T. Berry Brazelton's 100th, and "Touchpoints"

The great pediatrician T. Berry Brazelton’s hundredth birthday will be celebrated April 23, 2018, at a symposium at the Boston Marriott hotel in Newton, MA. A stellar group of speakers will be there and people in the Boston area may want to attend. It is expensive though—so for my part I am going to offer here some reminders about Brazelton’s concept of “touchpoints” as a way for parents to organize their childrearing work.

Brazelton’s various “touchpoints” books, and his work together with Joshua Sparrow and others, focused on times of developmental changes in the lives of babies and young children, and the way those changes can disrupt family life and create parental anxiety (see www.brazeltontouchpoints.org). Guidance about these times of change and disruption can help parents keep calm and work through expectable disruptions.

It’s a big flaw in human thinking that we tend to expect things to stay the same as they are at any moment. If something doesn’t go well, we imagine that there will never be any improvement and are deeply discouraged about the future and life in general. If everything is fine, we dismiss the possibility that anything less desirable could happen, and expect smooth sailing ever after. Learning that life—and parenting—has ups and downs is quite difficult, but this lesson, if learned, helps everyone to weather difficult times. Brazelton’s “touchpoints” approach suggested that if parents can anticipate times of disruption, they will deal with those times more comfortably when they do come.

People other than Brazelton have considered this issue in terms of events in early development. Anna Freud, for example, suggested that there were natural times of what she called “regression”—periods when an infant or child who had been easy to care for became temporarily more difficult, cried a lot, had tantrums, slept or ate poorly, for no apparent reason. It’s interesting that she used the term “regression” for this behavior, because that implies that the child has gone back to acting as he or she did earlier. Actually, though, periods of “difficult” behavior may mean that a child has progressed, not regressed. A 4-month-old is not afraid of strangers and does not fuss when approached by new people, but a 10-month-old, with more advanced cognitive and emotional development, is likely to cry and try to hide, and may be much distressed when introduced into a new environment with new caregivers. Increased maturity of a child can go with greater care difficulties from the parent’s viewpoint, but it can be hard for a parent to see things that way, and when other people express annoyance or concern about developmental steps they do not recognize as progress, parents’ lives are made even harder.

Arnold Gesell and Frances Ilg, who in the 1940s and ‘50s published books for parents and teachers about developmental changes, talked about “interweaving” of negative and positive changes during infancy and the preschool period. The idea again was to anticipate and prepare for events rather than being startled and badly disrupted by them.

Brazelton’s real contribution to the idea of “touchpoints” is that children’s developmental steps—the same ones that may make parents anxious or angry—can be reframed and reinterpreted as evidence of good development. Just as parents look forward to developmental milestones like sitting alone, walking independently, the first word, they can be guided to recognize what Anna Freud called “regressions” as developmental progressions. Because some of these developmental steps are fairly predictable, parents can be encouraged to anticipate them and find them delightful as well as possibly problematic. (I’ve always thought that if I could design a greeting card, I would do one that says, “Congratulations! Your child was afraid of a stranger for the first time today! Her development is going very well!”)

Brazelton’s work looked at a range of changes in areas of development that can provide “touchpoints” for parents. For example, he noted that at about 4 months, babies’ increasing interest in the environment may make them more difficult to feed, as they stop nursing to look at other people in the room or to explore the mother’s face. By about 9 months, their desire to use their newly-developed pincer grip makes them want bits of food to pick up and decreases interest in being spoon-fed. By 12 months, new skills and an increased need for independence indicate developmental progress. Parents can take pleasure in these changes and work to accommodate them by providing changes in diet and encouragement to move forward—or they can fight the changes, making themselves and the babies unhappy. (If the parents accept the belief of some alternative therapists that emotional attachment occurs when an adult feeds the baby, they will definitely run into anxiety and difficulty on this point.)

The Touchpoints books are very much worth a look for parents of infants and toddlers.