| Child Health + Development | New Baby | New Parents

Early relationships key to healthy kids

What we know about infant brain development is relatively new. Most of the study in this field has been done in the last two decades, and local researchers and sociologists credit one Seattle woman, Kathryn Barnard, R.N., Ph.D., with helping advance local research, clinical practice and policy issues regarding the mental health and development of infants and toddlers.

Barnard retired this spring from her position as the founder of the Center for Infant Mental Health and Development at the University of Washington. Colleagues, pediatricians, social workers, baby advocates and researchers gathered recently at a symposium to honor her retirement and recognize Barnard's contribution to infant development over the course of her entire career.

Presenters at the conference spoke on groundbreaking local research, as well as the work that still has to be done to help parents, caregivers and physicians give babies their very best start.

Early relationships are important for providing a baby with a good beginning. Bonding can start before a baby is born, with parents talking and reading to their unborn child. After birth, it's important for parents to watch closely to learn their newborn's cues, so they can recognize and respond to the baby's needs before he's in distress. When this process goes well, the baby is calm and content; feeling secure his basic needs will be met allows him to focus on learning social skills.

But when a baby does not form a strong connection early on with a caregiver, research presented at the symposium says it can lead to developmental delays, as well as emotional and social problems that can be difficult to repair.

Sheri Hill, Ph.D., faculty lead on policy on infant mental health and development at the UW School of Social Work, said this is because the most potential for brain development and growth occurs from infancy to 3 years of age. It is, Hill said, the "the brain-changing primetime in a child's life."

"If a strong bond does not form or is interrupted early in life, we know the baby can disengage from its mother or other caregivers," Hill noted.

All symposium speakers agreed that early relationship building is key. If babies have a strong bond with their parents and caregivers, they can focus on learning other skills that are important to brain development. Without a strong foundation, a baby's brain may not learn important social skills that are essential to long-term mental and emotional health.

Healthy babies learn to relate to people in the world at an early age. Researchers found that babies can understand the feelings of others and show empathy. Andrew Meltzoff, Ph.D., co-director of the UW Institute for Learning and Brain Sciences and co-author of the book, The Scientist in the Crib, said this starts with babies learning to follow their mother's gaze to determine what she feels about a certain person or object.

Babies who follow gaze, and who watch other babies and children, can learn and remember from simply observing others. Meltzoff found that babies who are in tune to those around them are more likely to have thoughts and feelings that show empathy towards others -- a key concept in social development.

This emphasizes the significance of early bonding to help make children empathetic individuals. Parents can encourage children to share and help others; and since babies and children learn from observing, parents can model empathy themselves.

T. Berry Brazelton, M.D., founder of the Child Development Unit at Boston Children's Hospital and author of numerous parenting books, noted that in his experience, every parent wants three things for their child: a positive self-image, a genuine caring about other people and a hunger for learning.

Brazelton has worked to help parents see how their own emotional health influences their approach to parenting, and ultimately shapes their children. He said parents need more overall support to deal with the enormous stresses they are under today, and specifically spoke on how mothers can experience feelings of loneliness and isolation, which contribute to feeling overwhelmed. He encouraged pediatricians in the audience to get the mothers of their patients with children of the same age together, in order to provide a support group.

As a society, Brazelton said, "We've got to back women up. We have to give them decent child care. We know how to do it, and we don't do it.

"Unless we can do something to help parents with these stresses," he added, "children and babies are going to feel it."

Katie Amodei is a Lynnwood-based writer, public relations consultant, mother and stepmother.

Barnard: A pioneer in infant mental health

Kathryn Barnard, R.N., Ph.D., founder of the Center for Infant Mental Health, has been at the forefront of research and policy work on behalf of infants and families.

"Social and emotional health is just as important as physical health in infant brain development," Barnard says. "In fact, chronic neglect can be more damaging than physical abuse."

The impact of early relationships on brain development was not well known before Barnard first became interested in the topic. Armed with a new master's degree from Boston University, she was first hired by the UW School of Nursing in 1963 to teach growth and development to undergraduate nursing students and to provide the nursing role in the Child Health Center's Clinic for Mental Retardation, now part of the Center on Human Development and Disability. The latter experience was transformational.

"Most of what nurses do is to observe," Barnard explains, "and it did not take me long to notice striking similarities in many of the families I was seeing." Case study by case study, conference by conference, the award-winning researcher recalls, "I began to realize that the majority of mental retardation in this country comes from environmental issues."

Despite this fact, there was no way at the time to identify or treat at-risk infants before small problems developed into large ones, such as mental retardation or other learning or behavior disorders. This led Barnard, in 1973, to create the first-ever research-based guidelines for both assessing parent-child interactions and providing appropriate interventions. Called NCAST, the new protocols were transmitted to nurses across the country via satellite technology and have since trained an estimated 30,000 health professionals around the world.

In the years that followed, Barnard established herself as a pioneer in infant mental health -- the study of early relationships and their impact on brain development. In 2001, she realized a life-long dream by launching the UW Center on Infant Mental Health and Development.

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