2“ We reach backward to our parents and forward to our children and through their children to a future we will never see, but about which we need to care.Carl Jung“ The Best of Times and the Worst of Times for Today’s Children”“It is both the best of times and the worst of times for today’s children. Their world possesses powers and perspectives inconceivable 50 years ago: computers, longer life expectancies, the ability to reach out to the entire planet through television, satellites, air travel and the Internet.Children want to trust, but the world has become an untrustworthy place. The sometimes-fatal temptations of the adult world can descend upon children so early that their ideals become tarnished. Crack cocaine is a far more addictive and deadly substance than marijuana, the drug of an earlier generation. Strange depictions of violence and sex come flashing out of the television set and lodge in the minds of children. The messages are powerful and contradictory:... Television pours a bizarre version of reality into children’s imaginations. In New York City, two 5 year-olds argue about whether there is a Santa Claus and what Liberace died of... Every stable society transmits values from one generation to the next. That is civilization’s work. In today’s world, the transmission of values is not easy. Parents are raising children in a world far removed from the Ozzie and Harriet era of the 1950’s , when two of three American families consisted of a breadwinner (the father), a caregiver (the mother), and the children they were raising. Today fewer than one in five families fits that description”(Morrow,1988). As Montessori teachers you have the wonderful opportunity and the sobering responsibility to influence today’s children in their first 3 years of life. You are, at once, providing the first line of defense as well as the building blocks for the future of our children. You are fortunate to be guiding our children with the Montessori philosophy as your background. “My vision of the future is no longer of people taking exams and proceeding on that certificate from secondary school to the University, but of individuals passing from one stage of independence to a higher, by means of their own activity, through their own effort of will, which constitutes the inner evolution of the individual” (Montessori, 1936, cited in Montessori, 1970, p.42, Theories of development, Crain, 2000, p.83).
3If I could have watched you grow As a magical mother might. If I could have seen through my magical transparent belly,There would have been such ripening within…Anne Sexton, My Little Girl, My String Bean
4Pregnancy Physical care intrauterine development prenatal environmental influencesexercise and nutritionEmotional CareStress and AnxietySupport SystemEducational Careapproaches to childbirthmedical interventionsFertilization- During sexual intercourse, 360 million sperm (bathed in a protective fluid called semen) move through the vas deferens, a thin tube in the male reproductive system. At climax, semen is ejaculated into the woman’s vagina. The sperm swim upstream, through the cervix and into the fallopian tube, where fertilization takes place sperm reach the ovum (female egg) if one is there. Sperm can live up to 6 days and an ovum can live 1 day after being released into the fallopian tube during ovulation which occurs 1x every 28 days. Most conceptions result from intercourse during a 3 day period (on the day of the 2 days preceding ovulation). If fertilization takes place, the sperm cell penetrates the ovum and the result is a zygote (fertilized egg). Now the zygote has 1/2 of its genetic make-up from the mother and 1/2 from the father because each gamete(sex cell=sperm and ovum) contain 23 single chromosomes. When fertilization takes place the zygote has 23 pairs of chromosomes (23 single from mother and 23 single from father) to a total of 46 chromosomes. This is the correct number of chromosomes for human beings. If any anomolies take place with this number, either more or less chromosomes, than physical and/or intellectual deficits result. We will talk about one of these in more detail later, a form of Mental Retardation, called Down’s Syndrome. The sex of the child is determined by the pair of chromosomes that are combined at the moment of fertilization. The ovum carries and x chromosome and the sperm contains either an x chromosome or a y chromosome. Sperm containing x chromosomes are called gynosperm and those containing a y chromosome are called androsperm. Dr. Landrum Shettles of New York Fertility foundation has said that we can determine the sex of the child with about 80-85% accuracy through timing. The closer to ovulation, the greater chance of it being a boy since androsperm are less viable (don’t live as long) than gynosperm. Thus, the farther away from ovulation, the greater chance that the gynosperm are still alive (can live up to 6 days) and the greater chance that the zygote will have an xx combination which is a girl. During genetic testing, a karyotype is done, which is a chromosomal map of the embryo/fetus. The pairs of chromosomes are arranged from shortest to tallest and numbered from 1 to 23. The 23rd site is the place where the sex chromosomes are placed. If it contains xy, it is a boy and if it contains xx, it is a girl.
5Prenatal Development 38 weeks of pregnancy 3 general periods of development1- the period of the zygote2- the period of the embryo3- the period of the fetus
6Period of the Zygote (fert.-2wks) Zygote multiplies and travels through fallopian tube to the uterus where it will attach to the uterine lining at about the 7-10th day after fertilization.Implantation occurs and now the mother’s blood begins to nourish the organism.It is now called the embryoA membrane called the amnion develops around the organism and amniotic fluid now surrounds the developing baby. This keeps the temperature constant and acts as a cushion against jolts caused by the woman’s movement. Next, the chorion surrounds the amnion, and with its villi(fingerlike blood vessels) attaches to the uterine wall, and from this, the placenta develops. The placenta is connected to the organism by the umbilical cord. As many as 30% do not make it past this phase, due to a variety of reasons- sperm and ovum do not join properly, cell duplication never begins etc. nature prevents prenatal abnormalities. (Berk, 1999, p.104)
7Period of the Embryo-2wks-2mos. 4th week th week pictureorganism responds to touch at time, & can moveall major structures and systems are forming21 days (3 wks) eyes begin to appear24 days -cells for the heart differentiate28 days -urogenital system is apparent-arm and leg buds emerge5-8wks -arms and legs differentiate more-face forms, intestinal tract develops8th wk -rudimentary eyes, ears, mouth, tooth buds,arms and legs moving, brain forming, fetal heartbeat
8Period of the Fetus (2mos.-birth) 12th week -3 inches long and weighs 1 ouncecan move arms, legs, fingers, and toescan form a fist, can curl toes,fingerprints are presentcan smile, frown, suck its thumband swallowsex is distinguishablecan urinateeyelids open and closefingernails/toenails appear12th week is the end of the 1st Trimester
92nd Trimester 16 weeks - 5 1/2 inches long and 4 ounces in weight movements can be felt by motherend of 2nd trimester- all neurons are now in placeglial cells (support and feed neurons) are still growingand will do so until after birthfetuses will try to shield their eyes with their handsfrom the light of a surgical fetoscopy procedure
103rd Trimester 22 -26 weeks - Age of Viability- fetus has a chance of survival if born nowcerebral cortex enlarges24 wks - fetus can feel pain28 wks - awake 11% of the time- blink eyes-reaction to sounds- sweet and bitter32 wks - hearing is well integrated- can learn to show preference for particular sounds at birthIntroduction of sweet or bitter substances by the 3rd month(??) of pregnancy into the amniotic fluid can cause the child to swallow, grimace and move, indicating that it can recognize differences in taste (Silvana Montanaro, 1991).
11Prenatal Environmental Influences Teratogens-“Teras” greek word “monstrosity”environmental agent that does damage to the babyprescription and nonprescription drugs1-thalidomide- drug for nervousness or nausea; a mild daytime sedative- no longer in use. When taken during pregnancy musculoskeletal defects such as malformations of limbs, heart, gastrointestinal and urinogential systems etc. 1st real knowledge of father’s contribution to birth defects. Mothers of some babies hadn’t used thalidomide but fathers did. Transmitted through the semen.2-aspirin- ingredient in many different medications, read the label-- mental retardation, limb abnormalities, fetal death, bleeding in the newborn...3. illegal drugscocaine- addicted babiesheroine- addicted babiesmethadoneat risk for variety of problems- low birth weight, physical defects, breathing difficulties, possibly death at birth, less attentive to environment throughout first year, motor development is slow, difficult to calm down, cuddle and feed. More irritable and shrill cries because addicted at birth. Mothers with problems of their own often have trouble with these babies and that is why the baby’s problems are likely to persist.
12Teratogens (cont.) Alcohol- Fetal Alcohol Syndrome Smoking (FAS)occurs to mother’s who drink heavilymoderate drinkers can have some effectsfacial deformities, defective limbs and heartbelow average intelligence, MRSmokinghigher pre-term births and lower birth weightsfetal and neonatal deaths higherinfants who are awake more on a consistent basisrespiratory problems and sudden infant death syndrome aremore common among the offspring of mothers who smokeduring pregnancy (2-3 x more likely than non-smokers)
13Maternal Factors Exercise - regular & moderate can lead to increased birth weight- regular & vigorous can lead to lower birth weightNutrition- operates the same as teratogens-sensitive period- famine during 1st trimester- miscarriages & physical defectsbeyond 1st trimester- survived but underweight & small headsdamage to CNS- fewer brain cells and lower brain weight,especially if during the last trimester when the brain is growingrapidly in sizedistort the pancreas, liver, kidney and blood vessels andincrease the risk heart disease and diabetes in adulthood
14Emotional Care Stress and Anxiety- intense fears, anxieties produce physiological changesrespiration and glandular secretions- adrenaline secretionsrestricts blood flow to the uterus and oxygen to babyone study showed anxiety in pregnancy related to newbornirritability, hyperactivity, eating and sleeping problemsSupport System-risks are greatly reduced if mother has husband, family orfriends to give emotional supportreassuring mother of fetal well-being reduced anxiety andbabies were less irritable and scored hi on neonatal testsAntenatal depression (depression during pregnancy) may have an impact on children’s development- one study suggested that babies may have 1/3 greater chance of having cognitive and/or behavioral problems. Women with persistent depression during pregnancy had a 50% greater chance of having children with diagnosed problems. Some of the risk though, can be attributed to a higher risk of having post partum depression if one has had antenatal depression.Symptoms of post partum depression-9-16 % of post partum women will experience PPDPrior PPD increases chance of having it to 41%-ability to function in life, anxiety, cognitive impairment, guilt, self-blame, and fear-difficulty in providing developmentally appropriate care for the infant-loss of pleasure and interest in life, sleep disturbance, feelings of irritability or anxiety, withdrawal from friends and family,Crying, thoughts of hurting yourself and/or your childChildren of mothers with PPD can:Become withdrawn, irritable or inconsolableDisplay insecure attachments and behavioral problemsExperience prob in cog, social and emo devHave a higher risk of anxiety/dep in childhood and adolesFathers can also be depressed in the postpartum period esp ifMother is depressedMarital relationship is unsatisfying or life has changed since the child’s birthPhysiological correlations:Decline or fluctuation of reproductive hormones-estrogen and progesteroneExposure to toxins, air pollution, poor dietOther stressors:Prev exp with depMarital dysfunction, young motherhood, acute stressors like (death of loved one), difficult infant temperament etc.InterventionsGet emotional and family/friend supportGet enough rest and nutritionSeek professional mental health services esp cog beh tx and interpersonal tx
15Sensory Richness of Prenatal Life “Conception and pregnancy constitute the 1st chapter of our personal history… even in the prenatal environment the developing human being is dynamic and interacting”Dr. Silvana Quattrochi MontanaroAs Dr. Montanaro states, there is much sensory richness in prenatal life. It offers to the developing child much information about itself and helps in the “construction of its body map”. Our “body map” is the immediate experience of existense… in developing the body map, we utilize the the sense of touch and the rudiments of a sense of self-awareness. These basic sensory experiences help us define our border-lines by which we can start to differentiate ourselves from the environment.The skin is one of the most important of the sense organs for this purpose. It is complete by 7-8 weeks of pregnancy. It is the most important source of information about ourselves and the environment. The sense of touch acts as a form of communication and defines our relationships throughout life. Touch helps us communicate when all other forms of communication are not yet present or are lost. Eg. Newborn, child, Alzheimers patient There is always an affective dimension to touching.Frans Veldman- founder of the Institute for Aptonomic Communication, (aptonomic=science of touch) suggests that touching the mothers abdomen with light pressue from 4 months onward, stimulates the fetus to respond and “awakens the parents sensitivity to the living child in the wound” This begins a “Prenatal affective attachment” and forms the basis for the affective relationship after birth. In addition, the child experiences the womb, the amniotic fluid, the hands sucking its own thumb and touching its own face. These types of stimulation are the beginnings of relating to one’s environment.
16Children sweeten labors. Francis Bacon, Essays, 1625
17Approaches to Childbirth hi tech hospital deliverynatural childbirth in the hospitalnatural childbirth in a Midwife Centernatural childbirth in the homeIn every culture, birth has assumed such importance that is is surrounded by meticulous rituals. Usually these rituals depend on the values of the culture. In our culture, we value technology and so we place our faith in technical equipment to ensure a safe and perfect delivery. However, many times a discrepancy arises or some disadvantages occur with a high tech birth. Many times, for example, the psychological aspects of the birth for the mother, father and the family are neglected or replaced by efficiency, speed and ease in the hospital routine. It is important to realize that a hospital birth is just one alternative to a birth service. ASK ABOUT OWN EXPERIENCESHospital birth- very advantageous for hi-risk births- people under 20, over 35, expecting twins, someone who has diabetes, toxemia or hypertension. With these groups the chances for a normal delivery has greatly improved.Disadvantages are having to succumb to the routine of the hospital, the beauracracy of their procedures and the lack of input into their procedures.-being attached to a fetal monitor during labor,- track of heart rate without need for a nurse, good for legal cases and good with complications, but woman is attached to this the whole pregnancy and is less active which can produce longer labor, more pain etc.- why can’t the nurse monitor and in fact, the midwife does., not being able to eat or drink in case you need anesthesia, the increase in the number of c sections, the often lack of massage of the peritineum and so it is routinely cut, sterile, frightening hospital room and delivery room, having no one with you during labor, father being encouraged to stay away from the birth process and giving birth in a supine position because its easier for the doctor even though a sitting position relies on the natural use of gravity, used to give enemas, shaving pubic hair, routine iv’s so as to have blood vessels open if complications arise, woman in natural birth drink fluid to keep blood volume high.
18Birth Apgar Scale: 2x test for health status of baby Complications: oxygen deprivation-1-22% of babies with Cerebral Palsy (CP)have experienced “anoxia” (inadequate oxygen supply). CP results from brain damage and produces difficulties in muscle coordination, “clumsy walk”, uncontrolled movements, and unclear speech. The disorder can range from mild tremors to severe crippling and mental retardation.2-Respiratory Distress Syndrome- often occurs to infants born more than 6 wks early, lungs are poorly developed, air sacs collapse and lack of oxygen causes permanent brain damageHeart raterespiratory effortreflex irritability (sneezing, coughing,grimacing)muscle tonecolordone 2x and rated at 0, 1, 2 to a total of 10Complication (psychological)= for mother - post partum depressionaffects child--as child is alert and responsive--mother is not--thus child begins to show vacant gaze, turning away, crying, looking sad or angry--mother in turn, feels guilty and inadequate---depression deepens.6 mos.-- babies of depressed mothers--irritable, negative mood, attachment difficulties (Teti et al., 1995)persists--depressed parents usually show inconsistent disciplineeither lax or too forceful, disengaged or hostile (Zahn-Waxler, 1990), thus children show adjustment difficulties, avoid parents insensitivity--withdraw and depressed themselves, anger, hostile, impulsive, antisocial (Conger et al.95) Intervention successful in most cases (Cooper&Murray,97)
19Birth Complications: pre-term and low birth weight babies < 35 weeks and weight < 51/2 lbsbirth weight often predicts survival and developmentfrequent illness, inattention, over-activity, low intelligence test scores, deficits in motor coordination and school learning sometimes extend into the childhood yearslower the weight, the greater the risk for problemsSmall for Date babies- greater risk because probably experienced poor nutrition/dysfunctional placenta
20Interventions- for pre-term babies coaching in recognizing and responding to baby’s needsbabies gained steadily in mental performance to match full-term babies“kangaroo care” holding infant close to chest= promotes oxygenation of body, temperature regulation, better feeding and more alertness- parents gain confidence about being able to care for their preterm babymedical, parent training, cognitively stimulating day carenormal range at 3 in intelligence, psychological adjustment and growthBut will lose ground by 5 unless there is high quality intervention (cognitively stimulating day care)Moderate to mild birth trauma –did well if in stable family environment-those exposed to poverty, family disorganization and mental illness did not do well