I am beginning a series to share the findings of child development researchers and neuroscientists who have genuinely inspired me in my 11-year journey to create“Mind in the Making.” Their research is truly “research to live by.”
The first person I’m writing about is Heidelise Als of Harvard University, because her studies are so instructive in how we can help children deal with challenges and learn to become stronger as a result. Perhaps surprisingly, learning this skill doesn’t just happen when children are older. Als’ research is with pre-term babies born 10 to 12 weeks before their due date — the most fragile babies in neonatal intensive care units. When adults watch what young children do to cope successfully and then create situations where they can do more of the same, the process for learning to take on challenges is seeded.
The insight that led to Als’ research began in her native Germany when she was as a teacher of 3rd grade boys. One of the boys, Reinhart, always came to school early, sat in his seat close to the front of the classroom, lined up all of his pencils and books on the desk and was ready for the day to begin. Since Reinhart was doing very well and got good grades, Als decided to move him farther back in the room so another child who needed extra help could have a seat in the front. She says:
“Reinhart moved promptly, yet the next day he didn’t come in. He had never missed a day of school. I was very concerned. He didn’t come the next day.”
After a few days, Als stopped by the bakery Reinhart’s family ran. His mother told her that the doctor couldn’t find anything wrong, but her son had been vomiting. The clue came when Reinhart’s mother mentioned, “He did tell me you moved his seat, and he’s now sitting farther back.” Als says:
“I learned from that that despite [seeing] the image of a very competent child, I should have known from his need to have everything [lined up at the start of the school day] –that he didn’t have the flexibility that other children had.”
Reinhart was given his old seat back when he returned to school, but Als gained even more from that experience. She learned how important it is to “read” the language of children’s behavior, to figure out how they cope best and then build on their own positive coping strategies. This lesson was reinforced after she moved to the U.S. to attend graduate school and had her own child, who is significantly brain damaged. She had to learn to understand the language of his behavior in order to help him.
Als brought that sensitivity into her research on premature babies. Through advances in technology in the 1970s, these babies, who couldn’t yet breathe on their own, could be kept alive with medical ventilators that, in effect, breathed for them. What really interested Als was “to see what these babies were up against” and how they were handling these stressful situations.
As she observed them, it became clear to her that good medical care was coming at the price of good developmental care:
“[The premature babies] would be pinned down, held down, strapped down, and even chemically treated, if needed, so that they would not breathe against the ventilator [in order] to let the ventilator do the work that it needed to do.”
A similar kind of scene took place when a nurse or doctor wanted to check on a baby, listen to the baby’s heart rate or change him or her:
“The baby would just splay out — all four limbs would fly out, and then the baby would try to grasp at something, but the nurse by then would already be [putting her] stethoscope on the chest, listening to the chest sounds. And then she would turn the baby over again and listen to the back, and then she would start to suction [his lungs] and then she would give a nebulizer treatment.”
As the check-up progressed, Als reports, babies would become more and more distraught; finally, they would “go limp and typically stop breathing.” It was clear to Heidelise Als that the medical care was so focused on caring for these premature babies’ hearts or lungs that they were neglecting the care of the whole child:
“It seemed we were wasting a lot of the baby’s energies that were very precious. We were going against the baby. We were pushing the baby to become exhausted and give in.”
When a baby who was initially feisty gave in, the medical charts would record that the baby had become well adjusted. But Als saw a different reality:
“The baby had given up. The baby just let the world happen.”
Als and her colleagues — nurses and doctors — set out to improve developmental care and to document that it can make a difference: They thought of this as listening to their behavioral “language.” She says:
“If we can understand the ‘words’ the baby is saying, maybe we can fill in the meaning of the sentence and understand the message.”
These observations led to solutions. For example, if the baby’s hands splay out, give the baby something to hold onto. If the baby is squirming under the bright lights, make the lighting softer. If the baby is getting agitated, hold the baby until his or her breathing becomes more stable. After documenting and recording behavior, they launched into a study where the nurses “read” and then responded to the baby’s behavior in ways that built on that baby’s coping strategies, and thus gave the baby more control.
The results of this experiment were impressive. There was reduced severity of chronic lung disease in these premature babies, improved brain functioning, improved growth and earlier release from the hospital. In addition, their care was significantly less costly.
Here’s the lesson I take from this. Children, even those as young as premature infants, are less prone to the harmful effects of stress when they are supported in managing their own stress by being helped to use the strategies they have for coping and for calming down.
And when children are older, they can become an even more active part of figuring out themselves how to deal with tough times. Als tells the story of a child for whom any reminders of 9/11 (like fire trucks) would trigger emotionally flooding. With the help of adults, he created his own strategy to calm down. He would put his head down on the table to “think” and would wait until he had “thought enough” — and then he was ready to go on.
From these studies, it is clear that we can help children learn to handle tough times if we enable them to become increasingly active partners in creating their own solutions. It has worked for me and it has worked for my children. What about you?
This story is taken from “Mind in the Making.”