2Counseling Schedule: Infancy Establishing RoutinesDiscipline = TeachingFirearmsModeling Behavior6 and 9 MONTHSChild CareFamilySafe EnvironmentParenting StyleBonding and Attachment2 and 4 MONTHSWhat Babies DoParental FrustrationParent Mental HealthParent Support2 DAYS to4 WEEKSINTRODUCEVISIT
3Infancy1-7Early caregiver relationships set the stage for future relationshipsSecurely attached young children have an easier time developing positive, supportive relationshipsEmerging evidence shows that securely attached young children are found to have more8-15:Balanced self-conceptAdvanced memory processesSophisticated grasp of emotionPositive understanding of friendship
4Infancy CounselingIs this what you expected?Be on the lookout for families who are socially isolated or experiencing family discord.Who helps you with your baby?How much time do you have off from work?If there is a gun in the home, how is it stored?Being a new parent can be exhausting. How are you doing?
6Welcome to the World of Parenting! Visit: 2 Days to 4 Weeks Helps parents understand the normal development of newbornsProvides information about coping skills for parentsDiscusses changes in the ways parents may now relate as a couple
7How to Use this Tool Helpful Hint! Whenever appropriate, include both parents in the conversationDiscuss infant crying and ways to handle it:Crying is normalCrying upsets parentsSometimes, parents just need to let the baby cryHelpful Hint!I love the way your baby looks at you, soothes to your voice. You’re doing a great job!Support new parents withpositive statements:
8Parenting Your Infant Visit: 2 and 4 Months Helps parents understand normal development of 4- to 9-month-old infantsStresses importance of building family connectionsDiscusses 3 problems:ColicTrouble sleepingClinging to parents
9Your infant is alert, growing well, and has a beautiful smile! How to Use this ToolReiterate messages about crying and parental frustrationEmphasize to parents the importance of having time together without their babyHelpful Hint!Support new parents with positive statements:Your infant is alert, growing well, and has a beautiful smile!
10How Do Infants Learn? Visit: 6 and 9 months Offers practical suggestions to parents based on a newborn’s brain developmentEncourages activities like reading or singing to promote brain growthHelps parents understand that exploration is a natural developmental need
11How to Use this Tool Helpful Hint! Ask parents about their social connections. Refer to sections “Others Who Care for Your Baby” and “Taking Care of Yourself”Utilize the “Social Connections” worksheet from the Clinical GuideTalk about child care arrangementsHelpful Hint!Wow, your baby is really interested in my stethoscope! I like the way she lets me examine her, but she is always looking over at you for assurance.Notice infant’s new behaviors and parent-child interaction:
12Provides information needed to make informed decisions Your Child is on the Move:Reduce the Risk of Gun Injury Visit: 6 and 9 monthsCorrelates childhood injuries/ deaths due to firearms and presence of handguns in the homeEmphasizes that a child’s curiosity about guns overwhelms any lessons learned about gun safetyProvides information needed to make informed decisions
13How to Use this Tool Helpful Hints! Discuss handguns in the context of other household hazardsSince some parents may not be in agreement concerning the presence of handguns in the home, encourage them to look at the brochure together to make an informed decisionHelpful Hints!In areas of country with high rates of gun ownership, some practices offer reduced price or free gun locksBe aware of the potential lethality of domestic violence in homes with handguns
14Counseling Schedule: Early Childhood VISITINTRODUCE12 and 15 MONTHSChild Development andBehavior18 MONTHS and 2 YEARSChild’s AssetsGuided ParticipationMedia3 and 4 YEARSPeer PlayingSafety in Others’ HomesTalking About EmotionsPromoting Independence
15Early Childhood16-20Communication skills allow young children to sustain bouts of playHow young children learn to react is greatly influenced by:Parental relationshipParental behaviorHome environment
16Early Childhood Counseling Encourage alternatives to TV, such as outdoor activity or reading.Normal toddler behavior may be especially difficult for families with little social support.“She really pays attention when we talk; does she understand when you speak to her?”“Does your child have opportunities to play with other children this age?”“Teach your child by providing positive reinforcement for desired behaviors.”“What do you think your child does best? What does he enjoy doing?”
18Describes the basics of a behavioral approach to parenting toddlers Teaching Good Behavior:Tips on How to Discipline Visit: 12 and 15 MonthsDescribes the basics of a behavioral approach to parenting toddlersPositive reinforcement for desired behaviorsLimit settingAdvises parents about effective alternatives to corporal punishment
19How to Use this Tool Helpful Hint! Start conversations about toddler behavior with gentle inquiries“Your child is growing and developing well. Have tantrums started? How do you handle them?”“What is your child doing new since last visit? What do you want to change?”Endorse the core message: a simple approach for teaching toddlers how to behave wellHelpful Hint!Be on the lookout for children with difficult temperaments, families who are socially isolated, and families experiencing discord
20Playing is How Toddlers Learn Visit: 18 Months and 2 Years Helps parents understand normal toddler behavior and advises them how toProvide a stimulating environment during this period of major brain developmentUnderstand the natural curiosity and exploration of toddlers
21How to Use this Tool Helpful Hints! Discuss normal toddler play behaviorProvide parents with guidance on the types of toys that stimulate imaginationHelp parents identify places where they can meet other toddlers and their parentsHelpful Hints!Check in with parents about how their family relationships are faringSupport toddler’s parents with positive statements:What a delightful child you have! He is really curious about the world. This is great to see!
22Pulling the Plug on TV Violence Visit: 18 Months and 2 Years Provides information about the influence of TV violence on childrenOffers tips for parentsSet limits on TV timeKnow what children are watchingWatch programs with childrenDo not put TV in a child’s room
23What’s your favorite TV show? How to Use this ToolIdentify alternatives to TV, such as toys that use imagination or outdoor play when possibleRecognize that alternatives can be challenging, as TV often provides free in-home child care for families who cannot afford organized activities or who live in unsafe areasHelpful Hint!Ask the child:What’s your favorite TV show?The child’s response often indicates the kind of TV programs being watched, which provides a topic to open discussion with parents
24Young Children Learn A Lot When They Play Visit: 18 Months and 2 Years Introduces the importance of peer playingIncludes tips on how to make play opportunities successfulAssists parents in solving common difficulties, such as aggression and rejection
25How to Use this ToolAsk if child has opportunities to play with other children of the same ageUse parent’s answer to discuss how the child plays or how to find other childrenHelp parents problem solve any play or playmate issuesHelpful Hint!Try to notice something about what children are wearing, the toys they bring, or their behavior:I see you really like trucks.Do you and your friends play with trucks a lot?
26References1. Bretherton I, Munholland KA. Internal working models in attachment relationships: a construct revisited. In: Cassidy J, Shaver PR, eds. Handbook of Attachment: Theory, Research, and Clinical Applications. New York: Guilford Press; 1999:89-1112. Sroufe LA, Fleeson J. Attachment and the construction of relationships. In: Hartup WW, Rubin Z, eds. Relationships and Development. Hillside, NJ: Lawrence Erlbaum Associates; 1986:51-713. Sroufe LA, Fleeson J. The coherence of family relationships. In: Hinde RA, Stevenson-Hinde J, eds. Relationships Within Families: Mutual Influences. Oxford, UK: Clarendon; 1988:27-474. Thompson RA. Early sociopersonality development. In: Damon W, Eisenberg N, eds. Handbook of Child Psychology. Vol 3: Social, Emotional, and Personality Development. 5th ed. Hoboken, NJ: John Wiley & Sons; 1998:25-104Sroufe LA, Egeland B. Illustrations of person-environment interaction from a longitudinal study. In Wachs TD, Plomin R, eds. Conceptualization and Measurement of Organism-Environment Interaction. Washington, DC: American Psychological Association; 1991:68-846. Sroufe LA, Carlson E, Schulman S. Individuals in relationships: development from infancy through adolescence. In: Funder DC, Parke RD, Tomlinson-Keasey C, Widaman K, eds. Studying Lives Through Time: Personality and Development. Washington, DC: American Psychological Association; 1993:
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28References15. Park KA, Waters E. Security of attachment and preschool friendships. Child Dev. 1989;60:16. Bradley RH, Caldwell BM, Rock SL. Home environment and school performance: a ten-year follow-up and examination of three models of environmental action. Child Dev. 1988;59:17. Collins WA, Laursen BP, Hartup WW. Relationships As Developmental Contexts. Minnesota Symposia on Child Psychology 30. Mahwah, NJ: Lawrence Erlbaum Associates; 199918. Dunn J. Young Children’s Close Relationships. Newbury Park, CA: Sage; 199319. Hartup WW, Rubin Z, eds. Relationships and Development. Hillsdale, NJ: Lawrence Erlbaum Associates; 198620. Maccoby E, Martin J. Socialization in the context of the family: parent-child interaction. In: Mussen P, Hetherington E, eds. Handbook of Child Psychology, Volume 4: Socialization, Personality, and Social Development. 4th ed. New York: John Wiley & Sons; 1983:1-102
29Elizabeth Hatmaker-Flanigan, MS AcknowledgmentsHoward Spivak, MDRobert Sege, MD, PhDElizabeth Hatmaker-Flanigan, MSBonnie KozialVincent LicenziatoKimberly Bardy, MPHThis project was supported by Grant No JN-FX-0011 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.