Infant and Toddler Crying: To Soothe or Not to Soothe? Josh Thompson Lydia Leeds Mini-course on the nature of crying, its purpose anthropologically, observation and assessment of crying as an indicator or a child’s development and emotional well-being. A discussion of the value of providing self-soothing strategies to children and additional caregiver coping strategies for excessive criers will also be provided.

Texas Association for the Education of Young Children Annual Conference October 9, 2004

A survey of knowledge about Infant & Toddler Crying 1. At what age does crying peak? 4 weeks 6 weeks 16 weeks 24 weeks Purpose: Participation Collect random samples from center aisle (color coded) Best answer: B. 6 weeks 

A survey of knowledge about Infant & Toddler Crying 2. How much time per day does the normal 3 month old spend crying? 15 minutes 30 minutes one hour three hours Purpose: Participation Collect random samples from center aisle (color coded) Best answer: D. three hours

A survey of knowledge about Infant & Toddler Crying 3. At what time of day do infants cry the most? morning (6am – 12pm) afternoon (12pm – 6pm) evening (6pm-12am) late night (12am-6am) Purpose: Participation Collect random samples from center aisle (color coded) Best answer: C. evening

A survey of knowledge about Infant & Toddler Crying 4. At what age is crying related to language development? 15 months 18 months 24 months 36 months Purpose: Participation Collect random samples from center aisle (color coded) Best answer: B. 18 months

A survey of knowledge about Infant & Toddler Crying 5. Choose the best phrase to complete this sentence: “Picking up a three-month-old every time she cries … … is likely to spoil a child.” … teaches the child to be demanding.” … reduces frequency of crying.” … teaches the child to trust.” Purpose: Participation Collect random samples from center aisle (color coded) Best answer: D. teaches the child to trust

1. At what age does crying peak? B. 6 weeks 2. How much time per day does the normal 3 month old spend crying? C. One hour 3. At what time of day do infants cry the most? C. evening (6pm-12am) 4. At what age is crying related to language development? B. 18 months 5. Rate the following behavior "Picking up a three-month-old every time she cries“ D. teaches the child to trust Purpose: Participation Collect random samples from center aisle (color coded) Best answers: B. 6 weeks D. three hours C. evening (6pm-12am) B. 18 months D. teaches the child to trust  

The Normal Crying Curve

The Nature of Crying “[N]eonatal crying is a species-specific behavior which achieves its likely evolutionary function (infant survival) by reliably eliciting responses from caregivers.” (Gustafson 1990 p.45) Neonatal crying, species-specific Function: survival Reliably eliciting responses from caregivers (Gustafsson (1990) p 45) Cry definition: sign, symptom, signal Sign: neurological organization Normal Natural Cyclical patterns Symptom of dis-equilibrium (Brazelton, 1985, see Solter, 1995, p31 Signal: evokes response o       Pain o       Hunger o       Colic o       Discomfort o       Boredom o       Stress reducing Variance o     Colic o     Trauma o     Disability

The Nature of Crying Three primary functions: Sign Symptom Signal

The Nature of Crying Sign Neurological organization Normal Natural Cyclical patterns Insert picture of grimace

The Nature of Crying Symptom of disequilibrium of state of being This shift is common, predictable, and independent of caretaker.

The Nature of Crying “Temperament is innate: It’s not a product of the environment, your responses, nor of your child’s attempts to elicit some response from you.” (McKay (1996) When Anger Hurts Your Kids p. 38)

The Nature of Crying colic hunger pain discomfort boredom distress Crying is a Signal that something is not okay pain discomfort boredom distress

Back to the Curve

Colic – Rule of 3 Off the curve A three month old infant “… who, otherwise healthy and well-fed, had paroxysms of irritability, fussing, or crying for a total of three hours a day and occurring on more than three days in any one week” (Wessel, et al, 1950) for more than three weeks.

Off the curve Trauma – physical or emotional, which has resulted in prolonged disequilibrium

Off the curve Disability – neurological disruptions, chronic pain, or genetic abnormalities

Observation & Assessment Observer/participant Become fluent in the “language” of crying Competent secure care Observer/participant Sign – note: Caregiver responses to evening fussiness cannot change frequency, but can affect duration (Barr, 1990, p 355) Symptom – read, interpret, understand Signals evoke response o       Note time, age, freq, duration, rhythm, pitch, tone, intensity o       Pain o       Hunger o       Colic o       Discomfort o       Boredom o       Stress reducing Achieving equilibrium Assisted Unassisted Practice id Prone: face in, face out, football. Sitting: ·        Infant massage ·        Caregiver self check: Averse reaction (Frodi & Senchak, 1990, p 77) ·        Competent secure care – walk away ·        Equipping parents w/ confidence

Observation & Assessment Sign – note: it’s a good thing Neurological organization

Observation & Assessment Symptom – not personal, it just is, a state of being Disequilibrium

Observation & Assessment colic hunger Crying is a Signal that something is not okay pain discomfort boredom PAIN – short, loudly piercing wail, high pitched, short apnea HUNGER – short, continuous bursts, insistent, medium pitch COLIC DISCOMFORT - intermittent BOREDOM – whimper in bursts DISTRESS distress

Observation FATT DRIP Frequency Duration Age of the child Rhythm Time of day Intensity Tone Pitch The FREQUENCY The DURATION The AGE of the child The RHYTHM The TIME of day The INTENSITY The TONE The PITCH

Goodness of fit

Soothing strategies Assisted self-soothing Caregiver assisted soothing Unassisted self-soothing

Assisted Self-soothing Soothing strategies Assisted Self-soothing Pacifiers Swing Blankets Music Teddy bears

Soothing strategies Caregiver Assisted soothing Holding Swaddling Infant massage Singing (to) Swaddling: -215 to -140

Unassisted self-soothing Soothing strategies Unassisted self-soothing Thumb-sucking Rocking Self-stroking Humming

Toddler Strategies Describe Distract Disengage Zach at 2 ½: -601 to 554

Caregiver coping strategies (Brazelton, 2003, pp 19-20) ID the cry Try the obvious Speak softly, bring the pitch and volume down Hold his arms and body to avoid startles Swaddle him Try to identify the kind of cry and what the baby’s other behaviors are telling you. Use other clues – for example, time of last feeding, last nap, last diaper change, baby’s reactions to sounds, light, air temperature, activity, and movement. Change him. Try feeding him. If it is soon after a nursing or a bottle, he probably won’t need to be fed again. Still, sucking is a powerful soother. Help him find his fist or thumb. Or let him suck on your finger or sugar water. Speak softly and comfortingly until you break through the crying, then try to bring the pitch and volume of his crying down by slowly lowering your own voice. Hold his arms and body to avoid startles. Swaddle him with his baby blanket, so that his legs and arms are firmly contained. Be sure to place him on his back, and near you, so that you can be sure that he does not snuggle down inside his blanket, where he could possibly suffocate.

Caregiver coping strategies (Brazelton, 2003, pp 19-20) Pick him up to cuddle Try massaging his back and limbs gently Sing to him Walk with him Use white noise or motion Use a “football hold.” Pick him up to cuddle. Try massaging his back and limbs gently. Sing to him. Walk with him. Even rock him up and down, or gently swing him. Use white noise or motion. Parents tell me they set their infant on a washing machine, or use a “white noise” machine to soothe him. Some take the baby for a ride in the car. While this may work, crying is likely to start again when the repetitive stimulation stops. It creates a kid of shutting out in small babies that we call “habituation”: An infant quiets, even puts himself to sleep, but only to avoid all the commotion. It is likely to work only as long as the repetitious stimulation persists. When the crying starts again, it is usually due to whatever set it off in the first place. Another way to quiet a fussy, unsettled baby is what I call a “football hold.” Placing the baby across your forearm on his belly, chest in your hand, legs and arms dangling, your other hand securely on his back, you can gently rock the baby up and down. When he begins to quiet, he’ll lift his head and look around. Sing to him and croon comfortingly. As he slows to quiet, use his interest in the world to maintain his quiet alertness. Watch his eyes open wide. Many babies quiet, often because it is more difficult when they are on their bellies to take the deep breaths that are necessary to crying. But the rhythmic rocking and the interesting sights and sounds also help him to maintain his control. This method can offer a short break for desperate parents.

Caregiver coping strategies Caregiver self check: Excessive exposure to crying may tip the motivation from a concern with the infant’s distress to a desire to alleviate your own discomfort in listening to the cry.

Caregiver coping strategies Competent secure care – walk away

Questions & MORE Questions When is it appropriate to soothe a crying child? When do we let them cry it out? Ending: Zach -135 to 00:01

Associate Professor Early Childhood Ed Texas A&M University-Commerce Lydia Leeds MA SNLLeeds@yahoo.com Josh Thompson PhD Associate Professor Early Childhood Ed Texas A&M University-Commerce  Josh.Thompson@TAMUC.edu Invite, explain, set expectations jt – parent of 4, ap TAMU-C in ECE, child language researcher LL – parent of 4, professional parent educator, ??