Exits

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I looked at the mother who was sitting in front of me. She was crying softly. I slid my stool over towards her and told her I would help her find a way. She opened her eyes and dabbed them with the matted Kleenex she held in her hand. “I have tried everything,” she said to me. “Nothing seems to work. Every day on my way home from work I pick him up from daycare, and he never listens. He hits, he kicks, and I don’t know what to do.” I leaned towards her and put my arm on her shoulder. “We have to find a way to take care of you. Once we do that I can help you with your son.” “Can you,” she asked me. “I can’t but you can,” I answered.

Parenting is a demanding job. It ensnares you into thinking it is endless. At times you feel as if you are locked in a cell without an exit. Children depend upon us for survival.  From infancy through the teen years parents must be vigilant to identify and provide for the needs of children while keeping them safe. Learned parenting behavior and the biological drive to protect offspring, encourage and influence the way parents recognize, understand and respond to a child’s needs. These responses are limited by time, resources, finances and the emotional competency of prior learned behavior.

Studies have shown that over 50% of parents feel they have no sources of emotional and physical support. Financial stress adds another hardship. These stressors make it difficult for parents to meet the needs of their children.  Stress encourages parents to neglect their own needs and self-care soon disappears.

Parents who neglect their own self-care are at risk for losing patience and compassion. Their lives are bordered by fear, procrastination and self-doubt. Dreams, passions and aspirations are forgotten and behaviors are modeled that do not teach self-awareness and self-care. This loss of self is accompanied by fear, anger, shame and guilt. These become learned behaviors that are then passed on to a new generation prone to social isolation and fueled by anger due to the loss of self.

Self-care must be simplified and programmed into your daily life. You must acknowledge, speak up and walk away when self-care is threatened. You must seek out people, places and things that provide comfort, connection and safety in an ever accelerating world.  When self-care is embedded within your life it provides for both you and your child. You receive the personal, social, emotional, intellectual and spiritual benefits and model behavior that changes the biological and emotional decision for your child.

Take a walk and look at the magnificence of nature.  Eat dessert, read a romantic novel, watch a movie, go to a comedy show, walk on the beach, exercise or just brew yourself a cup of tea or hot chocolate. Call a friend or take a nap. Take up dancing or start a scrapbook. Learn how to say “no.” Go to the library, learn a new language or start playing that instrument you have not played since you were a child. Meditate, attend a religious service or volunteer for a favorite unspoken cause.

Each of us built the rooms in which we live. Each house is our challenge and responsibility.  Every room must contain exits for daily and emergency use. Exits provide the safety and security to live a life filled with passion and inspiration. If circumstances arise and you find yourself in darkness look for a light. If there is none, listen and reach out to someone near. They will lead you to safety. Begin your journey today.

Being Bullied

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Do you know what it feels like to be bullied? I Do. Being repeatedly bullied changes you. It can either leave a mark or induce change.

As a new freshman in high school I turned the corner and quickly scanned the hallway. Experience had taught me what to look for and how to look for it. Repeated bullying teaches you how to scan a sidewalk, a playground, a gymnasium, a room or a hallway. Never make direct eye contact and never, ever stop listening. While most children look for their friends, those who are bullied see sudden movement and hear the shuffle of feet and always know where the closest exit is. As I walked down the long hallway I approached a group of boys. They leaned on open lockers and their laughter echoed off the tile floor. Laughter was always more worrisome than loud talking.  I drifted over to the other side of the hall and softened my shoulders as I shifted my books to my other arm. You always kept one arm free when passing a bully. The laughter did not change and I sighed silently as I turned the corner and began scanning the next hallway.

For the observer bullying is often difficult to recognize. It can happen everywhere and anytime. For the one who is being bullied, bullying is always recognizable. It includes both spoken and unspoken actions, words and behaviors. A tilt of a head, a look in the eye, a sudden turn, a push, a trip, a sound or a series of words all indicate unwanted and unsought after aggression that has been directed at you. When you are young it starts with simple name calling, teasing or taunting. When these behaviors are repeated and are associated with one child trying to control or scare another child it becomes bullying. Threats of physical harm, rumors, embarrassing false stories and inappropriate sexual comments soon follow and you change. Not everyone becomes a victim but everyone changes. You notice social behaviors including how others avoid you or leave you out of games. You learn how to recognize the bully as well as those who assist and reinforce those who bully. Knocking, tripping, punching and hitting become a sport and if you are smart enough you learn how to scan and disappear.

There is no single reason why a child becomes a bully. Fear, anger, inadequate attachment, lack of control and low self-esteem are common themes. A lack of compassion and respect for others and the pursuit of social power and attention are also commonly seen in those who bully. Bullies may be well connected to peers or they may be loners who are isolated and easily pressured by others. Bullies tend to be aggressive and have difficulty following rules. They resort to dominating behaviors when they become frustrated and often think badly of others. They view aggressive behavior in a positive way and tend to have friends who bully others. In adulthood bullies often continue to have problems both at work and at home.

Children who are bullied tend to be different from others. They may be smart, sensitive, short, tall, overweight or just “different”. The way they dress, the words they choose or the way they act turn them into magnets. Bullies are drawn to these children and search for targets who are weak, depressed, anxious or unable to defend themselves. Bullying soon follows.

The best way to eliminate bullying is to talk about it and model appropriate interpersonal behavior. Bullying must be recognizable and understood if we are to prevent it. Bullying can be prevented by keeping all lines of communication open, urging all children to seek help if bullied and for those who are not bullied to be encouraged to step in and stop bullying before it happens. In this way all children will benefit. We must be clear, consistent and concise about how aggressive behavior harms both the giver and the receiver. We must never tolerate bullying and must model in our daily lives the use of effective non-physical positive discipline techniques that encourage appropriate behavior and discourage inappropriate behavior.

Being bullied changed me. I became a protector of others and along the way learned how to protect myself. Listen to your child and search for those children walking down the hall who know how to disappear. Your support, your teaching and your words of encouragement can allow an invisible child to hear the laughter and not the shuffle of feet.

Breastfeeding Success in the Hospital

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Mothers who receive emotional encouragement and informational support about the positive benefits to their health and the health of their child throughout their pregnancy are more likely to breastfeed after delivery and continue to breastfeed for at least 1 year following delivery. Support and advice are available during prenatal visits and from family and friends but involvement in breastfeeding classes or breastfeeding support group meetings can be very beneficial. Mothers often decide whether to breastfeed very early in their pregnancy. This is not a decision that is made at the end of the pregnancy. Healthcare providers play an essential role in this process. Information and support must be provided as soon as the mother to be is aware she is pregnant. Spousal support and workplace support are also essential.

From the moment of delivery contact between mother and the new infant must be supported if breastfeeding success is to be enhanced. This includes skin-to-skin contact between mother and infant immediately after birth and frequently thereafter. This contact has many physical and emotional benefits for both mother and child. Breastfeeding should be initiated within the first hour after delivery and Vitamin K injection and the application of topical eye ointment should be delayed until after the first breastfeeding.

During the first 48 hours following delivery rooming in should be encouraged and supported. This allows maternal-infant contact. Skin-to-skin contact should also continue to be encouraged and supported. There should not be time restrictions to breastfeeding. Breastfeeding should be frequent. Mother and staff must wake the infant if needed to allow breastfeeding 6 to 8 times on the first day and 8 or more times on the second day. Breastfeeding technique should be observed and close attention given to latch problems.  Formula, water, glucose water, bottles and pacifiers should be discouraged. During the first two days of life the infant’s weight and elimination patterns should be closely monitored.

Breastfeeding success is often linked to an infant’s readiness to nurse, breastfeeding positioning and the infant’s ability to obtain an effective latch. Parents must be aware of cues from their new infant that indicate a readiness to breastfeed. These include sucking on the hand, rooting and smacking of the lips. Mothers must be comfortable with and in their surroundings. Due to body exposure during breastfeeding mothers often feel uncomfortable, anxious or hesitant. Privacy and a well supported chest to chest position between mother and infant are essential. During breastfeeding the goal is for the infant to achieve a wide open mouth position with the tongue down and the entire nipple and some of the areola in the infant’s mouth. While the infant is nursing the mother should look for rhythmic sucking movements and listen for audible throat clicks which indicate her infant is swallowing. As milk production increases this audible swallowing will increase. Initial breastfeeding during the first few days may cause some discomfort. Care must be taken to prevent pain from breast engorgement, an improper latch or skin irritation. Overall, breastfeeding should be pain free.

Breastfeeding Success After Discharge Home

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During the first week following discharge home your infant should breastfeed between 8 and 12 times every 24 hours. Some infants may breastfeed more often. Your infant should show signs of being full and satisfied within 30 minutes. You will notice after nursing that your breasts will feel softer and less full. Your infant’s stools will transition from black to green and then become brown and eventually a wet yellow mustard color and consistency. Stool output will gradually increase and near the end of the first week stool frequency may increase to 4 or more stools per day. Often your infant will stool with every breastfeeding. Urine output will also increase to at least 5 times per day and often occurs with every stool.

After arrival home it is important your spouse and all of those who love and care about you provide you the emotional and physical support to allow you to continue to breastfeed. Arriving home with a new baby is a time of joy which can be easily displaced by anxiety and guilt. By asking for support and allowing yourself to receive support you will lessen the chance of fear, guilt or anxiety hindering the development of a secure attachment between you and your infant. If you are having difficulty with milk production or latch seek support and advice from your doctor and seek advice from a Lactation Consultant. Joining a Breastfeeding Mothers support group can also be very helpful.

Every mother must support her own needs. Resting every time the infant rests is a good place to start. A healthy diet and adequate hydration are essential. The use of a pacifier or supplemental formula should continue to be discouraged until adequate milk supply is established. This often takes about 1 month. Occasionally the use of an electric breast pump to encourage milk production will be recommended. Supplemental expressed or pumped breast milk is also occasionally given. During the first week of life 400 IU/day of Vitamin D should be initiated.

During the first 6 weeks of life feeding every 8 to 12 times per day is normal. Some infants may continue to require even more frequent feeding. Night feedings are normal and during growth spurts feeding may be even more frequent. Typical growth spurts occur after 10 days and then after 3 and 6 weeks. These spurts may last for 1-2 days. The more milk your infant takes from your breast the more milk will be produced. This allows milk production to be based on the needs of your child. Your child does know best. Continue to stay well hydrated, eat healthy and use alcohol and caffeine in moderation. No specific food restrictions are necessary. If you are placed on a medication talk to your doctor to make sure it is safe to continue to breastfeed. Very few medications prevent breastfeeding.

Continue to avoid formula supplementation if at all possible. The use of formula increases your infant’s risk for illness and changes the gut flora which keeps your child healthy and prevents many gastrointestinal illnesses. Breast milk is the only food your infant needs during the first 6 months of life.

Challenges to Breastfeeding

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Although there are many challenges to breastfeeding most of them can be managed with adequate preparation, education and support.

If a mother is HIV positive or is suffering from ongoing drug or alcohol use then breastfeeding is contraindicated. Rare infants with Galactosemia, Tyrosinemia and certain forms of PKU should also receive special formula and not breastmilk.

Mothers should avoid the use of medications, supplements and herbal preparations while breastfeeding unless they are clinically necessary. The vast majority of medications a mother would be prescribed while breastfeeding are safe to use. If a mother is experiencing depression subsequent to the delivery of her infant, it is much safer for the mother to be treated with an anti-depressant medication than for the mother not to be treated. Most anti-depressant medications can be safely used by breastfeeding mothers.

The risk of exposure to a maternal medication during the first few days of breastfeeding is lowest since the volume of maternal milk is lowest at this time. The book titled Medications and Mother’s Milk by Dr. Thomas Hale is a good reference.  Drugs should be chosen for breastfeeding mothers that have a short half-life, high protein binding and low oral bioavailability. Most of the time it is safer and healthier for an infant to continue to breastfeed rather than changing to formula. In some situations discontinuing breastfeeding for a short period of time while continuing to pump and discard breastmilk is necessary. This is seen when a mother is required to receive a radioactive compound to treat her own medical condition.

Jaundice is a common problem seen in infants who breastfeed or formula feed. In the past when an infant who was breastfeeding developed jaundice the breastfeeding was stopped due to concerns breastmilk would increase the jaundice. This is no longer the case. Breastfeeding should continue and if there is not effective milk transfer due to the infant being sleepy or if there is excess weight loss supplemental breastfeeding with expressed breastmilk should be initiated. The level of jaundice should be followed closely especially for premature infants.  Other options include donor human milk or formula. Advice from a Lactation Consultant in these situations is very helpful.

Breast engorgement is a common issue. It can be prevented by frequent breastfeeding and hand or pump expression of milk if engorgement is an issue. Warm compresses before nursing and cold compresses after nursing can also be helpful. On occasion anti-inflammatory medication like ibuprofen can be used.

Mothers are often concerned about inadequate milk supply. This is usually a false perception. It is important this issue is addressed directly and accurate answers given.  Parents must document adequate urine and stool output while monitoring weight gain in the infant. These are the best indicators for adequate milk supply and milk transfer from mother to the infant.

Although smoking is strongly discouraged smoking is not a contraindication to breastfeeding. Breastfeeding reduces the risk of respiratory illness in infants even if the mother is still smoking. A mother should not, however, smoke around her child. Homes, cars and child care locations should all be smoke free.

Some babies who breastfeed can be very fussy. This is usually due to your infant’s temperament and not due to breastfeeding. Providing skin to skin contact, increasing carry time either in your arms or in an infant body carrier and increasing the frequency of breastfeeding can often help. Walking with your infant is helpful as are swaddling, swaying and making soft white noise shushing sounds.  Avoid excessive stimulation due to sights, smells and sounds and do not overly stimulate with motion. A final option is to encourage sucking on your finger or a pacifier if your infant is over age 1 month.

Another challenge to the new breastfeeding mother is sore nipples. Time and patience are essential. Soreness can frequently be avoided by improving your infant’s position and latch during feeding. Superficial fungal or bacterial infections can also occur but these are uncommon. Talk to your doctor and medication can be prescribed if required. If there are signs of a fungal infection (yeast) then treatment of both infant and mother is necessary. Antifungal ointment can be applied to your nipples after each feeding and continued until you are symptom free for 3-4 days. Your infant should be treated with oral mycostatin (nystatin) drops which can be prescribed by the doctor. These can also be applied to your nipples after nursing. Your infant may show white plaques in the mouth and on the tongue. This is called thrush. All pacifiers should be washed well in hot soapy water and nystatin can be applied to the pacifier. Other treatments that can be considered for your infant include oral 0.5% Gentian Violet that is applied to your infant’s mouth one time each day for three days. This can cause staining of clothes and skin. Always check to see if your infant has signs of a yeast diaper rash that is common when your child has thrush. If this is present then treatment with an OTC medication such as clotrimazole 2-3 times per day is needed.

Mastitis is common when your breast is not emptied after nursing. This can lead to pain, redness and swelling of the breast. Weaning is not recommended. The best treatment is frequent breastfeeding to “empty the breast.” Continuous warm compresses are helpful as is soft breast massage prior to nursing. Pumping can be used if breastfeeding is too painful. Anti-inflammatory medication such as ibuprofen can be helpful and antibiotics are prescribed for you if there is pain and fever over 12 hours in duration.

The Cupcake

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Why does quiet time foster the ability to connect?

One of my fondest memories is walking hand in hand with my mother to a corner store one block away from our house. We made this trip many times when I would wake from naps. She would buy me a chocolate cream filled cupcake and arriving home we would sit silently on our porch steps sharing that cupcake and watch cars go up and down our street.

Parents are confronted every day with new techniques and ideas on how to raise a bright, sensitive, respectful and resilient child. The importance of attachment, emotional competency and a sense of others are consistently discussed as is the ability to perceive the intent, purpose and meaning of others. To accomplish these goals parents are drawn to active parenting styles that engender and support specific traits and behaviors.

One of these active styles is clear, consistent, concise and confident parenting.   Another is the ability to set reasonable boundaries that support respect in the parent-child relationship. Without such boundaries many children believe the role of a parent is to fulfill not only their needs but also their wants. These active parenting skills are important but they all must be broadened by a healthy parent-child connection.  Such a connection is fostered through passive parenting opportunities that support the sharing of feelings and thoughts without words or actions. This sharing can be accomplished by spending quiet time with your child.

Life is seldom in slow motion. For parents life has two speeds, fast and faster. This is why parents and children must find opportunities to connect during periods of quiet rest and relaxation.  A quiet presence allows you and your child to connect. Distractions hinder our ability to connect.  Quiet and the reflection foster your child’s ability to share and support the importance of silent contemplation, rest and relaxation.  This ability is essential for self- development and enhances your child’s ability to initiate and maintain future healthy relationships.

Don’t wait! You do have the power to change the speed of life for both you and your child. How comfortable are you with silence? You will be amazed by the hugs and smiles you discover when you hit the pause button and a previously unseen and unheard world unfolds. What memory of you will your child remember?

Parenting Basics

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Parenting advice is often difficult to hear, understand and incorporate into our daily lives.  No one enjoys criticism no matter how constructive it is. On some days everyone wishes they had a parenting GPS to follow. Due to the complexity of parenting responses and the diversity of behaviors children express a single map is not available. There are, however, certain basic steps to follow that will help you end up at the right destination.

The first step is to recognize when you need help and advice. Everyone needs help. Learn how to ask for and accept help graciously and not feel judged. Parenting skills only improve with repetition and practice. Sometimes it is easier for others to see our mistake.  Deliberate practice and looking at your responses critically through your eyes and the eyes of others you respect will point you in the right direction.

The second step is reflection. Every parent must reflect on the concept perfection is not what we seek. Studies support the need to have a correct behavioral response only thirty percent of the time for your child to learn and acquire an appropriate behavior. Certainly, we all aim for a higher percentage but a better batting average is not needed. You will know when you find this sweet spot when frustration, anger, shame and guilt fade and are replaced by a general feeling of success that your goal has been reached.  Another concept to reflect on is that behaviors change. When you are worn down and believe there is no hope just sitting back and waiting a few days often allows new behaviors to develop and the old problematic behaviors to resolve.

The third step is to monitor your reaction. When the above signs of frustration, anger, shame and guilt begin to dominate your thoughts it is time for you to seek professional help and advice. The importance of knowing when it is time to pursue self-care and seek supportive counseling for you is essential.  Neglecting these feeling can lead to negative parenting responses and unhealthy health consequences for you.

The fourth and final step is to monitor your responses. Perseverance and determination will help you become successful. Committed and basic responses are often best. Find a mentor who can help you stay on track and provide focused immediate feedback to you. As with most teaching the steps to follow are explanation, demonstration, imitation, correction and repetition.  Focus on improvement but be willing to accept negative feedback if you want to challenge yourself to improve your parenting skills.

Handling Negative Emotions

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It is important every child learns how to handle negative emotions. Children must know how to feel strong emotions without hurting themself or another. The ability to cope with and express these feelings is something every parent must support within their child.

Emotion coaching uses reciprocal parent to child communication to teach empathy. The parent becomes a role model, and by taking the child’s emotions seriously, the parent is able to better understand the child’s perspective.

Every parent must be aware, attentive and responsive to the child’s emotions. By connecting and listening to the child a parent is better able to model healthy behavior for the child and help the child describe and name the emotion being felt. The final step in this process is to help the child find and choose solutions that allow the child to move past the negative emotion and develop a strong sense of resilience and a healthy emotional attitude.

When a parent is presented with a negative emotion it is easy to dismiss or disavow the emotion. Parents often distract a child from the negative situation by substituting a positive one. This is not healthy. Children must learn how to accept and manage negative emotions. Other parents will disavow negative feelings by telling a child it is not acceptable to feel that way. This is also wrong. In the same way a parent who “takes on” the negative emotion of the child without providing solutions is not advancing the child’s emotional development.

Children must learn that becoming scared, sad, angry, nervous and afraid are all part of life. In fact, fear, frustration, anger, inadequacy and rejection are all programmed into us. How a child learns to manage these feelings will determine the amount of stress a child encounters and the amount of positive emotions that arise from these encounters.

Many children are taught to consciously suppress and unconsciously repress negative feelings. This denial is unhealthy and often leads to the projection of negative emotions onto others. Other unhealthy tendencies include the use of temper tantrums, outbursts and body language to release enough negative tension to allow the child to “go on” and an “ignorance is bliss” approach that suggests momentary distraction allows a child not to think about and experience the negative emotion. These types of defense mechanisms are unhealthy since they do not foster autonomy. They support the development of shame and doubt which lead to dependence and withdrawal.

Parents who listen, talk and support a child through the turbulence of negative emotions allow a child to own and control responses and at the same time support the development of socially acceptable behavior. If such support is not present, fear without reason predominates and anxiety develops. A child without this support is unlikely to develop the initiative to reach out to others due to hidden fear and negative emotions. This leads to guilt which further hinders emotional development.

What can you do to connect with your child? Be attentive and responsive to your child’s needs while being attuned and sensitive to your child’s temperament and developmental level.  In this way you will help your child experience negative emotions, reframe situations, build positive emotional experiences and develop a strong sense of initiative and autonomy.

To check out our discussion on WJET click here: https://vimeo.com/75968619

A Happy Little Girl

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Happiness is a gift from within.

I looked up from the menu and saw this young girl standing next to me smiling. Her hair touched the top of a billowing white dress and her black patent leather shoes sparkled.  I cocked my head to the side and said: “Well, hello.” Speechless, she continued to smile. A woman swept over from a distant table and knelt down beside her. “Doctor Barber, I apologize for bothering you but, my daughter saw you come in and asked if she could go over and say hello.”  The next thing I knew she was standing next to your table.  I am so sorry for interrupting your dinner.”  The little girl continued to smile. “She and her sister play doctor and take turns being you.” You are going to be a great doctor someday,” I said to her.  Her smile grew larger. “Come on honey. Let Doctor Barber finish eating.”  She reached up and gave me a hug and skipped back to her table.

Children are born with an ability to live in the moment. Their feelings fueled by love, attention and affection drive their actions. They are able to feel what they want while still controlling what they do.   Attachment fueled by love, attention and affection leads to a sense of happiness, security and satisfaction. For adults this skill and connection is often lost.

The older we become the more our lives are illuminated by responsibility. Schedules and illness shorten our lives. Minutes, hours and days filter out the joy as we become unhealthy and unhappy. This unhappiness fosters the conscious suppression and unconscious repression of desires and feelings.  Life is devoured by rejection, anger, frustration, internal inadequacy and the stress of endless repetition.  One day ends so another can begin.

We must not allow unhappiness to replace positive emotion.  Abundant acts occur daily in each of our lives when we take the time to live in the present moment.

That young girl reminded me of my own power and capability to seek and find happiness no matter where I am or whom I am with.  I realized we have the innate ability to feel good when we take the time to give and receive unconditionally.  This power is within each of us.

Do you choose happiness? The choice is yours.

The Importance of Exercise

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Exercise is an essential component of a healthy lifestyle and leads to good physical health.  There is no single best activity but keeping your exercise routine fresh, exciting and social improves your chance to continue exercising.  Everyone should exercise from infancy through adulthood.

Exercise must always be done in a safe environment. Make sure you drink enough water and always warm up before you begin moderate to strenuous activities. Appropriate flexibility and strength must be present before many activities should be pursued. This includes core strength and an adequate base of muscle, bone, heart and lung strength. Lastly, equipment, pace and duration must always be considered.

The benefits to exercise are both physical and psychological. Physical benefits include improved lean body mass, improved heart and lung function and strong bones and muscles.  Psychological benefits include improved sleep and learning, enhanced self-esteem and a healthier general sense of well-being.  Exercise decreases stress and aides in the restoration of balance to our daily lives.

Exercise is a learned behavior and must be linked to a nutritious diet and adequate sleep and recovery. It must be started at an early age and become part of your daily activities. It must be inexpensive and readily available. It is best to include 60 minutes of a combination of moderate and vigorous exercise in your daily routine.

In recent years physical inactivity has become our standard. This has many causes including our use of automobiles rather than walking or biking, the deep penetration of labor-saving devices into our daily lives and the prevalence of electronic games and other devices that distract and support “sitting” behaviors. Even school schedules have changed with many physical education classes now being cancelled. In many urban areas children are afraid or not allowed to play outside due to safety concerns.

Children under age two years should not watch TV and children from age two to six years should watch less than two hours a day. Older children should keep screen and electronic device time under two to four hours a day. Most teens in the US spend more time with electronic devices than they do sleeping.

For infants the focus should be on developmentally appropriate motor skills. These types of exercise should be lively, consistent and spontaneous. Exercise that is imbedded within tummy time, diaper changing and dressing is best.  Peek-a-Boo , So-Big and Patty Cake are great choices.  Be cautious about the amount of time your infant spends in swings, bouncy chairs and car seats.

For the toddler to pre-school aged child the joy of movement is the focus. Children during these ages need to gain a sense of physical control over their bodies. They become stronger and leaner. They learn about spatial relationships in terms of hand-eye and foot-eye coordination.  They learn how to manipulate more than one object at a time and they develop a sense of stability and rhythm.  Walking, hopping, galloping, skipping, marching, running and obstacle courses are all perfect activities for this age.

As a child enters the school age years between five and ten years there is a transition to activities that have flexible rules and basic instructions.  Teamwork and the integration of motor and cognitive skills become increasingly important.

During the teen years personal interests and socialization opportunities are the focus. Team activities increase and vigorous exercise is common. Some risk-taking behaviors become incorporated into exercise and competition becomes more important. Throughout this period it is important to support in your child the importance of effort rather than outcome.

For more information check out my discussion on WJET.