Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Wednesday, July 18, 2012

Attachment and Day Care, Part 2


In yesterday’s post, I commented on the concerns of Elisa B., the mother of two-year-old Billy, about his distress in day care after he was moved to a new classroom and separated from his favorite teacher. Elisa said Billy had been in day care since he was 13 months old and had adjusted slowly, but now cried when being dropped off and cried when he saw the favorite teacher in the hall.

Elisa has now told me that she talked to Billy’s teachers and they stated that the separation from the favorite teacher had been intentional. The day care staff felt that by age 2 ½ children should be discouraged from attachments to a few people and encouraged to be friendly with many caregivers. They also told Elisa that the plan is to move Billy to yet another classroom six weeks from now.

As I pointed out yesterday, the National Association for the Education of Young Children and other early childhood groups like Zero to Three favor limiting children’s caregivers to a small number of familiar people until at least 36 months of age. One of the reasons for this guideline is that familiar attachment figures can serve as “secure bases” for young children. In the presence of the attachment figure, the child can explore new territory, checking back or going back to the adult for reassurance from time to time. Without an adult who can be a secure base (and unfamiliar people cannot do much of a job on this), young children are often reluctant to explore and may appear withdrawn or even go into a tantrum of protest. Their ability to learn under these circumstances is limited, in comparison with that of children who can draw on a secure base person for support. As they move into the preschool (age 3 to 5) period, children become more self-reliant and more skilled at dealing with strangers and depending on friends of their own age. They can then cope reasonably well with larger groups, larger staff to child ratios, and staff changes--  except that even these older children will handle injuries, illness, or fear much better when they can be with familiar, sensitive, responsive caregivers

Organizing day care around the characteristics of infants and toddlers is one aspect of Developmentally Appropriate Practice (DAP). DAP is a central theme of all current professional guidelines about child care and early childhood education and is essential to NAEYC accreditation.  It’s not at all clear to me why Elisa’s day care center staff seem to reject standard DAP guidelines, but it should not be forgotten that high-quality, DAP-oriented care is expensive, and that a center can be much more profitable if it embraces a philosophy claiming that it is good for young children to be forced into unfamiliar situations and discouraged from using a secure base created by an attachment relationship. This is one reason why not-for-profit day care centers tend to be of higher quality than the for-profit kind.

It’s often easiest to think of DAP in terms of children’s chronological ages, but in fact age is not the only factor determining a child’s needs. Development in different areas--  like physical and social abilities—can be quite different in a given individual, and development in any area may move rapidly and then take a long pause on a developmental plateau. This means that understanding what is developmentally appropriate for a given child depends on knowing that child as a unique person. Day care providers cannot do this effectively unless they have plenty of time with each child, so they can work with individuals rather than with groups most of the time. (Large amounts of the day spent in group work are a sign of poor-quality care for infants and toddlers; what might be acceptable for a 5- or 6-year-old does not work well for young children.) One of the problems created by concentrating on group work is the making of arbitrary decisions like the one Elisa reports as a plan to put Billy through another change of classrooms soon, even though he has clearly not yet adjusted to the last change.

Knowing a child as an individual involves more than being able to assess his or her skill levels. A critical aspect of individualization is understanding a child’s temperament, the personality characteristics created by biological factors. I will be talking about those tomorrow and showing how relevant they are to Elisa’s and Billy’s situation.

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