Infancy and Early Childhood

Counseling Schedule: Infancy

• Establishing Routines• Discipline = Teaching• Firearms• Modeling Behavior

6 and 9 MONTHS

• Child Care• Family• Safe Environment• Parenting Style• Bonding and Attachment

2 and 4 MONTHS

• What Babies Do• Parental Frustration• Parent Mental Health• Parent Support

2 DAYS to

4 WEEKS

INTRODUCEVISIT

Infancy1-7

• Early caregiver relationships set the stage for future

relationships

• Securely attached young children have an easier time developing positive, supportive relationships

• Emerging evidence shows that securely attached young children are found to have more8-15:

• Balanced self-concept

• Advanced memory processes

• Sophisticated grasp of emotion

• Positive understanding of friendship

Infancy Counseling

Being a new parent can be exhausting. How are you doing?

If there is a gun in the home, how

is it stored?

How much time do you have off

from work?

Is this what you expected?

Who helps you with your baby?

Be on the lookout for families who are socially isolated or experiencing family discord.

Infancy Brochures

Welcome to the World of Parenting!Visit: 2 Days to 4 Weeks

Helps parents understand the normal development of newborns

Provides information about coping skills for parents

Discusses changes in the ways parents may now relate as a couple

How to Use this Tool

• Whenever appropriate, include both parents in the conversation

• Discuss infant crying and ways to handle it:

• Crying is normal

• Crying upsets parents

• Sometimes, parents just need to let the baby cry

Helpful Hint!

Support new parents with positive statements:

I love the way your baby looks at you, soothes to your voice. You’re doing a

great job!

Parenting Your InfantVisit: 2 and 4 Months

Helps parents understand normal development of 4- to 9-month-old infants

Stresses importance of building family connections

Discusses 3 problems:• Colic

• Trouble sleeping

• Clinging to parents

How to Use this Tool

• Reiterate messages about crying and parental frustration

• Emphasize to parents the importance of having time together without their baby

Helpful Hint!

Support new parents with positive statements:

Your infant is alert, growing well, and has a beautiful smile!

How Do Infants Learn?Visit: 6 and 9 months

Offers practical suggestions to parents based on a newborn’s brain development• Encourages activities like reading or

singing to promote brain growth

Helps parents understand that exploration is a natural developmental need

How to Use this Tool

• Ask parents about their social connections. Refer to sections “Others Who Care for Your Baby” and “Taking Care of Yourself”

• Utilize the “Social Connections” worksheet from the Clinical Guide

• Talk about child care arrangements

Helpful Hint!

Notice infant’s new behaviors and parent-child interaction:

Wow, your baby is really interested in my stethoscope! I like the way

she lets me examine her, but she is always looking over at you for

assurance.

Your Child is on the Move: Reduce the Risk of Gun Injury

Visit: 6 and 9 months

Correlates childhood injuries/ deaths due to firearms and presence of handguns in the home

Emphasizes that a child’s curiosity about guns overwhelms any lessons learned about gun safety

Provides information needed to make informed decisions

How to Use this Tool

• Discuss handguns in the context of other household hazards

• Since some parents may not be in agreement concerning the presence of handguns in the home, encourage them to look at the brochure together to make an informed decision

Helpful Hints!

• In areas of country with high rates of gun ownership, some practices offer reduced price or free gun locks

• Be aware of the potential lethality of domestic violence in homes with handguns

Counseling Schedule: Early Childhood

• Peer Playing• Safety in Others’ Homes• Talking About Emotions• Promoting Independence

3 and 4 YEARS

• Child’s Assets• Guided Participation• Media

18 MONTHS and 2 YEARS

• Child Development andBehavior

12 and 15 MONTHS

INTRODUCEVISIT

Early Childhood16-20

Communication skills allow young children to sustain bouts of play

How young children learn to react is greatly influenced by:• Parental relationship

• Parental behavior

• Home environment

Early Childhood Counseling

“She really pays attention when

we talk; does she understand when

you speak to her?”

“Does your child have

opportunities to play with other

children this age?”

“What do you think your child does best? What does he enjoy

doing?”

“Teach your child by providing

positive reinforcement for

desired behaviors.”

Encourage alternatives to TV, such as outdoor activity

or reading.

Normal toddler behavior may be especially difficult for families with little social

support.

Early Childhood Brochures

Teaching Good Behavior: Tips on How to DisciplineVisit: 12 and 15 Months

Describes the basics of a behavioral approach to parenting toddlers• Positive reinforcement for desired

behaviors

• Limit setting

Advises parents about effective alternatives to corporal punishment

How to Use this Tool

• Start conversations about toddler behavior with gentle inquiries

• “Your child is growing and developing well. Have tantrums started? How do you handle them?”

• “What is your child doing new since last visit? What do you want to change?”

• Endorse the core message: a simple approach for teaching toddlers how to behave well

Helpful Hint!Be on the lookout for children with difficult temperaments, families who are socially isolated, and families experiencing discord

Playing is How Toddlers LearnVisit: 18 Months and 2 Years

Helps parents understand normal toddler behavior and advises them how to

• Provide a stimulating environment during this period of major brain development

• Understand the natural curiosity and exploration of toddlers

How to Use this Tool

• Discuss normal toddler play behavior

• Provide parents with guidance on the types of toys that stimulate imagination

• Help parents identify places where they can meet other toddlers and their parents

Helpful Hints!

• Check in with parents about how their family relationships are faring

• Support toddler’s parents with positive statements:

What a delightful child you have! He is really curious

about the world. This is great to see!

Pulling the Plug on TV ViolenceVisit: 18 Months and 2 Years

Provides information about the influence of TV violence on children

Offers tips for parents• Set limits on TV time• Know what children are watching• Watch programs with children• Do not put TV in a child’s room

How to Use this Tool

• Identify alternatives to TV, such as toys that use imagination or outdoor play when possible

• Recognize that alternatives can be challenging, as TV often provides free in-home child care for families who cannot afford organized activities or who live in unsafe areas

Helpful Hint!

Ask the child: What’s your favorite TV show?

The child’s response often indicates the kind of TV programs being watched, which provides a topic to open discussion with parents

Young Children Learn A Lot When They Play

Visit: 18 Months and 2 Years

Introduces the importance of peer playing

Includes tips on how to make play opportunities successful

Assists parents in solving common difficulties, such as aggression and rejection

How to Use this Tool

• Ask if child has opportunities to play with

other children of the same age

• Use parent’s answer to discuss how the child plays or how to find other children

• Help parents problem solve any play or playmate issues

Helpful Hint!

Try to notice something about what children are wearing, the toys they bring, or their behavior:

I see you really like trucks. Do you and your friends play

with trucks a lot?

References

1. Bretherton I, Munholland KA. Internal working models in attachment relationships: a construct revisited. In: Cassidy J, Shaver PR, eds. Handbook of Attachment: Theory, Research, and Clinical Applications. New York: Guilford Press; 1999:89-111

2. Sroufe LA, Fleeson J. Attachment and the construction of relationships. In: Hartup WW, Rubin Z, eds. Relationships and Development. Hillside, NJ: Lawrence Erlbaum Associates; 1986:51-71

3. Sroufe LA, Fleeson J. The coherence of family relationships. In: Hinde RA, Stevenson-Hinde J, eds. Relationships Within Families: Mutual Influences. Oxford, UK: Clarendon; 1988:27-47

4. Thompson RA. Early sociopersonality development. In: Damon W, Eisenberg N, eds. Handbook of Child Psychology. Vol 3: Social, Emotional, and Personality Development. 5th ed. Hoboken, NJ: John Wiley & Sons; 1998:25-104

5. Sroufe LA, Egeland B. Illustrations of person-environment interaction from a longitudinal study. In Wachs TD, Plomin R, eds. Conceptualization and Measurement of Organism-Environment Interaction. Washington, DC: American Psychological Association; 1991:68-84

6. Sroufe LA, Carlson E, Schulman S. Individuals in relationships: development from infancy through adolescence. In: Funder DC, Parke RD, Tomlinson-Keasey C, Widaman K, eds. Studying Lives Through Time: Personality and Development. Washington, DC: American Psychological Association; 1993:315-342

References

7. Thompson RA. Early attachment and later development. In: Cassidy J, Shaver PR, eds. Handbook of Attachment: Theory, Research, and Clinical Applications. New York: Guilford Press; 1999:265-286

8. Cassidy J. Child-mother attachment and the self in six-year-olds. Child Dev. 1988;59:121-134

9. Verschueren K, Marcoen A, Schoefs V. The internal working model of the self, attachment, and competence in five-year-olds. Child Dev. 1996;67:2493-2511

10. Belsky J, Spritz B, Crnic K. Infant attachment security and affective-cognitive information processing at age 3. Psychol Sci. 1996;7:111-114

11. Kirsh SJ, Cassidy J. Preschoolers’ attention to and memory for attachment-relevant information. Child Dev. 1997;68:1143-1153

12. Laible DJ, Thompson RA. Attachment and emotional understanding in preschool children. Dev Psychol. 1998;34:1038-1045

13. Cassidy J, Kirsh SJ, Scolton KL, Parke RD. Attachment and representations of peer relationships. Dev Psychol. 1996;32:892-904

14. Kerns KA. Individual differences in friendship quality: links to child-mother attachment. In: Bukowski WM, Newcomb AF, Hartup WW, eds. The Company They Keep: Friendship in Childhood and Adolescence. New York: Cambridge University Press; 1996:137-157

References

15. Park KA, Waters E. Security of attachment and preschool friendships. Child Dev. 1989;60:1076-1081

16. Bradley RH, Caldwell BM, Rock SL. Home environment and school performance: a ten-year follow-up and examination of three models of environmental action. Child Dev. 1988;59:852-867

17. Collins WA, Laursen BP, Hartup WW. Relationships As Developmental Contexts. Minnesota Symposia on Child Psychology 30. Mahwah, NJ: Lawrence Erlbaum Associates; 1999

18. Dunn J. Young Children’s Close Relationships. Newbury Park, CA: Sage; 1993

19. Hartup WW, Rubin Z, eds. Relationships and Development. Hillsdale, NJ: Lawrence Erlbaum Associates; 1986

20. Maccoby E, Martin J. Socialization in the context of the family: parent-child interaction. In: Mussen P, Hetherington E, eds. Handbook of Child Psychology, Volume 4: Socialization, Personality, and Social Development. 4th ed. New York: John Wiley & Sons; 1983:1-102

Acknowledgments

Howard Spivak, MD

Robert Sege, MD, PhD

Elizabeth Hatmaker-Flanigan, MS

Bonnie Kozial

Vincent Licenziato

Kimberly Bardy, MPH

This project was supported by Grant No. 2001-JN-FX-0011 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.