Encouragement versus Praise: Effects on children's motivation, behaviour and development

Encouragement versus praise: Effects on children’s behaviour, motivation and development,  

 Author: Natalie R. Garmson, Edith Cowan University, 3rd Year BA Psychology (major: SocSci)

Praise and encouragement are both methods of positive feedback adults give to children; however adults give praise to children in different ways, which have the potential to both support and undermine children’s behaviour and development. Whilst encouragement is considered fundamental for children’s learning, growth and development, praise, on the other hand is complex because there are different types of praise, whose effectiveness varies according to the context in which it was given, the quality of its use and the interpretation of the child (Dinkmeyer & Dreikurs, 2000; Henderlong & Lepper, 2002; Larrivee, 2002; Watts & Pietrzak, 2000).

This essay will discuss the effectiveness of encouragement and praise, the differences and the consequences of both as well as the underlying theories. The effects on children’s intrinsic and extrinsic motivation, self-esteem and performance are explored in detail as are the effects of teacher praise and encouragement in the classroom.  The language of how to encourage children efficiently will be highlighted and the use of encouragement in scaffolding will be discussed. It will be argued that encouragement is superior to praise because of the greater positive outcomes on children’s behaviour and development and subsequent positive long term consequences.

Encouragement is a method of positive feedback that focuses on effort, improvement and what the child is doing rather than the outcome (Burnett, 2002; Larrivee, 2002; Dinkmeyer & Dreikurs, 2000; McCormack, 2000). Encouragement underpins the child rearing approach based on Alfred Adler and Rudolf Dreikurs (McCormack, 2000) which is deeply rooted in individual psychology. Dinkmeyer and Dreikurs (2000) highlighted the Adlerian principle emphasizing that children’s behaviour has purpose, meaning and is goal oriented, and it is through their behaviour that children learn to express goals, attitudes and expectations. Other Adlerian principles stated by Pryor and Tollerud (1999) and White, Flynt and Draper (1997) include that children interact with the social environment through experimentation, develop positive adult-child relationships and are in control of their choices, with the wrong choice leading to inappropriate behaviour. Encouragement is the logical consequence which follows children’s inappropriate behaviour. Encouragement assists children’s motivation to change their misbehaviour which is often the result of discouragement (Pryor & Tollerud, 1999). Adler believed that although children are active participants of their development, their development is shaped by hereditary and environmental forces; for example, the social environment is important because it is where children learn skills such as co-operation (De Robertis, 2011).

Encouragement focuses on children’s assets and strengths, promotes self-confidence and self-esteem, fosters internal motivation, teaches self-improvement and is focused on future behaviour (McCormack, 2000). It also teaches children about responsibility, self-evaluation, perseverance, acceptance of mistakes and failures and an appreciation of success (Larrivee, 2002). To foster a child’s worthiness and provide encouragement, adults can use effective communication skills such as active listening, respect the child for who they are, show confidence in their abilities, provide opportunities for success, focus on the strengths of the child, show and say “I love you”, spend quality time with your child and help your child to accept and overcome mistakes and failures (Dinkmeyer & Dreikurs, 2000; McCormack, 2000; Watts & Pietrzak, 2000). Parents and teachers can help develop children’s mastery of skills and competence by the use of scaffolding. The technique of scaffolding is used frequently within the zone of proximal development (Edwards, 2002). Adults use scaffolding by asking questions to assist children with their development and understanding of the task, creating an environment optimal for learning and competency (Neitzel & Stright, 2003).

The study by Neitzel and Stright (2003) provides evidence to support Edwards (2002), concluding that there was a positive association between mothers who use scaffolding and children’s subsequent academic competence. Encouragement was also found to reduce disruptive classroom behaviour. Similar results have been found by Yelland and Masters’ (2007) review of the use of scaffolding in learning and teaching processes. Teachers assisted students with problem solving by including mental strategies to help students develop a greater understanding of the task. Scaffolding by teachers in the classroom to solve tasks, including the use of encouragement, was more likely to produce students with a good understanding of mental strategies than without scaffolding (Yelland & Masters, 2007). In addition, parental encouragement resulting from a reaction to students’ grades was positively associated with intrinsic motivation and a higher academic performance. Children who received encouragement preferred to attempt challenging tasks and were interested in learning and problem solving (Ginsburg & Bronstein, 1993). Therefore, encouragement for children is an important method of feedback that assists with improvement of cognitive skill in the classroom; however, another method used by adults to give positive feedback is praise.

Praise, in contrast to encouragement, is a method of positive judgement that focuses on the outcomes, performances or attributes of the child (Kanouse, Gumpert & Canavan-Gumpert, 1981, p. 98 as cited in Henderlong & Lepper, 2002) as well as the child’s worth and approval-seeking behaviour (Burnett, 2002). Theories that are associated with praise include attribution theory and self-perception theory (Henderlong & Lepper, 2002). The attribution theory is the process by which individuals explain the causes of their behaviour or accomplishments subsequently guiding their behaviour. Children base their motivational behaviour on factors such as lack of effort or lack of ability. The self-perception theory hypothesizes that our internal states are managed by our own behaviour together with environmental influences such as praise. For example, external influences such as rewards for children result in children being extrinsically motivated whereas the absences of external influences are more likely to result in children participating in a task because it is personally rewarding, therefore are intrinsically or internally motivated (Henderlong & Lepper, 2002).

Praise focuses on the outcome, that is, it is given after the task is completed and is usually an expression of approval, for example, “That’s great” or “Good job”. Praise is associated with external motivation, by offering rewards, and competitiveness, with children more likely to compare performances with each other than themselves, consequently reducing co-operation between children (McCormack, 2000). Praise has negative consequences, such as the capacity to discourage children from completing tasks, focuses on the expectation that children rely on praise, is more likely to be associated with conformity and has the ability to affect self-esteem and self-discipline. Praise is more likely to foster children’s fear of failure and disapproval from adults of children, with children often seeking other’s evaluations for their accomplishments (Larrivee, 2002). Thorkildsen, Nolen and Fournier (1994) interviewed seven to twelve year olds about the fairness of different methods for influencing motivation to learn, using encouragement, rewards or effort based strategies. They found that most children agreed praise for good performance is unfair because it caused competition and fear of failure amongst those children who did not perform as good. Praise was viewed as short term only, not assisting with self-improvement.

Praise can be interpreted in many ways, depending on the child’s background, personality and culture (Larrivee, 2002). Praise also varies depending on what the adult focuses on.  For instance, ability or person praise is based on children’s ability such as intelligence, for example, “You’re so clever” or “You must be smart at maths”. Effort or process praise is based on children’s effort such as hard work “I see you put in a lot of hard work to get that result”. Dweck (2007) reports that praising intelligence can have a short term positive effect however this type of praise is more likely to be detrimental in the long term. In comparison, praise for effort, perseverance, strategies or improvement has potential to promote motivation, for example “That seemed like a hard assignment, but I liked the way you stuck with it and finished it” or “I like how you worked out different ways to solve the math problem” (Dweck, 2007).    

 Kamins and Dweck (1999) examined the implications of person praise versus process praise on self-worth and coping mechanisms.  They found that person praise, based on children’s behaviour or performance was more likely to foster learned helplessness than compared to process praise, based on children’s effort or strategy. Process praise was found to improve children’s mastery oriented response after a setback or failure, whereas person praise focused on fixed traits such as intelligence or personality which is performance based (Kamins & Dweck, 1999). Similarly, Burnett (2001) (as cited in Burnett, 2002) investigated primary school students’ preferences for praise in the classroom and found that almost all students preferred praise for effort over praise for ability, with private praise favoured over public praise, mainly due to feelings of embarrassment but also being made a target and put in the spotlight in front of other students.

Mueller and Dweck (1998) investigated how different types of praise negatively affect student’s motivation and performance in fifth grade at school, which further supports studies by Kamins and Dweck (1999) and Burnett (2002). Following success on a task, those students praised for intelligence or ability were performance oriented whereas those students praised for their effort or hard work were mastery oriented, focussing on strategies to enhance their learning. Students believed that intelligence was a fixed trait, measured by their performance level, whereas effort and hard work had the ability to change, depending on their motivation and knowledge of the subject. The findings concluded that praise for intelligence had more adverse consequences on student’s achievement and motivation in comparison to praise for effort (Mueller & Dweck, 1998). In addition, this is explained by Dweck (2007) on the difference between fixed mindset versus growth mindset.

Dweck (2007) explains that praise is associated with how students think about their intelligence, that is, whether they have a fixed mindset or a growth mindset. Those students with a fixed approach believe their intelligence is fixed and unable to change, whereas students with a growth mindset believe that intelligence is something that can change with effort and learning. Individuals who possess a growth mindset are more likely to attempt tasks that are challenging and will persevere in order to complete it, while individuals who reduce their effort in order to avoid setbacks or possess a fear of failure and avoid challenging tasks demonstrate a fixed mindset. Other research on ability praise, effort praise and intrinsic motivation (Koestner, Zuckerman & Koestner, 1987, as cited in Henderlong & Lepper, 2002) support Dweck’s (2007) analysis of mindset. The findings indicated that ability praise led to an increase in engagement on tasks than did effort praise, however, when students were required to persevere on a task, or experienced setback or failure, they were more likely to give up.

At what age then does praise start to affect children’s learning, development and motivational behaviour? A study by Gunderson, Gripshover, Romero, Dweck, Goldin-Meadow and Levine (2013) investigated the use of different types of praise on one to three year olds in the home environment and the impact this had on motivation five years later. They found that variations in parental praise, particularly process praise, predicted children’s motivational behaviour at ages seven and eight years and that parental praise can influence children’s development from as early as toddlerhood. Furthermore, according to Brummelman, Thomaes, de Castro, Overbeek and Bushman (2014), children who have low self-esteem are more likely to avoid challenging tasks because they have learnt that certain types of praise, such as inflated praise, produces higher expectations of themselves for future performances. Children with low self-esteem are more likely to believe they lack the ability to attempt challenging tasks and consequently fear failing on tasks. Inflated praise uses additional words to give a very positive evaluation, for example, “You drew an incredibly beautiful drawing” or “You kicked the soccer ball extremely well” and is more likely to be used by parent’s wanting to increase children’s self-esteem. Compared to non-inflated praise, inflated praise was found to be more detrimental to children’s learning, as well as more likely to be damaging during mid to late childhood when children become more realistic about their feedback as they compare performances with their peers.

Given that children’s motivational behaviour can be affected as early as the toddler years, what effects do influences on children’s behaviour, such as intrinsic and extrinsic motivation, have within the classroom, and can praise be an effective motivational strategy?  Firstly, for praise to be effective, it must be authentic and spontaneous, and must be a genuine reaction to children’s achievements (Brummelman, Thomaes, de Castro, Overbeek & Bushman, 2014; Larrivee, 2002). Larrivee (2002) found that younger children, for example, in primary school, are more likely to be extrinsically motivated, whereas older children, for example, in secondary school, tend to be intrinsically motivated. Teachers can encourage students to be intrinsically motivated through self-evaluation of their own achievements and performances using their personal standards and values.

Barker and Graham’s (1987) study compared praise with neutral feedback to children aged four to twelve years following the successful completion of a task. Compared to neutral feedback, those children who were praised were higher in effort (Barker & Graham, 1987) suggesting that praise which is associated with children’s internal drive such as persistence and effort can have a positive effect on children’s behaviour and learning and thus have the potential to be an effective motivational strategy. However, praise also has the potential to undermine intrinsic motivation by adversely affecting children’s performance and confidence to task risks. Teachers or parents who give children praise by offering rewards or incentives for good behaviour or successfully completing tasks are more likely to decrease children’s engagement in a task, therefore reducing children’s intrinsically motivated behaviour (Henderlong & Lepper, 2002). It is important to note as well that the type of praise given and its influence on children’s motivation may vary depending on the children’s cultural background. Most studies on praise use Western countries where children are primarily from individualistic cultural backgrounds, whereas in collectivist cultures such as Asian countries, achievement outcomes focus more on children’s effort than ability. Praise for effort it is more effective in collectivist cultures than compared to individualistic cultures, however praise is used less often in Asian cultures. Collectivist cultures place importance on both efforts involved and outcome of the task, thus children in Asian cultures are more likely to be internally motivated. For these reasons, teachers should be mindful of the fact that different cultures use praise for children’s motivation in various ways and for different reasons (Henderlong & Lepper, 2002).

Further effects of teacher’s praise in the classroom as noted by Larrivee (2002) include the negative effects that praise may have on students. These include the potential for students to increase learned helplessness, a negative effect on learning ability, discourages creativity; students may also demand or depend on praise especially if it is given inappropriately, students fear of living up to expectations, discourages democratic values and discourages freedom of expression. Therefore, our society values democracy and a democratic classroom is one that supports self-evaluation, self-reflection and fosters acceptance and respect, thus supporting Adlerian principles which emphasise the uniqueness of the individual, the importance of the self and that children’s development forms the foundation of interactions within the social environment (DeRobertis, 2011).

In conclusion, encouragement focuses on the child as an individual, his or her creativity and development which occurs within the social environment. Encouragement focuses on the child’s development as opposed praise which is focused on the outcome of the task or behaviour. Encouragement allows risk taking, stimulates intrinsic motivation, provides self-determination and fosters competence through mastery-oriented behaviour, whereas praise can be harmful for children’s behaviour, learning and development particularly if it is inauthentic. Praise can influence children’s motivational behaviour depending on whether it is intrinsic or extrinsic, whereas encouragement is primarily intrinsic. Encouragement supports children’s self-esteem compared to praise which can be detrimental to self-esteem. Inflated praise and person praise produce greater negative long term consequences than any other form of praise as well as compared to encouragement. Finally, encouragement can be likened to the foundations of a house; encouragement provides nurture and support enabling the child’s self-esteem, motivation, learning and development to thrive. Encouragement is therefore essential for a child’s wellbeing, mental health and healthy development. Praise can be likened to the roof over the house. There are many types or models, depending on the type of house that exists will therefore influence the outcome. The incorrect roof type can weaken the house and its foundations, much like the type of praise and the context in which it is given.

References

Barker, G. P., & Graham, S. (1987). Developmental study of praise and blame as attributional cues. Journal of Educational Psychology, 79(1), 66-66.

Brummelman, E., Thomaes, S., de Castro, B. O., Overbeek, G., Bushman, B. J. (2014). “Thats not just beautiful- that’s incredibly beautiful!”: The adverse impact of inflated praise on children with low self-esteem. Psychological Science, 25(3), 728-735. doi:10.1177/0956797613514251

Burnett, P. C. (2002). Teacher praise and feedback and students’ perceptions of the classroom environment. Educational Psychology, 22(1), 5-16. doi: 10.1080/01443410120101215

DeRobertis, E. M. (2011). Deriving a third force approach to child development from the works of Alfred Adler. Journal of Humanistic Psychology, 51(4), 492-515. doi: 10.1177/0022167810386960

Dinkmeyer, D., & Dreikurs, R. (2000). Encouraging Children to Learn. New York, NY: Routledge.

Dweck, C. S. (2007). The perils and promises of praise. Educational Leadership, 65(2), 34-39.

Edwards, M. E. (2002). Attachment, mastery, and interdependence: A model of parenting processes. Family Process, 41(3), 389-404.

Ginsburg, G. S., & Bronstein, P. (1993). Family factors related to children’s intrinsic/extrinsic motivational orientation and academic performance. Child Development, 64(5), 1461-1474.

Gunderson, E. A., Gripshover, S. J., Romero, C., Dweck, C. S., Goldin-Meadow. S., & Levine, S. C. (2013). Parent praise to 1- to 3- year olds predicts children’s motivational frameworks 5 years later. Child Development, 84(5), 1526-1541. doi: 10.1111/cdev.12064

Henderlong, J. & Lepper, M. R. (2002). The effects of praise on children’s intrinsic motivation: A review and synthesis. Psychological Bulletin, 128(5), 774-795. doi: 10.1037//0033-2909.128.5.774

Kamins, M. L., & Dweck, C. S. (1999). Person versus process praise and criticism: Implications for contingent self-worth and coping. Developmental Psychology, 35(3), 835-847.

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McCormack, P. M. (2000). Encouragement versus praise. Today’s Catholic Teacher, 33(6), 74-75. Retrieved from http://www.parentteachersupport.org/documents/6-Encouragement.pdf

Mueller, C. M., & Dweck, C. S. (1998). Praise for intelligence can undermine children’s motivation and performance. Journal of Personality and Social Psychology, 75(1), 33-52.

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Importance of Positive Attachments from Zero to Three and Children's Wellbeing

Abstract

Attachment refers to the close emotional relationship formed between a caregiver and their infant in the first few years of life.  The relationships and interactions a child experiences during the first 3 years of life affect the child’s social and emotional wellbeing later in life.  This can be either a positive or negative outcome, depending on the type of attachment formed between the primary caregiver and the child.  This essay reviews the development of secure attachments versus insecure attachments and briefly discusses child developmental theories relating to attachment security and wellbeing, including Urie Bronfenbrenner’s ecological theory, Erik Erikson’s psychosocial theory and John Bowlby’s attachment theory.  Research evidence indicates that children chronically exposed to negative environments are more likely to form insecure parent-child attachments that impair a child’s health, wellbeing and development. In contrast, the parents of securely attached children provide an improved quality of care that is more sensitive, consistent and responsive to a child’s needs, with improved social and emotional wellbeing and development of the child.  It will be argued that a child’s social and emotional wellbeing is enhanced through the development of positive attachments during the first 3 years of life.

Importance of Positive Attachments from Zero to Three

and Children’s Wellbeing

From the moment of birth, an infant interacts with many people in the social environment.  These interactions together with relationships formed during the early years, when attachments are formed have a profound effect on a child’s social and emotional wellbeing (Berk, 2012, Kochanska, 2001; Siegel, 2001).  McCain and Mustard (1999) proposed that the development of a child’s brain, especially during the first three years, effects the emotional growth and social competence during later life.  Furthermore, Siegel (2001) recognised that caregivers play an important role in a child’s healthy development since the child relies on the caregiver to provide emotional support and to manage their emotional reactions, thoughts and feelings.  During the first years of life, an infant’s brain is vulnerable to adverse experiences such as stress, and as a result the capacity for emotional self-regulation and future emotional competence is dependable upon positive social interactions and parent-child attachment security, including parental sensitivity (Schore, 2001; Shonkoff & Phillips, 2000).

The attachment relationship between a child and their primary caregiver, usually the parents (Brown, Mangelsdorf & Neff, 2012, p. 422), can be classified into different attachment styles (Berk, 2012; Cameron, 2008; Kochanska, 2001).  Whether a child develops secure or insecure attachments depends on many factors such as infant and parent characteristics, stressors, cultural values, community resources and family circumstances such as marital support and financial stress (Berk, 2012; Cameron, 2008).  These factors contributing to the parent-child attachment security are explained within child developmental theories that are discussed within this essay.

Psychoanalytical and ethological theories of Urie Bronfenbrenner, Erik Erikson and John Bowlby propose various factors fundamental to the development of the child and the affect it has on the child’s social and emotional wellbeing.  These include the quality of relationships, interactions with people including the social environment and the emotional attachments formed (Berk, 2012). 

It will be argued that a young child’s social and emotional wellbeing is enhanced by the development of positive attachments during the first three years of life.  According to Berk (2012), a positive parent-child attachment facilitates a greater chance for optimal growth and development than an insecurely attached child, who is more likely to have experienced a lack of sensitive, responsive caregiving, physical deprivation and in extreme cases, abuse or neglect.

The essay examines attachment security in relation to a child’s social and emotional wellbeing.  The essay identifies factors that affect attachment security, and then focuses on insecure attachments and the risk factors associated with impaired attachment security, and finally the identification of parenting interventions as a way to maintain and support a positive parent-child relationship.

Secure attachments

The development of a secure attachment is fostered by a consistent, sensitive and emotionally available parent who provides a child with the opportunity to form a close bond.  The parent is tuned in to their child’s needs, observing body language and behaviour and responds appropriately to the infant’s cues (Berk, 2012). Attunement supports the infant’s social and emotional development through regulating the parent-child interactions that contribute to brain maturation (Siegel, 2001).  According to Kochanska (2001), trust in the caregiver and continuity of care also contributes to secure attachments.  Parents’ of children with secure attachments are more likely to be emotionally available and sensitive to their child’s needs.  A child who is securely attached develops positive relationships with others (Shonkoff & Phillips, 2000).  Therefore attachment security can be described as the parent acting as the secure foundation, allowing the child to trust the parent and explore the environment at his or her own free will (Cameron, 2008). 

Emotional availability and emotional competence

Volling, McElwain, Notaro and Herrera (2002) carried out a short term longitudinal study, investigating the emotional status of both mother and father dyads, the individual disparity between parent and infant behaviour, infant emotional competence, attachment and emotional self-regulation.  The study was conducted in two parts.  The first part investigated aspects of attachment when the infants were 12 and 13 months old.  The second part of the study involved the children, then 16 months old, in an observational task investigating emotional availability. The results indicated that when the parents were more emotionally available (interacting in a sensitive and positive manner) during play sessions, the child tended to respond in a positive way.  The results of the teaching task found that as the task became more challenging for the child, only those securely attached were able to regulate their emotions as compared to children identified as insecurely attached who displayed more negative emotions and behaviour.  The research also advocated that in a family where both parent-child relationships are insecurely attached early in life, the child is left in a fragile state, unable to emotionally self-regulate.  Based on observations of the father-child relationship, the study supports research that a parent’s early emotional availability during infancy is related to the development of a child’s ability to self-regulate their emotions (Volling et al., 2002).  The results of this study are consistent with Erik Erikson’s psychosocial theory, taking into account that during the first year of basic trust verses mistrust, if the caregiver consistently interacts in a positive way with sensitivity, warmth and empathy, the infant places trust in the caregiver and therefore feels safe to explore the surrounding environment (Berk, 2012).  According to Berk (2012), Erik Erikson’s psychosocial theory highlighted that for each stage of a child’s development, psychological conflicts occur that can be resolved either positively or negatively, depending on the quality of the relationship.  This impacts on whether a healthy or poor outcome is achieved. 

Parental sensitivity, involvement and continuity of caregiving

            Furthermore, a more recent study by Brown, Mangelsdorf and Neff (2012) investigated associations between father involvement, paternal sensitivity and father-child attachment at 13 months and 3 years using methods including a questionnaire, video encoding from observations and a father-child play task.  The results indicated that involvement, sensitivity and secure attachment at 3 years are significantly related, and that 13 month olds attachment to their father predicted the fathers’ sensitivity at 3 years.  Involvement and sensitivity together predicted father-child attachment at 3 years. Thus, parental sensitivity is one predictor of attachment security.  Moreover, Brown et al. noted that the continuity of the father-child attachment security remained stable from 13 months to 3 years of age, suggesting additional benefits for the continuity of social and emotional wellbeing of the child. The study suggested longitudinal associations such as parental sensitivity, relating to the quality of the father-child relationship, in sustaining a positive father-child relationship (Brown et al., 2012).  Brown, McBride, Shin and Bost (2007) (as cited in Brito, Barr, Rodriguez , & Shauffer, 2012) further support the finding of parental sensitivity and attachment security, stating that “The quality of the parent-child interaction is more important than the quantity of involvement” (p. 27), however if the father is involved and the interactions are of a positive nature, this too benefits emotional self-regulation and social competence of the child (Cabrera, Tamis-LeMonda, Bradley, Hofferth, & Lamb, 2000; Coley, 1998, as cited in Brito, Barr, Rodriguez & Shauffer, 2012), suggesting that attachment security is very complex, determined by multiple factors.  The research findings of Gunnar, Brodersen, Nachmias, Buss and Rigatuso (1996) in their study examining stress reactivity and attachment security in 18 month olds, found that those infants securely attached at 18 month had mothers who provided continuity of care that was responsive and sensitive during the previous year, as compared to those children determined as insecurely attached.  Thus the findings by Gunnar et al. (1996) provide further evidence to support the correlation between parental responsiveness, sensitivity and attachment security. 

A clear link can be seen between secure attachments during the early years and the development of social-emotional competence during childhood and later in life. According to Denham, Wyatt, Bassett, Echeverria and Knox (2009), the emotional availability of the parents influences the emotional competence of the child, thus supporting the findings by Volling et al. (2002).  Mechanisms such as the continuity of the parent-child attachment and emotional security in establishing social and emotional competence in later life, as derived from a secure parent-child relationship, are consistent with Bowlby’s attachment theory (Kochanska, 2001).  John Bowlby theorised that human attachments developed from an evolutionary perspective of the survival of the species. The deeply rooted symbiotic relationship between an infant and the primary caregiver results in the formation of an emotional bond during the first year of life (Berk, 2012, Schore, 2001; Stronach et al., 2011).  According to Cameron (2008), fundamental to Bowlby’s attachment theory are the contributions of responsive and sensitive caregiving to the development of secure attachment relationships.  Bowlby observed that underlying a child’s mental health and wellbeing is how capable a child is of managing stress (Schore, 2001).  Bergin and Bergin (2009) advocate a similar proposal to Schore (2001) in that “attachment is the foundation of socio-emotional well-being” (p. 141).  Consequently, the findings by Brown, Mangelsdorf and Neff (2012), who suggested that continuity of attachment security throughout life benefits a child’s social and emotional development, are supported by Bowlby’s premise.

Insecure attachments

In contrast, insecure attachments can be characterised as avoidant, ambivalent or disorganised, depending on the ease at which a child responds to their caregiver after a period of separation (Cameron, 2008; Kochanska, 2001).  Insecurely attached children may show signs of being unresponsive, distressed and anger, not easily comforted or hesitant to explore the environment (Berk, 2012; Kochanska, 2001; Shonkoff & Phillips, 2000).  A child who experiences prolonged exposure to parental depression, abuse and neglect or family stressors is at an increased risk of developing emotional regulation difficulties, anxiety, depression or behavioural problems that impair the development of positive attachments and emotional self-regulation (Berk, 2012; Shonkoff & Phillips, 2000, Shore, 1997). Infants of caregivers who consistently provide overstimulating, disengaged or overly interfering interactions are more likely to be classified with disorganised attachment (Berk, 2012; Shore, 1997).  Disorganised attachments are also associated with trauma during the early years (Schore, 2001), with trauma causing physiological changes that affect future social competence and emotional development (Witten, 2010).

Maternal mental health and sensitivity

Mothers suffering from depression are often inconsistent with their interactions toward their infant, often withdrawing or becoming hostile.  Depression is more likely to contribute to an insecure parent-child attachment as opposed to a secure attachment (Shonkoff & Phillips, 2000).  A study by the National Institute of Child Health and Human Development (NICHD, 1999) observed mothers and their infants over a 36 month period, investigating the link between maternal depression, the mother-child relationship and how these factors influence a child’s behaviour and outcome at three years.  The mother and child were assessed four times during the 36 month period.  The results suggested that maternal depression is a risk factor for a child’s social and cognitive development. Furthermore depressive symptoms such as irritability and emotional withdrawal are more likely to foster decreased sensitivity.  Women who experienced chronic depression were the least sensitive whereas women not depressed displayed increased sensitivity.  An important finding of this study found that those mothers who were the least sensitive showed a decline in the rate of sensitivity from the 15 month assessment to the 24 month assessment.  According to researchers from the NICHD (1999), the decline in sensitivity may correspond with the child’s increase in autonomy during toddlerhood, thus challenging the mother to manage her child’s behaviour. This suggestion is consistent with Erikson’s psychosocial theory, who theorised from the age of one to three, a child’s conflict revolves around autonomy verses shame and doubt.  The conflict can be positively balanced and resolved if the caregiver provides guidance, responsive and sensitive caregiving, with the outcome being to foster autonomy.  In contrast, caregivers who shame and doubt, or are controlling, force the child to doubt his or her ability and independence. 

Other factors affecting attachment

The study by NICHD (1999) also implied that depression is associated with multiple risk factors such as financial stress, lack of support or marital conflict, and that research focussing on maternal sensitivity and the quality of the mother-child relationship together with other risk factors would be important to further increase our understanding of the correlation.  This implication is supported by Shonkoff & Phillips (2000) who suggest that “parental sensitivity is associated with financial stress, marital support and life circumstances” (p. 262).  This implication can be further understood using Bronfenbrenner’s ecological theory, suggesting that children develop within various levels of the community, affected by interactions and relationships not just within the child’s immediate surroundings but in the wider community and social environment (Berk, 2012, pp. 25-26).  Thus, if a mother has little outside support within the community or within her family, or is in need of financial assistance, this has the potential to affect her child’s behaviour and wellbeing. 

In addition, Atkinson et al. (2000) conducted a meta-analysis based on 35 studies, reviewing the links between attachment security and social marital support, stress and maternal depression.  Based on their analyses, they concluded that attachment security is significantly related to marital support, stress and depression.  However, Atkinson et al. mention that further research into these constructs, including in what context they are measured as well as using different methods to evaluate the outcome is warranted.

Parenting interventions

            Given the importance of how positive attachments can enhance the social and emotional wellbeing of young children, parenting interventions are seen as an important step in maintaining a positive parent-child relationship (Shonkoff & Phillips, 2000).  Parenting programs such as the “Baby Elmo Program” (Brito, Barr, Rodriguez , & Shauffer, 2012, p. 27) designed for incarcerated parents, aims to strengthen the quality of the interactions, the quality of the parent-child relationship and encourage positive attachments all of which are useful in providing support for families.  Positive outcomes include increased parental sensitivity and improved health and wellbeing of the parent and child.  This is particularly important for parents who have limited or inconsistent contact with their child (Brito, Barr, Rodriguez , & Shauffer, 2012; Shonkoff & Phillips, 2000).  The core premise for the framework of an intervention program is Bronfenbrenner’s ecological theory.  When applied to a particular circumstance, it is important to include other significant people that would directly or indirectly affect the parent-child relationship, and not just the immediate parent-child dyad (Brito, Barr, Rodriguez , & Shauffer, 2012).  This reflects the complexity of Bronfenbrenner’s ecological theory but more importantly, the inclusion of other authority figures in the wider community who also play a significant role in providing support for the families.

            In conclusion, the enhancement of a child’s social and emotional wellbeing is fostered by positive attachments during the first three years of a child’s life.  Given that children who are insecurely attached to their caregiver show an increase in negative emotion and behavioural difficulties as compared to securely attached children, the importance of the caregiver’s role in maintaining a positive relationship cannot be underestimated.  Attachment security is vulnerable to multiple risk factors that negatively affect the parent-child attachment; therefore parenting intervention programs play a crucial role in strengthening the quality of the caregiver-child relationship and the interactions within.  In contrast, parents who are tuned-in to their child’s emotions and behaviours and provide consistent and sensitive caregiving, tend to develop a secure attachment with their child.  Thus, for a child to develop a healthy social and emotional wellbeing, positive attachments during the first three years of life remain fundamental to this outcome.

References

Atkinson, L., Paglia, A., Coolbear, J., Niccols, A., Parker, K. C., & Guger, S. (2000).  Attachment security: A meta-analysis of maternal mental health correlates. Clinical Psychology Review, 20(8), 1019-1040.

Bergin, C., & Bergin, D. (2009). Attachment in the classroom. Educational Psychology Review, 21(2), 141-170. doi:10.1007/s10648-009-9104-0

Berk, L. (2012).  Infants, children and adolescents. (7^th ed.). Boston, MA: Pearson Education.

Brito, N., Barr, R., Rodriguez, J., & Shauffer, C. (2012). Developing an effective intervention for incarcerated teen fathers.  Zero to Three, 32(5), 26-32.

Brown, G. L., Mangelsdorf, S. C., & Neff, C. (2012). Father involvement, paternal sensitivity, and father-child attachment security in the first 3 years. Journal of Family Psychology, 26(3), 421-430. doi:10.1037/a0027836

Cameron, C. A. (2008). Identification and classification of childhood developmental difficulties in the context of attachment relationships. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 17(2), 58-68.

Denham, S. A., Wyatt, T. M., Bassett, H. H., Echeverria, D., & Knox, S. S. (2009). Assessing social-emotional development in children from a longitudinal perspective. Journal of Epidemiology and Community Health, 63(1), 37-52. doi:10.1136/jech.2007.070797

Gunnar, M. R., Brodersen, L., Nachmias, M., Buss, K., & Rigatuso, J. (1996). Stress reactivity and attachment security. Developmental Psychobiology, 29(3), 191-204.

Kochanska, G. (2001). Emotional development in children with different attachment histories: The first three years. Child Development, 72(2), 474-490.

McCain, M., & Mustard, F. (1999). Reversing the Real Brain Drain: Early Years Study-Final Report. Toronto, Ontario, Canada:Children’s Secretariat, Government of Ontario. Retrieved from http://earlyyearsstudy.ca/media/uploads/more-files/early-years-study-en.pdf

National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network. (1999). Chronicity of maternal depressive symptoms, maternal sensitivity, and child functioning at 36 months. Developmental Psychology, 35(5), 1297-1310.

Schore, A. N. (2001). Effects of a secure attachment relationship on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1-2), 7-66.

Shonkoff, J. P., & Phillips, D. (Eds.). (2000). From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academy Press.

Shore, R. (1997). What have we learned? in Rethinking the brain: New insights into early development (pp. 15-55). New York: Families and Work Institute.

Siegel, D. J. (2001). Toward an interpersonal neurobiology of the developing mind: Attachment relationships, “mindsight,” and neural intergration. Infant Mental Health Journal, 22(1-2), 67-94.

Stronach, E. P., Toth, S. L., Rogosch, F., Oshri, A., Manly, J. T., & Cicchetti, D. (2011). Child maltreatment, attachment security, and internal representations of mother and mother-child relationships. Child Maltreatment, 16(2), 137-145. doi:10.1177/1077559511398294

Volling, B. L., McElwain, N. L., Notaro, P. C., & Herrera, C. (2002). Parents’ emotional availability and infant emotional competence: Predictors of parent-infant attachment and emerging self-regulation. Journal of Family Psychology, 16(4), 447-465. doi:10.1037//0893-3200.16.4.447

Witten, M. R. (2010). Traumatic experiences in infancy: How responses to stress affect development. Zero to Three, 31(1), 38-42.

Movement and Learning: the importance of unstructured play versus playing on the computer

Much has been written about the importance of unstructured play for children (websites such as Childhood101, Awe & Wonder, Maggie Dent, Nature Play WA to name a few), however there is little information (should I say 'research') that specifically looks at the negative impact that playing computer games (for long periods of time on a daily basis) has on the learning ability of young children and adolescents (research such as longitudinal studies that assess changes in an individual over time may provide useful data). A research article "Children, Wired: for better and for worse" (September 2010) echoes my thoughts when it states "... little is known about how these pathways mature or how development is affected by technology use. Such research is urgently needed..." If your child (especially boys) plays for hours on the computer, take note! (yes, I have three boys!). I am specifically referring to non-educational computer games in this blog.

CAUTION: 

CHILDREN NOT AT PLAY

My twelve year old son has recently been assessed as having Integration Deficit after seeing an audiologist (he had his hearing and auditory processing assessed). Children that have Integration Deficit typically find it difficult to process information that requires both hemispheres of the brain (the right and left hemispheres). An example would be where a child is required to process both auditory and visual information at the same time, something that is required on a daily basis in the classroom. A child with Integration Deficit has impaired development of the corpus callosum. The corpus callosum is a band of nerve fibres that connects the right hemisphere and left hemisphere of the brain, required for interhemispheric communication. What does this mean academically? A child with Integration Deficit may have difficulty with reading out loud (the ability to perceive prosody), reading comprehension and taking dictation. The flow on effect of this could be that the student then loses focus and attention in the classroom as understanding becomes too difficult. One cannot assume that playing computer games causes Integration Deficit (that would be implying causation), but when I consider the hours he has spent on a daily basis in front of the computer (over the past seven or so years), this has taken away time that could have be spent in unstructured play, creative play and using his imagination to strengthen neural pathways through other activities. There are periods of intense brain maturation at particular times in our lives; the first is during the first three years and the next between six to eight years of age. During these times, the connections between the corpus callosum and the vestibular system are strengthened. Unfortunately it is becoming more common that children as young as three are able to access gadgets such as iPhones and iPads. Not only that but know how to use them, turn them on or off, and watch YouTube! This is my concern for children: that constant exposure to playing computer games is having an unhealthy effect on the development and learning ability on their developing brain. But how much is too much?

One article published in the Daily Telegraph newspaper shares many parents' concerns;

"Distressed families flood psychiatrists over children dangerously addicted to computer games and the internet"

Carla Hannaford, Ph.D in her book, "Smart Moves" says that to assist learning, she recommends:
1. Ban computer, tv and video games before the age of eight (to encourage children's imaginations to develop)
2. Incorporate a daily movement program that includes an hour of unstructured play such as swimming, dancing, sports, Brain Gym, yoga and rough-and-tumble play
3. Reduce simple sugars in children's diets

I am currently reading about the teenage brain and technology here. Findings from research into addictive computer gaming suggests the following could occur: a reduction in attention span (impacting on the learning process), weaker social skills and social development, impulsiveness and short attention spans (due to an over-active amygdala), and the fact that the hours spent on playing computer games could be spent on other  hobbies or sport. Another study suggests preventative factors that could be tried to reduce the amount of time children spend playing computer games, including attention switching (for example playing a sport or interest in another hobby), self education regarding the associated risks of online gaming addiction and parental monitoring such as setting up boundaries and time limits.

Why is it then that children have the ability to become so obsessed with or addicted to playing computer games? It has to do in part with a chemical in the brain called dopamine. Dopamine is a neurotransmitter (a chemical that transfers information from one neuron to another). The release of dopamine whilst playing computer games gives a feeling of satisfaction, pleasure, reward and emotional arousal. Children receive satisfaction and reward through playing computer games but they can also feel the same 'natural high' through play. Play (unstructured/spontaneous and imaginative) integrates both the body and mind, stimulates the vestibular system and produces oxytocin, all of which assist children with learning. Hannaford notes that it is  boys that require more movement than girls for brain growth and development.

How can movement from play have a positive impact on learning? We must first understand the vestibular system and how it influences brain activity. The vestibular system controls movement and balance, giving us the ability to move against gravity. It is the first sense to develop in utero and continues to develop throughout adolescence. It integrates our senses and enhances brain function. Spinning, climbing, crawling, rough-and-tumble play, bouncing on a trampoline, riding a bicycle, somersaults, handstands, bouncy castles, swings and swimming are just some activities your child can do to coordinate the two hemispheres, creating an efficient brain which has well developed neural pathways. Given this information, you can understand why play time during recess and lunch time at school are important not just for children's health! Some great activities that children can do outdoors can be found here.

We wanted to buy our kids another trampoline, after the springs broke on the other one; little did I know then the additional benefits we would all gain! After doing extensive research, we bought an awesome trampoline that looked safer than the traditional style. Can I say our boys love it (and it has no springs)! Since we bought it last year, the boys have been on it every day, rain or shine (it also doubles as a wrestling arena). Unfortunately though they still spend too much time on the computer or watching television. It feels like a constant battle against wills and I take great pleasure when I say "Im turning the computers off now" (with stares and glares and tantrums from BOTH my 12 year old and 4 year old) but I know it is for their health and wellbeing.

I have just watched a fantastic talk by Dr Dimitri Christakis, father, pediatrician and researcher, who echoes my thoughts and concerns. I recommend you watch it too. In his talk he explains what happens to babies and young children's brains when they watch television programs that are fast paced and over stimulating.

Ashley Montagu, anthropologist, sums up the definition of play rather well:
"In the early formative years, play is almost synonymous with life. It is second only to being nourished, protected and loved. It is a basic ingredient of physical, intellectual, social and emotional growth".

If you are a parent going through something similar to me, I hope I have helped to explain about why it is so important for your  kids to have a well balanced life. Our children are in a technologically driven world of gadgets and the World Wide Web. Gone are the days of typing on a typewriter, instead replaced by keyboards on computers. Books are slowly being replaced by eBooks and Kindle's (although I still love to hold and read a book!). Children read about history and geography and other subjects online.... what about the days of visiting a library?

All feedback and comments welcome. Thank you :)
Natalie

References:

http://www.dailytelegraph.com.au/news/distressed-families-flood-psychiatrists-over-children-dangerously-addicted-to-computer-games-and-the-internet/story-e6freuy9-1226207549370

http://www.learninglandscapes.ca/images/documents/ll-no9-final-lr-2.pdf#page=71

Online game addiction among adolescents: motivation and prevention factors
http://0-www.palgrave-journals.com.library.ecu.edu.au/ejis/journal/vaop/ncurrent/full/ejis201156a.html

Wilson, D. E. Developing the magical mind through movement, 2011
http://www.schoolmoves.com/shop/index.cfm/feature/2_6/developing-the-magical-mind-through-movement.cfm

Neuron,"Children, Wired: For Better and For Worse" vol 67 issue 5, 9th September 2010, pages 692 - 701

Hannaford, C. PhD. Smart Moves: why learning is not all in your head, Utah, U.S.A. 2005

Goddard Blythe, S. The Well Balanced Child: Movement and early learning, U.K. 2005

How to calm your toddler with massage

Mums and dads are increasingly becoming aware of the many benefits that massaging their baby has to offer. It is so lovely to see the smiles and giggles and gurgles from the babies, while mum or dad are giving them a massage, especially as they lay still (sometimes the older babies may test their new 'rolling' skills out!). However, when baby has grown up and is now an active toddler (roughly between the ages of one year and three years), parents may stop massaging their child all together or struggle to find ways to massage them as they are so active!

This is one of the reasons why I have written a book, to help inspire and encourage you as parents to continue to massage your child, or, if you are new to massage, you will find this book very easy to follow as it contains photos (of myself massaging my two children aged 10 years and 2 years at the time) and diagrams plus colourful illustrations to engage your children.

So, WHY massage your toddler? Especially if they are so active?

Is your toddler constantly on the go? Are they easily excitable or over-stimulated? Do they sometimes have trouble sleeping or seem anxious? Would you like to know how YOU are able to CALM them and RELAX them?

MASSAGE is the answer!!

Here is a photograph of myself massaging my 2 year old son (abdominal or 'tummy' massage). 

A wonderful massage oil to use is Sunflower or Sweet Almond oil (cold pressed, organic is preferred). To find out why mineral oil is NOT suitable I have written another blog post on this subject. Idibidi Kids now has a range of ORGANIC massage oils suitable for babies and children!

Here is a page "The Weather Massage" taken from the Idibidi Kids Guide to Children's Massage (eBook):

This is an example of a positive touch game, although not massage as such, is a positive way you can reconnect with your child, ideally at the end of the day. This is a lovely way you can interact with your child in a positive way. I encourage you to talk to your child about the different seasons, and what you see and feel in each season (educational at the same time).

The book is now available as a PDF file on CD for $14.95 AU.

Always remember to ask your child "would you like a massage"? As massage is a form of touch, you want to respect your child's answer. If they say 'no', maybe ask again later. It is important for your child to understand that it is OK to say no to massage. Enjoy the special time you have together; it is a lovely way to bond and keep connected with your child while they are an active toddler!

Children's Massage CD giveaway!

The Idibidi Kids Guide to Children's Massage: for parents and carers (2nd ed.), is now available on CD! RRP $14.95, also available online ($9.95). To celebrate the launch of the eBook on CD, Idibidi Kids is giving away a CD ! All you need to do is comment below in this Blog post in 20 words or less how old your kids/grand kids are and why you would like to win the Children's Massage CD. Note this giveaway closes Tuesday 6th December 2011.

Here's a little about the CD:

Does your child seem restless, over-stimulated or constantly on the go?

Do they have trouble sleeping, or feel anxious or stressed?

Are you look for a positive, nurturing activity you can do with your child?

Massage is the answer!

The Idibidi Kids Guide to Children's Massage, 2nd ed. is a unique and innovative eBook that will engage parents and children for hours. This eBook includes a section on rhymes, songs and other positive touch games that have been colorfully illustrated to encourage children to interact, as well as to stimulate their imaginations. Photographs and easy to follow instructions allow you to confidently massage your child and to help relieve many childhood ailments, such as chest congestion, tension headaches, sinus congestion and tummy troubles. Massage is very calming for kids of all ages!

Experienced certified infant massage instructor and  massage in schools instructor, Natalie Garmson, explains why massage and healthy touch is so important for children of all ages. She has met with many families, health professionals and organisations, and attended conferences and workshops, both in child development and infant mental health.

Further information about the eBook can be found at http://www.idibidikids.com.au/guide-children-massage.html

Massaging your child, especially before bedtime, will help calm your child's parasympathetic nervous system. Calming their nervous system will encourage a peaceful night's sleep, perfect for active little toddlers! A gentle massage, even on the shoulders, is a lovely way to reconnect with older children too.

Nightmares and Night Terrors... whats the difference?

During the course of a night's sleep, your child will go through different stages of sleep. Initially they will fall into a deep sleep, often referred to as NREM (non-rapid eye movement). NREM sleep consists of four stages. Stages one and two is where the body shifts from drowsiness into sleep, and in stages three and four, delta waves increase, signalling a deeper sleep (or slow wave sleep), where the body relaxes its muscles, lowers body temperature and decreases the rate of respiration. Also note that the growth hormone increases during NREM sleep. It is during NREM sleep your child may experience night terrors, usually one to two hours after falling asleep. If your child is experiencing night terrors, they may appear awake but they are not. They might start walking around and appear anxious or confused. If this happens with your child, it is recommended that you stay with your child but do not try to wake them. Instead guide them back to bed and stay with them until they appear calm and sleepy. In the morning they usually wont remember the night terror.

What you can do to help:

• talk to your child about any problems, issues or worries they may have

• keep a regular bedtime ritual

• make sure they don't go to bed too late (keep a reasonable bedtime)

• a massage whilst they are lying on their bed before sleep to calm their body and mind

• if the night terrors continue, seek advice from your G.P.

• avoid chocolate and sugary foods prior to bed

• use a night light if it helps to relax your child (on a dim setting)

Non REM and REM sleep occurs approximately every 90 minutes, in a cyclical pattern. As the night progresses, your child will spend less time in non REM (deep) sleep and more time in REM (active) sleep.

Nightmares, on the other hand, occur during rapid eye movement (REM) sleep. They are usually frightening dreams that your child will wake to. REM sleep accounts for approximately two hours sleep per night (or 25% of the time your child is asleep). Nightmares are quite common in young children. About one quarter of children have at least one nightmare every week. Talk to your child about any worries they may have. Sometimes for the younger children, getting them to draw their nightmare will help. It is important to remember that children experience stress too and that this may be impacting on their sleep. Follow the above points on what you can do to help your child if they experience a nightmare.

Has your child experienced a night terror or nightmare? What are some ways that you have helped your child?

References:

Australian Family magazine, winter 2011 "Night Nasties" by Gill Canning, p 10-12

Burton et al Psychology, 2nd ed. 2009. p 190-192

Rosenzweig et al Biological Psychology, 1996. p 502-504

Sharing Birth Stories

You may be wondering why I want to share my birthing stories. To be honest all three births (three boys!) were wonderful, but different in their own ways. To summarise in one sentence... yes I had three vaginal deliveries, yes they were all relatively short labours (seven hours, four hours and just under four hours for my third) and yes they were all without drugs or gas. Reflecting back on my birthing experiences spanning the past eleven years, I look back with fond memories of the birth's of my three sons.

But what if your birth experience was traumatic? Have you read other women's birth stories and thought 'why wasn't my birth experience as good as that'? or have your heard 'horror stories' that make you fear childbirth? As Dr Kathleen Kendall-Tackett quite rightly says "The birth of a child, especially a first child, represents a landmark event in the lives of all involved. For the mother particularly, childbirth exerts a profound physical, mental, emotional, and social effect. No other event involves pain, emotional stress, vulnerability, possible physical injury " (1). Dr Kendall-Tackett offers some great advice on what you can do if you have experienced a traumatic birth experience in her article "Making Peace with Your Birth Experience" (2). Given this powerful statement you wonder why 'debriefing', 'counseling' or 'sharing your birth experience' are not a standard part of postpartum care, or at least offered to women after childbirth (whether that be by the midwife, obstetrician, clinical psychologist one to one or in a group environment). Would the incidence of Post Traumatic Stress Disorder (PTSD), Post Partum Depression (PPD), or anxiety related disorders decrease? (3). What about social support whilst you are pregnant? Studies have suggested that women who have had social support during pregnancy have gone on to have an 'easier childbirth'. Not only that but during the postpartum period as well (4).

To read more birth stories, I encourage you visit Dr Bronwyn Harman's blog http://drharmanmodernfamily.blogspot.com/2011/08/my-birthing-story.html?spref=fb

How you feel emotionally and mentally about your birth experience can have a direct impact on your relationships, including the relationship with your baby. Negative thoughts about your childbirth experience can affect the mother-infant bond. Activities such as participating in infant massage classes can help strengthen the bond between mother and child, in a nurturing and supportive environment.

So without further ado, here are my birth stories.... all three of them (grab yourself a cuppa!).

Master 'E' is eleven nearly twelve years old. I had just turned twenty four when he was born the following month. My pregnancy was wonderful, I enjoyed every minute of it. I had little morning sickness (a couple of days I recall), was fit and healthy. We went for many walks and I continued my mainly vegetarian diet but included fish for the omega 3 benefits for both me and my unborn baby. I kept a diary, something I did a little with Master 'D' during my second pregnancy but not so with my last pregnancy. I guess that had something to do with being too busy looking after the kids and running the household! Master E was a week past my E.D.D. (my due date) and feeling a little desperate to meet my baby, I consulted with a naturopath who prescribed Caulophyllum homeopathic tablets. To this day I will never know whether it was this or that I took castor oil mixed with orange juice to help get things happening (or maybe both!). After nearly passing out on the floor with diarrhoea, contractions started in the early hours. Then my waters broke, I remember it gushing out on to the cushions I was sitting on and it was all happening! My partner was passing me hot face clothes for my back whilst I was rolling around on the beanbag, trying to stay focused and in control. We drove to the Family Birth Centre (KEMH) around 7am. When we got there I promptly banged my fists on the reception counter declaring "Im here. Get me in the bath NOW!!" (or something to that effect. You could tell I was going through transition as the contractions were coming on fast and strong!). The midwife examined me and I was 7cm dilated. Wow, I thought, I had done most of the hard work at home! My birth plan included being in water as 'pain relief'; luckily no one was using the spa/bath at the time. During the later half of my pregnancy I had done a fair bit of reading about labour and what alternative therapies I could use for pain relief. Water was one of them (not that I was totally against using gas/pethidine or an epidural or even a Cesarean should it be required). Aromatherapy was also another option (via massage or in an essential oil burner). I had an aromtherapist, Rosemary, at the birth, as well as my partner and mother. Rosemary acted like a doula in a way; an extra support person which was fantastic. I had got to know Rosemary quite well as I received a monthly massage from her throughout the whole pregnancy. Ooh that was bliss, my hour of total relaxation! Combining regular massage with some pregnancy yoga and I felt that this was good preparation mentally (and somewhat physically) for the impending birth. Reflecting back, I do believe this helped me to focus throughout the seven hour labour. I even had my eyes closed for the majority of it, as this helped me to focus within and go with the flow (not to fight the pain). So, getting back to the final stages of labour, after I got out of the bath, I felt the urge to push. The midwife suggested sitting on the toilet as the angle was favourable for my baby to 'pop out'... and there he was, with a little bit of pushing, Master E was born! (Eleven years ago you were not permitted to have a water birth so I had to get out of the bath). The funny this is, that I cannot stand pain. Even paper cuts make me feel woozy. So it is truly amazing to think that for someone who feels faint with the sight of her own blood or paper cuts, I could go through seven hours of labour and deliver my baby boy.

Nearly eight years later and I was due to give birth to my second baby, another boy, except this time my circumstances were different. I did not have my partner beside me, throughout pregnancy or for the birth. My wonderful mother was with me again (thank goodness). So it was just mum and I. Master 'D' was born at a public hospital closer to me, purely for the fact that being by myself at the time I felt safer in the knowledge that should I require an ambulance, I was literally five minutes from the hospital. Second time round and this pregnancy was pretty much trouble free, except for a week or so of the dreaded morning sickness. I also had a bleed at around fifteen weeks, enough to have another scan to check that the baby was okay. At full term they offered me a 'sweep and stretch' which I declined. I was hoping labour would start by itself as with my first son. I lost the mucous plug/show at thirty nine weeks so I was thinking it would be any day now... well that was not to be! I knew things were starting to happen around my due date as I had been feeling very mild period-like pains. A close friend and I had been talking about how her waters had started to leak, and it was probably a good thing we had as that is what happened to me (although I did not know at the time). I called my parents to look after Master E who was asleep at the time. I said to my mum 'oh dont worry lets just go in for a check up' and I even told her to leave the hospital bag in the car! Well, the midwife did a quick test to determine if my waters had broken and yes, they had (to my surprise!). Holy... I thought, Im going to have my baby tonight!! After she broke my waters, about thirty minutes later my contractions started. This was the early hours of the morning. At one point I said I wanted an epidural but the nurse told me it was too late for that (thank goodness because I knew I could get through it, I just had to stay focused and in control). I believe that by not having a supportive partner by my side I was not relaxed as much as I wanted to be, as much as I love my mum its just not the same. It took about an hour to push my baby out and they did use the forceps, hence the cone head look when he was born! What I didnt like (I should have written a birth plan) was that they had me on my back pushing with my feet in stirrups. Totally against an active birth which is what I prefer (that is, standing, using gravity to assist, squatting and on all-fours) and I had a drip in my hand 'just in case'. But apart from that, there he was, another beautiful baby boy!

Fast forward nearly four years to the present and here I am, with Master 'B', the newest member of the family. Blake was born eleven days early in June 2011. My labour was just under four hours. He was also born at the Family Birth Centre, KEMH, even though I now live hundreds of kilometres away in the country! The saddest part of my labour with Blake is that my partner missed the birth by one hour. He was due to drive up four days after Blake was born, but because he came early it caught everyone by surprise (its roughly a six and a half hour drive to Perth). On the other hand, I got to experience a water birth, something I really wanted with Master E eleven years earlier. I was walking back to my bedroom at the house we were staying at in Perth when my waters broke, this time well and truly! Ethan was still awake but Darcy was in bed asleep. It was just after nine pm. I tried to keep calm but started shaking, knowing that my partner would probably not make it as I seem to have fairly quick labours (I phoned him straight away along with the midwife who was on call). I managed to stay in bed for nearly two hours, relaxing as much as possible, with a hot wheat bag. The contractions were like strong Braxton Hicks, nothing too painful, more annoying as I was trying to sleep. Just before midnight they started coming on quite strong, so my dad stayed at the house with the boys while mum drove me to the Birth Centre. It was a thirty minute drive, in this time I had had a few more contractions. We arrived sometime before one am. I had another quite powerful contraction while kneeling on all-fours on the door mat outside the Birth Centre! Now what a sight that would have been if you were driving past! The midwife arrived shortly after as there was no one roster on at the birth centre. Lucky for me the spa/bath was all mine! The midwife examined me and I was eight centimetres dilated. Once I was in the water, ooh it felt wonderful. The warmth of the water helped me to relax and focus. I remember thinking 'go with the flow', the analogy that a contraction is like a wave, it builds until it peaks then it subsides. Dont get me wrong, contractions ARE painful but the water helped take the edge off the pain. My mum was fantastic, giving me my drink so I could have little sips to keep hydrated, and providing a hand to squeeze tight. His head and shoulders were born under water, then I stood and the rest of his little body slid out. It was amazing. I sat down in the bath while the water drained and cuddled my little man. I did it.... again!

References

(1) http://www.bestthinking.com/articles/medicine/psychiatry_and_neurology/psychosomatic_medicine/the-psychological-impact-of-birth-experience-an-underreported-source-of-trauma-in-the-lives-of-women"

(2) http://www.infantrisk.com/content/making-peace-your-birth-experience

(3) Raphael, B., Preston Wilson, J. Psychological Debriefing: theory, practice and evidence. 2000, Cambridge University Press. p 272-276.

(4) Dewar, G. http://www.parentingscience.com/childbirth-trauma.html "The psychological effects of childbirth stress"