Parenting pathways-1

 Let me share an article 'The role of parenting in developing communication skills in infants and toddlers- an experience from a Child Development Centre', which I sent to the Developmental Paediatrics Unit at CMC Vellore, for a conference, which was arranged in April, 2023 at Vellore.

I have updated the article, giving some more information on the child development initiatives that ASHIRVAD, Developmental Paediatrics Department at MOSC and the department of Physical Medicine and Rehabilitation of the Bangalore Baptist Hospital, jointly sponsored during the last four years. 

In fact, at the fortieth year of ASHIRVARD, an initiative for Child Development, started in 1983, fostering development of its services in Chennai, Nagpur, Vellore, Pondicherry, Bangalore and Kolenchery, the following narration of the events and experiences of the last four years highlight some of the aspirations we pursued. 

During my morning walk recently, I noticed tender cashew nuts covered with red ants in the cashew tree inner garden. I felt awful. The red ants suck the sap from the pulp of a tender nut, which would have become a full cashew nut in few months. If not sprayed with insecticides, these nuts would have considerably reduced the pulp inside, sometimes leaving them as a shell without any pulp! 

The cashew nuts have to survive this vulnerability!

1 The changed infant nurturing practice

It was while walking back to our cottage after sighting the cashew nuts covered with ants, some thoughts about the vulnerability of an infant in the  changing circumstances, in which they grow up now, dawned on me. For most part of my childhood and later years, till the technology revolution invaded the homes from the nineteen eighties, with the use of the colour TV, computer, internet, later the Mobile phone, iPads, etc, parenting was an interactive process between infants and parents.  The parenting process of a new born was at the centre of a family’s daily rhythm. Now infants and toddlers have to adapt to the priorities parents choose for themselves. Now in the words of Dr Susan George, while referring to the technology invasion in our home capturing the pre-school children, wrote: 'Their bodies are with us but their mids are sold'!

I remember how parents used to sing to their children, tell stories, read stories from picture books,  play with them with balls made of paper or coconut palm leaves, go to a nearby stream to play in the water, play in the sand, make clay models, etc,. Even when I was training to be a paediatrician in the seventies, it was common for parents to give reasonable attention to promote communicative habits in infants and toddlers by engaging them in play.

Just as the red ants invade and harm the tender cashew nuts, the overuse of mobile phones, TV, internet and iPads distract and impair the normal development of language, communication and social skills of  pre-school children! The machine interface has replaced the normal physiological human interface between infants or toddlers and their parents. 

2. A challenge to  Infant’s processing skills

The auditory system of an infant is conditioned to recognise human voice from few weeks  after birth. The visual cortical system enables an infant to recognise the mother's face by about three months and develop a reciprocal smile with a familiar person by four to six months. The human voice, facial appearance, the feel of the person who often carries the infant, his or her odour, the touch and strokes on the face and hands or rituals during bath time, feeding time or while or changing the napkins create a sense of familiarity and curiosity in an infant. 

An infant, who babbles or makes jargons sounds in the latter half of the first year, as early imitations of regular sounds heard at home, goes on to express variety of sounds, syllables and words before the first birthday. An infant wants to communicate and reciprocate as he or she grows up in an environment of words, gestures, actions, pictures, singing, etc. Being in such an environment increases the communication instinct of an infant. 

Now about seventy percent of pre-school children, who come to the Child Development Centre, where I work now, are brought by their parents, for not having shown the proficiency of language development expected at two or three years. The history of many infants is that,  from the time of starting the weaning food at six months,  they were introduced to the visual screen of TV or Mobile phone, where they watched advertisements, cartoons or other entertainments for four to six hours during the day. Some of them slept late and developed fragmented sleep due to the over-activation of their visual and auditory systems. Since most mothers, if they work outside home, return to work after six months of the maternity leave, the breast feeding got discontinued and a third person would have taken charge of the infant care. This further hampers the development of attachment behaviour between the infant and parents, required as a foundation for developing normal language and communication process.   

The eco-system of the human interface is replaced by the machine interface, which might be  a factor for the current explosive numbers of toddlers brought to Child Development Centres for delay in their language, social skills and behaviour.  Is this a consequence of making the TV or Mobile phone as the 'Third parent' !

3. A change in co-parenting

The machine interface is an invader that displaces infants and toddlers from being attentive to human voices, their faces and interactive communication. Adding to this, if the infant is left without the usual rituals of being sung to (not listening to music from the phone), played with, taken for social contacts with adults and children, or engaged in play at home with toys and household articles, then the delay in the interactive and communication process would get compounded.

The mind set of some parents currently from what I come across, is that the Internet, Mobile phones, cartoons, etc  are good for pre-school children as they would help to develop proficiency in language early. What toddlers do is repeat the machine language in the way they heard in the cartoons, without knowing the meaning or context. They parrot a language which is too early for the brain to process for its semantics, pragmatics and prosody. The colourful screen, animations, movements, stereotypical body movements of the cartoon figures with no semblance to normal human body or appearance or behaviour, freeze an infant or a toddler to a fixation of sight and sound which occupy their mind, displacing the human interactive process they needed to develop for normal communicative intent and content. 

The American Paediatric Association suggested that children below four years watch mobile phones or the TV only when one adult accompanies a child, in order to explain to the toddler what is going on in the screen, that too less than half an hour in a day. It is not ideal to let  children below six months to watch TV programmes on a regular basis. Often infants and toddlers jointly watch the adult TV programmes with their parents, which add to the complicity of the causal pathways for the delay in acquiring the language and social skills.  

4. Adverse influences on child development

We seem to have created an iatrogenic developmental delay of language, communication and social behaviour in infants and toddlers by overexposing them to the visual screen! 

Another dis-service professionals do to the parents is to announce this, as an Autistic Spectrum Disorder, without carefully studying the causal pathway for this developmental delay. Only a few pre-school children might have an unknown cause for the developmental delay. Most of the toddlers were already vulnerable due to hereditary factors, antenatal events or perinatal risk factors, which initiated  their developmental delay. This got compounded by lack of human interface, which if present would have naturally enhanced the neuro-plasticity for some recovery from the developmental delay. 

I feel disturbed by large number of pre-school children showing low values of vitamin D, Iron, Zinc and high levels of IgE, ASO titre, and cholesterol in blood. The premature closure of the coronal sutures observed in seventy percent of pre-school children with communication dysfunction who visit us alarms me. Is it linked to low levels of vitamin D from early infancy! A few publications appeared on this topic from this department.  I have some clarity now from the evidences gathering from 2002, that the Cortical Electrical Dysfunction identifiable in the EEG of about thirty five percent of pre-school children with language and communication disorder or sleep dysfunction might be factor in the causal pathway for  their developmental delay. 

During a pre-school health survey of 540 children in a school we noticed that less than five percent were left handed unlike the normal distribution of ten percent or more of left handedness. This raised the suspicion of enforced change of handedness at home or school. In the pool of pre-school children we welcome with language and communication disorders, about twenty five percent of children had a prominence of their left thumb and great toe, while they use the right hand as the dominant hand or are ambidextrous. In such children a high percentage used the left leg to kick a ball. 

We are now developing a criteria to distinguish between natural left handedness and acquired left handedness due to cerebral insult. The interference with the lateralisation of dominance and its impact  on evolution of language and communication dysfunction that arises out of it is now in an advanced stage of a study in our department. We are shocked how there is consistently low pulse oximetry readings at night in children, who have obstructed nostrils with or without snoring, which have gone unnoticed for a while in many pre-school children. 

Most families do not follow a sound sleep hygiene practices leading to fragmented sleep caused by sleep latency disorder, sleep interruptions and disturbed sleep-wake rhythm. From the time I was involved in setting up a sleep monitoring room with EEG tracing in 2004 for children in the Hall of Residence, at the Developmental Paediatrics Unit at CMC Vellore,  I have pursued the role of sleep dysfunction in behaviour and communication dysfunction since then.  The three studies published from this department on sleep and the benefit of using Melatonin to overcome the sleep related disorders, carry the message of the value of monitoring the sleep behaviour of children at home. We rely on the videos parents take to help us understand the sleep ignition process, sleep duration and sleep related disorders

Let me quote one of the articles to indicate the thought process that evolved in responding to the sleep related challenges in pre-school children. 

International Journal of Contemporary Pediatrics

Thampy M et al. Int J Contemp Pediatr. 2023 Apr;10(4):546-553

http://www.ijpediatrics.com

pISSN 2349-3283 | eISSN 2349-3291

DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20230735

Original Research Article

Megha Thampy1, M. C. Mathew2, Anna Mathew3*, Liya Grace Kurian4, John Michael Raj5

The role of melatonin in regulating sleep wake disorders in children attending the developmental pediatrics outpatient service of a tertiary care hospital in South India

2Department of Developmental Pediatrics and Child Neurology, 3Department of Pharmacology, 4Department of Developmental Pediatrics, 5Department of Biostatistics, 1MOSC Medical College, Kolenchery, Kerala, India

Received: 20 February 2023 Revised: 15 March 2023 Accepted: 16 March 2023

*Correspondence:

Dr. Anna Mathew,
E-mail: mosc.research@gmail.com

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: We have observed that 75% of children with neurodevelopmental challenges visiting the Developmental Pediatrics department of this institution have sleep wake disorders. Disturbed sleep has a negative effect on learning and behavior. In this study we assessed the effectiveness of melatonin in improving sleep wake disorders in children with developmental compromise from this south Indian state.

Methods: Children with developmental challenges having sleep wake disorders confirmed by the pediatric insomnia severity index PISI, who were prescribed a daily dose of 3mg of melatonin participated in this prospective, observational, longitudinal study if the parents gave written informed consent. Parents were educated in the practice of sleep hygiene. The sleep disturbance scale for children (SDSC) was used to assess the overall pattern of sleep and six common disorders before and three weeks after starting melatonin.

Results: Based on the PISI scores, 13, 58 and 20 children had mild, moderate and severe insomnia respectively. Melatonin improved sleep latency, increased duration of sleep, decreased night awakenings, crying spells, dreams and daytime drowsiness. There was a significant improvement in the sleep pattern as indicated by better scores in the total SDSC score as well the scores for the six sleep disorders (p<0.001).

Conclusions: Melatonin has a significant role to play in regulating duration and quality of sleep and improving sleep pattern in developmentally challenged children with sleep-wake disorders.

Keywords: Melatonin, Sleep disorders, Neuro-developmental challenge, Sleep-wake rhythm disorders 

5. A fall out of the COVID time restrictions

It is the COVID season which brought this to its current serious situation. All were advised to keep 'social distancing'. But what was needed was to practice ‘physical distancing’ and engage in creative ways of sustaining social communication. The on-line schooling legitimised the prolonged use of the visual screen at home.  The inadequate social vigilance by the professionals, added to the woes of parents struggling to find a way forward to engage their pre-school children, when social restrictions prevailed for over two years.    

The post-COVID season calls for urgent corrective measures and emergency action plan to help toddlers and preschool children, who are currently struggling to catch up in their language, communication and social skills! The therapy centres, offer occupational therapy, speech therapy and behaviour therapy to pre-school children. But more action is needed to offer parenting education to restore communicative and interactive practices at home.

6. Towards restoring healthy parenting practices 

Let me share six exercises of the last two years in the Child Development Centre where I work, which arose out the need to engage parents and professionals to promote a communicative and interactive environment at home and at the pre-schools. 

The first exercise was to invite parents of pre-school children to have a weekly online interaction on co-parenting and define the content of the nurturing behaviour to promote play based engagement with children at home. This involved each parent taking turns to be with their child during a meal time, bath time, play time, bed time, outing time, etc. It was one way of restoring the routines and rituals associated with infant and toddler care, which got dislocated during the COVID season. Some parents who brought feedback gave indications of how they were able to find an alternative way to media over exposure, by introducing new experiences through play. 

The publication below, released in 2021 by ASHIRVAD at the time of the tenth Anniversary of the Developmental Paediatrics Unit at MOOSC Medical College,  is a guide to parents to observe and record the developmental sequences of children in ten domains, and for parents to be keen observers of the developmental path, their children take. This was a step towards making parents primary developmental champions of their pre-school children. There are video links provided in this booklet, which help parents to follow the steps involved in taking, weight, height, mid arm circumference, and observe skills of hearing, and vision. 

The second exercise was to popularise the idea of creating a Child’s Corner and play at home. A child’s corner is a place at home to locate the collection of toys, books, art and craft materials and other visual aids which would engage pre-school children. The Child Development Centre uploaded  videos in the u-tube to propose a design for a child’s corner at home and illustrated how this can make children gravitate towards play and interaction. The traction towards the visual screen could be partially altered when children have an area at home, which reminded them of what they can do with their toys. We have had parents bringing back encouraging reports of how the child’s corner gave an interactive space for parents and children to explore new activities. The link to the videos:

         https://youtub.be/kqdTnSWBvco  and https://youtu.be/1eONrsUbwkA .

The third exercise that we got involved was to create videos of nursery rhymes and action songs, sung by the professionals in the Child Development Centre and upload them in the u-tube. They were sung and acted in a way, that parents watching them would get introduced to the way rhymes and action songs can be used to engage pre-school children to initiate them to sing along and follow the actions. Most young parents we were in touch, got used to screening the rhymes to the pre-school children, while they sang along and joined in  the actions.  The videos we created helped some parents to return to live singing without the video, which captured the attention of children and promoted better interaction. The link to the videos:

 https://www.youtube.com/watch?v=1fMNug5ncyM

            https://youtu.be/1Y2j_e6kZ88                            https://youtu.be/0xG1jJpBi5E

The fourth exercise was to invite all parents who came to the Child Development Centre  to visit the Family Life Centre, which is a room of exhibits of toys, books, papercraft for children  and posters displaying the different stages of child development from infancy to adolescence. This exposure to the canvas of child development was introduced to the parents for them to pause and reflect on what changes they can bring in their parenting style of pre-school children.

Parents were drawn by what they saw and heard from the professional accompanying them to arouse interest in revising the parenting practices. The child development process is often nebulous in the minds of parents. The visual images help parents to develop a perspective to promote child development practices  by proactive steps in parenting.  

The fifth exercise was to create a manual for parents, Accompany your child, a plan for monitoring the developmentally challenged child (1-5 years), which in its 70 pages of parent friendly presentation, give charts describing the developmental domains.  

Parents can observe and record the developmental process of their pre-school child every two months. This manual is being used by some parents for self-monitoring the development of their pre-school child. They carry this with them when they come to visit us and show their recording of the developmental process of their pre-school child in different domains. 

The sixth experience was getting some professionals to meet online weekly for two years, to discuss the issues of child development and clinical pathways to support developmentally challenged children. The physical Medicine and Rehabilitation department of the Bangalore Baptist Hospital under the leadership of Dr Vinita Varghese created the Zoom platform for this during the COVID season. This provided a forum for peer reviewing some of the activities we were promoting to augment the parent-involved and home-based child development plan. 

7. The way Forward 

All Child Development Centres have two cardinal functions. One is to be a resource centre engaged in paving the way for the developmental journey of a child through an individualised action plan. The second is to enable parents to pursue sound parenting practices to make homes formative and educative for child development.  

What pre-school children have lost in the recent years is the normal communicative environment at home. They were denied regular school experience during two academic years due to the COVID restrictions. Now is the time to restore to pre-school children, their regular communicative environment both at home and in the pre-schools. 

Parents and professionals are to be partners in this journey!

M.C.Mathew (text and photo)

A note: All the percentages of different co-morbidities referred to in this article is based on the unpublished data from the department of the Developmental Paediatrics, MOSC Medical College, Kolanchery, Kerala, India. They are preliminary findings of the studies currently going on.  

Acknowledgments: The professionals at the MOSC Child Development Centre, Miriam, Liya, Shalini, Femy and Femine for creating the videos. Shalini composed Accompany your child; Dr Anna Mathew edited it and ASHIRVAD published it. Dr Vinita Varghese of the Baptist Hospital co-ordinated the weekly online professional forum. 

A pathfinding journey!

This news bulletin published on 14th September 2021, when we stepped into the tenth year of the child development services for children, I felt that the call to 'Build to Belong', the logo of the department, came upon us even more clearly. 

You can get an online PDF version of this bulletin by writing to childdevelopment@moscmm.org  

In about six weeks children in some classes would return to school after a gap of 18 months of the Corona pandemic season. 

Lok out for reflections on the following topics in the coming days!

1. Children's transition

2. Teacher's dilemma

3. Parent's concerns

4. School administrator's situation

5. Health provider's thoughts

In this unprecedented situation, there are more questions than answers. I hope we can explore them based on the information available to us. 

All movements to plan for children returning to school would be conditional to how the pandemic fades away or surfaces in waves!

M.C.Mathew(text and photo)

.

 

A Meal time!

One of the difficult times for parents is to get a two year old child to get to sit in one place and feed himself or herself. Most parents resort to make them watch TV or mobile phone while been forced to eat. They eat with no awareness of the texture, flavour, odour and consistency of food. They eat unaware of the movements of lips, tongue, throat and all the movements associated with swallowing. Eating becomes a passive activity just as watching the TV.

A better way to get a toddler to start into a good way of eating food is by helping a child to be at the family table form about a year when a child is able to sit unsupported. It is the sight, colour, flavour and the seeing others eat which forms the first impression for. toddler to want to taste all that are served on the table. All children seek for food when they are hungry. Reserve offering food while at table along with others. Even when a snack has to be offered it is best done with a child sitting on a high chair at the dining table. The high chair, table, meal time rituals and patience to introduce food to a child would make a child want to be at the table to share a meal. There might be exceptions with soem children on account of tier special situations developmentally.

The habit of having the family meal with TV or audio on ought to be replaced with conversations which children can enjoy. Often what children are happy to hear are about things that happen in and around the house. I am of the opinion that conversation pertaining to the adult's world ought to take place elsewhere and not at the family table. Some parents woeful even read s tory at the end of a meal to close the family meal with good thoughts fo ra child to stay with. 

The food fads which children develop are directly relational to the proclamations that adult make about the food he or she likes or avoids. The conversation about the taste of rtes food or anything physical about the food is a bad introduction or example to children. It is not just the taste which determines the quality of food; so why talk about taste and complain about what is less or more in the cooked food, which is an ungraceful way of making the one who cooked food feel disappointed or hurt. 

Children observe and pick up habits adults practice. A table is apace to honour each other and not to criticise anyone or make others as the agenda of conversation. 

A child told me that he does not like ice cream because his father did not eat ice cream. Le tis remember that meal times are habit forming; meal time conversations influence the thought process of children; and meal time can be an endearing time between members of the family. 

Food times are relational times and are most formative for children in the early years of their lives. 

Let su make it that way.

The Sunbird in the photos above find nectar! Children too would come to the table to find their food, if the memory of the meal times is refreshing and enjoyable!

M.C.Mathew(text and photo)

The twins at birth and thereafter!

The majority of children are born as single. 

There is an increase in the number of twin pregnancies. 

Most families would be aware of the twin pregnancies, thanks to the foetal ultrasound done in the third month or earlier months of pregnancy.

There are some differences  that a mother would experience in a twin pregnancy. Often they are medically manageable. 

It is after the twins are born the real challenges to care for both of them surface. From the way both have to be breast fed, at three hours of interval, there are challenges for the mother. Normally with a single baby moth gets a rest in between the breast feeding as a baby would be asleep. Feeding both babies would take about an hour or more as against twenty minutes for a single baby. Thus the time gets prolonged while taking care of both babies. Often other members in the family would offer help in bathing babies and looking after the personal needs of the babies. Most twin pregnancies end up in delivering the babies by Caesarean section in which case, the mother takes about three months for full recovery from the operation. 

Most babies if born at full term of t pregnancy would be ready to interact socially by about three months. That is why a mother would find the experience more demanding and perhaps stressful. The bonding between a mother and her babies at this time is crucial for developing attachment behaviour. For this to happen, a motor herself has to be directly involved in the care of her babies. 

By the time the babies are about six months they are mobile in the bed and would soon be ready to move about by crawling to explore the environment. It is during this time both babies might have two different temperaments. One is easily consolable and the other is not so. A mother might get unsettled in coping with the different behaviour patterns of the two babies. One might sleep less at night and more during the day. One might feed well and adjust to three hour feed and the other might demand more feeds or feeding time. 

I have come across mothers beginning to show the strain of mothering twin babies when they enter to the sixth months of the babies. 

I have heard from some others about the way they adjust to this difficult situation. They hand over the upkeep of the home to someone else and stay free of that responsibility. 

From the early months of pregnancy some mothers help an older sibling, especially if he or she is less than three years of age, by getting help from the father of the child or another person at home. He or she gets the child used to another person to give bath, get the child ready, feed the child, etc so that this responsibility is fully taken over when the twins have arrived. 

The extra physical care of the twins when they are in the age group of nine months to one year is what would exhaust a motor as by that age they are awake most of the day time during the day. They might follow a different rhythm during the day and night, in which case the mother would need extra help to meet all the needs of both children. 

Many mothers resort to taking leave of absence from work for one year from their professional work, to which they are entitled according to the current maternal benefits offered by their employees.  

I have come across fathers availing paternal leave that they are entitled to, in some situations to be a buffer during this adjusting process. 

By about 18 month the twins are ready for more engagement emotionally, socially, behaviourally that some parents would use the benefit a dependable crèche close by to let children be exposed to a social environment for three or so hours each day. Most parents take turns to avail of part time jobs to tide over this period of extra demands. 

All children are with parents only till bout three years of age. After that they share the day time between home and pre-school.

This calls for greater vigilance to give children best of experiences at home till three years of age, for them to feel secure and safe. 

The first two years of  twins are crucial that both parents are to be  equally involved in giving them the experiences of stability they would need. 

I have come across parents seeking the help of neighbours during the week ends to involve tree children socially so that parents have few hours of respite form the routine they go through during the week. 

There are special circumstances when the twins are born pre-term or with low birth weights. They would need additional support. 

The department where I work has brought out a publication recently, which would be available for parents from 15th September, 2021 to observe the developmental process of children from birth to five years. The booklet is a simple to use to guide for parents to observe the developmental processes of children in the domains of vision, hearing, motor skills, behaviour, language, pre-school skills, sleep, etc.    

Taking care of twins is different form taking care of one baby!

I shall come back to discuss more about parenting of twins. 

M.C.Mathew (text and photo)

A Beatle !

A battered flower in rain! But a Beatle stays on it!

One experience children in the pre-school years face is a battered environment!

Most homes area on an auto-pilot mode due to what parents have to juggle with several responsibilities. 

What I heard a three year old child whisper to his mother was, 'Will you have time for me to read to me at bed time!

I watched the mother becoming tearful on hearing this!

I heard the mother' story of having to do all the chores at home in the evening. By that time her son would have gone to sleep lying in the  sofa! She carries him to bed around 11 pm when she goes to bed tired and exasperated. 

It is sad to let a child go to sleep unattended! We increase the feeling of loneliness in pre-school children if they are left alone at that transition time between day and night! 

Most homes are at a edge on account o several pressures that come upon them due to the existential demands of daily living. 

Is it not true that young children who cannot make a fuss beyond a certain level for fear of getting punished, suppress their needs and suffer for want of what they look forward to each evening at bed time! To have father or mother beside in that transition time. 

For a child a day of activities come to eat end at bed time. Most children fear the evening as they have to stop their play and go to bed. It is beyond the capacity of a child under five years to think that a night of sleep is necessary for health and well-being. They like to prolong the day into night. 

During the interview with twenty-five  parents I met with last week, I asked all of them to find the bedtime practice fo their young children. The average time of under five children went to bed was ten pm and getting up at 7 am.! Although that was eight hours of sleep majority and interruptions during sleep.  

Most children who had interruptions were those who went to sleep on their own or resisted to go to sleep. 

Sleep time is a transition time. Most young children need help during such a transition time. Being with then at bedtime assures them. They let go of their desire to hang on to play more at night recedes form tis pre-occupation when they get private time with one of their parents when they can cuddle in the proximity of one of their parents. It is the same presence thy might expect when they get up to feel welcomed during the transition time to wakefulness. The in between times at bed time and getting up times are stressful times for children as they cannot fathom the details that lie ahead of them. If a family were to take a child to the  children's corner at home, rather than force the child for a milk drink which most children dread every morning, children might begin the day more cheerful. 

A beatle in a battered flower! 

A child in a battered environment of home!

Protect children during transition times! Moving from one activity to another for children is difficult. They require prior preparation and physical presence of one of the parents to adjust to the transition till they can think and feel on their own!

M.C.Mathew (text and photo)

A broken Bud !

As I watched this bud broken and hanging in a slender support, I wondered whether it is a symbol of what happens to some children, who are developmentally challenged!

Most children who come seeking for help are children who go through difficulties which freeze them in the developmental process on account of what they suffered. Their circumstances have been difficult because of which they find the developmental progress difficult and demanding. 

To have been denied of all prospects of development because of what they suffered is unfortunate.

What Amazed me was, how the bud was still holding in a slender form, with the prospect of it becoming a flower. 

That gives plenty of hope for children and their parents because there is still life left in the flower bud to allow it to become a flower.

I have often come across this as a reality in many children. Amidst many difficulties which children might go through, what would sustain them would be the help they would find from their home and family. 

The professionals whom parents would consult would be another source of support for children; the teachers at school provide a link in the developmental achievement; the civil society has to be mindful of children and their needs.

A developmentally challenged child would need support from various places and people to be able to overcome the disadvantage they are through.

The child development of developmentally challenged children is a major concern in any developing country, as about 15 percent children born would have special needs!

A collaborative plan of action is needed for their development. 

M.C.Mathew (text and photo)

 

Buds in Monsoon- pre-school education during COVID time

Monsoon is not a good time for most of the flower bearing plants. And yet most of those plants survive the monsoon and return to their blossoming life during the prolonged monsoon season this year

I was asked yesterday a question by Shalini, colleague in the place where I work, 'Are there not new possibilities for pre-school children, who have been looking forward to begin their schooling life for 18 months now'!

That set me thinking as children around three years have been denied of any experience of a school life, class room experience or the rhythm of a week-long schooling and the delight of a  week-end  at home. 

I have come across at least three alternatives which some communities have experimented in some parts of India to substitute for the missing link in the life of children, who were waiting to join pre-school. 

1 Neighbourhood Learning

I know of a group of parents who got the three year olds in their neighbourhood together for three hours in a day to meet for activity based learning  Each day, there were five children who met in a public place, in a church or  a marriage hall campus, with due diligence to follow all the COVID protocols. Parents or teachers, each day two of them, who did not have to go to school or other work place volunteered to be available. They were made ready to have a plan for each day, to allow children to explore learning with Montessori equipment and creative activities with paper craft, listening to stories read or with flannel graph,  learning from nature walk, narration of events from the experiences at home, etc. This formed the daily play based learning agenda.  

Children came for this outing with readiness and eagerness to be part of a non-formal learning process. It took a while before children got used to wearing masks and follow the practice of sanitising hands. The routine also involved having snacks in between the three hours. What children could not do was to be physically close or play games which involved physical proximity to each other. 

I heard from some parents, who were involved in this experiment that this experience restored the longing of children to be at school and gave parents an idea of how they could engage children during the rest of the day from the example of what was done for them in the mornings. 

The children were rescued from TV dependence and got introduced to a discipline of a routine, similar to what would happen in a regular pre-school season. The outcome was children were happier and parents felt glad for provision of a semblance of a pre-school experience. 

2. School initiated learning process

After the severe restrictions of schooling were lifted I know of few schools who allowed children to come to 'visit' schools once or twice a week for three hours in groups of four or five children by prior arrangements. At least two teachers were available each day. This voluntary option offered to parents to choose, became popular as most parents found this outing a valuable respite for children from being home bound. They met some of their friends and could have some informal class room experience of activity based exploration. Teachers entertained them with stories, nature walks, paper craft, activities to develop their hand-skills and co-ordination. They could even play with a ball standing at a distance from each other. 

During this time teachers allowed children to narrate their stories or draw or enact stories, none of which would be a COVID risk, as physical distance from each other could be maintained. 

The teachers who were starved of being in touch with children had an opportunity to renew the contacts with children and gave them an emotional connect which teachers looked forward to. 

The parents found this as an example for them to engage children on the other days when they did not go to school. The feed back  about this experience from parents, teachers and children gave me an impression that there are alternatives that we can continue to pursue even now when schooling is still a distant reality for a while. 

Children find a new identity when they can have an association with their class rooms during this time. Pre-schoolers are in a formative stage where trauma of denied schooling might be interpreted by children in different ways. I came across a child, who said, 'My parents do not send me to school because I am naughty'! How many three years old children can understand even a little about a pandemic and its adverse effects! They are used to thinking instantly and not laterally. What they miss  can be attributed to 'not being good enough to school'. We might not even sense that a pre-school child entertains such a thought in their perception. 

I wish schools would feel for children and do something soon to get children catch up in their growth by adding the schooling experience! How terrible for them to  have a prolonged denial of this aspiration to be at school! It is a void which they shall turn back to view as a lapse on the part of teachers and schools!

3. Community Home schooling  

I know of a hospital in rural Bihar, who decided to create a substitute for regular schooling for children of their staff, by bringing children together for four hours each day, by dividing them into three groups and parents of children taking responsibility in between their hospital work to be tutors to children. The stories of benefits to parents  and children I gather form this experience are significant and outstanding. 

The hospital got three of their staff equipped to offer learning support for children through on line learning mode. The hospital set up separate class rooms to accommodate five children in each class and continued the regular curriculum as per the school schedule. 

The staff who volunteered to help brought their skills for the benefit of children. They got children introduced to gardening, pet rearing, dancing, public speaking, story telling, cooking, designing, etc that children found this form of life skill centred schooling most amusing. I know of parents who do not have to be after children to get ready to go to school on time. 

The hospital staff who volunteered to do this got a new glimpse of what hey can do at home to enhance the creative instincts of their children. They spoke of a new consciousness of parenting they learned from this exposure to the educational aspect of their children. For children, it was an experience of learning where they discovered more dimensions than reading and writing. 

The introduction to self directed projects made a big difference to parents, as they learned how children can be engaged in areas of their interest at home.  

Parents also feel relieved that this form of learning by doing, experiencing and exploring inside and outside the class room, gave them enough inspiration, that they were not seeking to view Television during  every in-between time. 

 

Let me conclude!

I have a suspicion that adults have not yet fully felt the grief of children in being denied a  schooling for a second year! This easy option of on-line learning is a poor substitute to be fully depended on! At best it can be an adjunct to other forms of active learning. 

Where are the friends of children, who feel with children and be moved to find alternatives to suit children and not just adults!

If children do not get primacy of attention during difficult times and receive the best of the options, adults would be judged by history for their casual outlook to childhood learning during this pandemic season! 

M.C.Mathew(text and photo)