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Pride
in Parenting: Training Curriculum for Lay Home Visitors
Linda
T. Diamond, M.S. and Marion H. Jarrett, Ed.D., editors.
Unit 17
Child Growth and Development: Four to Eight Months
In this unit, participants will review developmental milestones of infancy, learn how to help parents understand stages of development and interpret infant behavior, share activities that both parents and their babies will enjoy, recognize possible problems in infant growth and development and identify available resources for babies and parenting families.
| Objectives |
By the end of this unit, participants will be able to:
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| Time | 32 hours |
| Outline | A. Developmental
Milestones |
| Materials |
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| Advance Preparation |
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A. Developmental Milestones
(14 hours)
| Rationale: | Give the
Parenting Support Specialists a framework into which to fit the detailed
information which is to follow by introducing the 4 to 8 month old
baby based on information in Caring for Your Baby and Young Child
pp. 189-190.
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1. Appearance
| Rationale: | Mothers will continue to notice changes in their baby's physical appearance during these early months. Parenting Support Specialists can help mothers know what to expect. |
| Procedure: | Mini-lecture. Babies should continue to gain about 1 to 1 1/4 pounds a month. By 8 months, the baby will weigh about 2 ½ times what he weighed at birth. His bones continue to grow. He will get about 2 inches longer during this period and his head will grow about an inch. (Refer to Growth Chart). How much the baby grows is not as important as the rate of growth. Each time the mother goes to the doctor, he will plot the baby's height, weight and head circumference on a growth curve to be sure the baby is following the same curve. |
2. Skill Areas
| Rationale: | Understanding normal growth and development will help PSSs interpret baby’s behavior to parents. |
| Procedure: | a.Timeline Activity Ask participants to choose a partner. In teams, have participants place various developmental tasks from birth to 8 months (written on post-it notes) at the approximate age where they first appear on a timeline posted on the wall. The timeline should include each month from birth to two years of age. (Save this timeline and use it in future sessions.) When all developmental tasks have been placed, ask the participants to look at the timeline and, following discussion, make any changes they wish. Tell them that we will review the timeline at set periods during the day and they can make further changes during these times. b. Mini-lecture and demonstration. Review the developmental milestones presented in Caring for Your Baby and Child, pp. 191-202. Give each participant a copy of Developmental Milestones (Handout #1). Include Movement, Vision, Language Development, Cognitive Development, and Emotional Development. Write these categories on a flip chart and tape this paper to the wall in the front of the room. Discuss and demonstrate the skills in each of the developmental area. Use appropriate toys to show skills, ask participants to give examples of skills from their own family or experience with children, and connect present skills to development during the first four months. Review the relationship between object permanence and separation anxiety, and between development of the pincer grasp and introduction of finger feeding. c. Videotape and discussion. Show a typical 4-8 month old baby using the video, "The Developing Child-Infancy." Ask the trainees what skills they observe in each developmental area. Process their responses by writing them on the flip chart. Participants may discover that some observed skills can represent more than one area. Stress the inter-relatedness of skills throughout infant development. d. Activity: Review of Timeline. Ask participants to look at the Developmental Milestones (Handout #1) they have and check the placement of the developmental tasks on the timeline. Tell them to change any they now think should be in a different place. Discuss any differences of opinion stressing the individuality of each child and the range in which skills normally develop. |
3. Developmental Alerts (2 hours)
| Rationale: | Since PSSs will be seeing mothers and babies regularly. Their knowledge of developmental alerts can help them identify potential problems that could result in needed intervention. |
| Procedure: | a. Discussion. Remind participants that each baby is an individual and will develop at his own rate. However, there may be times when the Parenting Support Specialist is concerned about a baby during this time of 4 to 8 months. Ask participants to tell you what they would consider warning signs for medical or developmental problems during this period. Process their answers by writing them on the flip chart. b. Activity. Refer each participant to their copy of the Developmental Alerts Handout (Handout #3) from Resource Mothers Unit 12 and the Developmental Health Watch (Handout #4) from p. 200-1 of Caring for Your Baby and Child. Ask them to incorporate the Alerts from Resource Mothers into the longer Developmental Health Watch List, then match any warning signs that were listed by the trainees to the ones included on the charts. Discuss each of the developmental alerts and health watch points. Have participants point out into which development area each health watch fits. Answer any questions they have about what is normal or typical development and when they should be concerned. Also, introduce basic special needs vocabulary such as cerebral palsy, mental retardation, autism, etc. c. Activity. Refer each participant to their copy of Safety Check (Handout #5) from p. 213-214 of Caring for Your Baby and Child. Discuss each item. Ask participants why they think it might be difficult for the mothers with whom they are working to follow these safety rules? How might they encourage them to follow the rules? Ask them to be specific. Give each participant "Immunization Alert" (Handout #5). Review. |
B. Providing Guidance and Support (7 hours)
| Rationale: | In this part of the training, participants will examine ways to interact with infants and with parents around child development issues. As pointed out in the Resource Mothers training, it is important for Parenting Support Specialists to learn how to support and encourage without undermining the self-esteem of the parents. |
| Procedure: | 1. Preparation for "Providing Guidance and Support". Explain the activities to be done in Providing Guidance and Support. Have books, curricula, kits and other developmental materials to be used available for review by trainees. 2. Review of Developmental Milestones as they appear on the flipchart and timeline. Discussion of feeding as it relates to this age level:
Discuss Behavior and Discipline as presented on pages 211 and 212 of Caring for Your Baby and Young Child as well as other relevant information for this age such as: Discipline is a gift to a child, not punishment:
Present short scenarios for group. After each scenario ask: Are expectations realistic? What should happen?
This topic will be covered in detail in a later Unit. 3. Mini-discussion. If Parenting Support Specialists understand the usual course of development, they can make judgements about what kinds of play and interaction will facilitate development and can help guide the parents whom they work with. Ask participants to think about the 4-8 month old: How might parents best play with their babies during this time? What are some toys that might encourage the baby to develop skills appropriately? 4. Use the Partners in Learning Curriculum cards (1 hour) Describe the format of the curriculum cards and how they will be used on the home visits. Review the developmental functioning areas that are targeted by the activities. Ask the group to name the area being targeted by some sample activity cards. Role plays with Partners cards (1 hour) Divide the group into pairs and give a Partners card to each PSS. Have each pair role play for the group with one person being the mother and the other PSS presenting the Partners activity for that visit. Have the group comment on each role play. Use Overhead #1 to guide feedback. Baby demonstrations (1 hour) Arrange to have a normal infant between 4 and 8 months join the group to demonstrate developmental skills characteristic of this age range. Point out the infants social interactive capability at this age, how she/he uses toys, the type of vocal behaviors she/he demonstrates, and her/his gross motor skills. Have each of the PSSs engage the infant in an activity. Be sure to have some appropriate toys available. 5. What is perception? Discuss idea of different perceptions, particularly of mothers, PSSs, daycare workers. When attempting to relate to another person:
What goes into our perceptions?
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C. Site Visit (7 hours)
| Rationale: | Observing infants and caregivers at this stage will make the information more meaningful to the PSSs. |
| Procedure: | Participants visit day care center, day care homes, or other programs to observe typically-developing infants from four to eight months old. Participants may all visit one center or go to two or more to different centers. A member of the Pride in Parenting training staff should be present for part of the time or should ensure that on-site staff are able to guide trainees in observation and interaction with infants. Ask each participant to focus on one child as they follow along the site visit observation form (Handout #6). After everyone has completed their site visit, come together as a group. Ask each participant to discuss the child(ren) she observed and the developmental milestones she observed. How did the parent/caregiver facilitate the child's development? Return to the site observations when talking about developmental alerts. |
D. Summary and Review (15 minutes)
| Procedure: |
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Unit 17 Handout #1
Developmental
Milestones
Four to Eight Months
By the End of This Period
- Brings hands to feet and feet to mouth
- Reaches for toy with one or both hands
- Rolls stomach to back and back to stomach
- Sits alone and plays with toy
- Able to hold a small object in each hand
- Bangs objects in play
- Brings hands across midline
- Tries to pick up small objects
- Anticipates routines when sees familiar objects (bottle)
- Explores objects by mouthing, shaking and banging
- Finds a toy that has been partially hidden
- Begins to understand the concept of simple games (peek-a-boo)
- Imitates vocalizations and actions
- Recognizes self in mirror
- Babbles strings of sounds (da-da-da-da)
- Begins to imitate sounds
- Smiles and laughs during play
- Stops crying when talked to
- Responds to own name
- Recognizes a few familiar words (bye-bye, mommy)
- Knows primary caregiver from others
- Shows mild to severe anxiety at separation
- Infant to infant interaction increases
- May cry when left alone or put down
- Shows awareness of strange environments
Unit 17
Handout #2
Helping Parents to Be Parents
The following guidelines illustrate some ways that PSSs can help their clients become more successful parents.
1. Give the idea of being a mother or father positive meaning and identity.
Help parents feel like parents -- admire them. Give them credit for what they do, have fun together with the infant, and reassure them that their infant is doing well.
Indirect comments are useful. Don't just admire the baby. As you say something positive about the baby, credit the parents. For example:
- "Mommy dressed you so warmly today. She knows exactly what you need in this cold weather."
- "You are so big; Mommy knows exactly how to feed you to make you grow."
- "You are so nice and clean; Daddy knows exactly how to give you a bath."
- Other examples?
2. Make the mother and father feel special.
Support and encourage the attachment between parent and child. For example:
- As the baby smiles at the parent you might say, "Mommy gets the best smiles from you! I know how much she loves you!"
- When the baby looks at your new or strange face say, "You sure know your Mommy best of all. I can see you staring at me. You don't know me at all!"
- When the baby fusses you can say, "Mommy knows how to comfort you best of all," as you guide and support her response to calm the infant.
- Other examples?
3. Focus on the infant or parent's experience and not on right or wrong.
Communicate to your clients the fact that babies have feelings by "talking through the baby." This means that the PSS talks as though she were the infant. For example:
- "Hold me tight. I like to be wrapped up tightly too."
- "Don't turn me so fast. It's scary and I'm afraid I'll fall."
- "Lunch was delicious. I really love your milk, Mommy."
- Other examples?
4. Focus on issues relevant to the baby's specific stage of development.
To help parents learn to read the baby's cues and signals you might say:
- "You want to tell Daddy something, don't you?"
- "Look how he turns around to look for you just after he crawled away. He's making sure you're still there."
- "You need your Mommy's help, don't you?"
- Other examples?
5. Focus on how the present behavior of a client's baby will impact on the future.
If you see the baby with a book you can say, "When you grow up you're going to be so smart because Mommy is already getting you ready!" By saying this, you can encourage the reading of books to the baby.
- If the baby pounds on a toy, "Mommy is so good with tools and you are following in her foot steps."
- Other examples?
6. Build the parents' self-esteem by selecting and admiring success.
Every time a child is doing well, point it out and paint a picture of the child as a successful learner and the mother (or father) as a successful parent.
- "You really got him to listen when you got his attention first, before asking him to do something."
- "You really taught her how to put away her toys when she's done playing."
- Other examples?
In Summary:
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Unit 17 Handout #3
Developmental
Alerts
This is a checklist that the PSS can use when observing a client's child on her 6 month visit. Remember that all children are different, so it's not essential that each baby is able to do everything on this list at a given month. But if the PSS observes children who cannot do many of the things suitable for their age, she should encourage her clients to talk to their health care providers about their babies' development.
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6 Months:
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Unit 17 Handout #4
Developmental
Health Watch
Four to Eight Months
- Seems very stiff, with tight muscles
- Seems very floppy, like a rag doll
- Head still flops back when body is pulled up to a sitting position
- Reaches with one hand only
- Refuses to cuddle
- Shows no affection for the person who cares for him
- Doesn't seem to enjoy being around people
- One or both eyes consistently turn in or out
- Persistent tearing, eye drainage, or sensitivity to light
- Does not respond to sounds around him
- Has difficulty getting objects to his mouth
- Does not turn his head to locate sounds by four months
- Doesn't roll over in either direction (front to back or back to front) by five months
- Seems inconsolable at night after five months
- Doesn't smile spontaneously by five months
- Cannot sit with help by six months
- Does not laugh or make squealing sounds by six months
- Does not actively reach for objects by six to seven months
- Doesn't follow objects with both eyes at near (1 foot) and far (6 feet) ranges by seven months.
- Does not bear some weight on legs by seven months
- Does not try to attract attention through actions by seven months
- Does not babble by eight months
- Shows no interest in games of peekaboo by eight months
Unit
7 Handout #5
Safety Check
Four to Eight Months
Car Seats
- Buckle the baby into an approved, properly installed car seat before you start the car. Keep the seat in backward-facing position until the child is able to sit independently.
Drowning
- Never leave a baby alone in a bath or near a pool of water, no matter how shallow it is. Infants can drown in just a few inches of water.
Falls
- Never leave a baby unattended in high places, such as on a tabletop or in a crib with the sides down. If he does fall, and seems to be acting abnormally in any way, call the pediatrician immediately.
Burns
- Never smoke, eat, drink, or carry anything hot while holding a baby.
- Prevent scalding by reducing the water heater setting to 120 degrees or lower.
Choking
- Never give a baby any food or small object that could cause choking. All foods should be mashed, ground, or soft enough to swallow without chewing.
Immunization Alert
At four months your baby should receive:- Second DTP injection
- Second oral polio vaccine
- Second HBCV injection
And at six months:
- Third DTP injection
- Third oral polio vaccine (only in high-risk areas)
- Third HBCV injection
Unit 17
Handout #6
PIP Training
Site Visit Observation
Age of Child Observing:
Number of Children:
Number of Adults: 1. Observe the environment carefully; look at facilities, materials and personnel. In what way(s) is it appropriate for:
a. Children’s
play and interaction:
b. Daily caretaking:
c. Safety:
a. Children’s
play and interaction:
b. Daily caretaking:
c. Safety:
a. Motor:
b. Cognitive:
c. Emotional:
d. Social:
e. Communication:
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What the Child Prefers |
How Do You Know |
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For Toys or People? |
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For Specific Toys?
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Unit 17 Overhead #1
Role Play Feedback
- What do you think you the Parenting Support Specialist did well?
- What could the Parenting Support Specialist have changed or done differently?
- What other things do you think the Parenting Support Specialist might say or do to help a mother in this situation?
Unit 17 Post-Unit Test
- List 5 major developmental milestones during the 4 to 8 month period.
- List 3 specific ways a parent can help her baby develop during this period.
- What changes occur in the baby at this stage of development that require changes in parenting?
- How can a PSS work with parents to encourage their growing attachment to their baby?
- List 3 developmental observations about which a PSS should be concerned.
Unit 17
Handout for use at end of each Unit
Post-Unit Evaluation
Unit
Covered: _____
Date: _____
- Do you feel we covered all the information in this unit that we said we were going to?
- What did you like best about the unit?
- What did you like least about the unit?
- Was the information in this unit presented clearly? If not, please explain.
- In which skill areas do you feel you need more practice or help?
- How can we make this unit better?
- Any additional comments?
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View Description for this Item
University of Illinois at Urbana-Champaign