Do Masks Delay Speech and Language Development?

During a child’s first few years of life, they are rapidly developing communication skills. Whether by smiling, cooing and babbling, pointing and gesturing, or saying their first words, children express themselves from birth. But a year and a half into the COVID-19 pandemic and no solid end in sight, some families wonder whether continuous use of face masks by daycare providers, preschool teachers, and other adults may negatively affect their child’s speech and language development.

While this is a natural concern, there is no known evidence that use of face masks interferes with speech and language development or social communication. Plus, children can still get plenty of face time at home with mask-free family members.

​How do babies learn to communicate?

Babies are hard-wired to communicate. From day 1, they are watching their loved ones’ faces and mouth movements. They are listening to them talk (for families that use spoken language), and making attempts to interact with their parents and caregivers. Each milestone builds on another.

Parents and other family members encourage this development by talking, singing, playing peek-a-boo, reading, and engaging their baby in numerous other ways every day. The more language a child is exposed to—and the more undivided attention a parent can give to their child as they feed them, bathe them, change their diaper, practice tummy time with them, push them in a stroller, and play outside with them—the better the child’s communication skills will likely be.

Can mask use cause delays in speech and language development?

A key part of learning to communicate for a child is watching the faces, mouths, and expressions of the people closest to them. Babies and young children study faces intently, so the concern about solid masks covering the face is understandable. However, there are no known studies that use of a face mask negatively impacts a child’s speech and language development.

And consider this: visually impaired children develop speech and language skills at the same rate as their peers. In fact, when one sense is taken away, the others may be heightened. Young children will use other clues provided to them to understand and learn language. They will watch gestures, hear changes in tone of voice, see eyes convey emotions, and listen to words.


Tips to better communicate with children while wearing a face mask

Here are some ways that people who wear face masks can help when they interact with your child:

  • get the child’s attention before talking
  • face the child directly and make sure nothing is blocking the child’s view
  • speak slowly and slightly louder (without shouting)
  • ensure a child is using hearing aids or using other hearing devices, if they have been prescribed
  • use eyes, hands, body language, and changes in tone of voice to add information to speech
  • ask the child if they understood; repeat words and sentences when necessary
  • reduce noise and reduce distractions

You can share these tips with your child’s day care provider, preschool, and others who regularly interact with your child while wearing masks.


How to boost your child’s communication skills as use of face masks continues

Remember, babies and toddlers learn the most from their family! Families can help with speech and language development and social communication through face time at home with family members who aren’t wearing masks. By providing dedicated time to converse with your child without screens or other interruptions—for example, at bath time and dinner time—children should reach their expected milestones.

Regardless of mask use, some children will take longer to reach speech and language milestones—and some may need help meeting them. Speech and language delays and disorders are common in young children, but these are highly treatable with help from a certified speech-language pathologist. If you have concerns about your child’s skills, don’t delay—seek an evaluation as early as possible. Children can be evaluated for free through their local early intervention program (no referral is necessary). After the evaluation, your child can receive free or low-cost treatment if needed. Children quality for these services based on the degree of their delay (each state has different requirements), not family income.

How are speech and language services provided with masks?

Some children were already receiving early intervention services, or were seeing a private speech-language pathologist, before the pandemic. Many families continued these services, but others took a break for various reasons and are now looking to start again. Still other parents and caregivers may have developed concern for the first time over the past year and a half. Regardless, families should know that speech/language therapy services are still occurring—and children are still making significant progress—at this time, even if an speech-language pathologist is wearing a mask.

Some speech-language pathologists have been providing services virtually (called telehealth). While young children may have a difficult time sitting in front of a computer, early intervention is often focused on parent coaching—giving caregivers techniques to boost their child’s communication skills. Speech-language pathologists are also still working directly with children, both through telehealth and in-person. In person, some providers use clear masks so their faces are still visible or masks with face shields to provide additional protection—or work with children outside when possible.

Remember

When it comes to use of face masks, the bottom line is safety first! Masks reduce transmission of COVID-19 and can make in-person schooling possible during the pandemic. Luckily, your child’s speech and language skills can continue to grow.

If you have any concerns or questions about your child’s communication skills, your pediatrician can help. They can evaluate your child’s progress and, if needed, provide provide you with contact information for the early intervention program in your area or a private speech-language pathologist. A searchable database of professionals is also available from the American Speech-Language-Hearing Association at http://www.asha.org/profind.


Copyright © 2021 American Academy of Pediatrics and American Speech-Language-Hearing Association. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Face Masks for Children During COVID-19


Masks remain a simple but powerful tool to protect against COVID-19, especially for children too young to get the vaccine yet.

Read on for answers to some frequently asked questions about masks and children during the COVID-19 pandemic.

Why do we still need to wear face masks?

It is possible to have COVID-19 but not have any symptoms. That’s why wearing face masks is still so important, especially for unvaccinated children. Masks reduce the chance of spreading SARS-CoV-2, the virus that causes COVID-19.

A child or adult is considered fully vaccinated two weeks after getting the final dose of COVID-19 vaccine.

Should children wear masks?

Until a child is fully vaccinated against COVID-19, they should continue to wear a face mask and keep a safe physical distance indoors around people they don’t live with or who may have the virus. Anyone unvaccinated should also wear face masks outdoors in large group settings or when physical distancing isn’t possible.

Face masks can be safely worn by all children 2 years of age and older, including most children with special health conditions, with rare exception.

Children should not wear a mask if they are under 2 years old, however, because of suffocation risk. Also, anyone unconscious or unable to remove a face covering on their own should not wear one.

When do children need to wear masks?

Children age 2 and older who are not yet fully vaccinated, with rare exception, should wear masks when they are at school, child care or camp, and while participating in group activities such as most indoor sports and outdoors sports that have close contact. They should also wear masks any time they are unable to stay a safe distance from others, such as the grocery store.

Everyone should also continue to wear them when traveling on a plane, bus, train, or other form of public transportation, and at the airport or station.

If you have a medically fragile child or an at-risk adult in your household, you may want to consider having anyone at home who is not fully vaccinated wear masks at home to help protect them.

How do I help my child get used to wearing a mask?

It is understandable if your child seems afraid of wearing a mask at first. Here are a few ideas that might help make them more comfortable:

  • Look in the mirror with the face mask on and talk about it.
  • Put a mask on a favorite stuffed animal.
  • Decorate them so they’re more personalized and fun.
  • Show your child pictures of other children wearing them.
  • Draw one on their favorite book character.
  • Practice wearing the face mask at home to help your child get used to it.

For children under 3, it’s best to answer their questions simply in language they understand. If they ask about why people are wearing face masks, explain that sometimes people need to wear them to stay healthy.

For children over 3, try focusing on germs. Explain that germs are special to your own body. Some germs and good and some are bad. The bad ones can make you sick. Since we can’t always tell which are good or bad, the face masks help make sure you keep those germs away from your own body.

The good news is, children have gotten used to masks and are less likely to feel singled out or strange about wearing them. It has quickly become the “new normal” for all of us.

What about children with special health care needs?

  • Children with weakened immune systems or who have health conditions that put that at high risk for infections are encouraged to wear an N95 mask for protection.
  • Children with medical conditions that interfere with cognitive or lung function may have a hard time tolerating a face mask. For these children, special precautions may be needed.

Is there a “right way” to wear a mask?

Yes. Place the mask securely over the mouth and nose and stretch it from ear to ear. It should fit snugly along the sides of the face without any gaps. It can be held on with ear loops or ties. Remember to wash hands before and after wearing it and avoid touching it once it’s on. When back home, avoid touching the front of the face mask by taking it off from behind.

Wash and completely dry cloth face masks after each wearing.

Note: Face masks should not be worn when eating or drinking. Also, make sure the mask has no choking or strangulation hazards for young children.

What kind of face mask is best?

Face masks with multiple layers of fabric are fine for most people to wear. Try to find the right size for your child’s face. Adult masks are usually 6×12 inches, and even a child-sized 5×10 inch covering may be too large for small children.

How do I keep my child from touching their face mask?

It may be challenging for very young children not to fidget with their face mask, so expect to give your child plenty of gentle reminders. When mask-wearing is reinforced by adults and peers, they will learn to follow directions. Just like children understand that they must wear bicycle helmets and buckle into their car seats, they will learn to wear masks correctly and routinely when needed.

How do I protect my baby who is too young for a mask?

The best way to protect your baby is to practice physical distancing, and encourage people who are around your baby to wear face masks and take other measures to reduce COVID-19 risk.

Remember

Along with physical distancing, hand washing and vaccination as soon as everyone in your family is eligible, mask wearing is key to reducing SARS-CoV-2 infection and spread. If you have any concerns about your child’s health, talk with your pediatrician.


Source: American Academy of Pediatrics (Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Ten Tips for Your Child’s Success in School

It should come as no surprise that success — or failure — at school starts at home. Studies have linked poor academic performance to factors such as a lack of sleep, poor nutrition, obesity, and a lack of parental support.

The good news is that those same studies also show higher test scores for students who live in homes where healthy habits, regular routines, and good communication exist.  How can you ensure your child heads off to school this fall with the best possible foundation? Follow these 10 tips and watch your child thrive.

Enforce Healthy Habits

You can’t perform well when you don’t feel good. To help your child have the best chance at doing well in school, make sure she follows healthy habits at home. Choose a bedtime that will give your child plenty of sleep, and provide a healthy breakfast each morning. Encourage exercise, and limit the amount of time she spends watching TV, playing video games, listening to music, or using the computer.

Stick to a Routine

Most kids thrive on structure and will respond well to routines that help them organize their days. In our house, for example, my son gets dressed, makes his bed, and eats breakfast while I make his lunch and pack his school bag with completed homework and forms. When he gets home in the afternoon, I serve him a snack and he does his homework while I prepare dinner. Your routines may differ, but the key is to make it the same every day so your child knows what to expect.

Create a “Launch Pad”

Veteran parents know it’s important to have a single place to put backpacks, jackets, shoes, lunchboxes, and school projects each day. Some call it a “launch pad,” while others call it a “staging area.” Our area is a hook by the back door.

Whatever you call it, find a place where your child can keep the items he needs for school each day and keep him organized. Then you’ll know right where to find everything during the morning rush.

Designate a Space

At school your child has a desk or table where she works. There is plenty of light, lots of supplies, and enough room to work. Why not provide her with the same type of environment for homework? A designated homework space often makes it easier and more fun for children to complete assignments at home. A desk is great, but a basket of supplies and a stretch of kitchen counter work just as well.

Read, Again and Again

It is often said that children spend the first several years learning to read, and the rest of the lives reading to learn. The written word is a gateway to all kinds of learning, and the more you read to your child, the better chance he has of becoming a proficient and eager reader.

Try to sit down with your child to read a little bit every day, give him plenty of opportunities to read out loud to you, as well, and above all have fun. While the importance of reading with your child cannot be stressed enough, it should not be the cause of stress.

Learn Always

Your child may be past the preschool years, but home education is still a critical part of his overall learning experience. “Some of the attitude recently is that it’s up to the schools and teachers to figure it all out, to make sure children are learning and healthy and safe,” says Barbara Frankowski, M.D., MPH, FAAP, and member of the AAP Council on School Health. “There’s only so much teachers can do. Parents have to fill in with good support at home.”

Look for ways to teach your child throughout the day. For example, cooking combines elements of math and science. Use the time when you make dinner as an opportunity to read and follow directions, to discuss fractions, to make hypotheses (“What will happen when I beat the egg whites?”), and to examine results.

Take the Lead

Children learn by example. Let your kids “catch” you reading. Take time to learn a new skill and discuss the experience with them. Sit down and pay bills or do other “homework” while your kids do their schoolwork.

If you display a strong work ethic and continually seek out learning opportunities for yourself, your kids will begin to model that same behavior in their own lives.

Talk Often

Do you know how your child feels about her classroom, her teacher, and her classmates? If not, ask her. Talk with her about what she likes and doesn’t like at school. Give her a chance to express her anxieties, excitements, or disappointments about each day, and continue to support and encourage her by praising her achievements and efforts.

Show Interest

Don’t limit your support to your child; extend it to her teachers as well. Meet the teachers and stay in regular contact by phone or email so that you can discuss any concerns as they arise. Not only will it pave the way for you to ask questions, but it will also make the teachers more comfortable with calling you if they have concerns about your child.

Expect Success

Perhaps the most important way you can support your child’s efforts at school is to expect him to succeed. That doesn’t mean that you demand he be the best student or the best athlete or the best artist. Rather, let him know that you expect him to do “his best” so that he’ll be proud of what he can accomplish.

If you make that expectation clear and provide a home environment that promotes learning, then your child will have a greater chance of becoming the best student he can be.


Source: Healthy Children Magazine, Back to School 2007. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Are You Over-Helping Your College-Bound Teen?

As a parent, it’s difficult to watch your child struggle. At any age, you hurt for them. You want to help―but there comes a point when helping can be harmful.

Removing obstacles from their path may make life easier in the short term, but as they approach college and young adulthood, it could set them up for bigger problems.

So, how can you help your teenager learn to navigate life’s obstacles? Here are some tips.

  • Change your focus. Instead of helping your kids “avoid difficulties,” help them “get through difficulties.” To do this, try to think of difficult circumstances as “teachable moments” for your child.
  • Avoid quick fixes. We’ve all experienced occasions when our children’s stress became our stress, too. It’s hard to hear that your son was picked last for a team in gym class, or that other girls chastised your daughter for her outfit. It sometimes seems tempting to deal with adversity by taking an easier road. Removing the child from that ‘awful’ school. Buying the trendy outfit.
  • Give your child the freedom to fail. This may just be the hardest thing to do; we don’t want to see our kids fail. We may still call the high school teacher about a bad grade or keep track of our 18 year old’s exams and doctors’ appointments. But the biggest gift we can give our children is the freedom to fall, dust themselves off, and get back up again. This does not mean that we never extend a helping hand. It just means that we need to let them learn how to navigate and adapt so they’ll be prepared. Life is bound to throw them some curve balls, and we aren’t always going to be there.
  • Promote independence. Coach your child on how to talk with their teachers about a bad grades rather than doing it yourself. Encourage your college-bound kids to make their own appointments and remember their own schedules. They may miss appointments or oversleep for school, but that creates a learning opportunity. We know that in real life, if we miss an important meeting at work, there are usually consequences. Learning about this as a student is better than learning how to manage life and cope with difficulty as an adult.
  • Make college decisions together. What’s most important to your child when it comes to choosing a college? Yes, I said your child. Not you. Many factors go into selecting one college over another, not just which school has the “superior academic reputation.” What often sways the vote one way, or another are the basics: cost, distance, location, and size. What does your teen want? Is it different than what you want? Have conversations and listen. Learning your child’s preferences at the outset will help all of you to narrow the search and come to a decision that all of you feel comfortable with.
  • Ask about mental health support on campus. The American College Health Association Survey on health showed that over 60% of kids in college have “overwhelming anxiety” at some point; and that the average time to access a counselor is 1 week. If you have a family history of mental health disorders, your child is a greater risk. The Jed Foundation provides a detailed guide for parents and students that includes questions to ask about the services and programs a college provides to help students manage their mental health and thrive in the campus environment.

By Hansa Bhargava, MD, FAAP. Source: American Academy of Pediatrics (Copyright © 2019): The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Stages of Adolescence

Adolescence is the period of transition between childhood and adulthood. It includes some big changes—to the body, and to the way a young person relates to the world.

The many physical, sexual, cognitive, social, and emotional changes that happen during this time can bring anticipation and anxiety for both children and their families. Understanding what to expect at different stages can promote healthy development throughout adolescence and into early adulthood.

Early Adolescence (Ages 10 to 13)

  • During this stage, children often start to grow more quickly. They also begin notice other body changes, including hair growth under the arms and near the genitals, breast development in females and enlargement of the testicles in males. They usually start a year or two earlier in girls than boys, and it can be normal for some changes to start as early as age 8 for females and age 9 for males. Many girls may start their period at around age 12, on average 2-3 years after the onset of breast development.
  • These body changes can inspire curiosity and anxiety in some―especially if they do not know what to expect or what is normal. Some children may also question their gender identity at this time, and the onset of puberty can be a difficult time for transgender children.
  • Early adolescents have concrete, black-and-white thinking. Things are either right or wrong, great or terrible, without much room in between. It is normal at this stage for young people to center their thinking on themselves (called “egocentrism”). As part of this, preteens and early teens are often self-conscious about their appearance and feel as though they are always being judged by their peers.
  • Pre-teens feel an increased need for privacy. They may start to explore ways of being independent from their family. In this process, they may push boundaries and may react strongly if parents or guardians reinforce limits.

Middle Adolescence (Ages 14 to 17)

  • Physical changes from puberty continue during middle adolescence. Most males will have started their growth spurt, and puberty-related changes continue. They may have some voice cracking, for example, as their voices lower. Some develop acne. Physical changes may be nearly complete for females, and most girls now have regular periods.
  • At this age, many teens become interested in romantic and sexual relationships. They may question and explore their sexual identity―which may be stressful if they do not have support from peers, family, or community. Another typical way of exploring sex and sexuality for teens of all genders is self-stimulation, also called masturbation.
  • Many middle adolescents have more arguments with their parents as they struggle for more independence. They may spend less time with family and more time with friends. They are very concerned about their appearance, and peer pressure may peak at this age.

The brain continues to change and mature in this stage, but there are still many differences in how a normal middle adolescent thinks compared to an adult. Much of this is because the frontal lobes are the last areas of the brain to mature―development is not complete until a person is well into their 20s! The frontal lobes play a big role in coordinating complex decision making, impulse control, and being able to consider multiple options and consequences. Middle adolescents are more able to think abstractly and consider “the big picture,” but they still may lack the ability to apply it in the moment. For example, in certain situations, kids in middle adolescence may find themselves thinking things like:

  • “I’m doing well enough in math and I really want to see this movie… one night of skipping studying won’t matter.”
  • “Do I really have to wear a condom during sex if my girlfriend takes the pill?”
  • “Marijuana is legal now, so it can’t be that bad.”

While they may be able to walk through the logic of avoiding risks outside of these situations, strong emotions often continue to drive their decisions when impulses come into play.

Late Adolescents (18-21… and beyond!)

Late adolescents generally have completed physical development and grown to their full adult height. They usually have more impulse control by now and may be better able to gauge risks and rewards accurately. In comparison to middle adolescents, youth in late adolescence might find themselves thinking:

  • “While I do love Paul Rudd movies, I need to study for my final.”
  • “I should wear a condom…even though my girlfriend is on birth control, that’s not 100% in preventing pregnancy.”
  • “Even though marijuana is legal, I’m worried about how it might affect my mood and work/school performance.”

Teens entering early adulthood have a stronger sense of their own individuality now and can identify their own values. They may become more focused on the future and base decisions on their hopes and ideals. Friendships and romantic relationships become more stable. They become more emotionally and physically separated from their family. However, many reestablish an “adult” relationship with their parents, considering them more an equal from whom to ask advice and discuss mature topics with, rather than an authority figure.


Parents: How To Help Your Children Navigate Adolescence

Children and their parents often struggle with changing dynamics of family relationships during adolescence. But parents are still a critical support throughout this time. Here are some things you can do:

  • Help your child anticipate changes in his or her body. Learn about puberty and explain what’s ahead. Reassure them that physical changes and emerging sexuality is part of normal, healthy development. Leave room for questions and allow children to ask them at their own pace. Talk to your pediatrician when needed!
  • Start early conversations about other important topics. Maintain open communication about healthy relationships, sex, sexuality, consent, and safety (such as how to prevent sexually transmitted infection and pregnancy, and substance use). Starting these conversations during early adolescence will help build a good framework for discussions later.
  • Keep conversations with your child positive. Point out strengths. Celebrate successes.
  • Be supportive and set clear limits with high (but reasonable) expectations. Communicate clear, reasonable expectations for curfews, school engagement, media use, and behavior, for example. At the same time, gradually expanding opportunities for more independence over time as your child takes on responsibility. Youth with parents that aim for this balance have been shown to have lower rates of depression and drug use.
  • Discuss risky behaviors (such as sexual activity and substance use) and their consequences. Be sure to set a positive example yourself. This can help teens consider or rehearse decision-making ahead of time and prepare for when situations arise.
  • Honor independence and individuality. This is all part of moving into early adulthood. Always remind your child you are there to help when needed.

The adolescent years can feel like riding a roller coaster. By maintaining positive and respectful parent-child relationships during this period, your family can (try to) enjoy the ride!


By Brittany AllenBrittany Allen, MD, FAAP and Helen Waterman. Source: American Academy of Pediatrics (Copyright © 2019). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Shyness in Children

My child is shy and does not make friends easily. Should I be worried?

Although childhood shyness is commonplace, it concerns many parents, especially those who place great value on sociability. Some children become shy because of harsh life experiences, but most are born that way. For some middle-years children, social situations and interactions can be terrifying. When they come in contact with new children, they rarely feel at ease. Typically, they are unwilling or unable to make the first move, preferring to abandon a potential friendship rather than reach out to the unfamiliar. A few of these timid children may be emotionally distressed, but they are in the minority. In fact, some children are just naturally withdrawn and slow to warm up in new situations.

Severe Shyness

In some cases, shyness can be disabling. Extremely shy children often do not adapt as well as most of their peers in the classroom and on the playground. The longer this pattern exists, the more difficult it is for children to change. Shyness can increasingly lead to purposeful avoidance of social settings and withdrawal, and ultimately create an inability to function effectively as a social adult. If your child’s shyness becomes debilitating, it may be caused by an anxiety disorder or a temperament pattern; then an evaluation by a child mental-health professional would be helpful.

Time to Adjust

Most shy children, however, do well in relationships and in social settings once they are past an initial period of adjustment. Children who have difficulty establishing and maintaining relationships even after the ice-breaking period merit more concern and attention. Eventually, many (and perhaps most) children who are shy learn to conquer their tendency. They function in ways that are not obviously timid or reticent, although inside they may still feel shy. Parents can gently guide or direct their children into social situations in which they can learn to successfully interact.

Rejected Children

Most children want to be liked, yet some are slow in learning how to make friends. Others may long for companionship but might be excluded from one group or another, perhaps picked on because of the way they dress, poor personal hygiene, obesity, or even a speech impediment. Youngsters are often rejected by peers if they exhibit disruptive or aggressive behavior. Still other children may hover on the fringes of one clique or another but never really get noticed. These neglected children spend most of their time alone.

Rejected youngsters are overtly disliked by their peers and are constantly made to feel unwelcome. They often tend to be aggressive or disruptive and very sensitive to teasing. They may be bullies and rule-violators, or they may be so unsure of themselves that they invite the rejection of others. They might also be rejected because of their impulsive and disruptive behavior. Some of them may have attention deficits or hyperactivity.

Neglected Children

Neglected children, on the other hand, are not overtly rejected and teased but are often just ignored, forgotten, not invited to parties, and are the last ones picked for a team. These youngsters may be perceived as loners but might be passive and detest their isolation. Others may actually prefer to be alone. This latter group might be respected and admired by others but simply feel more comfortable in solitary pursuits or in spending time with parents, siblings other adults, or even pets. They may also lack the social skills and self-confidence necessary for them to enter social arenas, often because of limited social experiences. Or they may be more shy, quiet and reserved than most of their peers.

How Parents Can Help

Successful peer interactions require a variety of skills and special ways of interacting. Parents should look for these skills in their children and help develop and model them.

  • Coping with failure and frustration
  • Coping with success
  • Coping with change and transitions
  • Coping with rejection and teasing
  • Managing anger
  • Using humor
  • Forgiving
  • Apologizing
  • Refusing to accept a dare
  • Thinking up fun things to do
  • Expressing affection
  • Avoiding dangerous situations
  • Defending himself
  • Comforting someone
  • Sharing
  • Making requests
  • Self-disclosure
  • Giving a compliment
  • Expressing appreciation
  • Coping with loss
  • Sticking up for a friend
  • Doing favors
  • Asking for help
  • Helping others
  • Keeping secrets

Source: Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

How to Share Books with Your Preschooler

Even children in preschool can enjoy books and learn from sharing books with you. Sharing books with your children can help them learn to talk better and get them ready to listen and learn in school.

Making Books A Part of Your Child’s Bedtime Routine

Set aside 20 to 30 minutes with the TV off for sharing books as part of your regular bedtime routine. Regular bedtime routines started when children are young help prevent future bedtime struggles. Teaching your children how to fall asleep alone by putting them in bed awake helps prevent future night wakings.

4 Year Olds Can:

  • Tell you which books they want to share with you.
  • Pretend to read a favorite book aloud to you.
  • Tell you how a story is like things they have seen or done.
  • Ask you questions about books you are enjoying together.
  • “Correct” you if you skip a word or page in a favorite book.
  • Tell you the story in a favorite book in their own words.

What Parents Can Do:

  • Find a quiet, comfortable place for book sharing.
  • Ask your child to tell you about the pictures and the story.
  • Respond with enthusiasm to your child’s questions and comments.
  • Ask your child to show you all the things in a picture that are alike in some way. You can say: “Can you find all the blue things?” or “Show me all the things that can fly.”
  • Point out colors, shapes, numbers and letters in their books.
  • Take your child to your local public library to borrow books or to enjoy Story Time.

Source: Committee on Early Childhood (Copyright © 1994 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

How to Ease Your Child’s Separation Anxiety

Separation anxiety varies WIDELY between children. Some babies become hysterical when mom is out of sight for a very short time, while other children seem to demonstrate ongoing anxiety at separations during infancy, toddlerhood, and preschool.

To All You Working Moms & Dads

The trick for surviving separation anxiety demands preparation, brisk transitions, and the evolution of time. I would suggest we parents suffer as much as our children do when we leave. Even though we are often reminded that our children stop crying within minutes of our leave-taking, how many of you have felt like you’re “doing it all wrong” when your child clings to your legs, sobs for you to stay, and mourns the parting?

As a working mom, separation anxiety creates questions for me. Although it is an entirely normal behavior and a beautiful sign of a meaningful attachment, separation anxiety can be exquisitely unsettling for us all.

Here are facts about separation anxiety and tips to improve the transitions I’ve learned the hard way (I’ve made about every mistake):

Facts about Separation Anxiety

  • Infants: Separation anxiety develops after a child gains an understanding of object permanence. Once your infant realizes you’re really gone (when you are), it may leave him unsettled. Although some babies display object permanence and separation anxiety as early as 4 to 5 months of age, most develop more robust separation anxiety at around 9 months. The leave- taking can be worse if your infant is hungry, tired, or not feeling well. Keep transitions short and routine if it’s a tough day.
  • Toddlers: Many toddlers skip separation anxiety in infancy and start demonstrating challenges at 15 or 18 months of age. Separations are more difficult when children are hungry, tired, or sick—which is most of toddlerhood! As children develop independence during toddlerhood, they may become even more aware of separations. Their behaviors at separations will be loud, tearful, and difficult to stop.
  • Preschoolers: By the time children are 3 years of age, most clearly understand the effect their anxiety or pleas at separation have on us. It doesn’t mean they aren’t stressed, but they certainly are vying for a change. Be consistent; don’t return to the room based on a child’s plea, and certainly don’t cancel plans based on separation anxiety. Your ongoing consistency, explanations, and diligence to return when you say you will are tantamount.

How to Survive Separation Anxiety

  • Create quick good-bye rituals. Even if you have to do major-league- baseball–style hand movements, give triple kisses at the cubby, or provide a special blanket or toy as you leave, keep the good-bye short and sweet. If you linger, the transition time does too. So will the anxiety.
  • Be consistent. Try to do the same drop-off with the same ritual at the same time each day you separate to avoid unexpected factors whenever you can. A routine can diminish the heartache and will allow your child to simultaneously build trust in her independence and in you.
  • Attention: When separating, give your child full attention, be loving, and provide affection. Then say good-bye quickly despite her antics or cries for you to stay.
  • Keep your promise. You’ll build trust and independence as your child becomes confident in her ability to be without you when you stick to your promise of return. The biggest mistake I ever made in this regard was returning to class to “visit” my son about an hour after a terrible transition. I was missing him, and although the return was well intended, I not only extended the separation anxiety, we started all over again in the process. When I left the second time (and subsequent days) it was near nuclear.
  • Be specific, child style. When you discuss your return, provide specifics that your child understands. If you know you’ll be back by 3:00 pm, tell it to your child on his terms; for example, say, “I’ll be back after nap time and before afternoon snack.” Define time he can understand. Talk about your return from a business trip in terms of “sleeps.” Instead of saying, “I’ll be home in 3 days,” say, “I’ll be home after 3 sleeps.”
  • Practice being apart. Ship the children off to grandma’s home, schedule playdates, allow friends and family to provide child care for you (even for an hour) on the weekend. Before starting child care or preschool, practice going to school and your good-bye ritual before you even have to part ways. Give your child a chance to prepare, experience, and thrive in your absence!

It’s rare that separation anxiety persists on a daily basis after the preschool years. If you’re concerned that your child isn’t adapting to being without you, chat with the pediatrician. Your pediatrician has certainly helped support families in the same situation and can help calm your unease and determine a plan to support both of you!


Source: Mama Doc Medicine: Finding Calm and Confidence in Parenting, Child Health, and Work-Life Balance (Copyright © 2014 Wendy Sue Swanson). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

5 Secrets to a Smarter Baby: School Readiness Can Start Now

As parents, we all want happy, healthy babies. Not only that, we want them to be smart.

Growing research in early brain development shows there are some basic things you can do right now to start raising a child who is curious about the world and ready to learn. These early education activities we’re talking about are simple―and screen free!

Use the “5 Rs of Early Education” in your daily activities right from birth:

1. READ together as a daily, fun, family activity.

  • The AAP recommends this to build language, literacy, and social-emotional skills that last a lifetime. It’s never too young to start reading with your baby. Reading to your child, research suggests, boosts activity in parts of the brain that form the building blocks of language, literacy skills and imagination.

2. RHYME, play, talk, sing, and cuddle together often throughout the day.

  • The AAP encourages parents to use play to help meet their child’s health and developmental milestones, beginning from birth. Need ideas? Here are some great ways to do this based on your child’s age. Talk with them about things they see around them, at home, at the store, or while traveling. Enroll in quality early education programs and activities, take time to visit a children’s museum or local library, and enjoy story time.

3. Build ROUTINES for meals, play, and sleep.

  • This helps children know what to expect and what is expected of them. Brush, Book, Bed, for example, is a great way to structure your child’s nighttime routine. Eating at least three family meals together each week is associated with healthier kids, according to a study published in Pediatrics.

4. REWARD everyday successes (especially for effort toward goals like helping others).

  • Catch your child doing something good and praise them for it! Praise from those closest to a child is a very powerful reward. Talk with your pediatrician about how to shape and manage your child’s behavior, model the good behavior, and reinforce it by using positive discipline techniques that build a child’s self-regulation skills. Your child’s social, emotional, and behavior skills are equally critical to school success.

5. Develop RELATIONSHIPS that are nurturing, respectful, and consistent.

  • A strong parent-child relationship helps protect against the lasting effects of adverse childhood experiences (ACEs), traumatic situations that can lower a child’s chance of doing well in school. As you strive to teach your child about healthy relationships and choosing friends wisely, don’t forget to model them in your own life. Demonstrating good relationships skills with your spouse or partner, and taking time to nurture close friendships with others, is as important as simply talking about these skills–if not more so.

You are your baby’s best teacher.

A certain toy is not necessary for your child to reach his or her next developmental milestone. There is no one app that will teach your child to read. While it’s easy to fall victim to the marketing, YOU are what your child needs to start on the path toward school readiness with daily reading, rhyming, routines, rewards, and relationship building.


Source: American Academy of Pediatrics (Copyright © 2019). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

How to Prepare Your Older Children for a New Baby

A new baby brings joys and challenges to a family. You’re excited, but you may also be nervous about how your older children will react to the newborn.

All sorts of questions come up: How should we tell our older children that they are going to have a baby brother or sister? Will they be jealous of the new baby? How can we help them get along? 

Children of different ages will react differently to a new baby.

Knowing what to expect from each age group will make it easier to handle the changes in your family.

Toddlers – Ages 1 To 2 Years

Children of this age will not understand much about what it means to have a new brother or sister. However, let your child hear you talk about the “new baby” and feel your excitement. She may not understand why you are excited, but your attitude will rub off on her and she will feel excited too.

Keep in mind, you may not be able to satisfy the needs of both children all the time—especially not by yourself. If you feel overwhelmed, look to your partner, other relatives, and friends for support and an extra set of arms.

  • Look at picture books about a new baby. At the very least, your child will become familiar with words like “sister,” “brother,” and “new baby.”
  • When the new baby arrives, try to do something special for your older child. Reassure her that she is still loved. Some ideas include giving her a special gift, letting her spend some time alone with dad, grandma, or another special adult, or taking her someplace special.

Preschoolers – Ages 2 To 4 Years

At this age, your child is still very attached to you and does not yet understand how to share you with others. Your child also may be very sensitive to change and may feel threatened by the idea of a new family member. Here are some suggestions that may help ease your preschooler into being a big brother or big sister.

  • Wait a while before telling your preschooler about the baby. Explain it to your child when you start buying nursery furniture or baby clothes or if he starts asking about mom’s growing “stomach.” Picture books for preschoolers can be very helpful. So can sibling classes (ask your hospital if it offers them). Try to tell your child before he hears about the new baby from someone else.
  • Be honest. Explain that the baby will be cute and cuddly but will also cry and take a lot of your time and attention. Also, make sure that your older child knows that it may be a while before he can play with the new baby. Reassure your child that you will love him just as much after the baby is born as you do now.
  • Involve your preschooler in planning for the baby. This will make him less jealous. Let him shop with you for baby items. Show him his own baby pictures. If you are going to use some of his old baby things, let him play with them a bit before you get them ready for the new baby. Buy your child (boy or girl) a doll so he can take care of “his” baby.
  • Time major changes in your child’s routine. If you can, finish toilet training or switching from a crib to a bed before the baby arrives. If that is not possible, put them off until after the baby is settled in at home. Otherwise, your child may feel overwhelmed by trying to learn new things on top of all the changes caused by the new baby.
  • Expect your child to regress a little. For example, your toilet-trained child might suddenly start having “accidents,” or he might want to take a bottle. This is normal and is your older child’s way of making sure he still has your love and attention. Instead of telling him to act his age, let him have the attention he needs. Praise him when he acts more grown-up.
  • Prepare your child for when you are in the hospital. He may be confused when you leave for the hospital. Explain that you will be back with the new baby in a few days.
  • Set aside special time for your older child. Read, play games, listen to music, or simply talk together. Show him that you love him and want to do things with him. Also, make him feel a part of things by having him cuddle next to you when you feed the baby.
  • Ask family and friends to spend a little time with your older child when they come to see the new baby. This will help him feel special and not left out of all the excitement. They might also give him a small gift when they bring gifts for the baby.
  • Have your older child spend time with dad. A new baby presents a great opportunity for fathers to spend time alone with older children.

School-Aged Children – Ages 5 and above

Children older than 5 years are usually not as threatened by a new baby as younger children are. However, they may resent the attention the new baby gets. To prepare your school-aged child for a new baby,

  • Tell your child what is happening in language she can understand. Explain what having a new baby means and what changes may affect her—both the good and the not so good.
  • Have your older child help get things ready for the new baby by fixing up the baby’s room, picking out clothes, or buying diapers.
  • If possible, have your older child come to the hospital soon after the baby is born so she feels part of the growing family.
  • When you bring the new baby home, make your older child feel that she has a role to play in caring for the baby. Tell her she can hold the baby, although she must ask you first. Praise her when she is gentle and loving toward the baby.
  • Do not overlook your older child’s needs and activities. Let her know how much you love her. Make an effort to spend some time alone with her each day; use that as a chance to remind her how special she is.

Source: Adapted from Sibling Relationships (Copyright © 2007 American Academy of Pediatrics, updated 3/2007). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.