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Emotional Development : Researchers Identify Babies' Milestones

January 22, 1985|SANDY ROVNER | The Washington Post

Some babies, declares one researcher, "seem to be born three drinks ahead." More mellow, that is, than most.

(That's three figurative drinks, of course. Even three drops would be too much--and do no good--for inconsolable newborns.)

Almost any mother of two or more will tell you that no two are alike--from the moment of birth. Along with the laid-back babies, who seem to take to life--to take on life--with zest and equanimity, there are the babies who are born in a state of what the infant psychiatrists call "emotional disorganization," seemingly unable from day one to deal with the stress of being alive.

But experts today are finding that these apparent differences--whether observed by midwife, psychiatrist or modern mom--are genuine manifestations of budding emotional organization on the part of the infant. Some do it better than others. Some can't do it at all without some immediate help. Others may stumble--or be tripped--along the way.

Emotional Milestones

Building on the pioneering work of Swiss psychologist Jean Piaget, who laid out the steps in the cognitive development of the child, today's child psychiatrists, including a team at the National Institute of Mental Health and a spinoff group of clinicians in private practice, have identified similar step-by-step development of emotions.

And they are discovering subtleties of emotional learning, requiring specific parental (or care-giver) participation beginning at birth. Some of the emotional steps, or milestones if they are missed, can retard subsequent development on the intellectual or cognitive, as well as the emotional level. In its most severe form, a child's failure to master increasingly complex emotional milestones can cause him to withdraw from the human world into what appears to some as a kind of autism.

Sometimes, pioneering child psychiatrist S. Reginald Lourie says, these emotional deficits can even be fatal.

Much of the initial work on emotional development was in families where specialists perceived particular risk factors--psychiatric illnesses, lack of support systems and other ongoing and serious problems. But Lourie, who was for 25 years director of psychiatric services at Children's Hospital National Medical Center in Washington, Dr. Stanley I. Greenspan, Dr. Robert Nover and other researchers at the Mental Health Study Center of the National Institute of Mental Health, now have amassed enough evidence to document this conclusion:

Attention to an infant's emotional state, according to specific milestones they have been able to set forth, is as important to any assessment of any baby as is his rate of growth, IQ or physical health, whether or not risk factors exist in the family.

Pinpointing Emotional Patterns

Greenspan, chief of the study center, says that years of study and clinical treatment of multi-risk families, along with observations about the varying temperaments of newborn infants, have now permitted the mapping of "emotional milestones of early development."

"This permits us," he says, "to pinpoint not only when a child sits up, crawls, walks, talks--those kinds of things every parent looks for--but, with growing specificity, the normal or maladaptive emotional patterns in babies and young children."

How critical these milestones may be is demonstrated by results of a recently completed study, Greenspan says, "showing that the more risk factors (likely to interfere with mastering the emotional milestones) a family has, the more probability there is of compromised intellectual and emotional development later on."

The study showed that in families where emotional disturbances in the parent were severe and chronic and no other support existed--such as a grandmother or well father--"there was a 20- to 25-fold greater probability of severe compromise of intellectual development by the age of 4, compared with those in families with only one or two (risk factors)."

These are the most severe cases. But research has also taught the specialists that even when the infant seems to miss the milestones--and the mastery of each is dependent on mastery of the one before--some form of intervention, perhaps only a matter of helping the care-giver read the baby's signals, can be valuable.

"When the child is beginning to go off the road at say, 4 months," Greenspan says, "it's a lot easier to nudge the child and the parents back onto the road than it is at 4 years, when you already have three years of perhaps maladaptive emotional coping strategies being built up."

Major Objective to Communicate

Because so much of this work is so new--much of the knowledge amassed or confirmed only in the past five or six years--a major objective has been to communicate the findings to pediatricians, neonatal nurses and other care-givers. A goal is that emotional assessments become part of the routine so-called "well-baby examinations."

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