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Can Childcare Providers Tell You When Your Kid Has to Be Potty Trained?

Dr. Jana quoted in article by Maressa Brown – Parents Magazine

(posted online 8/29/19)

Given how stressful potty training can be for parents and kids, the last thing either needs is to contend with discrimination from a daycare or preschool that refuses to accept a child who isn’t yet trained. And yet, every now and then, families face this very ordeal.

In 2011, a child was told not to return to her Arlington, Virginia, preschool until she stopped wetting her pants. Five years later……continue reading

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School-Readiness: Send Kindergarteners to School with These Key Social and Emotional Skills

Originally posted on my US News & World Report parenting blog (Aug 3)

FOR ALL PARENTS OF soon-to-be kindergarteners, by now, you’re well-acquainted with all the work that goes into preparing a child for school. Kindergarten readiness has long been associated with the ABCs and 123s, and understandably so. Mastering skills such as being able to count and recite the alphabet, and knowing one’s shapes and colors all serve to lay a strong foundation for reading, writing and arithmetic.

That said, it’s worth noting that an ability to develop and maintain relationships has recently been added to this list of so-called IQ skills. Its addition makes clear that social and emotional skills, along with several other skills often misleadingly described as “soft” and “non-cognitive,” are now being acknowledged as critical when it comes to school readiness.

Honing the ability to focus and pay attention, be a good listener, share, take turns and play nice with others may seem like common sense. Yet these types of “other” skills are now collectively being recognized to be of equal, if not greater importance, than IQ skills by everyone from educators, pediatricians and neuroscientists to economists, entrepreneurs and business leaders.

With that in mind, it’s important as the new school year begins that parents integrate teaching kids what I like to refer to as QI (think positive “life force”) skills as well, while helping them develop as students. This is something that you’ll want to do, of course, not just before their first day, but as they continue to grow and develop, both in the classroom and outside of it. Here’s a breakdown of QI skills – which I’ve also outlined in my book “The Toddler Brain” and my children’s book, “Jumping Into Kindergarten” – you’ll want to be sure to encourage and cultivate: ….

Read more…

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Taking Baby Brain Science to the Streets

There certainly seems to be a lot of encouraging activity taking place in the world of early childhood these days – from campaigns such as Let’s Move to efforts dedicated to identifying high quality child care and insuring that it is both accessible and affordable for all. As a pediatrician trained in the so-called “hard” sciences, one of the most intriguing aspects of this activity, in my opinion, is the movement to effectively and impactfully take early brain science to the streets.

Before jumping ahead to some of the exciting and innovative work that’s now being done, it’s worth reviewing (in admittedly oversimplified terms) how we got here. The 1990’s were characterized by a “concerted effort to enhance public awareness of the benefits to be derived from brain research,” earning it its recognition as the “decade of the brain.” In 2000, the IOM released a galvanizing consensus report on the science of early childhood development – representing both a rallying cry and a very big next step in the brain-building movement. Aptly titled From Neurons to Neighborhoods, it served as a broad and firm, evidence-informed foundation for what we are increasingly seeing: direct connections being forged between the burgeoning brain science and what’s being done to directly promote healthy experiences and environments for all young children…on our “streets” and in our neighborhoods, our communities and across the country.

I have found that on the brain science side of the equation, nowhere is the large and growing body of early brain-based research more accessible, compelling and clearly articulated than Harvard University’s Center on the Developing Child, under the leadership of Neurons to Neighborhoods editor, Dr. Jack Shonkoff. Based on a firm believe that the science of early childhood – right down to the developing brain architecture – can be used to develop more effective policies and services focused on building resilience, developing executive function and self regulation skills, and ultimately preventing the potentially neurotoxic effects of poverty, adversity and toxic stress for those most at risk.

Adding to our increasingly deep and detailed understanding of the baby brain is interdisciplinary research being done at places like the University of Washington’s Institute for Learning & Brain Sciences (I-LABS). Headed up by renowned baby brain researchers Patricia Kuhl and Andy Meltzoff, I-LABS is using intriguing modes of dynamic neuro-imaging such as MEG (magnetoencephalography) to not only provide compelling new insights, data and images about the connecting of neurons and the mechanisms for early learning, but also collaborating with people and organizations who can quickly translate this work into real-world applications.

With respect to these “real-world” applications, The First 1000 Days author Roger Thurow captures the importance of translating this science when he states, “If we want to shape the future…we have 1000 days to do it, mother by mother, child by child.” For anyone dedicated to doing just that, it’s heartening to see just how wide a range of brain-building efforts there are now in place across the country – all dedicated to helping all children reach their full potential by directly offering parents and caregivers evidence-based brain-building information, activities and support. Whether bringing the message to families where they live – on their phones, in their inboxes, on their screens or on their doorsteps – the following are a sampling of these brain-building efforts.

Vroom. Vroom’s brain-building message is clear: Shared everyday moments, from mealtime to bathtime, can easily be turned into brain building moments, and that parents have what it takes to become master brain builders. Suggestions for fun, everyday age-specific activities meant to “spark connections” are made easily available via the free Vroom app, along with practical tips, videos and even badges of encouragement. As for future efforts, watch for everyday brain-building messages to make their way on to the packaging of trusted brands. Supported by the Bezos Family Foundation, one look at the Brain Trust behind Vroom and it leaves no doubt that the best in early brain science is at its core.

Thirty Million Words Initiative. With a name based on the 1995 landmark findings of Hart & Risley, who found that preschoolers from families on welfare were exposed to a full 30 million fewer words than their high-income counterparts, Thirty Million Words Initiative is a Chicago-based, parent-directed program that employs the power of home visitation, one-on-one and group interactions, social media, and the use of the LENA word pedometer to study, build relationships, educate and support powerful parent-child interactions and children’s early language development.

Too Small To Fail. Given the foundational importance of early language development and exposure to words, Too Small’s to Fail’s parent-directed Talking is Teaching efforts include direct-to-parent tips and resources focused on talking, reading and singing with young children that are delivered via email and also available on Twitter (@TooSmallToFail). This is a partnership between the Clinton Foundation and The Opportunity Institute meant to improve the health & well-being of America’s children ages 0 to 5 years.

Text4Baby. Text4baby is a free mobile messaging service provided by Zero to Three – an organization dedicated to advancing the proven power of early connections – in partnership with Voxiva. Text4baby provides personalized, evidence-based health information in the form of text messages for moms and babies throughout the critical period of pregnancy and the first year.

Sesame Street. That’s right…when it comes to taking early brain science – complete with its implications for both cognitive and social emotional development – “to the street,” one needs look no further than the beloved Sesame Street. Founded on helping reach all children with life-changing opportunities to learn, a Sesame Workshop – RWJF collaboration is allowing the Sesame Workshop team to study how best to create and directly deliver the brain-building resources we now know are so fundamentally important for young children’s healthy cognitive and social-emotional development. If you aren’t familiar with past contributions of Sesame to this realm, just take a look at what they can endearingly do with key concepts such as self-control (a core component of executive functions skill development) and empathy.

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Biting: What To Do When Toddlers Bite

Originally posted on my US News & World Report parenting blog (Dec 11)

A CONCERNED MOTHER recently reached out to a large virtual support group of fellow moms to seek advice regarding a distressing incident involving her young child. She described all sorts of challenges that commonly face working moms today, from the adjustment involved in heading back to work to all-important considerations regarding child care. But at the heart of this particular discussion was a subject that I have long found to be of universal interest to parents and others who take care of young kids: biting.

The virtual response this mom got to her tale of woe was impressive: Hundreds of other moms weighed in, sharing their own biting experiences, insights and frustrations. As I’ve found over several decades interacting with young children and their caregivers, biting can become the bane of a parent’s existence – whether you’re upset your child has been bitten, or the frustrated parent of a biter.

To tackle this issue, I’ve found it most useful for everyone involved to step away from the particular situation at hand – at least for a moment – and start with a clear understanding of what biting does, and doesn’t, represent.

The best way I’ve found to explain it is that biting happens to be the least socially acceptable of all of the predictable and developmentally normal behaviors of early childhood. The thought of one child trying to take a bite out of another child has come to be perceived as far more distasteful than, say, hitting, pinching, pushing, kicking, shrieking or any of a whole host of less-than-desirable toddler behaviors. There’s something about the discovery of a human bite mark on one’s child that parents find especially disturbing. However, a young child’s predilection to bite both friends and foes isn’t abnormal.

Read more…

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Kids & Cars Seats, Why Safety Shouldn’t Take a Back Seat When You Fasten in Your Kids

Originally posted on my US News & World Report parenting blog (Sept 22)

THIS WEEK HAPPENS TO BE Child Passenger Safety Week – a week specifically dedicated to ensuring that parents, as well as anyone else who transports children, use the correct car seat and properly buckle kids in each and every time children ride in motor vehicles.

As a pediatrician with 15 years of experience being a child passenger safety technician and instructor, I am most definitely a fan of this week-long focus. That’s because the stakes are high when it comes to buckling kids in properly. Motor vehicle-related injuries continue to be a leading cause of death for children in the U.S.; and buckling up is the best way to save lives and reduce injuries. Child safety seats, when used correctly, can reduce the risk of death by as much as 71 percent, according to SafeKids.org.

Yet, despite all we know about the importance of passenger safety, nearly three-fourths of cars seats are still not being used or installed correctly.

Adding to this problem is a second challenge that’s by no means exclusive to car seats, but which stands to seriously thwart our collective efforts to keep our children safe in them. I’m talking about the culture of “mommy-shaming.”

Consider the photo that just a few months ago managed to capture the attention of the parenting world. The photo I’m referring to wasn’t just any picture shared by any mom. It was a snapshot of the then 18-month-old son of pop culture royalty Kim Kardashian and Kanye West. It also just so happened to be a shot of a not-yet-2-year-old strapped into a car seat that was facing forward, rather than rear-facing seat as generally recommended for a child of this age.

The parenting and media response was fast and furious. While the virtual dust has settled, I still feel the need to weigh in on a couple lingering aspects of this cause celebre.

Read more….

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Parenting & TED: Key Parenting Takeaways From the TED2017 Conference

Originally posted on my US News & World Report parenting blog (May 5, 2017)

AS ONE OF ONLY A FEW pediatricians at last week’s TED2017 conference in Vancouver, British Columbia, I want to let you in on a little secret I’m fairly sure most parents and conference attendees don’t know: The TED conference is actually a parentingconference.

Sure, influential people from around the globe gather to hear thought-provoking talks delivered on “the world’s largest stage.” But when you get right down to it, the 90-plus carefully curated talks collectively paint a picture of the world in which our children will live.

It is this glimpse into what the future holds for our kids that makes TED especially relevant to parents. Whether you’re the world’s greatest female athlete sharing thoughts on becoming a parent (as Serena Williams did), or a parent on the go, what unites us is our shared hopes and dreams for our children. The legacy we leave will depend on how well we prepare our children to live healthy, meaningful and productive lives in a rapidly changing, complex world. This makes parents the people most in need of knowing the direction in which the world is headed. Ironically, we are also the least likely to have enough spare time to watch a 15-minute video online. That’s why I’m so compelled to share a handful of key parenting takeaways from TED2017…

Read More…..

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Parenting News Flash: TV Under 2 isn’t exactly educational

Recent advice from the country’s largest advocacy group for children leaves me concerned that what I’m about to write is going to be met with poor reception. Following extensive review of more than 50 research studies, the American Academy of Pediatrics released its October 2011 Policy Statement: Media Use by Children Younger Than 2 Years. I would like to think that all parents of young children tuned in, but for those of you who missed it – here are some of the highlights.

First, let’s start with a few facts about the current state of our children’s media diet. A full 90 percent of parents report (admit?) that their children under the age of 2 watch some form of electronic media – on average consuming 1 to 2 hours of television a day. For 1 in 7 of these young children, we’re talking 2 or more hours a day of media. By age 3, nearly one-third of our nation’s youngest have televisions in their own bedrooms. While these numbers may not be entirely surprising, given the ubiquitous nature of ipads, iphones, ipods, computers, laptops and TVs, they should nevertheless be disturbing given what we know about the potential effects of screen time for babies and toddlers.

There are several important questions we all should now be asking before taking even one more baby step towards the TV set.

  • Are infant- and toddler-directed programs educational?
  • Is there any harm in letting babies and toddlers watch TV (and other screens)?
  • What is “secondhand TV” and why should I care?

Let’s start with the question of educational value. In the words of my pediatric colleague (and the lead author of the policy statement) Dr. Ari Brown, the phrase “educational TV/videos for children under two” is an oxymoron. That’s because in order for anything to be educational, children need to “get it.” This inherently involves understanding both the content and the context. Given that young children have been shown to fundamentally lack the ability to distinguish between programs shown backwards from those shown forwards, one would be hard pressed to suggest educational benefit from watching. Sure these TV-viewing infants and toddlers laughed at viewings in both directions – suggesting some entertainment value – but entertainment does not equal education.

That’s not to say that there’s no such thing as educational television, or that educational television can’t be entertaining. Studies have actually shown proven educational benefit for children over the age of two from quality shows such as Sesame Street. It’s just that if you happen to be one of the majority of parents who have been led to believe (most likely by extensive explicit and/or implicit marketing) that TV programs and/or videos are going to enhance your baby or toddler’s intellect, you need to tune into the fact that it’s simply not.

Okay, so screen time isn’t the answer to making your baby smarter. What about those parents who readily admit they use the TV (and various other screens) as a sure-fire reprieve from entertaining their babies/toddlers just long enough to make dinner, take a shower, make a phone call….you know – all those things that just about all parents of young children struggle to find time to do in the day. I get that, and readily admit that TV did, on occasion, get used as a babysitter in my own household.

But the fact of the matter is that there are several key concerns regarding the time toddler and infants spend in front of screens, not the least of which involve language development. We already see expressive language delays in the short term. And the fact that we don’t yet know for sure about screen time’s long-term effects on language should not rule it out. In the meantime, there is a valid concern that screen time interferes with “talk time” – especially given findings such as the fact that 84 percent of parents talk less when the TV is on, and 74 percent use fewer new words. This is huge, considering that we’re talking about the most crucial time for language development.

There’s also reason to worry about the quality of sleep our children are getting. While most studies thus far have looked at media effects on older children, we know that healthy sleep habits impact just about every other aspect of all children’s health. Remember that a reported 30 percent of kids under 3 have TVs in their bedrooms. We clearly need to tune in to the possibility that their sleep may be suffering as a result.

Even during our children’s waking hours, the time that babies and toddlers spend in front of screens may simply not be time well spent. Not if it ends up displacing reading, playing, and entertaining oneself. We know that free play is hugely important for young children’s development, as are 3-dimensional, real world interactions with parents and other caregivers.

I would imagine with all of that, many of you may now be tempted to adjust your child’s media diet just a bit – and that’s great. But before you simply commit to eliminating an episode or two of toddler TV from your child’s daily viewing schedule or limit how often your baby watches his admittedly captivating video, don’t forget to take into account your own viewing schedule. That’s right – the evidence presented by the AAP is equally worthy of your attention when it comes to having your own shows on in the background. In other words, as parents we also need to take into account what is now being referred to as “secondhand TV” – an unintended exposure that is occurring in an estimated 40 to 60 percent of households across America. While parents may report “the TV is on but no-one is watching,” the fact of the matter is that someone is watching. Someone, as in our children. One study found that young children playing in a room shifted their gaze to the television that was left on in the background three times every minute!

So with that news flash, what’s a parent to do? Pediatricians fully understand that screens are everywhere, and it is entirely unrealistic to avoid exposing young children 100% of the time. But it is well worth your time to acknowledge that in many instances, there are better things for them to do to help them learn and develop. The AAP recommends the following strategies for making this happen.

  • Set media limits for children under two, bearing in mind that the AAP discourages media use for this age child.
  • Opt for supervised independent play rather than screen time to occupy your child when you aren’t able to sit down and actively engage in play. A simple set of nesting plastic cups on the floor can work wonders for engaging toddlers while their parents prepare dinner.
  • Keep TVs out of all children’s bedrooms
  • Recognize that your own media use can have a negative effect on your children. Help your child avoid secondhand TV exposure.

Originally posted on Omaha World Herald’s Live Well Nebraska