Articles on adoption, foster care, & pediatrics

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Stimulating Early Development

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Here are some resources to help with early childhood developmental concerns. What's amazing about early development is that infants and toddlers naturally gravitate to activities that are "just hard enough" to build new skills. If you provide some basic toys and materials, a safe environment, and your loving, engaged attention, development will happen. But it helps to have some tricks and tips as well, as well as activities to use with children who seem stuck, or delayed. Early Intervention can also be invaluable in such situations.

The Good Samaritan Children's Therapy Unit (in Puyallup, Washington), publishes two nice, small books by Wendy Robins Lind, OTR/L. They can be ordered by phone from the CTU using a credit card (253-697-5225), and they each cost $12.50, shipping included.

  • "Stimulating Your Child's Development Through Play (Birth to two years)" - I really like this one - lots of fun, stimulating activities for each month of age
  • "Daddy as Baby's Playground" - Nice motor activities for Daddys (and Mommys) for children up to a developmental age of 1 year, and many older adoptees without solid crawling/walking will benefit from these exercises [facial hair alert - the Daddys in this book are mightily mustachioed. I think this is more a historical artifact than an actual endorsement of facial hair as stimulating to infant development, but stay tuned, folks. Maybe they're onto something ...]

A neat bunch of free activity sheets for enhancing development through FUNdamental movement concepts is available from Sparkplug Dance Developmental Movement. "More tummy time" is oft-recommended for all infants, but especially kids with head flattening, poor "push-up" skills or other delays, and to promote postural development and integrated locomotion (crawling!). Trouble is, we rarely tell parents how to make it tolerable and fun. That's where this lovely "10 Ways to Have Fun on Your Tummy, Baby!" handout comes in handy.

A very comprehensive guide is Why Motor Skills Matter : Improve Your Child's Physical Development to Enhance Learning and Self-Esteem, by Tara Losquadro Liddle. This book fills a big gap in the literature by thoroughly and practically addressing motor and sensory issues in the 1st five years of life, including special sections on low muscle tone and prematurity. It provides excellent descriptions of appropriate play and physical activities for children at various stages of development, especially for kids that do have motor delays or low muscle tone.

Stanley Greenspans's Building Healthy Minds: The Six Experiences That Create Intelligence and Emotional Growth in Babies and Young Children is another good resource. Even if your child missed out on some of these experiences early on, it's not too late to create them. Good information on temperament and sensory processing differences here as well.

For more books on early development, please see our list of Development and Learning Books, and the following articles on our site:

Early Development Links:

Talking to Your Children About Adoption

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The Child Welfare Information Gateway has a very thorough review of "Adoption and the Stages of Development", which is a good place to start.

Adoption.com also has an nice factsheet called "Explaining Adoption to Your Child". Adoption Mosaic has a number of excellent resources: "Talking to Your Kids About Adoption: 11 Tips", and "Pointers for Discussing Tough Adoption Subjects with Kids".

For age-specific guides, courtesy of Adoptive Families Magazine, download ...

 

Strategies from "The Pocket Parent"

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Here's a nice list of positive parenting strategies from "The Pocket Parent", which is a book I can't recommend highly enough. Succinct, creative, effective parenting ideas for 2-6 year-olds (and up). The idea is to keep it in your pocket - I say keep it in your bathroom, for consultation during your own timeouts.

The Essentials of Teething

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Teething - such a tragedy. You're rolling around, exploring your hands, feet, and the world with your mouth, which is the center of your sensory world ... and wham. Sharp teeth start poking through. It just ain't right. And if adults had "teething", we'd all be popping Percocets. Not a safe choice for the wee babes, however ... so short of major narcotics, what's a parent to do? 

Start with this - Parent Guide: The Essentials of Teething

I am also not a fan of teething gels - taste bad, numb the whole mouth, don't last long enough, and have the potential for allergic reactions. Stick with tylenol or ibuprofen, teething toys, gum massage, and cold rags.

Primary teeth eruption chart (from the ADA):

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Permanent teeth eruption chart:

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Picky Eating

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Three nice resources on this issue below. Remember: kids, and especially toddlers, fear novel tastes. It was adaptive when prehistoric toddlers were ambling around the jungle, but now, not so much. We often give up after a child refuses something 3 times, when it may take 10 or more non-coercive experiences with a new taste or texture to accept it. Make it look or sound fun, but don't force a child to eat particular foods. A wise pediatrician once said: "The two things parents can't control is what goes in and how it comes out." But you can control what you buy, prepare, and serve. These guides can help with the rest.

Start with the following links, and consider picking up one of Ellyn Satter's excellent pediatric nutrition books. If your child has consistent food refusal or oversensitivities to a certain taste/texture, poor growth, or coughing/sputtering/choking/painful reflux during meals, talk to your doc.

Protruding Tongues

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The issue of protruding tongues is a difficult one in international adoption. Everybody has a strong visceral reaction to seeing it because it is a feature of Down Syndrome. BUT - we can almost always rule out Down's based on other features in referral photos.

Another rare possibility but one that carries visual associations for people, and one that we test for routinely at birth in this country, is congenital hypothyroidism. This can cause coarse facial features, large fontanelles ("soft spot" on head), protruding tongue, low tone, constipation, lethargy, etc (many of which our kids have at first for other reasons) and is associated with cognitive delays if not promptly treated in the first months of life. This used to be called "cretinism", and may also trigger developmental concerns when seeing babies with their tongue out. We test for this routinely on arrival, and some countries (Korea) screen for it as well.

Protruding tongue can also happen with orphanage-related low oral-motor muscle tone from lack of appropriate feeding practices, not having toys to mouth and chew, and nutritional deficiencies. In general, low muscle tone can be associated with other developmental concerns, but it is a frequent finding in post-institutionalized children, and one that usually improves dramatically after adoption.

This is also not necessarily a muscle tone issue - it may be a common, benign involuntary tongue protrusion associated with concentration or excitement (a la Michael Jordan).

What our local developmental experts tell Dr. Bledsoe and I is that, without other features of Down's, protruding tongue (whether from larger tongue, lower oral-motor tone, smaller jaw, "Michael Jordan-ism", etc) is not necessarily a red flag for later mental retardation, etc. As with any tone issue, we need to follow it over time ... but it's an issue that usually improves with time.