Category: News

In my work providing reflective supervision and consultation (RS/C) to groups and individuals, I consistently find parallels to my role as a mother of young children. Most recently, I sought to take a family photo — you know, one that looks joyful and warm, showing the connectedness and synchronicity my family and I feel with one another during our best moments together. But after a few attempts, I simply gave up.

This failure to get a perfect family portrait got me wondering about the parallels to setting up a reflective experience for groups and individuals. Perhaps the first step to getting that magical photo is hiring a great photographer who can bring her skills and gifts to the photo session, who knows when a young child has simply had enough or needs a change of scenery, and who can identify when the lighting is poor or knows when she has finally gathered enough images. Similarly, providers of RS/C can hone their craft through ongoing training, learning the skills and practices that support others in settling into a reflective space, feeling held and supported in sharing their feelings authentically, and approaching their work with curiosity and openness. Through ongoing experience receiving and providing RS/C, consultants can build a capacity to trust in themselves, others, and the reflective process as a whole.

In taking a photo, the next step is to choose a good enough time, when children are typically rested, open to new experiences, fed and happy. By some miracle that might align with a time when lighting in the environment makes everyone look wonderful and parents do not have to wake up before the sun to make everyone look polished and presentable. Similarly, consultants and supervisors can be thoughtful about the times, places, and routines they establish for regularly scheduled RS/C sessions. Personally, back-to-back pandemic video conference meetings without pre-scheduled breaks  do not put me in a state to listen intently, attune, and reflect with others. Rather, setting expectations and inviting participants to think about times and places that they can come together  with no interruptions impacts what we can achieve together moment to moment inside the frame of the RS/C session. Important, too, is allowing time to slow down when schedules are busy and everyone is able to attend to the experiences of others in the group or their own reflective process.

Here is where things become complicated because the creation of a certain set of ideal circumstances can be difficult.  Even with the most thoughtful of plans, unexpected weather, illness, a disrupted routine, or any myriad of factors that might impact a small child’s mood or attention can derail his capacity to engage in a novel experience where he is expected to fully and joyfully engage with others.

Like a parent in a family photo, consultants must also keep in mind that life is always happening outside the frame.

Unexpected interruptions, overwhelming feelings of stress, busy schedules, a global pandemic, personal illness, or any number of factors might challenge or disrupt a supervisor or supervisee’s capacity to share their full attention with others in any given moment or session. The expression of hope for uninterrupted time to reflect, as well as acknowledgement of the challenges to this, can be discussed within the sessions on an ongoing basis. Perhaps now, in the midst of a pandemic, this should happen more than ever before.

So, picture day arrives. We are rested, fed, and dressed appropriately. We arrive at our location, but how can we get everyone to look at the camera and smile? Moment to moment shared attention and connection seems like the tiniest task, but perhaps they are the most challenging. My family simply could not do it this year! We were able to explain hopes and expectations to my 5-year-old. She followed suit, showing up as her bubbly, big, performative self in a new and novel experience.  Throughout the session we bounced, rocked, shook toys, and made every silly noise we could think of for my more slow to warm 1-year-old as the photographer snapped away. However, that perfect picture of the four of us never came to fruition — someone was blinking, looking away, distracted trying to get another person to smile, disinterested, or crying.  The subsequent photos did not give anyone a sense of synchronicity and connectedness. Rather, you saw four different people, four different capacities for attention, four different emotional experiences, and four different moment-to-moment responses to our interactions with each other and the experience frame after frame.

In the same way, even when consultants set up what appears to be an ideal set of circumstances to come together for dyadic or group reflection, there are still barriers to connecting with others in the reflective process. As consultants, we can certainly set up some guidelines for the reflective frame, such as letting participants know there might be a greater emphasis on the exploration of feelings and relationships or that supervisors may be “sitting on their hands” instead of problem solving. Yet all we can do is offer a gentle invitation into this way of thinking about themselves and their work, with the hope that everyone will engage, to the degree they can, in any given moment throughout our time together.

Akin to those first few awkward snapshots where everyone in my family was trying to figure out what we were supposed to be doing and how we were supposed to be with one another, perhaps in the early moments of the supervisor/supervisee relationship or when reflection is still a novel experience, participants may have difficulty showing up authentically, sharing feelings or exploring vulnerabilities. In certain snapshots of an RS/C session, you may find participants responding reflexively to what they are presented with instead of remaining open and curious. Perhaps in those moments, consultants can offer questions that promote reflection, much like we tried to shake a toy outside the frame of our pictures, hoping to spark a moment of interest and joy.  One moment my 1-year-old burst into laughter, but the next a little too much noise and novelty led to tears. We did our best to anticipate what his responses might be. Similarly, as consultants we can anticipate, but cannot control how supervisees respond to our inquiries. Instead, we can simply offer the opportunity to respond authentically, and wonder about their experiences and feelings, as well as the experiences and feelings of others (baby, parent, caregiver or worker), with the hope that they will feel supported in their attempts to explore experiences and interactions in this way.

Consultants, too, encounter their own barriers to being with others and inviting them into the reflective process. In my own set of family photos, I remember the difficulty of knowing where to focus my attention moment to moment. Do I smile at the camera, respond to the cues of my children, listen to the advice of the photographer or, in ideal moments, try to do all those things simultaneously? As consultants, we are trying to do many things at once: listen deeply, attune to an emotional undercurrent of the reflective process, hold our own internal experiences, and find a way to reflectively respond to others in a way that uniquely resonates with them moment to moment.

In one moment or session, we may have trouble attuning to the thoughts, feelings and needs of supervisees because the relationship is still new, or because the narrative they are presenting pulls on something inside us or our own history that may merit greater exploration in our own RS/C. In another frame, our own drive to teach or move others toward the reflective space actually moves us further from a sense of attunement and connectedness. In another frame, we may find our internal curiosity about certain aspects of the family story, the baby, the parallel process, or the provider’s responses so compelling that we shift the shared attention to those aspects of the narrative without allowing supervisees to fully explore other aspects of their work.  On a personal note, I often wonder how my attempts to do so much during RS/C sessions interrupt my ability to model authenticity and offer genuine connection to others, which is the aspect of my work that brings me the most joy.

In my opinion, the best family photos are filled with shared attention, connection, warmth, and authenticity. Sometimes there is just too much happening, outside the frame or within it, to cultivate those qualities in any given moment. My favorite family photos have not been staged or faked. Perhaps the most disruptive efforts to get anyone, though especially children, to take a “good picture” are the demands that they do so. In the same way, the idea that we can somehow force or fake connection or a reflective moment seems impossible.

Rather, the process of connection and reflection is just that, a process we come in and out of, one we can cultivate, one we can explore, one we can practice, one we can strive for, and over time one we might come to trust in.

When we are in it together, it’s a felt experience that holds for an entire session or a few fleeting frames.  Like my failed family photo attempts, in some sessions it never seems to materialize. When that is so, we can explore the experience, speculate about barriers, and support one another in trying again in our next session. Over time in group or individual RS/C, we will have a collection of snapshots that tell the story of our relationships to one another. Taken together, the snapshots reveal patterns for the ways in which we show up with each other. There will be moments we will look back on and laugh about, moments we are all looking different directions, moments where someone is distracted, moments filled with deep emotion, moments where we look lost, chaotic or awkward, and, if we are lucky, a few moments we cherish so deeply they are worth framing,

Sarah was an angelic-looking, bright-eyed four-year-old girl. She had a gleaming smile, immediate approaching behavior, and exuberance, but she was exhausting to manage at home and in her preschool setting. Her parents contacted me because of her aggressive behavior and inability to control her impulses, her refusal to follow instructions and directions, and her lack of awareness of her physical strength. Sarah gave hugs like a “Mama Bear.” One of the first things that her mother said to me was, “She just doesn’t know how to be gentle! She’s like a bull in a china shop!”

They sought treatment so they can help her adapt to situations better and to get along with other children better. Her mother would like help because she feels worn down!

Historically, Sarah was a full-term infant weighing almost eight pounds and obtaining APGAR scores of 9 and 10 at one and five minutes respectively. During her first year the major problem was her recurrent ear infections; she was given ear tubes when she was two.  Sarah was breast-fed for about eight months, and her mother recalled that her sucking response was like a vacuum cleaner! She had a “voracious” appetite. Her sleep pattern was not unusual, but when she awakened, even as an infant, she was active, alert, intense, and wearing on her mother. Mother described her husband as “a saint! He was and is the only one who can keep up with her!”

Sarah met developmental milestones on time; she began to present symptoms when she was about 2½. She had difficulty going along with family routines, was irritable, and very restless. She would get overly excited and was very difficult to calm down. Mother recalled that she was very sensitive to touch and would startle when she was touched. She began to display temper tantrums. Her over-excitability, restlessness, and tantrums have continued. She was described as one of the kids who goes from zero-to-sixty instantaneously. She had difficulty falling asleep and remaining asleep since she was about two. She never seemed to feel sleepy.

Sarah’s family included her eight-year-old and six-month-old sisters. Her parents, married 12 years, met in high school. They described their marital relationship as positive for both. They shared the childcare and they were both supportive of each other. Sarah’s mother was 35 years of age, her father 39. Both parents had college degrees and worked in the medical field. Sarah attended nursery school five days a week and was then cared for by a nanny — who had been consistent in her life — until her parents came home between five and six o’clock.

Mother stated that Sarah loved active, gross motor activities and had started a gymnastics class in which she was apparently doing well with the exception of having to be “corralled” to keep her in one place when she gets excited. She participated in all activities, but then want more and more when it is time to stop. She had boundless energy! Father commented on the fact that Sarah didn’t have an awareness of where her body stops and the next person’s body begins. She would run into people or objects and not feel pain, but when someone touched her, she over-reacted. Sarah also has displayed an interest in art and music and loves animals.

On an attention questionnaire, her parents indicated that she loses focus unless she is very interested in an activity. Her days are either excellent or poor with little “in-betweens.” She generally has difficulty finishing something that she starts. Her attention is variable as she “tunes in” and “tunes out.” Often, her attention is hard to attract and her work in school has an unpredictable quality. She can enjoy an activity one day and then the very next day she will reject the same activity.

Sarah was easily distracted by sounds and her parents felt that she did not attend to signals so she missed important information. She also was easily distracted by visual stimuli She craved excitement. Both parents agreed that she didn’t  think before she acted; she did the first thing that came to her mind, and she did too many things too quickly. She had difficulty making friends and she tended to spend a lot of time by herself. Punishment did not seem to affect her and she made the same mistakes over and over again. Talking to her about her behavior had no effect in changing her. In school she seemed to treat other kids like they are objects, bumping into them and pushing them out of the way.

Sarah and her parents have been healthy,  and there are no significant medical, mental health, or learning problems in her parents or extended family members.

According to the initial assessment process, several concerns presented by Sarah’s parents indicated that interoceptive awareness, or awareness of internal bodily signals, could be an area of challenge and warranted further investigation. Some of these reported concerns included:

Intervention:

Due to the possible interoception challenges affecting Sarah’s ability to successfully self-regulate, incorporating interoception into the therapy process was deemed appropriate. The Interoception Curriculum: A Step-by-Step Framework for Developing Mindful Self-Regulation (Mahler, 2019) provided the guide for implementation of this work.

To start, the work focused on Sarah’s ability to notice body signals or to become more aware of her internal bodily experience.

As outlined in Section 1 of the curriculum, each week Sarah focused on one body part, spending time engaging in fun activities designed to evoke sensations within that one body part, giving her practice noticing and describing the way that body part felt. For example, during the first session (week 1), Sarah, along with the parent in attendance, focused on the hands and explored all of the different ways their hands could feel using concrete Focus Area Experiments (e.g., putting hands in cool water, touching an ice cube, squeezing a ball, holding a handwarmer, blowing on the back of the hand, etc.).

During the week, outside of the session, Sarah practiced noticing the way her hands felt during daily activities. She did this in two ways: Her parents would use IA on the Fly, which is a strategy where they used specific verbal prompts to ask Sarah how her hands were feeling. Sarah also practiced noticing body signals by completing Body Checks with her parents. This strategy uses a visual support that contains a body outline as well as body part icons that contain descriptor words she could use to describe the way each body part felt (see Picture 1). Sarah would complete the Body Check verbally with her mom or dad guiding her through noticing how her hands were feeling in that moment. Sarah’s parents also began completing their own Body Checks along with Sarah so that it became a structured activity that facilitated greater attachment and attunement.

Picture 1: Sarah’s Body Check Chart.

Sarah and her parents moved through this same process over the next few sessions (completing Focus Area Experiments during the session and Body Checks for positive practice during daily activities outside of the session), focusing on a different body part each week. The order of body parts, as listed in Table 2, moved from more concrete outer body parts to more abstract inside body parts. By the time she completed this process for eight out of 15 body parts included in the curriculum, Sarah was able to independently identify how each body part felt in the moment, using a wide range of age-appropriate descriptor language (due to her age, it was determined to focus on eight main body parts and her parents could use the same process to work on noticing body signals in more advanced body parts as Sarah matured).

As Sarah and her parents participated in the lessons from Section 2 of the curriculum, they practiced connecting body signals to a variety of emotions. For example, Sarah discovered that when her muscles felt “jumpy,” that was a clue that she was really excited.  Or when her mouth felt “dry,” that was a sign that she was thirsty. At home, parents were taught to use IA on the Fly (verbal prompts) to guide Sarah in connecting the body signals she noticed to the emotion (e.g., “Sarah, you said your eyes feel heavy. That is a great clue! What emotion could it mean?”) Wrapping up the curriculum with Section 3, Sarah was guided in discovering feel-good actions that helped her body feel comfortable.

Clinical reasoning behind The Interoception Curriculum

The Interoception Curriculum allowed Sarah to playfully gain understanding and control over body feelings via a systematic process. The work was thoughtfully chunked into small sections to make it manageable and not overwhelming (e.g., focusing on noticing body signals in one body part at a time). The process was predictable, which made it feel familiar and safe for Sarah and doable for her parents to incorporate into a busy family routine. Parents were involved in every step of the process, and focus was on empowering them to be able to support Sarah in developing clear body-emotion connections.

Therapy often focuses on regulation or coping strategies and fails to account for the underlying mechanism (interoception) that serves as the alert to use the strategies.

The process used with Sarah targeted the ability to notice and connect body signals, which served as her motivation to self-regulate.

Due to this focus, Sarah gained a sense of control over her body feelings and became a notably more confident and regulated child.

Implications for Infant and Early Childhood Mental Health

Interoception is intimately tied to the infant population, and the implications for infant mental health interventions are enormous. Infants do not have the language to articulate their inner experience, but they do have the “body language” to express themselves, e.g., crying, prolonged irritability, and moodiness. As the infant matures and develops language, if we ask the right questions, we can become attuned to the child’s experience. In our clinical work if we begin to ask: “How do you know you’re angry?” rather than “Why are you angry?” we may get a shrug or the response “I don’t know,” and find out that the child is not receiving the interoceptive signals of anger.

A young child with whom I worked stated, “I don’t feel anger until the moment before I explode.” All the mindfulness work that was attempted to help him calm down before he got too angry went nowhere because he was not receiving the signals. Other children tell us that they have lots of feelings, but they don’t know what they are because their interoceptive systems are not working efficiently and they cannot differentiate the signals. Interoceptive signals help us differentiate self from other, enabling the young child to recognize that feelings in an interaction belong to oneself or to the other.

Interoception is a critical variable in infant-parent psychotherapy and brings a new dimension into our clinical work. The concept of interoception is essential in parent and professional training. Our experiences as infants become embodied and can affect our psychological development years later. I had firsthand experience with a young adult who had had a very serious urinary surgery when she was 18 months old. She came into therapy in her early 20s suffering from agoraphobia. She slowly made her own associations to the experiences of being taken away from her parents in the hospital, experiencing what felt like assault by doctors, being placed in a bare room in a crib with slats that confined her and experiencing an intensity of lighting that, as an adult, was similar to the lights in a friend’s house where she couldn’t get herself to sleep. As she became re-connected to these late infancy experiences and made her own connection to these experiences, she made major gains in therapy. She was able to do things for which she had been paralyzed until she began to understand these connections.

      If we help children get acquainted with their bodies from the beginning by helping them learn about sensations in each of their body parts, they begin to develop a sensations vocabulary and can tie these sensations together to develop an emotions vocabulary.

As children develop this awareness, with caregiver support they develop actions or strategies to deal with what they are experiencing. This has the possibility to decrease the number of children who develop early mood and disruptive behavior disorders. If we know what we are feeling and where we are feeling it, we can prevent and intervene to decrease arousal and help very young children develop neurophysiological modulation, sensorimotor modulation, control, self-control, and then self-regulation (Kopp, 1982). Our understanding of individual differences among children and the patterns of arousal in each individual child will enable us to develop the prevention and intervention tools that are currently limited at home, in school, and in clinical settings. This work is clearly cutting edge, and we still have a great deal to learn about it.

For further reading:

Craig, A.D. (2009) How do you feel-now? The anterior insula and human awareness. Nature Review Neuroscience, 10, 59-70.

Critchley, H.D., Wiens, S., Rotshtein, P., Ohman, A., Dolan, R.J. (2004) Neural systems supporting interoceptive awareness. Nature Neuroscience, 7, 189-195.

Damasio, A. R. Descartes’ Error: Emotion, Reason, and the Human Brain. New York: Picador.

Gilliam, Walter. “Pre–K Students Expelled at More Than Three Times the Rate of K–12 Students.” Yale News, 12 Sept. 2011, news.yale.edu/2005/05/17/pre-k-students-expelled-more-three-times-rate-k-12-students-0.

Fotopoulou, A. & Tsakiris, A. & Tsakiris, M (2017) Mentalizing homeostasis: The social origins of interoceptive inference. Neuropsychoanalysis, 19 (1), 3-28.

Kopp, C. (1982) The antecedents of self-regulation: A developmental perspective, Developmental Psychology,18 (2), 199-214.

Mahler, K.  (2019) The Interoception Curriculum: A Step-by-Step Framework for Developing Mindful Self-Regulation

Oestergaard Hagelquist, J. (2015) The Mentalization Handbook London, UK: Karnac

Thompson, R. (1988) Emotion and self-regulation. In Thompson, R. (1988) Socioemotional Development, Lincoln, Neb.: University of Nebraska Press.

Van der Kolk, B. (2015) The Body Keeps the Score. London, UK: Penguin Books.

Interoception as a Foundation of Infant Mental health     

We see interoception as a foundational concept for infant mental health. Our early development of a sense of self is an “embodied” sense of self that occurs prior to the development of a “mindful” sense of self. There has been an ongoing debate since the time of Freud regarding the origin of the self. Is the origin of the self related to the body and the sensory system or is the origin of the self related to social interactions?  Recently, Fotopoulou & Tsdakiris (2017) proposed that “building a mind, and understanding other minds, are embodied and tightly connected processes.” We argue that the constitution of the self is dependent upon the social mentalization of the body and particularly its homeostatic needs. In short, the radical aspect of our proposal is that social interactions do not shape only the reflective (narrative or extended) self and related notions of affect regulation and social cognition. Instead, the most minimal aspects of selfhood, namely the feeling of being an embodied agentive subject are fundamentally shaped by embodied interactions with other people in early infancy and beyond. Progressively these embodied interactions allow the developing organism to mentalize its homeostasis and hence they constitute the core of our objective subjectivity.

Sensory Systems are Developing in Utero

How might these systems be linked in infancy and what are the implications? First, our sensory systems are developing in utero so that sensory input is being processed even before the infant is born.

 The development of the tactile system

The tactile system is the first system to develop in utero and is the most mature system at birth. By the fifth gestational week, the embryo is able to sense pressure in the lips as well as the nose. By nine weeks gestation pressure is also sensed in the fetal arms, chin, and eyelids, and by 10 weeks the fetus is experiencing sense pressure in the legs. By 14 weeks, a healthy fetus can sense pressure in most of the body. In the fetus’ third trimester the touch sensors in the fetal skin are becoming wired into the insular cortex of the brain where the fetus can respond to the contextual features of touch (Weinstein, 2016, p. 128). Tactile awareness in the back and top of the head does not develop until the infant is born and this may enable the infant to weather the experience of labor and birth (Weinstein, 2016, p. 128). Touch is a primary sense for attachment formation.

The development of sight

The optic primordium cells that are necessary for the development of vision begin to form at about 28 days of gestation and, at approximately two months’ gestation, there are axon connections that form as the eyes grow and move from behind the cranium to their front positions. Between 14 and 28 weeks gestation there are about 100 million neurons that have formed but are not yet connected. The infant can see light through the mother’s belly and amniotic fluid by the last trimester (Weinstein, 2016, p.127).

The development of taste

By eight weeks gestation there are taste buds on the tongue. These buds are further formed around the mouth at 13 weeks. The fetus is able to taste amniotic fluid by four months gestation (Weinstein, 2016, p. 127).

The development of smell

By eight weeks gestation the fetal olfactory sense is near full maturation and by the end of the first trimester the main olfactory subsystem is a functioning sensory system. Smell receptors are functioning by 10 weeks gestation. Thus, the fetal olfactory system is working before the child is born. The smell of amniotic fluid, which is similar to the scent of breastmilk is already beginning to become familiar to the fetus.

Auditory system

Three-and-a-half weeks after fertilization the ears are beginning to differentiate (Weinstein, 2016, p. 126). The fetus is able to hear by the end of the middle of the second trimester (Weinstein, 2016, p. 126). Auditory information can be carried from the ear to the brain by four to five months gestation when the eighth cranial nerve is developed.  Weinstein (2016) notes that the most consistent sounds and rhythms that the fetus is hearing are the mother’s heartbeat as well as her voice. She also adds that the fetus (prenate) can respond to sound as well as indicate sound preferences by 23 weeks gestation and three weeks later is learning intonation, rhythm and other maternal speech patterns. By 34 weeks the fetal auditory threshold levels are comparable to adult preferences (Weinstein, 2016, p. 127).

The development of the proprioceptive and vestibular systems

Beyond the more well-known five senses, the proprioceptive and vestibular systems — ; sixth and seventh respectively — also play important roles in an infant and young child’s development The proprioceptive system functions and enables the infant to feel a sense of location as well as the position of different parts of the body in space and in relation to other animate and inanimate objects. It also enables the infant to have an inner awareness of body posture (Williamson & Anzalone, 2001). Williamson & Anzalone (2001) state that proprioception gives us information about the body’s orientation in space as well as the relation of other body parts to each other, the rate and timing of our movements as we move, the force that our muscles exert, how fast and much our muscles are lengthened or shortened when we engage in activities, and the angles at which each of our joints change as we move. Because the fetus moves in utero, the proprioceptive receptors enable the fetus to practice movements even before the infant is born. (Weinstein, 2016, p. 129). Our proprioceptive sense enables us to develop a schema of our body, i.e., a physical sense of self, an inner awareness of our body parts and how they relate to our larger body systems, and how these parts move through space (Williamson & Anzalone, 2001, p. 9-10).

The vestibular system that is in the bony labyrinth of the skull is also attached to our hearing mechanism. This system is comprised of three structures in our inner ears: the semicircular canals, the saccule, and the utricle. The semicircular canals enable us to register the speed, force, and direction as we turn our heads when we look around or when we swing. The functions of the vestibular system include the regulation of our muscle tone and coordination, our balance and equilibrium, the control of our eye movements so that we can maintain a stable visual field when we move, our maintaining and transitioning of our states of arousal, and our levels of attention (Williamson & Anzalone, 2001, p.8). Vestibular functioning that helps the body’s response to head movement and gravity is functioning early in gestation (Weinstein, 2016, p. 12-129).

What goes on even before an infant is born can impact the architecture and development of the fetus, programming the fetus to the kind of stimulation that will be experienced after birth.

Thus, a calm fetal environment prepares the fetus to engage with a calm postnatal environment. A stressful prenatal environment prepares the fetus to deal with similar stimulation after birth. If the external environment that is experienced after birth is different from the environment that the fetus has experienced in utero, the infant will not be prepared for that environment and this has important consequences for the infant’s interoceptive development and adaptation.

When the baby is born, he or she is placed on the mother’s abdomen and both partners experience body-to-body contact. The mother’s interoceptive system is fully functioning and the experience of the baby’s body on her resonates throughout her system. The experience is on a positive-negative continuum as well as on a high-low arousal intensity. The baby is experiencing visceral stimulation of warmth or coolness, softness or rigidity of the mother’s body, the sounds, intensity of light of the neonatal context. Over time the infant begins to form the seeds of his or her internal working model of the world. These experiences energize the interoceptive systems of both partners and are the earliest components in the development of attachment. When things go right for both the mother and the baby, the roots of a secure attachment begin to be experienced. However, when things do not go well, the stress system for both partners becomes activated. Such experiences may form the earliest foundation and predisposition of mood disturbances. This is an area for further study.

When the Hypothalamic-Pituitary-Adrenal (HPA) system is activated there is an increase of cortisol and the amount of blood that is pumped by the heart increases and the release of epinephrine cause the contractions of the heart muscles to increase. This is an interoceptive signal. When the HPA system in the infant begins to function, the release of these chemicals affect the developing emotional system of the child and most likely impinge on the development of the attachment and social systems. There is not yet data in infants to map the development of the interoceptive system, but we do have the tools to assess changes in the stress and attachment .

Research into the interoceptive system, stress system, and attachment system is imperative. If an infant or toddler has certain experiences or doesn’t have certain experiences, often the outcomes seem inevitable. More continues to be discovered about neurological and systems plasticity every day. Due to these growing discoveries, infant and early childhood professionals need to be proactive but cautious, and evaluations should be longitudinal rather than static and interdisciplinary and collaborative.

Implications for infant mental health

Infant mental health intervention is dyadic intervention; the port of entry is the infant-parent system. The infant affects the family system as the family system affects the infant. This has major implications for intervention. This fits in with interoceptive difficulties as well. In treating infants, toddlers, and preschoolers it is necessary to work with the parent-child system rather than with the infant, toddler, or preschooler alone.

The development of self-regulation is a primary outcome of interoceptive treatment, and this cannot occur unless the parent and infant, toddler, or preschooler are treated together.

Self-regulation is the foundation of mental health adjustment for all of us. If we are not able to modulate our neurophysiology, modulate our sensory systems, or develop control, self-control, and self-regulation we cannot function efficiently within any environment. Engagement, back-and-forth interactions, contingency, sharing, ideas, and eventually healthy reality sense, reality testing, and reality adaptation are dependent upon self-regulation. It starts from the outside (caregiver) being the external regulator,  while the caregiver’s regulatory techniques scaffold the child’s self-regulation skills.

The caregiver acts as a social biofeedback machine in which the infant learns about their internal signals and emotions through the caregiver’s feedback and response to their expressive cues (Buck, 1989). For example, at birth, initially the sensation of hunger is simply a vague, unpleasant feeling and the infant learns through interactions with the caregiver about the meaning and motivational value of the internal sensation of hunger (Harshaw, 2008). Taken together, the infant-caregiver relationship potentially influences the infant’s ability to:

1. Notice internal body signals: The infant recognizes body signals as important constructs that are validated and tended to consistently by the caregiver
2. Connect the body signals to the emotion: The infant begins to accurately interpret body signals through the feedback provided by the caregiver
3. Regulate by using a feel-good action: The infant learns to self-regulate through the observation of the strategies used by the caregiver to co-regulate

Future Considerations

To date, the interoceptive literature has been primarily anatomical and theoretical. Kelly Mahler is a pioneer in intervention with children. Her model fits exquisitely with the infant mental health model of treatment. Presently, her curriculum is used primarily with three-year-olds  and up, but with modifications it can be used with children as young as two. Working with children involves developing a vocabulary of sensations, and then an emotional vocabulary, before developing action strategies. These vocabularies stretch the range of words for sensations and emotions. The work of Lisa Feldman Barrett has shown that our emotional vocabularies tend to be limited and we do not spend time teaching children to differentiate gradients of sensations and emotions. Thus, by working with the dyad, both parent and child are learning about the different interoceptive experiences as well as the gradient of intensities that contribute to our individual differences.

By developing tools and techniques to help infants and toddlers to become maximally aware of their bodies and their interoceptive signals, there is more opportunity for doing preventive interventions. This will broaden the field of infant mental health intervention services. As more research is done on the development of interoception from infancy onward, the melding of interoception with infant mental health will be a powerful combination for treatment. This series of articles provides a beginning for researchers and practitioners to include the literature on interoception as a central foundation concept in infant mental health training programs.

Buck R. Emotional communication in personal relationships: A developmental-interactionist view. In: Hendrick C, editor. Close relationships. Newbury Park, CA: Sage; 1989. pp. 144–163.

Bruch H. Hunger and Instinct. Journal of Nervous and Mental Disease. 1969;149:91–114.

Harshaw, C. (2008). Alimentary epigenetics: A developmental psychobiological systems view of the perception of hunger, thirst and satiety. Developmental Review, 28(4), 541-569.

Oldroyd, K., Pasupathi, M., & Wainryb, C. (2019). Social Antecedents to the Development of Interoception: Attachment Related Processes Are Associated With Interoception. Frontiers in psychology, 10.

This article is the work of the Circle of Caring team under the clinical supervision of Vickie Novell, LMSW, IECMH-E® with the support of the consultants: Wendy Dawson, LLP, IMH-E®, Danielle Davey, LMSW, IMH-E® and Jill Vandoornik, LMSW, IMH-E®.

Welcome to the delicate world of childcare. The days begin and end with separations and reunions, some for the first time in very young lives. How do we support these precious moments of transition? How do we support the caregivers? Emotions and memories are gathered and created, swirling around the room filled with colors and caregiving. Whom do we trust with this space for such young souls? Fortunately we work with caring teachers who step up to share their creativity and energy with these young families. Of course, teachers bring their own emotions and memories but are often asked to  “leave them at the door” as they care for other people’s children. On the best day, there is care and concern, victory and resolve. On other days, there are different feelings — ones sometimes not acknowledged or even known. Where do these feelings go? What kind of memories do they awaken? What kind of memories do they make?

Given the Herculean task of development in all domains — the body, the heart, the soul, and the mind, the Early Childhood educator is indeed a jack of all trades. As pressure from the dreaded K (kindergarten) rears its ugly head and families bring in enormous burdens of poverty, trauma, and loss, teachers are often torn. Teachers are torn between the urgency to “get children ready for school” and “Did you hear what happened to that child/family?” Day-to-day priorities in the classroom are often at odds, not always based on child needs, sometimes driven by assessments, scores, and monitoring. Parents come and go, sometimes through only brief interactions, strained by their own days ahead and ones past, with their own journey of school and authority ringing in their hearts and minds. Let us not forget the lives of the teachers; those lives they are supposed to leave at the door. They, too, may be carrying emotional burdens — family illness, financial challenges, family stress, as well as their own trauma and loss.

Positive early childhood teacher-child relationships are highly correlated with future school and peer success, according to a growing body of research. Yet more and more young children are entering our classrooms with insecure and even disorganized attachment styles.

These children seek connection and support in challenging ways, sometimes struggling to accept emotional support and guidance from the kindest, most well-intentioned teachers.

So, what are we to do with these rooms filled with energy and possibility, bathed in feelings and memories? There are opportunities for teachers to find high-quality training in child development, trauma and special needs, but teachers are still understandably struggling. Even the best-trained teacher can still experience suffering and vicarious trauma. Developmental trauma or toxic stress occurs when “emotional pain cannot find a relational home in which it can be held” (Epstein, 2014). Early Childhood Educators are a relational home for the children in their care, but the load can be heavy.  Where is the teacher’s relational home?

The Circle of Caring Early Childhood Mental Health Consultation program at The Guidance Center is helping construct such a home. Through a generous grant from the Head Start Innovation Fund, four Infant and Early Childhood therapists have been working in 10 Head Start classrooms over the past 2½ years. Through monthly group reflective consultation for teachers and weekly classroom-focused reflective consultation, these teaching teams have developed a strong working relationship with their consultants. Based on the original statewide Circle of Caring Child Care Expulsion Prevention Program led by Kathleen Baltman, MA, IMH-E, our consultants  have been learning and growing alongside the staff and teachers. Through our transformation from IECMH therapist to ECMH consultants we have experienced first-hand how beautifully IMH principles and practices address the much-needed emotional support for these classrooms.

Early Childhood Mental Health (ECMH) consultants have a great opportunity to create a holding environment with the teachers so that they, as Jeree Pawl would hope, provide the same for the children and families. Thanks to researchers such as Walter Gilliam, Kadija Johnston, and Charles Brinamen, this growing field is revealing the critical and interdependent needs of these very young children, their families, and the teachers who care for them every day. As part of this professional community, Infant and Early Childhood therapists are well suited to offer this gift of presence for these systems and communities based on our training, experience, and deep commitment to reflective supervision and practice.  While our background provides a strong foundation for consultation work, the transition from clinical work to consultation requires training, support, and reflection.

“What about the baby?  Which baby?”

So how do we begin? Our port of entry and intervention is the relationship, but which one?

As one consultant remarked, “Being in the classroom is like being at a home visit — at the highest volume.

So many needs and feelings coming from so many different directions — teachers and children alike. At first glance — and feel — it can be overwhelming and seem like an impossible task. Me contain this? Where do I look? Where do I stand? Or sit? Who do I look at? Who on earth do I interact with? All consultants have experienced that moment of fight or flight, which professionally can look like flight/freeze — stand in the corner and just observe silently without looking at anyone. Or it can result in fight/control — take over group, intervene in behavior management, provide conflict resolution, and model. There is a flush of panic and responsibility, sometimes because of an acute attunement to the children and teachers’ internal experiences.

ECMH consultation work, like clinical IECMH work, begins with us, the clinician. Grounded in the belief that the port of entry and intervention is OUR relationship with the teacher, we have the responsibility of maintaining and repairing our centeredness so that our offering of ourselves can provide a place of calm and reflection. Disruptions are expected, as in all relationship work, and “good enough” consultation is the aim. Our response to the disruption — sensitive, thoughtful, and humble — is the very point of healing. Through the ongoing support of our reflective supervisor, we can work to return to that center. Our Circle of Caring program offers weekly group supervision to all consultants. Through this supportive environment, we learn to refine our internal instruments — our open, receptive, curious selves — so we can become more attuned to the implicit, affective communication of the teachers and children.

And so it begins…

At the start of the program more than two years ago, we were acutely aware of the need for a sensitive, deliberate approach. As in any relationship work, beginnings are an opportunity for a different felt experience of being seen, heard, and known. Leaning on the wisdom of mentors, we worked to keep in mind the “consultative stance” (Johnston & Brinamen, 2006) how the attunement to one’s way of being with the staff, teachers, and even the system, can communicate the calm, centered, curious state that will be the hallmark of the practice. From the details of meetings and schedules to the desire to approach as equals, we hoped that we were beginning the process of explicitly and implicitly demonstrating our goals and hopes.

Through early interactions and observations, consultants expressed curiosity about the teachers’ experiences of help in the professional setting. From the orientation to the project to the first classroom sessions and groups, consultants remained open to learning about the teachers’ needs and hopes for support, communication, and comfort with vulnerability and change.  Throughout our work we became more and more attuned to adult internal working models (IWM) that inform  the internalized expectation of their worth as a teacher/human, their efficacy, and their beliefs about others being helpful (or not), caring (or not), and accepting (or not). The teachers’ own personal IWM has been internalized and adapted based on their earlier caregiving experiences. We became more aware of the concept of professional IWMs. Often rooted in one’s personal IWM, professional IWMs are the ghosts of past helpers, site leaders, monitors, specialists, parents, and children. Sometimes coined bureaucratic transference, these are the conscious or unconscious expectations and predictions of how the professional will be assessed, be seen, be deemed worthy of help, and how efficacious they will be with the children and families. In addition, the professional IWM contains the experience and expectation of the availability and dependability of professional and emotional support from the work culture: Is it safe to ask for help, and how will that help feel? The following example occurred frequently at the beginning of the project, and again at crisis points in the work:

Teacher “Mary” had recently entered the program from another agency. During one of the first weekly classroom consultations, the consultant observed a busy, highly emotional classroom. Mary was working with a pair of children who were having difficulty with transition and ownership of materials; she stayed patient and present throughout the conflict. The situation resolved well and the children moved on to another activity.  During a lull in the commotion, the consultant took the opportunity to approach Mary and remark on how she noticed the positive effort that Mary had made, noticing that she was able to contain their feelings and help the children through a difficult time. Mary became teary-eyed and thanked the consultant. The consultant expressed surprise at Mary’s reaction, which seemed tinged with sadness. Mary went on to disclose that she had recently left a different system that  was highly critical of her, leaving her feeling judged and ‘less-than’ as a teacher. She was worried to have a consultant in the classroom and relieved to hear positive remarks. The consultant thanked her for being so open and they went on to discuss the goals of the supportive classroom work.

As we entered these relationships we became acutely aware of the need for transparency, predictability, and reliability for these teachers. Not unlike a family in crisis, teachers feel under the microscope and, unfortunately, bear the increasing weight of academic demand, monitoring stress, and systemic expectations. Explicit discussion of what the consultant would and would not do was an important part of the ongoing demonstration of our unique perspective. For example, we communicated at the beginning that there would be no writing down of thoughts or ideas, no strategies or lesson plans, no monitoring or reporting to the administration. Repeatedly we spoke to the concerns, spoken or not, of the worries about judgment and reprisals. We heard the requests for advice and strategies as an indirect expression of a variety of possible feelings. “Am I enough? I feel inadequate. Will you judge me? Are you better than me?” We worked to respond to the underlying feelings of fear, worry, insecurity, and apprehension through our calm, mirroring presence and reflections. Through our words and actions, we strived to communicate that the teachers are the experts and they are enough for these children and families.

“The eye of a hurricane”

Early Childhood classrooms, and especially Head Start classrooms, are a sea of emotions and experiences. Competing developmental and emotional agendas call out for skilled teachers who use their ability to stay present and calm to accompany the children through challenges and failures. This emotional work is the heart of learning, the creation of a safe haven and secure base from which to explore. An early childhood teacher must multi-task this emotional work with little to no time to pause, reflect or plan.  Add to that the unknown stress and trauma of all classroom participants, and you may wonder how teachers are able to stay present and connected at all. Though we all fall out of the calm center, it is no wonder that teachers feel barraged by needs, both concrete and emotional, and may go into autopilot or fight or flight. No wonder they may lose perspective; hence the need for support to regain their footing.

A central tenant of our program is the firm belief that teachers have their own powerful intuition and ability to create supportive, nurturing responses to children and experiences.

The barrier to these responses is, understandably, the dysregulation that occurs when faced with such high needs and limited reprieve and support. Our role with the teachers is to create a safe space where they can become more regulated, whether in the classroom or group setting. Knowing that the purpose of attachment is to promote safety and exploration, we look for opportunities to assess the state of being of the teachers and allow our relationship to become their secure base and safe haven. Inherent in this structure is the belief in developmental drive, “motivational structures (that) can also be regarded as fundamental modes of development. As such they are life-span processes that can be mobilized through empathy in the course of therapeutic action with adults”. (Emde, 1990)

We stand firmly in the belief that our role is to promote regulation, which will intuitively lead to curiosity. Co-regulation allows for the preoccupation with safety to shift to the “other,” us as consultants, the environment, and the children, not from a fear response, but from a neutral or curious state. Creating a safe relationship with the teachers and with each other in the group setting takes time and a gentle approach. At the beginning, “do for” is a state of a sensitive approach to joining the teachers in relationship, all the while remaining keenly aware of the cues and miscues of comfort and acceptance of intimacy. Keeping the components of attachment-seeking behavior in mind, consultants learned each teacher’s comfort by noting the affective content of greetings and goodbyes; content and tone of shared work or personal stories; physical cues such as proximity maintenance and comfort, and gaze; and narrative cues, such as fluency of speech, tone, breadth and content of verbal communications. Through this ongoing assessment, consultants begin the process of learning how each teacher communicates emotions, needs, distress, and comfort with support.

Lyons-Ruth et al. explored the concept of “relational knowing” or “how to do things with others” as the port of entry to change.  Lyons’ group offers the belief that this internal knowing is “as much affective and interactive as … cognitive… (and) begins to be represented in some yet to be known form long before the availability of language and continues to operate implicitly throughout life” (Lyons et al., 1998). This speaks to the belief that our relationship is the agent of change. What exactly, especially in the early education realm, is the underlying mechanism for change? Through creating a “moment of meeting,” two equals bring their perspectives, belief systems, and expectations together to co-create a new way of being. With “self as therapist,” the consultant will move into the emotional space with a teacher with curiosity and empathy for the teacher’s emotional experience. Often seen physically as a moving toward and away, the consultants pace and dose the “being with” according to the assessed comfort of the teachers. Throughout, the consultant develops an awareness of how, and in what circumstances, the teachers become dysregulated; what cues they feel safe showing, and how and if they use the consultant for support from the beginning.

Through the attachment relationship with the consultant, the teacher is given permission to speak the unspeakable without consequences. Robert Emde speaks of developmental empathy as a “…temporary sense of oneness with the other, followed by a sense of separateness to be helpful” (Emde, 1989). Through the process of marking and containing affect, teachers are shown that all feelings are accepted and safe to be expressed. Interacting at the level of IWM, these interactions are “new … nonverbal encounters (that) suspend the procedural relational knowledge … ( which) overrides earlier relational experiences. It thereby overwrites earlier memories” (Gossmann, 2009).

The nature of early childhood development and early parenting offers us a roadmap for the supportive work with teachers and staff.   As trust and feelings of safety increase, the teacher-consultant will begin to make use of social referencing as a regulation strategy. Robert Emde writes of social referencing as “a process whereby an individual, when confronted with a situation of uncertainty, seeks out emotional information from a significant other in order to resolve the uncertainty and regulate behavior accordingly” (Emde, 1989). During classroom consultation and times of distress, the benevolent presence and non-verbal encouraging stance of the consultant can have the same grounding effect on a teacher. Joint attention regarding a potential conflict or during an evocative experience creates a felt sense of being held in mind, while the consultant attends through a quiet presence, as Winnicott wrote, “being alone in the presence of another” (Winnicott, 1958). This encouraging, quiet attending is similar to a loving mother staying attuned to the almost-rolling infant’s expression of distress. That mother expresses a quiet reassurance and confidence in the child’s ability and need to struggle through the discomfort, while keeping attuned to the level of frustration so that it does not become flooded or lead to decompensation. If the arousal level becomes threatened, the mother knows the signs of dysregulation and moves in to repair and comfort. One classroom scenario speaks to our work from this vantage point:

Teacher “Kay” and her consultant had spent considerable time over the years talking about the challenge of being with children while they were distressed without becoming punitive, directive, or moving away. During one observation, a child became inconsolable, and Kay approached him. Knowing this was a touchstone moment for their relationship, the consultant moved physically closer to her in the room while attending silently. The teacher looked to the child, then the consultant, clearly showing signs of distress. The consultant remained quiet but demonstrated understanding and empathy through her body position and facial expression. In the silence, the teacher turned to the consultant and said, “I just don’t know what to do.” The consultant quietly vocalized empathy and understanding while staying physically present, but not moving to problem solving or even reflection. The teacher then turned back to the child and empathized with his feelings. The child calmed and was able, after a time, to return to classroom activities.

This is a simple example of parallel process at work. Doug Davies, LMSW, PhD., wrote about this through his exploration of the role of the supportive other “to contain big feelings, remain attuned in the midst of distress, set limits on dysregulated or aggressive behavior, and put moment-to-moment experiences into words (which) disconfirms the trauma-based model that she(he) is alone and vulnerable and that relationships don’t help” (Davies, 2010).

“You had the power all along my dear. You just had to learn it for yourself.”

 – Glinda the good witch

Our program, and many other IECMH consultation programs, draw from the rich IMH traditions of building reflective capacity as a way to enhance compassion, insight, and empathetic response. Two-hour weekly classroom-focused consultation and monthly two-hour group reflective supervisions complement each other to access not only the explicit narrative reflection work, but also the often more difficult implicit IWM and affective experience support.

Our monthly reflective consultation groups are a unique opportunity for teachers to pause, in a supportive atmosphere, and look more deeply on classroom experiences.  During these sessions, the teachers are encouraged to explore more deeply the children’s and parents’ experiences, as well as their own experiences, reactions and feelings. Over time, these moments support the expansion of their ability to be curious about the multiple meanings of children’s behaviors, the feelings behind that behavior, and ways the teacher can meet the underlying needs for emotional support and connection. Through the creation of an open, supportive group, teachers are given the opportunity to reflect on how their own inner perceptions and belief systems color their understandings of behavior and, in turn, their responses to challenging interactions. Through the gentle support of the consultant, as well as affirming peer presence, teachers have become increasingly more insightful to the families’ possible histories of trauma, school difficulties, communication challenges, and issues with shame, fear, and confusion.  The ability to practice creation of the narrative, and time and space for reflection, allows for a more regulated and deliberate approach to future children and interactions. Through case presentations and group discussion, individual insights become generalized to other children and classrooms. Though the pull for problem solving can be strong, consultants use their leadership to keep the reflective space for the whole group. There have been so many examples of how the change in perspective has directly affected the relationships and children in the classrooms. Here are two brief examples from the groups:

Teacher “Julie” discussed a family whose child had great difficulty following any routines or group activities. Julie shared that she felt pressured by the mother to force the child to participate, even though by Julie’s assessment this was too challenging for him. Through empathy and curiosity about mother’s felt experience, Julie began exploring the mother’s fears about her child’s possible disability and future struggles. Speaking to the consultant the following week, Julie reported that she went from feeling anger and frustration with the mother to sadness and compassion. Julie shared that the next time she saw the mother she noticed that the mom was hovering in the background. From a place of compassion, Julie was able to see the sadness behind the annoyance. She then went over to the mother, stood by her side, placed her hand on her back while they looked together at her child, quietly. Over the next weeks, the mother began sharing her fears about her child’s future, and over time was more flexible and worked as a team with the teachers.

Teacher “Alice” found one of the children in her classroom emotionally draining due to his ongoing behavioral challenges, high activity level, and great need for interaction and guidance. Through the support of the consultant and encouragement of her peers, she was able to admit that she was frustrated. The consultant and peers expressed empathy and compassion, communicating to Alice that her feelings were justified and tolerable in the group. There was a brief conversation and the group moved on to another topic. At the start of the next classroom observation, the teacher approached the consultant with positive energy. Alice had taken the weekend to consider the child’s perspective, wondering about his feelings and returned with a special backpack, embroidered with his initial, which just happened to be the same as her son’s. She encouraged him to wear it around the classroom whenever he wanted and to collect and keep whatever he wanted in it for the day. The consultant noticed he was more focused, better regulated, and able to follow routines, and though he still struggled in many ways, he was calmer. This was a wonderful example of empathy and parallel process.

The process of change in classroom-based consultation goes through many stages, from building the relationship, to “being with” as a co-regulation strategy, to the co-creation of new narratives and perspectives.

This process is not linear or static and is greatly affected by the stressors and regulation of all the players involved. The co-creation of perspectives and narratives takes place in the shared curious space — the “zone of proximal development,” as coined by Vygotsky — and is scaffolded by a trusted advisor to move to higher developmental levels. In the consultative relationship, this may include offering the consultant’s perspective as slightly different, in the effort to “see the same child.” Different from didactic instruction, this perspective sharing is the meeting of equals with different perspectives to create curiosity and creativity in assessment, and ultimately different responses. In this creative, safe space, dyads explore concepts such as cues and miscues, the effect of trauma on attachment and development, and how perceptions and IWM may affect an objective view. Far from the role of expert, the consultant is a side-by-side companion in the experience of turning toward a challenging situation. Through these experiences, a well-regulated teacher can make leaps of perspective and intervention based on new information regarding development, trauma and perspective. Here is a simple example.

Teacher “Cindy” began watching a child with the consultant in the classroom. This child was very busy, but Cindy had positive regard for him and expressed confusion and curiosity about his ability to engage in classroom routines and activities. The consultant took this opportunity to share her observation about the child’s limited play skills. She shared her observation that he confidently seemed to play on his own, but could only maintain cooperative play when Cindy and the other teacher supported him. The next week Cindy reported that she had spent the last week more specifically observing the child and providing teacher-led experiences with him and other children, with the long-term goal of building his independent skills to play with others. Cindy also reported that she had begun noticing that other children in the room had varying skills in cooperative play and she was intentionally scaffolding them as well.

The dance of the relationship

Our work through Circle of Caring has been an amazing, emotional, and growing experience. We have borne witness to teachers growing in confidence and peacefulness.

Over these few years, teachers have begun instinctively developing curiosity and compassion for even their most challenging children and families.

Through an empathetic lens, these amazing teachers are beginning to become freed up to create ways to develop new connections and build safety within their classrooms overall.  We have seen first-hand that the strategies and interventions that curious and compassionate teachers create are unique, individualized, and child focused. This confirms our worldview that the creation of a safe space for feeling and being seen and held leads to amazing discoveries. These innovative ways of teaching cannot be taught; these attuned ways of responding to the children come from their own hearts. Hearts that are given a safe space through reflective consultation to speak the unspeakable, process the intensity of the classroom environment, and allow themselves to be open and fully human.

A final story tells the beauty and hope for this work:

Upon entering into one of my new classrooms in my role as a reflective consultant, I remember taking the time to pause. As I listened to the harmonious sound of the children at play, I noticed a bright yellow beanbag chair on the floor. It was a particular shade of yellow that demanded attention. As the weeks went by, the teachers and the children began to show me the meaning of the yellow beanbag chair. This teaching pair showed me many of their individual strengths right away. They were able to respond, attend and support the children when both teachers felt confident in “knowing the problem” and could quickly provide a resolution that worked. When a child became dysregulated to the point of screaming, crying and throwing themselves onto the floor, the teachers would move toward the child, using all of the tools in their toolbox to try and calm them. When this did not work, they would give into the intolerance of the child’s big feelings and gently carry them over to the yellow beanbag chair. The screaming child would then be instructed to sit there until they could calm themselves down. This was a pattern that I began to see emerge as the months went by. Together the teachers and I remained curious about the times that they felt confident and the times that they “just didn’t know what to do; nothing is working.”

Several months into our work together, one of the teachers discussed a difficult child during the monthly supervision group. As the consultant, I remained attuned, connected and empathic as the teacher spoke about her experience with this child. Some of the group members wondered if this child was “an only child and spoiled.” The consultant explored this concept of the spoiled child more with the group. The group worked to define this idea of a spoiled child. “A spoiled child always gets what they want and can do anything without consequence.” One of the teachers then began to share her own childhood experience of being like that child. The consultant noticed a slight shift in the tone of this teacher’s voice as she spoke. When asked how that felt as a child, the teacher shared, “I was alone a lot. I was left to take care of myself.”  The group became quiet for a brief few moments. The teacher who was presenting broke the silence by being curious about the use of the yellow beanbag chair with this difficult child.  With support from the consultant, the group began to wonder about this experience from the child’s perspective. The teacher wondered out loud, as if speaking for the child, “I’m screaming and crying and need help and now I’m alone.” The conversation was not without debate and quickly shifted to the other’s perspectives. However, as the consultant, I noticed that something shifted for that teacher in that moment. The beauty of this program is that I knew I would see this teacher the following week in the classroom and could revisit this one on one.

The following week the teacher tried to put into the words her experience in the group. The safe exploration and curiosity around the use of the beanbag chair and the teacher’s felt experience in the group created a space for both the teachers and the consultant to begin to name when this was happening in the classroom. This allowed the teachers and the consultant to create a language around not only the use of the beanbag chair but the teacher’s internal experience that drove her to directing a child to the chair.

Several months later, two children were having difficulty sharing a toy in the classroom. One of the children became very distressed by this and began to cry, letting out a high-pitched shrieking sound that built in intensity. One of the teachers moved close to her. As the consultant, I moved in closer to the teacher as well. She tried talking to her as she swiftly moved in to pick the child up and place her on her lap. This only made the child more upset and her cry more intense. The teacher stood up with the child in her arms and brought her over to the yellow chair. However, today she did not walk away but instead sat close beside the child as she cried. I watched as the teacher’s eyes boomeranged around the room until landing on me. Our eyes met and without any words,  she conveyed to me her awareness of the change. I stood up and walked over to the teacher and the crying child. I sat next to the teacher and we both took a deep breath. The teacher expressed feeling helpless and unsure. She felt perplexed that trying to hold the child appeared to make things worse. Together we sat through each other’s discomfort and, over time, the child calmed. From that day on the yellow chair was no longer used. When children became upset, the teachers would join them where they were, physically and emotionally.

 This is why we do this work; why we wade through the emotions and memories with the teachers on behalf of the children and families. Together we work to create possibilities for the teachers, the young families, and ourselves. This journey and dance of healing is paved by presence, empathy, and curiosity with the dream to create a greater world full of loving, relational homes. We, the consultants of the Circle of Caring, are grateful for being able to share in this experience and look forward to the discoveries ahead.

Bibliography

Davies, D. (2010) Child Development: A Practitioner’s Guide. 3^rd Ed. New York: Guilford Press.

Emde, Robert. (2009) Facilitating Reflective Supervision in an Early Child Development Center. Infant Mental Health Journal, Vol. 30(6), 664–672 (2009).

Emde, Robert N. (12/1990). Mobilizing Fundamental Modes of Development: Empathic Availability and Therapeutic Action. Journal of the American Psychoanalytic Association, 38(4), 881–913. Research Support, Non-U.S. Gov’t, Los Angeles, CA: SAGE Publications.

Epstein, MD, Mark. (2103) The Trauma of Everyday Life. Penquin Press.

Gossmann, Martin. (2009) Affect-Communication: The “Something More Than Interpretation.” International Journal of Psychoanalytic Self Psychology. 3:3, 330-353.

Johnston, K., & Brinamen, C. (2006). Mental Health Consultation in Child Care: Transforming Relationships among Directors, Staff, and Families. ZERO TO THREE.

Johnston, K., and Brinamen, C. (2012) The Consultation Relationship – From transactional to Transformative: Hypothesizing About the Nature of Change. Infant Mental Health Journal. 33(3), 226-233.

Lyons‐Ruth, K., Bruschweiler‐Stern, N. , Harrison, A. M., Morgan, A. C., Nahum, J. P., Sander, L. , Stern, D. N. and Tronick, E. Z. (1998), Implicit relational knowing: Its role in development and psychoanalytic treatment. Infant Mental Health Journal, 19: 282-289.

Winnicott, D.W. (1958) Collected Papers: Through Paediatrics to psychoanalysis. London. Tavistock.

Other Helpful Texts

Davies, D. (2012, Summer) “The Therapeutic Preschool: An Intensive Extension of Infant Mental Health to Meet the Needs of Traumatized 3-6 Year Olds.” The Infant Crier, #133, Michigan Association of Infant Mental Health, 4-8.

 Heller, S., Boothe, A., Keyes, A., and Nagle, G. (2011) Implementation of a Mental Health Consultation Model and Its Impact on Early Childhood Teacher’s Efficacy and Competence. Infant Mental Health Journal. Vol. 32(2), 143–164.

A recent article in The Atlantic (Christakis, 2016) lamented the overemphasis on academics that characterizes much of early childhood education today, noting that the preschool and kindergarten years serve more as gatekeepers than supporters and “welcoming mats” to the elementary school years, particularly for children at risk.  Indeed, the first five years of a child’s life are dedicated to the preparation for “kindergarten readiness,” and many teachers today are under pressure to engage in didactic teaching practices aimed at promoting young children’s literacy and math competencies.

Unfortunately, such teaching methods often require young children to sit for long periods of time and reflect the use of highly structured teaching methods, paperwork and worksheets that are not in tune with the developmental needs of young children.  Even more concerning is that less developmentally appropriate practices are not only ineffective but also stressful for young children.  In fact, studies have shown that children in classrooms characterized by developmentally inappropriate practices show twice the level of stress (and stress-motivated behaviors) than their peers in more developmentally appropriate classrooms (Hart et al., 1998).  What do we mean by developmentally appropriate practices in early childhood?  For young children, play in the context of warm, supportive teacher-child relationships characterizes an optimal learning environment.

David Elkind once said, “Learning teaches us what is known, play makes it possible for new things to be learned. There are many concepts and skills that can only be learned through play.” Unstructured play, also known as free play, provides so much opportunity for growth. As Horne (2018) explains, play allows young children to acquire and master skills across a variety of developmental domains.  Further, children are free to invest their full emotional energy in their exploration and learning when they share predictable, warm relationships with their teachers, and teacher-child relationship quality is related to children’s more advanced play.

What skills are learned through play?

Play builds a variety of skills!  Play in all areas of the early childhood classroom (e.g., centers such as the block area or pretend play area) offers opportunities for solitary play as well as play near and in collaboration with others.  Such experiences help children build important social skills and mastery motivation (the desire to learn a new skill or master a new competency, for example).  Allowing children to make their own choices about play promotes autonomy and mastery.  In a world in which children have little power, play allows children to make choices according to their interests and goals.  Additionally, play promotes communication and language skills — critical competencies given that it is through communication and language skills that our needs are met and desires are known throughout our lives. Language skills such as holding a conversation, negotiation, vocabulary, and listening skills are supported in play in all areas of the classroom.  Moreover, through play, emotional skills — the foundation for so much learning — are also challenged and developed.  The following are examples of skill development supported through play:

Blocks and Manipulatives

Building block towers invites opportunities to experiment with cause and effect and practice balance and eye-hand coordination.  Building structures involves planning and reasoning, opportunities to notice and sort blocks by shape and size (categorization, seriation, classifying objects, parts and wholes) and provides practice in spatial orientation (e.g., how blocks fit together). Working with puzzles involves experiments with spatial orientation, problem solving, and eye-hand coordination.  Explorations with Duplos, chunky Legos and similar materials invite experimentation with planning and problem-solving as well as exposure to sensory experiences.  Toys that produce interesting effects, like a jack-in-the-box, promote young children’s more rapid cause and effect learning and application of that knowledge in later play (Hauf & Aschersleben, 2008). Over time, block play and play with manipulatives expose children to mathematical concepts in meaningful ways.  For example, observing that two small square blocks equal one rectangular block is math, specifically fractions, at work!

Sensory, Art and Music Experiences

Painting, play dough, water play, sand play and other sensory experiences engage all five senses and provide cause and effect experimentation (e.g., what happens if I use a light stroke versus a heavy stroke; what happens when I keep pouring water into the cup?)  Zero to Three (www.zerotothree.org) describes the development of cause and effect understanding as one of the foundational cognitive discoveries in the early childhood years.  Like other areas of play, sensory play offers opportunities to explore rich new language as teachers and children notice interesting textures and scents and engage in visual exploration of interesting materials.

Music experiences such as songs and chants promote literacy and language skills and also give young children practice in sequencing and memory skills (i.e., what comes next in this familiar story or repetitive chorus).  The development of these types of cognitive skills creates a positive early foundation from which the child can grow; such skills are related to a variety of later school-readiness and academic outcomes.

Pretend Play Experiences

Pretend play promotes perspective-taking and has been linked with the development of children’s self-regulation skills.

For example, as pretend play becomes more advanced, it requires children to modulate their emotions and behaviors in response to others so that the play continues.  Self-regulation, the ability to alter our emotions and behaviors in response to internal (e.g., our thoughts) or external (e.g., others’ behaviors) signals play a role throughout life in helping us navigate social relationships, school and work environments.  Pretend play also offers opportunities for practicing language skills, and children’s language acquisition is richer in the context of play than in other classroom activities (Cohen & Uhry, 2007).  Stanley Greenspan explained that through pretend play children also explore major themes in life, such as what it means to love and be loved.  The child cradling and feeding a doll in the pretend play area is not only imitating observed behaviors but also enacting how loving relationships look and feel.

Motor Play Experiences

Learning about our bodies is a fundamental task of early development. Through physical activity, children learn spatial awareness skills (e.g., imagine a toddler learning how to move her body around another child rather than walking into the other child), balance and  how to be safe.  Opportunities to practice fine and gross motor skills are also associated with children’s acquisition of strength and motor coordination.  Moreover, providing interesting and novel materials promotes motor exploration.  For example, infants make different types of stepping movements on coarse textures than they do on smooth textures.  Motor play also offers opportunities for language exploration and for developing cognitive concepts, such as opposites (in/out of the sandbox; over/under the slide).   Additionally, motor skills are related to many other areas of development.  For example, the ability to crawl or walk allows a young child to move away from a caregiver or teacher and return, allowing infants and toddlers to practice managing brief separations. Even this type of brief separation and reunion reinforces that infants and toddlers can be effective in finding their “safe base” whenever needed. So, in short, motor skills are related to attachment relationships!

Bookshare Experiences

Books provide opportunities for motor and sensory explorations as infants and toddlers explore books with their eyes, hands, and mouths.  Books and storytelling invite toddlers and preschoolers to hypothesize what will happen next (e.g., “If you give a mouse a cookie….  What do you think he’ll want next?”)  Books and storytelling proving opportunities to practice cognitive skills like sequencing (e.g., the repetitive text of “Caps for Sale” provides practice in sequencing). Young children’s stories addressing affective experiences (joy, sadness, anxiety) provide important openings to talk about the emotional cues, the contexts of emotions, empathy and perspective taking.  From manipulating books, children acquire literacy knowledge including understandings of written language, letter and word identification and book knowledge.  Sharing books and stories together, as with other forms of play, offer relationship building experiences as children, their peers, and teachers share interests and joy in being together.

Cooperative Mealtime Experiences

Mealtimes also offer developmental opportunities.  Meals build a sense of community as children engage in prosocial behaviors such as setting the table, passing bowls of food around the table, talking and being together.  Sensory explorations of food textures, scents, sights, and tastes promote sensory development and language skills.  Math concepts, such as one to one correspondence, are supported as children place one cup and one plate at each place setting or as a teacher or other children notice: “I had three crackers.  I ate one and so I have two crackers left.”   Children’s sense of self and autonomy are supported as children serve themselves in family-style dining in the classroom.

What does play look like?

Play offers many developmental benefits when supported and promoted in ways that are sensitive and responsive to children’s cues and interests.  Rymanowicz (2015) summarizes many of the key characteristics of high-quality play.

• Self-chosen and self-directed. The beauty of play is that it is based on children’s emerging interests and goals rather than on those of the adults.  This is a critical feature of play.  For example, studies have shown that child-selected activities predict greater vocabulary skills than do teacher-directed activities (Lippard, Choi & Walter, 2019).
• The process, not the product.  It is through the process of play that skills are practiced and acquired regardless of what a final product might be.  For example, it is the joy of feeling grass on the feet that promotes sensory development not the end result of walking outside.  It is not a completed block structure that promotes skills development; it is the journey of selecting blocks, stacking them, determining what makes the structure balance or topple, and so on that builds competencies.  Some play is exploratory with no particular goal in mind outside of experiencing the moment.  Other play has a goal determined by the child, and, often such goals are more about the creation process than a particular product (e.g., consider how many times you notice a child’s process and ending outcomes change and morph as the child engages in play).
• Individually constructed.  The child or children in play together determine the structure of the play — that is, the organization, pace and boundaries of play.  As I explain below, teachers can support and scaffold children’s experiences but their actions should be guided by children’s processes and cues.
• Imaginative, Active, and Fluid.  One of the most interesting things to watch in  children’s play is that it is not always tied to the rules of the “real world.”  In their play, children will escape the bounds of reality and, at other times, they will practice their understanding of the real world as expressed in their play. Play themes morph frequently, and these are examples of creative thinking and problem-solving. Teachers can learn a great deal about how children are feeling and what they are thinking by observing their play.

It is important to understand that every child develops differently and because of this each child’s play will look differently. It is through play that young children learn about our “symbolic world” and the themes and subjects we experience every day. Child psychiatrist Stanley Greenspan created the Floortime approach, which emphasizes the importance of child-led floor time to engage the child in complex play scenarios that build on real world readiness skills. Floortime encourages children to take initiative but also learn to negotiate and tolerate frustration, to engage in longer play episodes as skills are acquired, to communicate interests and needs, and to plan and carry out actions.  Greenspan’s model has most often been applied to children with special needs, but the principles of his approach are relevant to children of all developmental abilities.  Greenspan’s approach also emphasizes the importance of the symbolic world and recommends identifying and supporting real-life experiences (e.g., encouraging role playing) that are known to the child and are of interest to the child.

How do we support learning in play using a relationships-based approach? 

In an early childhood classroom, play should comprise the majority of the day.  When children are enacting their own choices, they are fully engaged, which means their focus and attention are in full bloom and the opportunities are endless.  Not only does this promote brain development and skill development, but it makes a young one want to come to school, want to learn and want to explore. But how is play best supported by relationships?  Relationships promote play in two key ways.

First, from an attachment-based perspective, young children’s experiences reflect a balance between the need for autonomy and exploration and the need for emotional security.

When the needs for emotional security are not met, emotional and physical energy is channeled to security needs at the expense of autonomy and exploration.

So, building close, predictable, warm relationships with young children affords them greater energy to devote toward autonomy and exploration, and that equates to greater learning and more optimal development.  For example, research has shown that warm, secure teacher-child relationships promote preschoolers’ self-regulation skills (Cadima, Verschueren, Leal, & Guedes, 2016), and teachers’ responsive interactions with children are linked to children’s cognitive skills (Hamre, Hatfield, Pianta, & Jamil, 2014).

Second, relationships provide the context in which teachers scaffold children’s play in individualized ways. As we observe young children in play, an infant mental health perspective leads us to ponder not only “What about the baby?” but “What about this child?”  We ask ourselves, “What is the child thinking, feeling, experiencing in this moment? What does this child want and need in this moment?”  From this reflective stance, with the goal of understanding the child’s internal states (e.g., thoughts, feelings, needs, goals), teachers respond with intention to support and scaffold children’s play in ways that are aligned to the child’s interests and goals.  By carefully considering what children need from us, teachers communicate respect and appreciation for young children as individuals each with their own unique experiences, interests, and goals.

In short, teacher-child relationships enable the child to feel felt and heard, and, in turn, children are emotionally fueled to learn and grow.   

Below are teaching practices that use the relationship to scaffold play and learning.

• Be physically and emotionally present. Teaching is complex, challenging work.  Given high rates of teacher stress, it can be difficult to be fully present in the moment with the child.  Teachers have the difficult task of managing competing demands for their time, attention and support while also regulating their internal thoughts, emotions, and perceptions of stress.  Yet, it is the teacher’s emotional presence and participation with children that promote children’s learning in the most optimal ways.
  • Watch and Respond to Cues: As noted by Rymanowicz (2015), teachers participate most sensitively by watching and responding to children’s cues. This allows the child to stay in the lead of play while also helping children to form connections between concepts in play.  When teachers allow children to take the lead and wait for invitations to play, children are more likely to feel felt and heard.
  • Use Open-Ended Questions and Comments Wisely: Research has shown that teachers’ sensitive (well-timed and not intrusive) open-ended questions promote children’s more complex block building and pretend play skills.  Well-placed questions and comments (e.g., observations about children’s activities) promote and extend play.
  • Value the Importance of Observation: Sally Provence once wisely advised, “Don’t just do something. Stand there and pay attention!”  Sometimes being physically and emotionally present does not always involve direct interaction with the child.  Sometimes supporting play means observing and learning about the child’s development from your observations.  Being an active observer and learner alongside the child gives teachers important insights into children’s developmental needs and interests.  These observations come in handy when planning future learning experiences.  Sometimes supporting means interacting and scaffolding sensitively.
  • Share the Same Level in Space: Finally, being physically and emotionally present also extends to where and how teachers place themselves in the classroom. Taking time to talk with children at their eye level and using open body position/body language communicates to children that their thoughts, communicative intentions and/or words are valued and desired.

• Respect the child’s discoveries. From our adult perspectives, we know how things are “supposed” to work; we understand the most effective and efficient ways to engage materials.  We want to see children succeed.  Collectively, this means that teachers may be tempted to show children the “right” way to engage materials or carry out play.  Yet it is the creative process, the mistakes, the rethinking and execution of a new plan and “owning” the experiences and discoveries that promote children’s critical thinking, problem solving skills, conceptual development and sense of mastery (Rymanowicz, 2015).  Support the child by using well placed open-ended questions to allow deeper investigations to take place.  Early childhood teachers are most effective as partners in children’s play rather than as supervisors or leaders of the play.
• Trust the process. Growth and development progresses in each child in unique timetables.  A “one size fits all” approach to curricular development and teaching rarely works.  Individualizing experiences for children and tailoring our interactions to each child’s temperament, prior experiences, interests and goals is most effective in promoting early development.
• Avoid interruption and be flexible. As a teacher, I’d like to add another important attribute to this section. Play needs to be uninterrupted.  Uninterrupted play means allowing  a child to be an explorer and learner and being flexible when young children are immersed in play.  For example, teachers who allow a child to finish play or come to a natural pausing or stopping point before inviting the child to diapering or toileting communicate respect for the child as an individual.  Extending free play time for a few minutes to allow children to complete their play or supporting children who wish to bring a toy with them for self-care routines are other examples of flexibility.

Classroom Environment

Finally, relationship-based approaches also inform how teachers create the early childhood environment.  The environment is thought of as the third teacher and reflects teachers’ perspectives about relationships. Here are some aspects to think about when setting up a learning environment.

• A classroom should be an inviting space that the children see as their own. Spaces for personal belongings, such as a cubby, and spaces for community belongings, such as where the watering can for the class plants is stored, help children know what to expect and to feel welcomed and valued. Other strategies include displaying children’s work throughout the classroom, involving children in care of the classroom, and creating photo books featuring children in the classroom, families, and shared experiences reflect high-quality relationship-based practices.  Experts also suggest using the language of community, such as referring to the children in the classroom as “friends” and referring to “our classroom” to build relationships and emotional closeness (which translates into emotional energy for well-being and learning).
• Another important element is the design of the room. Materials should be chosen for a reason rather than to fill shelves. Making materials easily accessible to children builds autonomy.  The room should be created to inspire and promote wonder and curiosity.

Play is for a critical component in healthy, early development.  When supported and facilitated in effective ways, play has a dramatic impact on cognitive, language, physical and social-emotional development.  As early childhood educators we have a huge job on our hands. A job that when done in effective, relationship-based ways contributes to children’s bright futures. I challenge you to imbed play into your curriculum. Allow children the time for uninterrupted, meaningful play and you will see the results! Good luck!

References:

Cadima, J., Verschueren, K., Leal, T. & Guedes, C. (2016). Classroom interactions, dyadic teacher–child relationships, and self–regulation in socially disadvantaged young children. Journal of abnormal child psychology, 44(1), 7-17.

Christakis, E. (2016). The new preschool is crushing kids.  The Atlantic, January/February. Retrieved from https://www.theatlantic.com/magazine/archive/2016/01/the-new-preschool-is-crushing-kids/419139/.

Cohen, L. & Uhry, J. (2007). Young children’s discourse strategies during block play: A Bakhtinian approach. Journal of Research in Childhood Education, 21(3), 302-315.

Hamre, B., Hatfield, B., Pianta, R., & Jamil, F. (2014). Evidence for general and domain‐specific elements of teacher-child interactions: Associations with preschool children’s development. Child development, 85(3), 1257-1274.

Hauf, P. & Aschersleben, G. (2008). Action-effect anticipation in infant action control. Psychological Research, 72(2), 203-210.

Horne, A. (2018). All Work No Play. Bridges Care and Education Center https://www.bridgescareandeducationcenter.com/single-post/2018/11/15/All-Work-and-No-Play?fbclid=IwAR0UrQsUzJt3mGFDqaX32T1-to0tZ5CCJcvrRjcoL56a_wumdMvhsg2M_E4

Rymanowicz, K. (2015, Oct. 19). The power of play — Part 2: Born to play. In Michigan State University — MSU Extension.  http://www.canr.msu.edu/news/the_power_of_play_part_2_born_to_play

Diversity and its Importance in Early Childhood

The concept of diversity takes various forms and is incorporated into many aspects of our life. From religion, gender, culture, family structures, and physical abilities, we are each brought into this world made up of many differences. For years we have thought that children will automatically form positive outlooks about the differences we each convey if we do not speak of those differences. However, research has shown that advocating and exposing children to diversity requires active promotion. Rodolfo Mendoza-Denton, a social psychologist at the University of California, says that we often think that young children are colorblind to differences, and we are hesitant to point out differences for fear that it promotes prejudice (Denton, 2011). However, numerous studies have shown that infants as young as 6 months are able to categorize people by both gender and race (Katz & Kofkin, 1997). By 2 years, toddlers use their recognition of race to reason about people’s behaviors. During toddlerhood, children notice and reason about differences, but studies also show that toddlers do not act on observed differences. However, by age 5, children express preferences for their own race (Kinzler & Spelke, 2011).  It is through daily interactions and observations of others’ comments and verbal and nonverbal behaviors that young children attribute particular meaning to race, culture and other forms of diversity.  By the late preschool years, such understandings inform behavior.

By ignoring young children’s attention to these differences, we as professionals unintentionally contribute to the prejudice and stereotypes that they gather from society.  In fact, young children’s racial beliefs are heavily influenced by their environments (Winkler, 2009). Silence about race doesn’t prevent children from noticing racial and other differences; instead, silence inhibits them from asking questions and having conversations about it. This is an especially important issue in classrooms lacking racial and ethnic diversity.

In less diverse environments, less exposure to diverse groups results in fewer conversations about diversity and, in turn, provides more room for prejudice. Wolpert states that we tend to assume that inclusion alone creates respect for differences. However, it is active conversation and support for children’s understanding of diversity that guards against the development of the stereotypes and prejudice that contribute to biased behavior (Wolpert, 1999). From the beginning of life, we all receive messages through television, computer games, music and books.

An anti-bias curriculum is an active process, using these outlets to foster exposure and later conversations about differences, diversity and, as the child develops, a sense of self.

What is Anti-bias Curriculum? What are the Goals?

According to the National Association for the Education of Young Children (NAEYC), an Anti-bias Curriculum is based on the educator’s deep belief in a system of justice and equality for all people, giving each child the opportunity for achievement. When implementing anti-biased approaches with infants and toddlers in mind, two of NAEYC’s goals stand out.  The first is that “Children express comfort within diversity, accurate language and caring human connections.” The second recognizes children’s emerging skills (with teachers’ support) in “recognizing unfairness and understand that it hurts.” Such skills become more evident during the preschool years as children begin to mature socially and emotionally and as they gain skills in perspective over time, but the roots of empathy are built in infancy and toddlerhood. In her book Start Seeing Diversity, Wolpert also outlines similar goals reinforcing the needs and importance for anti-bias curricula, one of which is to promote the child’s developing awareness of these differences and to help foster preschoolers’ empathic responses to others (Wolpert, 1999, p.13).

Effects on Children, Parents and Practitioners

How does an anti-bias curriculum affect relationships within these groups?   Secure relationships are typically characterized by respect, compassion, and awareness of self and other,  characteristics that are also consistent with anti-bias perspectives.  Secure relationships between teachers and children provide a trusting environment in which children are supported to grow and learn, including learning about similarities and differences in each other and in their communities.  For teachers, high-quality trusting relationships with colleagues and supervisors provide a safe environment in which teachers may feel empowered to become aware of their own implicit biases. In turn, awareness empowers us to notice when bias is informing our perceptions of and interactions with others and to take active steps to change our perceptions and interactions.   Of course, relationships are also important between parents and practitioners. Anti-bias curricula have a way of promoting these relationships by providing a welcoming sense to parents from diverse family structures and backgrounds. This allows for greater trust and communication between parents and professionals as they work toward supporting development for the child. An anti-bias system is a way of thinking that is translated by both parents’ and teachers’ actions and language.

Parents

Studies have shown that the parents of ethnic-minority children engage in racial socialization, defined by the American Psychological Association as the ways in which those parents teach their children how to navigate in a society that often presents racial inequalities and may associate them with negative stereotypes (Gaskin, 2015). These teachings also may include emphasizing the importance of one’s race and culture when it is not commonly or positively portrayed in society. Studies have found common themes in racial socialization to be teaching “cultural socialization, preparation for bias, promotion of mistrust egalitarianism and silence about race” (Strain, 2017). Often acts of racial socialization are not direct but may be subliminal messages that children receive from parents and extended family. Unfortunately, these messages may often include messages of bias and mistrust that children may begin to perceive about majority groups (Reynolds, 2017).

By incorporating anti-bias curricula, we as educators have opportunities to support children as they begin to see and embrace differences between themselves and others. Sadie Strain’s review on White Families and Socialization shows just how effective taking a colorblind approach has on the biases and assumptions of young children on diverse groups (Strain, 2017). By not talking about race to either ethnic-minority children or to those considered in the majority, we allow for development of negative assumptions, which are constantly influenced by the media. With the incorporation of anti-bias curricula in early childhood programs, we are able to combat these fears of mistrust stemming from both groups as they have opportunities to learn about each other.

Important Aspects in an Anti-Bias Curriculum

Professional Self-Awareness

One of the most crucial aspects of developing an anti-bias curriculum is the self-awareness of the professionals. We all have our own internal, implicit biases and it is important to become aware of them and how we think because these biases influence our behaviors and teaching to others. As stated in NAEYC, incorporating anti-bias approaches in a program is less about adding physical diverse materials and more about the overall goal of promoting opportunities for everyone to be represented.

Self-awareness can often be difficult to achieve because we are already equipped with our own biases, stereotypes and assumptions (Derman-Sparks, 2015, p.14). For Diversity-Informed Practice, Shea and McCormick (2017) discuss how professionals need to take a step back and reflect on how systems of oppression such as racism, sexism, homophobia and classism have had affected their lives. We often create conscious — as well as unconscious — stereotypes about certain groups based on our past experiences. Chandra Ghosh-Ippen reminds us that we want to ask these questions of ourselves but also of others.  That is, we are encouraged to consider the histories of others that differ from our own experiences, including how differences in histories reflect significant differences in felt and lived experiences.  By taking and maintaining a stance of openness and reflectiveness about self and other, we are better positioned to curb our biases.  Professionals are encouraged to review the Program for Infant and Toddler Care (PITC) training on Ethnic Self-Awareness https://www.pitc.org/cs/pitclib/view/pitc_res/261.

Notice Differences

Numerous studies have shown us how children as young as 6 months are able to recognize differences in characteristics such as race and hair texture. When incorporating an anti-bias curriculum, you can often learn what children are noticing through daily interactions with them. If you see that children are noticing differences in hair color, you may begin to introduce dolls that have various hair colors and textures. You may even incorporate experiences in the classroom that point out differences and similarities of children within the class, showing that you are all one community but have things about you that make you unique.

Respond to Awareness

As you notice the children commenting on their differences, the way you respond to their awareness can have a substantial effect on how they view them. A big misconception is that pointing out differences is the same as racism. This is incorrect because there would need to be an awareness of a stereotype associated with the given race. In young children you can help form positive views by celebrating differences (Denton, 2011). Prejudice and stereotypes come from society teaching that certain groups are deemed “good” while other are seen as “bad.” For example, when children notice someone of another race, they often point out their skin tone. Embrace their awareness of differences and even give praise on the beauty of the individual they noticed. More important, you can point out to the child what the individual has to offer as opposed to focusing on their looks (Parents, 2018). This can be bringing attention to another language they may speak or even a culture they are a part of.

Incorporate Diverse Materials

In the zero to three years, the goal of a diversity inclusive curriculum is to expose children to different categories of things they commonly encounter. For example, this may be exposure to toys representing foods found in different cultures in a pretend play area and eating foods from different cultures at mealtimes. Because the visual environment is such an important framework, educators should be sure to include images of the children and staff in their program along with their families. This can be a great example of showing different family dynamics while also instilling a sense of self in the child.

Around play areas teachers can provide images of various types of work showing a fair balance of men and women, as well as a balance of ethnic and racial groups (Derman-Sparks, 1989, p.12). Differently abled people and images of the elderly engaging in various activities should also be depicted. Books are another great incorporation as they can reflect different abilities, genders, and cultural backgrounds. Having a book in multiple languages gives good exposure to diverse populations as well. The goals of this curriculum can be implemented through different types of play, art materials and dolls as well. In their article Why Classroom Diversity Matters in Early Education, Reid and Kagan explain that because of funding, many early childhood education programs are often economically segregated. This results in an unintentional segregation of children by race and ethnicity as well (Reid and Kagan, 2015, p.5). These figures put an even greater importance on exposing and introducing children to diverse populations in these settings. The intention of incorporating an anti-bias curriculum is to promote overall education for all children, both those found in the majority and minority groups.

References

(2018). Age by Age Guide to Talking bout Race. Parents. https://www.parents.com/parenting/better-parenting/teaching-tolerance/talking-about-race-with-kids/

Derman-Sparks, L. & LeeKeenan, D. (2015). Leading Anti-Bias Early Childhood Programs. New York, NY: Teachers College Press.

Derman-Sparks, L. (1989). Anti-bias Curriculum: Tools for Empowering Young Children. Washington, DC: National Association for the Education of Young Children.

Gaskin, A. (2015). Racial Socialization. American Psychological Association. https://www.apa.org/pi/families/resources/newsletter/2015/08/racial-socialization.aspx

Katz, P.A. & Kofkin, J. A. (1997). Race, gender, and young children. Developmental Psychopathology: Perspectives on Adjustment, Risk, and Disorder, 21, 51-74.

Kinzler, K.D. & Spelke, E. S. (2011). Do infants show social preferences for people differing in race? Cognition, 119(1), 1-9.

Mendoza-Denton, R. (2011). Should We Talk to Young Children About Race? Psychology Today. https://www.psychologytoday.com/us/blog/are-we-born-racist/201104/should-we-talk-young-children-about-race

National Association for the Education of Young Children. Anti-Bias Education. https://www.naeyc.org/resources/topics/anti-bias-education/overview

Reid, J. & Kagan, S. (2015). A Better Start: Why Classroom Diversity Matters in Early Education. Washington, DC: The Century Foundation.

Reynolds, J. (2017). Predictors of Ethnic-Racial Socialization Profiles in Early Childhood Among African American Parents. Ann Arbor, MI: ProQuest.

Shea, S. & McCormick, A. (2017). Diversity-Informed Metal Health Practice in Our Current Context. The Infant Crier. https://infantcrier.mi-aimh.org/diversity-informed-infant-mental-health-practice-in-our-current-context/

Strain, S. (2017). White Families, and Racial Socialization: A Review. American Cultural Studies Capstone Research Papers. 7. h2ps://cedar.wwu.edu/fairhaven_acscapstone/7

Winkler, E. (2009). Children Are Not Colorblind: How Young Children Learn Race. HighReach Learning.

Wolpert, E. (1999). Start Seeing Diversity: The Basic Guide to an Anti-Bias Classroom. St. Paul, MN: Redleaf Press.