A study of child care in the first two years of life

Summary 1. Fifty-nine children were studied at a Well Baby Conference organized by the Visiting Nurse Association in Hamden, Connecticut, with a desire to determine, first, methods of child care actually in operation; second, to define problems in management encountered by the mothers; and third, to arrive at conclusions with respect to the function fulfilled by a psychologist in such a conference. The group studied was a little above the average with respect to intelligence and economic level. 2. On the whole, methods of child care were encouragingly good, indicating that education in this field is making headway. It was increasingly apparent, however, that individual differences in infants (with respect, for instance, to food and sleep requirements) are too little stressed in the literature and in common parlance, with resultant undue anxiety on the part of those mothers whose infants deviate most from the accepted standards, even though such deviations fall within normal limits of variation. Reassurance was often necessary to the effect that even marked deviations could be considered as characteristic of a given child and did not constitute a threat to his general well-being. 3. A very few instances of most of the problems of management recorded in the literature were encountered in the course of the study. Of the forty-six children studied more than once, twenty-seven presented practically no problems, thirteen presented a succession of transient minor problems, six evidenced persistent difficulties. The prognosis with respect to ultimate adjustment was thought to be good for thirty-three of these forty-six children, questionable for nine, and poor for only two of them. 4. The existence of a preliminary period of difficult adjustment in the first two or three months of life has also been insufficiently emphasized in the literature. That the child needs time to adjust to rhythmic conditions of living and the mother, in her weak and emotional state, to her new responsibilities was repeatedly evidenced in the course of this study. The importance of sympathetic supervision and advice during this period cannot be overemphasized. 5. The situation with respect to the function of a psychologist in a Well Baby Conference defined itself as follows: a. The way in which appointments were kept indicated that the mothers were very much interested in the information which the psychologist had to give them with respect to the infant's increment of mental growth. b. Many of the suggestions made by the psychologist failed to be incorporated in the mother's program of child care until her own practical experience emphasized the need. The fact that suggestions respecting physical care were eagerly sought for and immediately put into practice, while suggestions regarding care from the psychologic standpoint were seldom sought, indicates that education in this field lags far behind that in the physical field. Further community education with respect to the type of question a psychologist is equipped to answer is necessary before such an individual in such a situation can be of maximum usefulness. 6. In the last analysis the mother's attitudes in child care situations are of first importance in determining the child's behavior. Not only must she be intellectually receptive to current concepts of child care, but also she must be so constituted with respect to temperament and so adjusted in her own emotional life that she can put her intellectual concepts into practice if she is to be successful in the management of her child.