ITBD Therapy, LLC

HELPFUL HINTS
 

What to expect from prematurely born infants

The rule of thumb is to work with the expectations for your baby's corrected age.  For example, if your baby was born at 28 weeks, you should subtract 3 months from his chronologic age to find developmentally appropriate expectations. This is true for growth as well as for all aspects of infant care, including beginning feeding of solid food, looking for developmental milestones, etc. 

We typically correct for prematurity until it no longer makes a difference. When babies are less than a year of age, the prematurity is a much bigger factor than when they are 5 years of age.  For example, it is difficult for anyone to tell the difference between a child of 5 years and 5 years 3 months of age but very easy to tell the difference between a child of 6 months and 9 months of age. 

The confounding factors include degree of illness or disability (if any) associated with your baby's prematurity.  Babies who have lung problems such as bronchopulmonary dysplasia (BPD) or intracranial hemorrhage(ICH or IVH) will be more likely to have more delays or difficulties and need more supportive care. 

All premature infants are a bit more vulnerable to the impact of their environment on learning.  They do best when you keep your interactions very very slow and simple, aiming at keeping them relaxed and calm but alert and interested.  When they are young, they might need swaddling to help them to organize their bodies so that they can concentrate on eating or on looking at your face.  You might also notice that they turn their eyes away from your face when you talk too quickly or enthusiastically.  This is because they are getting too excited and need you to slow things down so that they have time to process what you are saying and doing. 

Helping babies to learn in the first year of life

Babies are born with particular temperaments, personality styles or family traits.  Their environment is a significant determinant in how these traits are expressed.  All babies are designed to learn most from adults who play with them one to one for a substantial part of their waking hours. 

Babies cannot learn from television or videos which are only flickering, flashing lights without meaning to them in the first year of life.  The exposure to these objects may interfere with their attention to the face and voice of adults which is their primary source of learning language and social interaction in the first year.  It may also interfere with their motor skills, which require practice and trial and error experiences to develop properly.  Even when children are not watching actively, the ongoing distraction of the background noise can interfere with the infant's ability to hear clearly and process the language sounds directed at them from their parents and siblings, resulting in inattention to spoken language and language delays.

The American Academy of Pediatrics made the suggestion several years ago that children not be exposed to television prior to age 2.  A recent study (April 2004) indicated that there was a strong association between television exposure at age 1 or younger and Attention Deficit disorder at age 7.  Child development specialists and teachers notice a pattern of behavior in young children exposed to too much television or video or computer interaction which includes inattention to face and voice of adults, lack of response to verbal directions, clumsy gross motor and fine motor skills, difficulty with speech sounds, poor impulse control. 

Children learn by doing and, in the first 2 to 3 years of life, primarily from adults, not from other children. You will help your baby learn most by getting down on the floor and participating in her play, helping him to manipulate objects successfully, offering her simple rattles and toys without lights and sounds.  Babies need textures, one sound or reaction for each of their actions to encourage them to be active participants in their own learning.  Reading and singing to babies is also key to their development of language and attention. 

How to read so your baby will listen

Babies are naturally drawn to your voice from birth.  Hearing is their first sense and is better than vision for most infants at the time of birth.  Talking slowly to baby and starting the habit of reading with baby when he is very young (4-6 months of age at the latest) helps baby to start to really absorb the sounds of our language.  Cuddling while you look at a book together from very early on gives baby a feeling of warmth and relaxation associated with books, which turns quickly into a love of books.

As baby gets to 6-9 months of age, you will notice that he is starting to notice the pictures more, especially if you point to them.  He will want to hold the book and chew on it more than look at it but you can provide him with a rattle or something else to chew and keep the book for reading if you want.  Plastic or cloth books in a play area will give him the chance for exploration of these objects but, when you are reading, try to encourage him to look and listen, even if it is just to name a picture as you point, not necessarily reading every sentence on a page.  The books for this age are best when they have simple large pictures and textures for baby to explore with your help.

Babies who are approaching a year will start to help you turn the pages, point to pictures in imitation of you and even imitate your sounds as you read.  They still prefer one or two words per page but some may listen to an entire sentence.  Try changing your voice to maintain their interest.  Many babies who are just learning to walk will discontinue their interest in books for a time as they are driven to move, but find a time when they are needing to settle down (nap or bedtime is often good) and use the books for this purpose. AVOID using television or video to settle babies at this age and NEVER NEVER put a television in the bedroom for the baby to fall asleep with!

When babies are nearing 18 months, they will be very aware of the story and may even be able to finish a short sentence of a rhyming book that they are familiar with.  They will readily point to pictures that you name and sometimes name the pictures themselves.  They will often sit with a book and pretend to read and usually turn the book right side up if it is presented to them upside down, because they really know that pictures represent objects.  This comes well before understanding the alphabet and is a precursor to reading (understanding that pictures are symbols comes before functional understanding of letters as symbols of words)