CHILDREN, COMMUNICATIONS, COMMUNITIES: Enhancing the Environments for Learning

Amer. J . Orthopsychiat. 52(4). October 1982

CHILDREN, COMMUNICATIONS, COMMUNITIES: Enhancing the Environments for Learning

Ann DeHuff Peters, M.S.W., M.D.

n an editorial in Science some years I ago, Margaret Meadz1 pointed out that parents, from their own experience, no longer can pass on all essential skills and techniques to prepare their children for their lifetimes. The explosion of technology has resulted in rapidly changing learning environments for the new generation. Parents and other adults in our society marvel at but are also threatened by the requirements and potentials. The rapidity of change has posed an even greater challenge to professional training for those of us who try to help families.

Learning, beginning at birth, or even antenatally according to some students in the field, obviously develops initially in interaction with family members. Numerous efforts have been and are being made to influence what goes on between parent and child. The field of parent education has been wide open, even before the days of WatsonJ1 and others, whose authoritative treatises and “thou shalts” received varying re- sponses from the literate audience to whom they were addressed. Most such

early works were not based on studies of large groups in which sophisticated statistics had been used. Rather, they came from convictions that certain things were right and everything else was wrong. (Does this sound familiar- another type of “Moral Majority?”) It is important to recognize in this context that statistics can be made to serve the same end. Statistical methods can only indicate the chance you take of being right or wrong. Even then, the techniques of analysis cannot improve a poor study.

Fortunately, many parents found it impossible to follow Watson’s advice to withhold any demonstration of affection and treat the young child like a miniature adult. As the world has proceeded, with ever more middle-class parents eager for “the word,” the plethora of books, magazine articles, films, parenting classes, and-newest of all-”Parent Effectiveness Training” have flooded the field and filled many a pocket. I do not deny that many young parents find consolation in reading about or in dis- cussing their children with others. A

The Presidential Address to the 1982 annual meeting of the American Orthopsychiatric Association, in San Francisco. Ann DeHuff Peters served as President of the American Orthopsychiatric Association, 1981-82.

646 0002-94321 821 040646-09 $00.75 @ 1 982 American Orthopsyc h iatric Association, I nc.

ANN DEHUFF PETERS 647

good number of years ago, I myself was greatly reassured in trying to cope with a crying baby at three o’clock one morn- ing by finding six different references on “crying” listed in the index to Spocks Pocket Book of Baby and Child Care.27 However, in many instances there has been no systematic effort to look at the appropriateness of a given offering to different audiences. We also assume that everyone can and does read, and we continue to write the same kind of com- plex sentences. We ignore the fact that many parents in many places happily raise their children without advice from the experts.

A serious lack of much presently- organized parent education is failure to involve the parents in designing the process to meet their particular needs and goals. Another problem stems from poor understanding of cultural and indi- vidual differences in goals and func- tioning. Can and should parents’ goals for their children be encouraged or sup- pressed? Is it wrong to push children to strive for excellence-as baseball pitch- ers, doctors, pianists, politicians, jock- eys, champion ice skaters? Stress and anxiety may not of themselves be detri- mental to learning, as Bower’ Stringer,** and othersI9 have shown. Is it right to be critical of families because they don’t fit one or another theoretical model? Are we, in our own professional training, open to change, to challenge? In insensitive hands, cumculum may be used in rigid and sequential fashion to alienate rather than help families. A parent effectiveness training session ordered by a southeast Texas judge for teenage parents accused, in my opinion without substance, of neglecting their two small children elicited the following description from the 18-year-old father:

“Well, she came out to the house and colored some clothespins and showed us how to put them in a coffee can.”

Messages pass constantly between children and the adults who care for them. The kinds of messages are strongly dependent upon the sense of personal integrity of the parents and other adults, their conviction about the worth of their efforts, and the cultural mores and milieu of the family. In many instances, we professionals have systematically helped to undermine these very qualities by focusing on our own concepts of potential or actual psychopathology, rather than recog- nizing and working to enhance family strengths. In 1938, Z i l b ~ o r g ~ ~ warned against overestimation of psychopathology. Not enough of us have heeded this wise advice.

For example, my own specialty, pediatrics, has long been guilty of such myopia. Most pediatricians come from middle-class families and have had little or no training in child development, child rearing, cultural diversity, or education. Despite this, members of our specialty have been systematically in- doctrinated over nearly 50 years to in- struct parents, “Just bring your questions and problems to me, and I will tell you what to do.” Since our training is heavily slanted toward pathology, that is what we seek. In treating major or minor problems of illness, we are often too busy to listen to the burning questions about behavior or to recognize that the quiet parent may be afraid to ask. Korsch16 and others’ have repeatedly documented the communication problems between physicians and patients. Are physicians indeed the best qualified to advise about child rearing, and do they reach the population most in need?

648 ENHANCING LEARNING ENVIRONMENTS

Has the move of social workers, psy- chologists, and educators into offices and private practice made them less ac- cessible to all except the most assertive? Are these the patients and clients who most need help? Do we all end up coun- seling the same individuals while bliss- fully closing our eyes to other, less amenable problems?

y professional life has been spent M with children and young families, and for the past 25 years I have been much involved with day care. As a clinical pediatrician in the 1950s, I saw many young children brought to a medical setting by adults other than their parents. These children were spending all or part of the day in other households or in organized centers. As a professional woman with small children at home, I was well aware of the need for help with child care. I began to inquire what was available to parents. The inevitable re- sult was that I was asked to chair a committee.

This national interdisciplinary committee asked questions that appeared to put the welfare establishment on the defensive. Where are young children during the day? Who looks after them? What do they learn and who helps them? Why are infants excluded from day care? If we are concerned with “good” learning environments, why has day care licensing never worked? Was the professional community doing anything about these issues? In those early 1960s, Spitz’s s t u d i e ~ ~ ’ . ~ ~ of infants in seri- ously deprived institutional settings were cited as the final word on the danger of care in groups for very young children. Day care as a service for children under three was almost universally forbidden in this country by state and

local agencies responsible for supervi- sion of children’s services.23 The Di- rector of Child Welfare Services at the Children’s Bureau told Dr. Carolyn Chandler and me, “You know very well that the only place for babies is at home with their own mothers.” However, only the United States and Great Brit- ain, of all industrialized countries, had not subsidized the development of day care programs for children of all ages whose parents were employed.” Most full-day programs had grown “like Topsy,” without organized plans, se- cure financing, or long-term goals for the enhancement of child development. Only the part-day nursery schools, organized first in the 1920s by and for the affluent middle class, had any kind of formalized educational component.

The questions and findings of this national committee led to a series of multidisciplinary conferences at the Na- tional Institute of Mental Health focusing on the child under the age of three.I2 Some of the participants voiced serious and vigorous reservations about “allowing” a child to be cared for by anyone except its biological parents. This attitude puts biology ahead of knowledge, and assumes that procre- ation prepares individuals for the com- plex tasks of child rearing. Other equally vocal participants maintained that biological parents could not carry this responsibility alone, that society should help them. Some even said they knew better than parents what was good for children. Out of the arguments and questions, plans were generated and new studies initiated, as well as communication between sometime dispa- rate individuals. Several research- demonstration programs-the Syracuse Children’s Center, the Frank Porter


Graham Child Development Center in Chapel Hill, the Infant-Care Center of the University of North Carolina, Greensboro-went on to compile im- pressive records of achievement.

The early ’60s was an exciting period for those professionally involved with child development and family relationships. Contributions to developmental theory of Erik Erikson, Jean Piaget, and others were bringing a wider perspec- tive to the study and understanding of the complexities of human development. New disciplines-developmental and educational psychology, sociology, cultural anthropology, special nursing, education--enlarged the traditional “team” of physician, clinical psycholo- gist, and social worker. The election of President Kennedy, knowledgeable about mental retardation and committed to help, brought developmental dis- abilities out of the closet. Project Head Start was under way. Federal agencies such as the Children’s Bureau, the Of- fice of Economic Opportunity, and the Office of Child Development encouraged program-oriented research, and looked for ways to help translate research into practice.

At the same time, integration of the public schools, mandated in 1954, was finally beginning to occur. These early efforts to change what had become an entrenched educational distortion placed the spotlight on our schools. What we saw was not very pretty. A spate of popular books-Why Johnny Can’t Read, l 4 a testimony to the ineffec- tiveness of our educational efforts; Death at an &rly Age;‘7 and Manchild in t k Promised Lund, which attested to inequities in our supposedly democratic society-were accompanied by Coles’s moving descriptions of black children in

the So~theas t ,~ in migrant familes,’ and as newcomers to the ghettos of North- em cities.6 This evidence of our failures as a fair and just culture were shocking to white middle-class sensibilities. Some mental health professionals sug- gested that Coles was too sentimental and not scholarly enough. But is com- passion for the mistreated sentimental? Is the graphic presentation of disad- vantage to the advantaged unscholarly?

All of these activities, developments, and publications were addressing different aspects of the same general topic: Learning. Studies of various aspects of learning--cognitive development, social and emotional development, the functions of the right and left brain, parent-child relationships, positive and negative learning-have literally ex- ploded during the past 20 years. In a recent review, Thomado has provided an excellent summation and critique of the many studies and theoretical con- structs in child development. My interest is in the application of theory to practice. What are the successes and failures? What needs further to be done? What do we want at the end-all the same product, as with Hitler youth, or diversity? What skills are needed to provide for a diverse society? To date, haven’t there been too many Spock-like fads and too little respect for cultural heterogeneity and differing parent goals?

ne of the major reasons I became 0 interested in day care, especially for young infants, was its potential as a positive family support service. It was, and still is, my conviction that one reaches parents most effectively when providing a service perceived by them as needed. Unfortunately, too many


professionals feel they cannot support new services unless they have been proved effective. Some ten years ago, an article by KaganIS in Psychology Today, entitled “Day Care Can Be Dangerous,” raised many objections to care outside the home, although the content was not as negative as it sounds. Kagan has disclaimed responsibility for the title, and subsequently, through research in day care settings, has added important information on early child development. But it is a continuing con- cern to those who work in community settings and know the needs of families that many mental health professionals still give only grudging approval to day care. Rutter’s recent reviewz4 concedes that “good” day care is not per se detri- mental to children, but there are still many qualifications. It is reassuring to those of us who have been advocates of investing time, money, and talent in de- veloping sound day care programs to be told by Rutter and others that we are not deliberately damaging children. We are not seeking “blanket approval” but rather assistance with a way of life for many families. Caldwell’s sensitive description of the necessary ingredients of an optimal learning environment) and numerous subsequent reports provide important guidelines.

To assess the reluctances, it would be helpful to learn how experiences in day care compare with those “in home.” Unfortunately, there is not much com- parable data on how different kinds of families function “in the wild.”34 Difi- cult as it is to collect unbiased data in ecologic settings, such observational information is vital if we are to under- stand the diversity of environments in which children learn. The longitudinal studies of a generation ago: the Denver

Children’s Research Project, the Fels Research Institute, and the more recent New York Longitudinal Study give information about only a small number of children in rather special settings. Other descriptive studies in the 1940s and ‘50s of families in various parts of the United States and other countries are no longer applicable to current society. Psycholo- gists have studied many bits and pieces, such as the development of language, of self esteem, and of moral values. But the composite picture is missing. The studies of the children of Kauai3* provide some answersAut again of a special population group. The most prom- ising source of up-to-date information about differing kinds of families is the ongoing study by Eiduson and her col- leagues at UCLA.I3

Those of us who have had extensive experience with minority and poor families, in general non-users of the usual parent-education offerings, can attest that many provide effective learning environments for their young children. These learning environments may be far more effective for the problems of today than those of Anglo middle-class America. We also know that it is erroneous to lump all minority and all poor families together, as some investigators have done.9 A natural setting that might have lent itself to study was the activity of the Parent Policy Councils of Project Head Start. As these mandated groups met and learned how to work together, they found they could influence what happened to their children. Some of these previously “pow- erless” families actually moved out into the political arena to fight for the things they believed in. Perhaps the very real successes of Head Start can be attrib- uted to its influence on the families of


the children. Is this a parent-education model worth emulating?

Another major influence on learning in our society is, of course, the school. In past generations, schools tended to complement other learning environments. Now, many see themselves as “taking over.” Many children enter formal school at a much earlier age than they did even a generation ago, as kin- dergarten and prekindergarten classes burgeon. In some places-e.g., Califor- nia and Atlanta4ay care for even younger children may be part of the public school system. The liabilities of our schools, the problems of financing, of adopting more flexible curricula, of mainstreaming, of teacher training, the exclusion of many children, especially from poor and minority families,* have been exhaustively described in every kind of communication medium. The successes have not been stressed enough, reflecting our national ten- dency to focus on pathology rather than strength. Within the past five years, Irving Lazar’s report18 on the effects of the early intervention programs of the 1960s’ and the long-term follow-up studies of the children from Head Start3’ have provided evidence that the 1969 Westinghouse Report33 was premature and incorrect. In comparison with their non-Head Start peers, children who received this early educational boost have achieved well. They have gone into all types of schools, managed to field the vagaries and make use of the positive aspects, and now in their teens are well ahead of their comparison groups.

Some schools and parents are beginning to get together again. In certain inner-city schools, for example in Chicago and New Haven, where princi-

active and critical participation of parents in their children’s learning and in school policy, learning has not been limited to children but has involved teachers and parents as well. In the Chicago schools, teachers

. . . were encouraged to adapt their styles of interaction and behaviors to the cultural idiom of the community.20

In the King School in New Haven, a long period of learning to trust one another, to fight productively, and to build collaborative partnerships brought parents and teachers together and resulted in dramatic improvement in scholastic achievement of the children.’O Another recently reported success story is the rise of Central High School in Little Rock to become

. . . far and away the best school in the state and

. . . one of the best public high schools in the nation.29

This is the formerly 100% white high school “protected” in vain by Governor Orval Faubus, which is now 53% black. Effectiveness of parent-school collab- oration has long been recognized in middle-class schools, although not uni- formly encouraged by school adminis- trators and teachers, who all too often look upon parents as “necessary evils.”

have just recently returned from a I visit to the People’s Republic of China, where we learned from a number of our hosts what the Cultural Revolu- tion had done in destroying educational opportunities for a generation of young people. The Chinese experience was one of decimation of advanced arts and technology. Is the present cutback in support of education and social pro-

pals and teachers began to demand grams this country’s Cultural Revolu-


tion? Shall we allow the “moral majority” (better named the “bigoted minority”) to force our educational process to produce sterile and “just alike” clones? The emphasis upon short-answer tests graded by machine has enabled educators to evade their responsibility to evaluate the achievement of each indi- vidual student. The continued reluc- tance to involve parents is hampering educational progress. Should groups like the Educational Testing Service set standards of competence for our society? Is there any better way of destroying diversity and democracy?

Margaret Mead’s words of 1969*’ are even more valid in 1982. We are in the midst of a communication revolution. The new generation needs skills in operating computers as we all needed to learn to read and write. A recent report in Sciencezz stated that legislation recently introduced in Congress may en- able the Apple Computer Corporation to donate acomputer to every school in the United States-lementary and high school alike. What an exciting prospect! We may all have to learn new languages, and the increase in demand for the Apple for the teacher might create enough jobs to alleviate some bad effects of Reaganomics.

Ortho has a long history of initiating and supporting innovation and change. In these troubling days, I would like to propose a new kind of leadership. Rather than wringing our hands over block grants and lost programs, we should look at the needs of families, children, and communities in the light of today’s technologic explosion. We need a renaissance of multidisciplinary con- cern for new kinds of community services. The security of our offices, and the comfortable feeling of one-to-one

private practice will not solve this country’s mental health issues. Because learning begins early and continues throughout a lifetime, we have a responsibility to help make that learning con- structive and productive.

Out of many possible recommendations, I offer four that are both basic and practical:

I . Expansion and adequate funding of day care services need active support, not half-hearted “maybes.” Mental health should be intimately involved. New methods of financing must be found for differing kinds of facilities in diverse locations. Advocacy requires selling the need for these services to management, to the power brokers, and to the county commissioners, not just to the parents, who already know the issues. To some among us, it may also mean selling it to ourselves.

2. Services of all kinds for families and children must be developed in settings and at hours convenient to potential users. The neighborhood storefront community mental health centers were beginnings, but yet ‘more variety is needed. Legal, medical, and dental clinics in large shopping malls have been very successful, a model of response to a changing society. Many people nowa- days work evenings and weekends, with welcome weekdays off. Why not us?

3. We should help public schools become community centers. These expen- sive facilities are wasted part of the day and part of the year and many are now closing in the face of a rapidly declining birth rate. Rental income might even be generated and a convenient location provided for many diverse activities. Mixtures of age and interest groups might help to counteract some of the isolation many feel in today’s society.

ANN DEHUFF PETERS

4. Smaller school units must be rein- stituted, so parents and others can par- ticipate in and influence the school environment. The large urban school system is unresponsive, not only to change but to the individuals within it and to the community. Incidentally, this might re- spond to the desire of many to decrease bureaucracy. Could some of the money saved by eliminating the 20 assistant superintendents and the large cadre of generally ineffective counselors be better spent on reinstituting art and music classes and special programs for special needs’?

These recommendations may not ap- pear to be “strictly” mental health. But are we not an interdisciplinary Associa- tion, committed to the improvement of the human condition? The future is now. Let us do something effective.

REFERENCES 1. B O W E R . E . 1964. The modification, mediation

and utilization of stress during the school years. Amer. J . Orthopsychiat. 34567-674.

2. BROWN. c . 1965. Manchild in the Promised Land. Macmillan, New York.

3. C A I DWEI.L . B . 1%7. What is the optimal learning environment for the young child’? Amer. J . Orthopsychiat. 37:8-21.

4. C O I ES. R . 1967. Children in Crisis, Vol. I: A Study of Courage and Fear. Little, Brown, Boston.

5 . COLES, R . 1972. Children in Crisis, Vol. 11: Migrants. Sharecroppers, Mountaineers. Lit- tle. Brown, Boston.

6. COLES. R. 1972. Children in Crisis, Vol. 111: The South Goes North. Little. Brown, Bos- ton.

7 . CHAMBERLIN. R . E T A L . 1979. Anevaluationof efforts to educate mothers about child development in pediatric office practices. Amer. J. Pub. Hlth 69:875-886.

8. C H I [ DREN’S DEFENSE FUND. 1974. Children Out of School in America. Children‘s Defense Fund of the Washington Research Project, Cambridge. Mass.

9. C H I I M A N . c. 1968. Poor families and theii- patterns of child care: some implications for service programs. In Early Child Care: The

New Perspectives, L. Dittmann, ed. Ather- ton, New York.

10. COMER, J . 1976. Improving the quality and continuity of relationships in two inner-city schools. J . Amer. Acad. Child Psychiat.

I . DAVIDSON, F. ET A L . 1964. Care of children in day centres. Public Health Paper No. 24. World Health Organization, Geneva.

2. D I r r M A N , I.., ed. 1968. Early Child Care: The New Perspectives. Atherton, New York.

3. EIDUSON, B. ET A L . 1982. Children ofthe children of the ‘60s. Papers presented to the American Orthopsychiatric Association, San Francisco.

14. FLESCH, R. 1955. Why Johnny Can’t Read. Harper, New York.

can be dangerous. Psychol. Today 4(7):36-39. 16. KORSCH, B . A N D NEGRETE, v. 1972. Doctor-

patient communication. Scientif. Amer. 227:M-74.

17. KOZOL, J . 1967. Death at an Early Age. Houghton Mifflin, Boston.

18. LAZAR, I . A N D DARLINGTON, R . 1978. Lasting effects after preschool. Final report of the Consortium for Longitudinal Studies to the Education Commission of the States. Cornell University, Ithaca, N.Y.

19. LEVINE, s. 1971. Stressand behavior. Scientif. Amer. 224:26-3 I .

20. LIGHTFOOT, s. 1981. Portraits of American families: exploring relationships between education and schooling. Presented to the Na- tional Association for the Education of Young Children, Detroit.

21. MEAD, M . 1969. Generation gap. Science 164:135.

22. N O R M A N , c . 1982. A plan to give an Apple to every U.S. school. Science 215:1484-1485.

23. PETERS, A . 1964. Day care: a summary report. Amer. J . Pub. Hlth 54:1905-1913.

24. RUTTER, M. 1981. Social-emotional conse- quences of day care for preschool children. Amer. J. Orthopsychiat. 51:4-28.

25. SPITZ, R. 1945. Hospitalism: an inquiry into the genesis of psychiatric conditions in early childhood. I n Psychoanalytic Studies of the Child, Vol. I , 0. Fenicheler c d . eds. Interna- tional Universities Press, New York.

26. SPITZ, R. 1946. Hospitalism: a follow-up report. I n Psychoanalytic Studies of the Child, Vol. 11, 0. Fenichel e/ ol, eds. International Universities Press, New York.

27. SPOCK, B . 1946. Pocket Book of Baby and Child Care. Pocket Books, New York.

28. S i R i N c E R , L . 1971. The Sense of Self. Temple University Press, Philadelphia.

15:535-545.

15. KAGAN. J . A N D WHITTEN, P. 1970. Ddy Care


29. TEMPEST, R . 1982. Excellence is the legacy of rights crisis. Los Angeles Times (Feb. 28).

30. THOMAS, A . 1981. Current trends in developmental theory. Amer. J . Orthopsychiat. 51:580-609.

31. WATSON, J. 1928. Psychologic Care of Infant and Child. Allen and Unwin, London.

32. WERNER, E. A N D SMITH, R. 1977. Kauai's Children Come of Age. University of Hawaii Press, Honolulu.

1969. The Impact of Head Start. Cleanng- 33. WESTINGHOUSE LEARNING CORPORATION.

house for Federal Scientific and Technical Information, U.S. Dept. of Commerce, Springfield, Va.

34. W I L L I A M S , T. 1974. Childrearing practices of young mothers: what we know, how it mat- ters, why it's so little. Amer. J. Orthopsychiat. 44:70-75.

35. ZIGLER, E. A N D VALENTINE, J . 1979. Project Head Start: A Legacy of the War on Poverty. Free Press, New York.

36. ZILBOORG, G . 1939. Overestimation of psychopathology. Amer. J. Orthopsychiat. 986-94.

For rept-int\: Ann DeHuff Pelen. M . D . . 1010 Muirlands Vista Way, La Jolla, Calif. 92037

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CHILDREN, COMMUNICATIONS, COMMUNITIES: Enhancing the Environments for Learning