The First Two Months

							                  The First
                 Two Months




Fogel
Chapter 5   Created by Ilse DeKoeyer-Laros, Ph.D.
            Overview Chapter 5
•   Physical and Motor Development
•   Perceptual Development
•   Cognitive Development
•   Emotional Development
•   Family and Society



                       Experiential Exercises
                      Co-regulating with Baby
Physical and Motor Development
                Newborn States
The fetal states of rest & activity develop into
sleeping & waking states

               • at 32 weeks gestation: REM & non-REM
               • by 38 weeks: several other sleep states
               • newborns sleep about 17 hours per day,
                 throughout the day and night
               • by 3 or 4 months, infants sleep more at
                 night than during the day, but night
                 wakings are common in infancy and
                 early childhood
  Physical and Motor Development
                        Newborn States
State          Description
Quiet sleep Respiration is regular; eyes are closed and not moving;
(NREM)        the baby is relatively motionless
Active         Muscles more tense; eyes may be still or display REMs;
sleep            breathing is irregular; spontaneous rhythmic startles,
(REM)            sucks, and body movements
Drowsiness Opening and closing of the eyes; increased activity; more
             rapid and regular breathing; occasional smiling
Quiet alert    Eyes open, scanning the environment; body is still;
                 respiration is more rapid than in sleep
Active alert   Awake, body and limb movements, less focused than in
                 the quiet alert state
Crying         Elevated activity and respiration rate; cry vocalization;
                  facial expression of distress
 Physical and Motor Development
                   Waking States

Newborns have two basic modes of response to
stimulation: orienting & defense
 – orienting – a heightened alertness that includes
   behavioral localization toward the source of the
   stimulation (a head turn to the source of a sound)
 – defense – a behavioral action that involves withdrawal
   from the source of stimulation
 Physical and Motor Development
                 Waking States
Newborns will orient to stimuli of moderate
 intensity and complexity



                     soft talking, moderate light levels,
                     and holding & rocking can enhance
                     alertness
 Physical and Motor Development
                     Crying State
• Crying is an organized rhythmic activity
  – there are different cries with different body responses
    and cry sounds
• The frequency increases between birth and 2
  months – then, it decreases
  – similar in many cultures with different patterns of
    infant care & response to crying
  – infants cry more when parents are slower to respond
Physical and Motor Development
             Crying State

     Colic is crying in which
        1. the infant cries at least 3 hours a day, on
           at least 3 days per week, for at least 3
           successive weeks
        2. the parents find the crying very intense
        3. the infant is otherwise normal; and
        4. the infant is relatively unresponsive to
           soothing & feeding
 Physical and Motor Development
                     Crying State
• What causes colic?
   – unknown
   – not caused by digestive problems, sympathetic
     nervous system arousal, or cortisol levels
• Factors related to colic
   – mothers who were highly stressed during pregnancy
     had higher chances of having a colicky baby
   – colicky infants are more likely to have sleep problems
     & to be inattentive, emotionally reactive, and sensitive
     to touch, food, and other stimulation at 3 & 8 years
 Physical and Motor Development
       The Effects of Crying on Adults

• Adults perceive crying as an index of distress &
  they try to figure out the source
  – nonparents are as responsive as parents
  – levels of arousal & responsiveness are equal for men
    & women
• Child abusers show greater arousal & more
  annoyance at cries than nonabusers
 Physical and Motor Development
                Soothing Infants

• nonnutritive sucking (NNS) immediately soothes
• swaddling reduces motor movement & startles;
  keeps the infant calm for long periods
• daily massage enhances alertness, sleep, growth
  & reduces stress and crying
• rocking can calm or put infants to sleep
• continuous sound can be calming, esp. when
  moderately loud & of low frequency (e.g., singing
  lullabies, humming)
                Newborn States
Newborn state is important
 1. the body needs periods of tranquility and rest to
    consolidate resources for growth
 2. attention to the environment depends on a stress-free
    state of quiet alertness
 3. state regulates the types of interactions newborns have
    with their adult caregivers




                                                  Picture from: flickr.com
                                                                                    www.babyzone.com



                                               Reflexes
      Reflexes
         – semiautomatic behaviors, triggered only by specific
           elicitors
         – look about the same every time they occur
         – have to run their course once triggered


                                                        See examples of reflexes on YouTube, such
                                                        as the sucking reflex at
                                                        www.youtube.com/watch?v=KIgzqRaYJsg




http://health.allrefer.com/health/infantile-reflexes-moro-reflex.html
                      Reflexes
                      Purposes
• Primitive forms of orienting behavior
  – e.g., rooting, sucking, and grasping
• Primitive defensive reactions
  – e.g., the Moro reflex, reaction to a cloth on the face
• Elementary coordinations for later adaptive &
  voluntary movements
  – e.g., stepping, crawling, and swimmer’s reflexes
• No clear function
  – e.g., the Babinski reflex – although the lack of a
    Babinski response may indicate neurological disorder
                                  Picture from: www.susheewa.com/blog/?p=866
 Physical and Motor Development
                       Reflexes
• Reflexes are highly variable within & between
  infants
  – depends on individual differences, age, time since
    last feeding & number of attempts to evoke the reflex
• Many disappear by about 6 months
  – brain developments and other factors play a role
    (e.g., weight & muscle strength in the stepping reflex)
 Physical and Motor Development
                        Reflexes
In sum,
 – newborn reflexes are extremely important for orienting
   the infant to the environment & for protecting the infant
   from harm
 – movements related to reflexes are not simply
   discharges in the brain, but depend on muscle
   movement, weight, state, illness & many other factors
 – reflexes play a role in the active development of the
   muscles, leading to increased strength & coordination
 Physical and Motor Development
                     Growth




Asynchronous growth: different parts of the body
  grow at different rates & at different times
Physical and Motor Development
                     Sucking
Sucking is a reflex that is crucial for survival – it
changes over time & becomes more voluntary
 Physical and Motor Development
                       Growth
The newborn’s arms & hands are among the least
controlled parts of the body
 – arm & hand movements seem uncoordinated but
   detailed video analyses show that they occur in
   meaningful patterns
Physical and Motor Development
                The Brain



 Neuroscience – the study of the brain &
 nervous system as it relates to
 psychological & behavioral functions such
 as moving, thinking, and feeling
   Brain structures and functions


Major areas of the
brain
 – brain stem
 – limbic system
 – cortex
    Brain structures and functions

The prefrontal cortex is least developed in infancy
             – connects limbic & cortical areas
             – responsible for social & emotional
               regulation
             – involves thinking, reasoning, and judging




                                           Picture from: www.cast.org
 Brain structures and functions
Most developed in infancy
 – brain stem – controls autonomic functions such as
   breathing and heart rate
 – limbic system – processes emotions and memories &
   some body functions
    • the important structures are the hippocampus, amygdala,
      hypothalamus, and pituitary gland
    Brain structures and functions
                The Limbic System



• Hippocampus – important in
  the formation of memories for
  events & sequences (autobiographical memory)
  – during the first 3 years, the hippocampus develops
    links with the language & cognition areas of the cortex
• Amygdala – plays a role in the formation of
  emotional memories, especially those around
  fear & safety

                                       Picture from: homepage.psy.utexas.edu
    Brain structures and functions
                The Limbic System



• Hypothalamus – links the brain to the endocrine
  systems of the body via the pituitary gland
  – regulates stress, body temperature, hunger, thirst,
    and day-night rhythms
• The pituitary gland produces hormones
  – for stress regulation, maintenance of body state,
    sexual activity, milk production in nursing mothers, &
    cell growth

                          Picture from: www.crnasomeday.com/anatpages/pituitary.htm
 Physical and Motor Development
                Two Hemispheres

• Right hemisphere – processes the majority of
  social & emotional activity
  – major development during the first 2 years of life
    (emotion regulation, attachments)
• Left hemisphere – more specialized for thinking
  & language
  – develops more rapidly after the first 2 years
Fetal and infant brain development
                  A critical period
The period from the 5th gestational month through
the age of 3-4 years is a critical period for the
development of the human brain
 – To understand why, we need to look at the structure of
   neurons – information storage
   & transfer cells
Fetal and infant brain development
                     A critical period
The brain develops by four basic processes:
 1. New cells are created via mitosis during the prenatal
    period
    • most development after this occurs by making cell connections
      & by pruning of unused neurons
 2. The brain becomes more efficient
    • glial cells guide growth & migration of neurons (prenatally)
    • myelination increases the speed of conduction along the axon
      (mostly right before & after birth)
Fetal and infant brain development
                  A critical period
3. Synaptogenesis – cells grow more dendrites & axon
   terminals & make more synaptic connections &
   neurotransmitters
Fetal and infant brain development
                      A critical period
4.The role of experience
   • experience expectant pathways await specific
     environmental input
      • e.g., pain elicits crying
   • experience dependent pathways are based on
     unique experiences
      • those that are used most become strengthened; those that
        are used the least eventually die
           Optimal & non-optimal
            brain development

Neural plasticity – the ability of the brain & nervous
system to seek novelty, learn, and remember by
continuing to alter the patterns of connections
between neurons
 – intact brains retain plasticity throughout life
 – impairments in social & linguistic skills, along with brain
   abnormalities, develop in infants reared in orphanages
   or infants not exposed to appropriate language
     Optimal & non-optimal
      brain development


Each baby in the first two years of life comes
  to assess the social world as either a safe
            or a threatening place
         Optimal & non-optimal
          brain development
Neuroception – nonconscious evaluation of safety
 or threat, by the nervous system and not the
 conscious mind (Porges, 2004)
          Optimal & non-optimal
           brain development
Neuroception is regulated by
  – Sympathetic & parasympathetic nervous systems
     • Sympathetic nervous system – prepares the body for action
     • Parasympathetic nervous system – allows the body to relax,
       slow down, process information, engage socially, learn &
       grow; the vagus nerve is most responsible for neuroception
  – The HPA-axis
The HPA-axis
When stress occurs:


Hypothalamus: CRH

 Pituitary gland: ACTH

Adrenal glands: Cortisol
           Optimal & non-optimal
            brain development
• Cortisol prepares the body for action in response
  to stress
   – increases blood sugar needed for action
   – feeds back into the limbic system where it heightens
     the formation of memories related to the stressful event
• If stress is persistent, cortisol is overproduced
   – prolonged activation of cortisol suppresses the immune
     system & physical growth
   – too much stress leads to a tendency to feel fear and
     threat in the future & can lead to post traumatic stress
     disorder (PTSD)
Optimal & non-optimal
 brain development
           Optimal & non-optimal
            brain development
In sum, the first 3 years of life are critical for brain
development
 – for the development of the limbic & prefrontal parts of
   the right brain, which is dependent on the quality of
   love, emotional sharing, & social engagement received
   & perceived
 – not for cortical & left-brain processes like reading,
   math, thinking, or musical ability
    Optimal & non-optimal
     brain development

  It is more important for infant brain
development to spend quality one-on-one
and family time than letting the baby play
 for long periods with expensive toys, or
    listen to Mozart, or watch baby TV
                 programs
        Perceptual Development
• Ecological perception – experience that relies on
  direct perception through the senses
  – the senses form the basic ways in which we are
    connected to the environment
• Newborns have the ability to see, hear, taste,
  smell, and feel – although not as focused or
  discriminating as adults can
        Perceptual Development
Newborn visual acuity & visual processing are
poor but improve rapidly
 – visual acuity is only 20/500 on average, due to an
   immature nervous system
 – the newborn’s visual world is rather blurry, but the
   infant can see colors
 – as a result of experience-dependent brain
   development, visual acuity improves to nearly 20/20 by
   6 months
        Perceptual Development
• Oculomotor skills – movements that the eye
  makes to
  – bring objects into focus
  – follow moving objects
  – adjust for objects at different distances
• Newborns’ tracking of moving objects is jerky,
  and they only follow slowly moving objects
  – at 6-8 weeks, following becomes more adultlike
    Perceptual Development
Scanning – the eye traces a path across a visual
       stimulus in small, rapid movements
        Perceptual Development
• Oculomotor control adjusts the eyes to see
  objects at different distances
• Depth perception – the ability to judge the
  relative distances between two objects &
  determine whether objects are close or far
  – The ability to compare the two retinal images (and
    therefore to see distance) emerges slowly between 3
    & 6 months
        Perceptual Development
• Can newborns see patterns?
  – Studies show that newborns can detect differences
    between visual images & seem to prefer some
    images more than others
• Newborns prefer
  – objects with clearly marked edges & outlines
  – circular patterns over straight lines
  – the external contours of a figure, especially if the
    edges are sharp
        Perceptual Development
Newborns have perceptual preferences that are
likely to bring them into contact with things that
enhance their survival
 – infants prefer faces over other objects
 – 1-day-old infants change their sucking response to see
   a picture of their mother’s face rather than the face of
   an unfamiliar female – but not when the mother is
   shown wearing a scarf
 – newborns prefer to look at faces judged by adults to be
   more attractive
 – they also prefer faces in which the other person’s gaze
   is directed toward the infant rather than averted
             Auditory Perception
• The auditory system is more mature at birth than
  the visual system
• Auditory sensitivity (sensitivity to sounds)
  involves loudness & pitch
   – newborns can hear sounds of 40-60 dB but only
     sounds from 50-70 dB can awaken them
   – they prefer sounds in the middle range; higher pitch
     over lower pitch; sounds made up of more than one
     note; and melodic sequences over a jumble of
     unrelated notes
             Auditory Perception
The most common source of such sounds is an
adult female voice, talking or singing
 – newborns prefer to listen to a song or story that their
   mothers had sung or read aloud 2 weeks prior to birth
   over an unfamiliar song or story
 – newborns seem to prefer heartbeat sounds similar to
   those they must have heard prenatally
 – infants can distinguish the voice of their own mother
   from the voices of other women.
             Auditory Perception
How do newborns distinguish speech sounds from
different people?
 – They may detect overall patterns of rhythm & pitch that
   differentiate one person from another
 – They may be able to hear differences among syllables
   that give them cues about a speaker’s uniqueness
    • By 1 month, they distinguish two very closely related speech
      sounds (e.g., “p” and “b”) and by 2 months, they recognize
      vowel differences
                      Taste
Newborns seem to distinguish the four basic tastes:
sweet, salty, sour, and bitter
                 – They show different responses to
                   these four tastes
                 – Sweet fluids seem to relax (see
                   pictures)
                 – Sour, bitter & salty tastes elicit
                   negative responses
                       Smell
• Newborns can differentiate between odors (incl.
  vinegar, licorice, & alcohol)
  – In response to unpleasant odors, they make faces of
    disgust and turn away
• They may recognize their mothers by odor
  – Newborns turn their heads more to a pad containing
    their mother’s breast milk than to one containing
    another woman’s milk
  – Breast-fed infants can also recognize their mother’s
    underarm odor & perfume & they prefer the smell of
    any breast milk over other types of smells
                        Touch
Many reflexes are stimulated by touch & newborns
show changes in behavior & heart rate in response
to tactile stimulation
 – They adjust hand & mouth movements when feeling
   soft vs. hard objects, or smooth vs. textured objects
 – They visually recognize an object they had previously
   touched, but not the other way around
 – In response to medical procedures (e.g., injections,
   circumcision), infants show increased distress and may
   exhibit sleep disturbances
          Perceptual Development
In sum,
 – newborns perceive with all their senses and their
   sensitivity improves rapidly over the first few weeks and
   months, due to brain development & experience
 – many forms of stimulation have no particular meaning
   for the infant but others are meaningful (e.g.,
   recognizing mom, crying in response to pain)
       Cognitive Development


Newborns possess a number of ways to process
  information that are referred to as cognition –
     including learning & memory, orienting &
             habituation, and imitation
         Cognitive Development
• Classical conditioning
  – possible when the unconditioned stimulus (UCS)
    evokes a rewarding natural response, such as a
    sweet taste
• Operant conditioning
  – once infants learn the connection between their
    behavior & a reinforcement, they can signal their
    preferences, using sucking rate or head turn
  – newborns can remember (e.g., a word repeated by
    mom) for appr. 24 hours & they prefer familiarity
       Cognitive Development
• Habituation is the decline in strength of
  responding after repeating the same stimulus;
  dishabituation is renewed interest
• Newborns’ motor and heart rate responses have
  been found to habituate to auditory stimuli,
  visual stimuli, and tactile stimuli
• Habituation can also be shown in premature
  newborns and even in infants born without a
  brain cortex (anencephalic)
          Newborn Imitation




Meltzoff & Moore (1977) showed that 12- to 21-
 day-old infants could match tongue protrusion,
  lip protrusion, mouth opening, hand opening,
                 and hand closing
              Newborn Imitation
• These findings have been replicated
   – One study showed that newborns also matched
     moving objects
   – One study found imitation of surprise, happy, and sad
     facial expressions
• Other studies failed to replicate these findings
   – babies show a wide variety of gestures following the
     model
   – there are wide individual differences
              Newborn Imitation
Newborn imitation may be a way of relating to
people
 – Infants who imitated more at birth gazed away from
   their mothers less at 3 months
 – Newborns’ imitation of tongue protrusion showed a
   different pattern of heart rate change compared to when
   they initiated the same movement (as if to get a
   response)
 – 6-week-old infants spontaneously reproduced the
   imitative response they had learned 24 hours earlier
   when seeing the adult model
       Newborn Self-Awareness:
                The Emergent Self
Evidence for early self-awareness comes from
studies that show
 – Newborn imitation (distinguishing own movements from
   the movements of others)
 – Differential rooting (more when touched by someone
   else than by touching self)
 – Differential crying (more when they hear tape
   recordings of other infants’ cries)
Newborn Self-Awareness:
      The Emergent Self


 The emergent self is the sense of
     self-sameness over time in
  behavior, feelings, and states of
              arousal
        Cognitive Development
In sum,
 – newborn cognition is limited to some simple forms of
   learning, memory, habituation, imitation, and self-
   awareness
 – early learning and memory are fundamental to survival
      • recognition of maternal sounds and smells
      • learning to orient to sweet fluids & milk
      • learning to avoid noxious smells & tastes
 – newborns prefer familiar sights, sounds, tastes, &
   feelings, and do not like to be stressed or challenged
                   Emotional
                  Development


Newborns can feel distress, contentment, disgust,
interest, & surprise
 – newborns ‘savor’ sweet liquids
 – they cry, thrash about, stiffen their bodies when
   distressed
 – when attending to faces, social interaction, & moving
   objects, they may show expressions of interest &
   surprise
      Emotional Development
• Some expressions (e.g., smiling) do not occur
  with any clear link to the situation
• Emotional development depends in part on how
  newborn forms of expression are interpreted by
  adults
             Family and Society
Adults and infants have mutually complementary
communications that get their interaction started
and set the stage for later emotional ties
 – Attachment – the maintenance of
   mutual proximity over time
 – Bonding – skin-to-skin contact
   immediately after birth,
   between mother and infant




                                     Picture from: raisingchildren.net.au
             Family and Society
            • Mothers & fathers explore the
              newborn’s body in a patterned way
              when given the opportunity –
              apparently important for survival
• However, there is no conclusive evidence linking
  these first few minutes of contact with later
  attachment security
  – When there is no immediate post-birth contact, lasting
    attachments can still be formed



                                           Picture from: www.smh.com.au
             Family and Society
There is also a social-psychological component
that may form the basis of later interpersonal
communication and attachment
 – early feeding patterns (suck-pause, jiggle-stop, suck-
   pause, jiggle-stop, etc.) precede later social discourse
 – animated adult faces & brightly colored objects prolong
   periods of alertness
 – the duration of parent-infant face-to-face play & infant
   attention gradually increases over the first 2 months
           Family and Society
• Studies of large-scale national samples show
  that fathers spend 20-35% as much time as
  mothers in direct infant care
• Men’s ability to participate in
  parenting tasks depends on
  the amount of social support
  they receive, particularly from
  their partners
• The more involved fathers
  are, the more involved they
  become
      Family and Society
• Father-infant and mother-infant interaction
  can be enhanced by specific interventions to
  orient parents to their newborns
  – E.g., 12-week-old infants whose fathers had
    been trained in massage & bathing were more
    likely to interact with their fathers & fathers were
    more likely to be involved with their infants than
    non-trained fathers
• Parenting occurs within a family system



                                       Picture from: www.childways.co.uk
            Family and Society
• First-time parents appear more hesitant with
  their babies, but this difference disappears after
  several months
                  • Firstborn newborns receive
                    more caregiving interaction
        Experiential Exercises:
                        Sucking
• Sucking is the first mouth movement that we
  master –later we build on our infant sucking
  ability as we learn to control thousands of other
  mouth & face movements
  – Lie on your right side in a fetal position, and place
    your hands close to your mouth
  – Gently protrude your lips & tongue and experiment…
  – Now try sucking movements…
• Many people experience a deep relaxation of
  the face after doing this lesson. What was your
  experience?
         Experiential Exercises:
          Somatic Awareness of the Hands
•   Sit in a chair & close your eyes – become
    aware of your body in the chair
•   Now, notice your hands – what position are
    they in? How do they feel?
    – Slowly move your hands…
    – Now, slowly curl & uncurl your right hand – then the
      left
    – Let your hands explore your body, clothes, the chair,
      & each other
    – Open your eyes and look at your hands as if you’ve
      never seen them before