she doesn't. I am sure it's not a hearing issue.

What is the best way to get a child's attention? I don't want to raise my voice as I repeat her name. And it scares me when I say, "Stop" or "wait" and she keeps on trucking!

Some children will gaze at you in wide-eyed wonder whenever you whisper their name. Stop in their tracks, make eye contact, await your words. I think those kids exist only in Hallmark fantasies, but they sure are nice, aren't they?

While attending is something a minutes-old infant can do, attending on command does not come naturally. It is taught. It's taught in a thousand happy interactions, each time a parent speaks to their baby and smiles adoringly, laughs when baby looks towards them.

By 21 months, this little girl certainly knows her name. So how do you get her to attend to it? Most learning at this age is best accomplished by making a game of it. Ask yourself some quesitons. What is the behaviour I'm after?  (Be as specific as possible.) How can we make a game of this?

In this case, what the mother wants is: the child to stop and make eye contact the first time mom speaks her name. Mom is careful not to be unreasonable about this: she knows that when the child is heavily involved in a task, she may not hear. (If you need the child's attention when they're very occupied, the best way is simply to go to them, get down on their level, and touch them while speaking their name. But you all know that!) However, the majority of the time, it is reasonable to expect a child this age to respond to their name the first  (or maybe the second) time it's spoken.

If you find yourself having to repeat the child's name half a dozen times, every time? If they never look at you until you're so exasperated you have to shout? You have a child who's trained you!

Let's see our goals. I want the child to make eye contact with me. What's a fun way to get eye contact? I'll bet you all have one, but you've never thought of it as a teaching tool. A couple spring to my mind - hide and seek, and peek-a-boo. Let's go with peek-a-boo. Now, how to turn this simple game into an Experience of Learning?

Let's see. You take your turn, then let baby take hers. When she takes her turn, call her name in delighted tones when she pops her hands off her eyes. Play it that way for a few rounds, and then start saying her name first. Call it out in the same tones you'd use for "peek!" (Or whatever word/phrase you use in your family version of the game!) If her name sounds like part of the game, she will probably respond by popping those eyes open and looking right at you. Bingo! Just the behaviour you're after!

Then you bridge the gap a bit between this game and non-play. "I see your eyes! Do you see mummy's eyes? Eyes!" Then play it over and over. Each time she opens her eyes to your calling her name, exclaim about seeing her eyes. In this way, she'll learn what "look at my eyes" means.

Then, next time you call her and she doesn't look up, you can walk over to her, tap her shoulder or take her chin gently in your hand. "When mummy says your name, you need to look at my eyes." Smile into her eyes. Now she knows what it means, and she's learning a new application for it.

Of course, you can make a game of this, too. When she knows what "look at my eyes" means, you can practice that, as a game. Turn her away from you. Call her name. She spins around and looks at your eyes. Throw it out at her at random times in the day, and whenever she remembers, laugh and clap. If she doesn't, your reminder should be light-hearted. "Oops! You forgot the eye game! Let's try it again." Keep it light and fun, though. If it's not fun, if it becomes too intense, she'll resist, and it will become a flashpoint for a power struggle. If you see resistance to the game, stop immediately.

 

And of course, it's only fair that she do the same for you. When she calls out "mumma! dadda!" you
have to stop and look at her! Eventually, when you call her name, you can use just the word "eyes" in a cautionary tone. A simple reminder cue word. "Emmet? Eyes?"

I use a similar technique for teaching them to stop when called. When out in public, I practice with the tots the "freeze" game. In a safe area, I let them wander away from me, and then I'll call out "freeze!" If they manage to freeze, I cheer and clap and make a big to-do. If they don't, it's "oops! you didn't freeze!" and we try it again. At 21 months, though, it's unlikely that a child will be tremendously reliable. Their attention span is short, and their impulse control very limited. At this point, the game is only intended to teach a concept that will be applied more rigorously in a few months. You're laying the groundwork for the future.

So that rocky hillside in your yard? For the next little while, it'll be up to you to keep her away from it, generally by simply stopping her and lifting her away. She's probably a little too young to be relied upon to respond to a solely verbal cue to keep her out of trouble! She'll manage it part of the time, but not 100% - and that hill probably requires 100%.

Cry It Out, Baby

The cry-it-out method is usually attributed to Ferber.  His sleep method, however, is actually a variation of the CIO method.  So is Weissbluth's.  The CIO method I'm talking about is the one maybe your mother or grandmother used.  It's the one my own pediatrician told my mother to use with me so she could stop spending her nights driving around only to have me finally fall asleep and then awaken as soon as she turned off the car.  It's the method Mary's father recommended when he saw she was having difficulty getting her first child to sleep.

What does this method entail?  It's pretty simple: put the baby down asleep at bedtime and don't return to the room until the end of the sleep period.  So, at nap-time, you put the baby down cooing and gurgling, walk out of the room, close the door, and don't return for two hours -- even if your baby is crying the entire time.  Same thing at nighttime.

According to those who use/d this method, after 3-5 days the baby should stop screaming and start sleeping.  Why does this method work in such a short period (though it may feel like forever as you're listening to your little one wail)?  Crying, some claim, actually acts as an amnesic (Fagen, Ohr, & Fleckenstein, 1985).  When little Johnny is crying in bed and you go to him, take him out of bed, and comfort him, he's learning that crying gets you to come to him.  His crying is rewarded.  If, however, you don't respond, then he'll forget you used to come when he cried in his bed, and instead of crying, he'll sleep. 

Other researchers, however, claim that crying raises cortisol levels, adversely altering the baby's brain and making it more likely that little Johnny will have PTSD as an adult.  (Admittedly, I couldn't find an actual study verifying this claim in any way.  All I could find was this opinion paper.  If anyone knows of an actual study, please let us know!)  This claim has some merit.  It's true that stress raises cortisol levels, and if a baby isn't getting his reward, then that can be stressful. 

So who's right?

-----

Fagen, J. W., Ohr, P. S., Fleckenstein, L. K. (1985).  The effect of crying on long-term memory in infancy.  Child Development, Vol 56(6), 1584-1592.

Radio Show

Laura and I have begun our climb to fame and (more importantly) riches!!

A week or so ago, we were contacted by a representative of KidDadsMoms.com, to see if we'd like to be interviewed on their World Talk Radio show. (Internet radio, don't you know. You hear it through your computer speakers.) Being the shy and retiring types we are, we hesitated for a full 14 seconds before saying yes. So, if you'd like to put voices to the personas, come and check us out. The show is airing at Tuesday at 1:00 Laura's time (Pacific) and 4:00 Mary's (Eastern) time. You can find more info on the site.

Q&A -- Does My Child Have ADHD?

We recently received this question from Erin:

My son is 2 1/2 years old.  He's cute, sweet, and smart, has a great vocabulary, and is actively participating in potty-training.  My Husband and I, however, are concerned he might have ADHD. 

He is very active in class and is constantly aggressive at home and at school.  He's in a preschool class with approximately 20 children and 3 adults.  He bites the other children frequently, often several times per day.  He knows this behavior is wrong and always apologizes immediately and remorsefully.  He agrees not to bite again and says, "I don't want to bite," yet he can't seem to stop himself.  Often, he bites the children without any provocation at all.  He bounces around the class without seeming to be able to focus on one activity for any length of time.  He often takes toys from several children at a time, quickly moving from one to another, until the teacher notices that several children are crying because of him.  For several months, we have talked to him about his behavior, while just considering it age appropriate and agreeing he is a rambunctious little boy, a challenge.  At a recent conference with his teacher, she admitted that his general behavior is definitely different from the other children. 

Other behaviors include:

Biting
Throwing
Pinching
Hitting
Pushing
Aggressive behavior (taking toys, etc.)
Refusal to sit during meal times, throwing food, spilling drinks, etc.
Refusal to sit during circle time

At home he acts the same way, minus the biting. His has an older sister that he loves very much, but he is aggressive to her as well. Is this just the terrible twos, or is it something more that we should be concerned about?  I’ve made an appointment to have him tested for ADHD, but the soonest he can be seen is 6 months from now.

First, according to the DSM IV, it's really difficult to make the diagnosis in children younger than 4 or 5 years old.  Thus, should the examining neurologist give your son this diagnosis, I would absolutely get a second, even third, opinion.  In the end, there is no absolute objective test for ADHD.  Most clinicians make the diagnosis based on behavioral criteria and use checklists completed by the parents and teachers -- clearly and nonobjective method.  A neurologist will most likely examine the brain since certain regions have been found to be smaller in children diagnosed with ADHD.  While this method may seem to be the most objective, there is still some concern since studies examining the brains of children with ADHD generally only include those who have been medicated (Krain & Castellanos, 2006).  Finding unmedicated diagnosed children is very difficult.  Thus, the question becomes: are the smaller brain regions due to the medication or ADHD? 

In the end, just be cautious and get as much information from a variety of sources as possible should you decide to get your son tested.

With that said, I, obviously, have not personally observed your son, so I can't say for sure whether or not he has ADHD.  What I can tell you, however, is that based on your description of his behavior, including further descriptions you supplied to me in private email communications, it sounds like your son has a very active temperament.  This does not mean, however, he has ADHD.  One can have an active temperament and still be able to focus for a period of time.  However, your son is still very young, so I don't really expect him to focus for too long. 

Additionally, the aggressive behaviors you describe, sound very much like normal toddler behavior -- especially since he started displaying them around 18 months of age (according to your email), which is when the "terrible twos" begin for a lot of kids (mine included!).  I know his teacher claims his behavior is "different" from the the other children, but it's not that different from what I've seen at other preschools or even at my neighborhood playgroup.

Before having him checked out for ADHD, I would use some behavioral modification techniques.  For instance, when he takes another kid's toy, show him, step-by-step, the proper way to handle this interaction.  Give him the words (which I know you do), AND give him the behavior.  Guide him through the interaction, cuing him to take the toy from Susie once she offers it to him. 

When he bites or hits, remove him from the situation immediately.  After giving him two minutes by himself (since I know you use time-outs), try to find out what he wanted.  Did he want the child's attention?  Your attention?  If possible, find out why he bit or hit.  This may be difficult, and he may not be able to articulate why, but since he's very verbal, I would give it a try without being too interrogative.  Whatever his response, teach him what to do instead of biting or hitting.  But keep it simple!  No lecturing!

If he gets up and walks around at mealtime (which is normal!), then I would tell him very clearly, "If you get up, mealtime is over."  You may have to take his food away a few times, but he'll get the idea.  Once he does get the idea, you'll still have to remind him, and he may stand-up instead of sitting (he is active, after all!), but he'll be far less likely to walk away from the table.

As far as getting up at circle time, honestly, I don't have a problem with this.  For a 2 1/2 year-old with an active temperament, I'm not surprised he wants to do something other than sit and listen to his teacher.  At some schools, children this age not required to sit at circle time.  Instead, they're given the option to do something quietly by themselves.  A program such as this may better suit his temperament.

Basically, you and his teacher should be very clear and consistent with your expectations, limits and boundaries.  And be sure to do it in a way that doesn't make him feel like he's "bad" or there's something "wrong" with him.  This is especially important because the behaviors have been going on for some time, so it's easy for everyone -- parents and teachers -- to feel exasperated and to show that exasperation to him through their own behavior.  Sometimes, if a child feels like he's "bad" he'll just keep misbehaving because "Why not? I'm bad anyway," or because he doesn't know what to do instead.  (I'm not saying that that is what's happening here -- I just think it's something to be aware of.)

If you don't see any positive change in his behavior after a couple of months (and be sure to keep a record of it), then I would keep the appointment with the neurologist and have him examined. 

-------

Krain, A. L., Castellanos, X. (2006).  Brain development and ADHD.  Clinical Psychology Review, Vol., 26(4), 433-444.

Gentle (aka No-Cry) Sleep Method

As in every aspect of parenting, there are as many theories as there are experts, and as many opinions as there are parents. Which makes for a whole heap of theories and a universe of opinions.

When it comes to children and sleep, the Great Divide falls at the issue of crying. Do I let my baby cry, or not? The two main strands are the polar opposite approaches of No-Cry (or gentle methods) and Cry-It-Out (CIO). Modified CIO falls in between, arguably closer to the CIO end of the continuum than the no-cry end.

Gentle sleep methods are based on the principle of crying avoidance. Its proponents wish to avoid their baby’s tears for any of a variety of reasons - besides the obvious one that no one enjoys listening to their baby cry!  In addition to parental comfort, gentle sleepers believe that crying harms the baby emotionally and/or psychologically, and that letting your baby cry adversely affects the parent-child relationship.

Most proponents of this method practice attachment parenting - at least at night! Co-sleeping is a common thread amongst those who wish to avoid nighttime tears, a sensible strategy for the parent using this method who wishes to get as much sleep as possible!

I’ve been in this business for a long time, and have seen the trends and fashions come and go. A parenting guru is crowned, reins a while, and then is deposed. The parenting guru for attachment parenting (a term he coined) is Dr. William Sears, author of (among some 29 other books) Nighttime Parenting, which came out in 1985. Over the years other experts have written other books from this same perspective, but too often, while useful in their specific ways, these books were primarily philosophical and/or medical, or aimed at a specific aspect of night-time parenting or specific sleep-destroying issue and lacked a clear “how-to” that parents sought.

"All right," a weary parent might well have asked. "I know I don't want my baby to cry, I'm cool with the philosophy, but I'm about ready to go into hysterics myself if I don't get some sleep!"

Enter Elizabeth Pantley, author of the No-Cry Sleep Solution, and current queen of gentle night-time parenting.

When Pantley sought advice for her second child’s sleep problems, she discovered there were two schools of thought. “In a nutshell, [says Pantley, they could] be summed up as ‘cry it out’ or ‘live with it.’ I wanted neither. I knew there had to be a kinder way, a road somewhere between nighttime neglect and daytime exhaustion that would be nurturing for my baby and for me.” Being as there wasn’t one, she developed one. Now that’s a resourceful mother!

For babies under four months of age, her advice is reassuring: don’t sweat it. They’re too young to be sleeping through. What you do at this time is get all the rest you possibly can, and try to set the stage for good sleep later. She discusses how to tell when your baby is sleepy, and spends time talking about sleep associations and how to modify them, if the ones you have aren’t working for you.

For babies over four months, she addresses how to help your baby fall back asleep on his own. She offers several suggestions for co-sleepers, and a six-step phasing to sleep for crib babies.

For these older babies, she offers a wide variety of strategies to ease baby into sleep. From this long list the parents are to choose the ones that they wish to use, the ones that ‘feel right’, make sense to them, the ones that just sound like a good fit. This becomes your “Personal Sleep Plan”, which you follow diligently for ten days. At ten days, you evaluate. (Handy charts and questionnaires are provided to help you with both your sleep plan and your analysis.) Then ten more days and another evaluation, until you reach your goal.

Does it work? First, understand that “sleeping through the night” is defined by experts as five consecutive hours. Five. Not eight or more. Just five. I don't know which brilliant "expert" decided five hours was sleeping through. Somebody weird, I'll bet.  It's certainly not the way most sleep-deprived adults would define it... Still, it's what's meant when a book mentions "sleeping through". Remember that - and be reassured. Or appalled. Depends on the context.

Of Pantley’s test group of 60 mothers with children ranging in age from 2 to 22 months, none had children who “slept through”. Using her method, by day ten 42% were sleeping through; by day 20, 53% , and by day 60, 92% . Not too shabby.

If you have the patience, this method can work for you and your baby.

Setting the Stage for Healthy Sleep

Sleep.  As parents, we sometimes feel we can never get enough of it.  We birth a child and suddenly we come to understand why sleep deprivation is used on prisoners of war.  We stop longing for those Saturday mornings when we could sleep until 10 a.m., and instead pray for at least 6 consecutive hours of uninterrupted dreamy bliss. 

Why is sleep so important to us?

Well, for one thing, we feel better when we're rested.  When we're not rested, we're more likely to feel depressed (Ross, Murray, & Steiner, 2005).  We're less optimistic in our outlook.  We may isolate ourselves as our desire for social interaction declines.  We may feel more bodily aches and pains (Hack & Mullington, 2005).  And, our decision-making and communication abilities are compromised (Harrison & Home, 2000).

Some of you may be thinking that these are just some of the necessary sacrifices we must make as parents.  We can't ignore our children when they're awake at night.  It is our job to tend to them and make them feel secure.  If that means giving up uninterrupted sleep, then so be it.

This is true.  But prolonged uninterrupted sleep can actually compromise our ability to care for our children.  When sleep-deprived, it's very difficult to maintain patience for a bundle of energy 1-year-old.  It may also be difficult to maintain the self-sacrificial attitude for more than a few months.  For some, resentment may rear its ugly head.  The point is, sleep is important for parents.

But it's also important for children.  Very important.

For children, the very development of their brains may be adversely affected.  For this reason -- and I'm going to show my bias here -- sleep should be a priority equal to feeding.  Not only can cognitive functioning be somewhat inhibited as the brain is unable to make necessary neuronal connections due to a lack of sleep, but later behavioral problems have also been linked to sleep deprivation in the first year of life (Sher & Zuckerman, 2005).  Not to mention that fact that a well-rested child is simply much more pleasant to be around!

But sleep is such a natural state.  Children will sleep when they're tired.  Right? 

Not necessarily.  Turns out that children love to be with us so much, and are so excited about being awake and alive, that they'll fight sleep.  This is why they may need our help in developing good sleep habits.  In fact, children whose parents pro-actively assist them with developing good sleep habits have better sleeping patterns than infants whose parents are not proactive (Wolfson, Lacks, & Futterman, 1992).

However, it's pretty obvious we can't force our children to sleep.  But what can we do to set the stage for good sleep habits?  Here's a little list compiled from many different parenting books I've read over the years.  If you have more, please add them in the comments!

Recognize when your child is starting to get drowsy.  Signs include red eyes, rubbing eyes, yawning (dead giveaway!), a glassy look in their eyes, drooping eyelids, less intense sucking (if breast or bottle feeding), a slow-down in activity, or even a red forehead (which was always a sign Tod-lar was feeling tired!).

Put your child down for sleep when you see the drowsy signals.  This is how you let the child determine the sleeping schedule.  If you wait too long after this period to put them down, they become hyperactive if a toddler, or cry inconsolably if an infant. 

(I have a friend whose 3-year-old wouldn't nap.  He went to bed at 8 p.m. and was up at 6 a.m. everyday.  My friend had a very hard time putting him down for bed.  When I asked her about drowsy signals, she watched for them and told me they occurred around 6:30 p.m.  I told her to put him to bed at that time.  She thought I was crazy.  After sleeping that night from 6:30 p.m. to 6:30 a.m. without any trouble putting him down or any night waking, that became his new schedule! And let me tell you, his disposition became much more pleasant all around in the afternoon!)

Don't bottle-feed or nurse them to sleep.  What?!  That's crazy!  A lot of books suggest this, and here's my take on it:  It's okay to do this in the beginning.  BUT, if this habit goes on for too long, well, then you may be nursing your kid to sleep every day and night for years.  No kidding.  I have friends who are doing this now.  One loves it.  The other doesn't, and now she feels "trapped" and doesn't know how to get her 3-year-old to sleep without it. 

Decide for yourself how long you want this habit to go on, keeping in mind that the longer it does, the harder it will be break!

Establish a bedtime routine.  The environmental signals of bathing, story-time, whatever, really help them to "know" it's time for sleep.  You may find them showing even more drowsy signals at this time.  And, routines can be established for even young infants. 

Put them down when awake.  Don't try to rock them to sleep and then put them down.  This rarely works anyway!  Let them learn how to put themselves to sleep.

Don't use a binky.  Again, you may want to use one in the first few months of life, but try putting them down without it, because eventually a) they'll have to give it up anyway, and b) you'll find yourself waking in the night to put it back in their mouths!  Again, let them learn how to put themselves asleep.

Don't respond to every little grunt or cry.  This was actually a mistake I made when my son was only two months old.  I responded to every noise he made until I realized I was waking him up!  Even if they are momentarily awake, give them a minute or two (or more if they're older) to see if they can put themselves back to sleep. 

If you have any other suggestions for developing good sleep habits, please share them!

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Haack, M., Mullinton, J.M.  (2005).  Sustained sleep restriction reduced emotional and physical well-being.  Pain, Vol. 119(1-3), 56-64.

Harrison, Y., Home, J. A. (2000). The impact of sleep deprivation on decision-making: A review.  Journal of Experimental Psychology: Applied, 6, 236-49.

Ross, L.E., Murray, B.J., Steiner, M. (2005).  Sleep and perinatal mood disorders: A critical review. Journal of Psychiatry & Neuroscience, Vol 30(4), Jul 2005. pp. 247-256. 

Wolfson, A., Lacks, P., Futterman, A. (1992).  Effects of parent training on infant sleeping patterns, parents' stress, and perceived parental competence.  Journal of Consulting and Clinical Psychology, Vol 60(1), Feb 1992. pp. 41-48.

ADHD Q&A

We've been having a little trouble here at PiP with our email account.  Somehow, emails mysteriously disappear ...

Someone sent us a question last month about ADHD and their child.  Sadly, this is one of the emails that has mysteriously disappeared.  This is such an important issue, I would really, really appreciate it if the person who sent the question would resend it.  PLEASE!

Otherwise, we're still backlogged a bit on questions, so those of you who sent us emails in late July, we have NOT forgotten about you and will get to them SOON.

Thanks for your patience, everyone!