Why I am keen to hear what Professor Stuart Shanker has to say about infant temperament!
In the European summer of 2011, at an International Infant Cry Research Workshop in The Netherlands, two world-renowned professors took questions from the floor.
“Do babies in the first 3-4 months of life have feelings?” a delegate asked.
The men glanced at each other. “We don’t know,” they replied, cautiously. “We simply don’t know. Most likely not, at that age.” In the first 3-4 months of life, these professors claimed, some infants have a more difficult temperament than others, but hours of crying each day is normal.
This is epistemological: what are feelings in humans, anyway? What is the physical sensation of fear or anxiety or grief? What is the interface between emotion, bodily sensation, cognition, and behaviour in any human being?
Research publications by one of these men continue to influence clinical management of unsettled babies worldwide. He proposes that delaying responses to the baby’s communications or patting the cot mattress when the baby cries and grizzles instead of picking the baby up will decrease night-waking. I disagree, as do more recent systematic reviews.
If there is one thing I know (and a few others in the room that day knew, too – women, to be honest, discretely catching each other’s eye, raising an eyebrow), it’s that babies are pure sentience, pure feeling, babies are embodied sensitivity to their environment.
Infants are shaped by our Homo sapiens environment of evolutionary adaptedness to expect life as an exterogestate foetus in those first few months after birth, connected to the mother’s breasts and milk, surrounded by the warmth and heartbeat and movement of a loving adult’s body, connected to the loving gaze and touch of older siblings and adults. If milk, closeness to the carer’s body, and rich sensory nourishment are not abundantly available, babies communicate fear and distress.
Later in that conference, a developmental psychologist spoke enthusiastically about infant temperament.
“It’s often said excessive infant crying is the first indication of a difficult temperament,” he explained briskly, then he gave us a history lesson. Back in the 1950s, the first wave of behaviourists viewed the newborn human as a flat, primeval landscape from which parents shaped the mountains and valleys of temperament. From the 1980s, developmental psychologists stepped in and argued that temperament is innate and shapes the way parents relate to an infant, so for the next couple of decades, everyone believed infants were born with the mountains and valleys of temperament pre-formed, genetically determined.
“Now,” the presenter explains, “researchers have concluded that temperament is a complex phenomenon.”
Like most everything else about humans, I think to myself.
Temperament arises out of a confluence of influences, interacting together. Genes have been shaped in Homo sapiens environment of evolutionary adaptedness and interact with environmental factors, such as pre-natal and post-natal influences and most importantly, parenting style, which alter the epigenome, which regulates genes. Some babies, due to innate tendencies, might be more susceptible to problem crying if things (like feeding) go wrong in the first hours and days and weeks. And sometimes baby’s behaviour in the first months of life may affect parents’ perceptions of the baby’s personality, which affects the way they interact with the baby, which affects the development of the baby’s personality in what is known as a developmental cascade throughout childhood.
Another eminent developmental psychologist took the lectern at the 2011 Infant Cry Research conference and began with a bold and damning condemnation of the ethnocentricity of developmental psychology. (Ok, some of you will have noticed by now that my story features a lot of successful white male professors, and all I can say is: yes, this topic is highly gendered, amongst other things. That’s another blog, for another day!)
“We make pronouncements about normality out of research that occurs in Europe, the United Kingdom, and North America,” this professor declared. He showed us a world map plotting the places from which developmental psychology research publications originate. The spots were clustered almost entirely in North America and Europe, an opaque mess, with a small handful of spots strewn in from around the rest of the world, one or two down in Australia.
“If our research is not representative of the world’s babies,” he asked, “why do we talk as if it is?”
In the decade that has passed since then, researchers and clinicians have continued to grapple with these important concepts.
Health professionals trained to teach first wave behavioural infant-care strategies argue that an infant learns to self-regulate through adult co-regulation. What they mean is that parents need to teach the baby that grizzling and crying does not result in the baby being picked up, at least not immediately. A baby who has learnt that there is no advantage to crying from the cot is, these folks argue, a baby who has learnt, through co-regulation, to self-regulate.
But we know that secure psychological attachment develops when loving adults develop a pattern of behaviour towards an infant which responds to his or her communicated feelings. Not just respond, I hasten to add (because the new label ‘responsive settling’ which is applied to graduated extinction strategies misleads parents) but respond in a way that is desired by the baby. Patting a mattress is a certain kind of response, but not the response the baby longs for: the baby longs for your arms, your warmth, your body.) Secure psychological attachment is not achieved through withdrawal of emotional support (translated into behaviour) but through the lavishing of emotional support (translated into behaviour). If your little one learns that you and others consistently respond with your body and your heart, then your little one becomes, as the months and years pass, more and more brave about venturing out on his or her own.
A few years after that 2011 Infant Cry Research conference, I became aware of the pioneering work of Professors Stuart Shanker and Stanley Greenspan, who propose that in the kindy and school years, the best way for children to learn self-regulation is not through external reinforcement or extinction of behaviour, but through relationship with kind or loving adults who believe that the child’s inner world is important and makes sense, at least to the child, even when the child’s behaviours appear challenging and nonsensical. I have been very interested in the way Shanker and Greenspan framed infancy and self-regulation: co-regulation means, before all else, responding with concern for what is happening in that little one’s feeling world. When I wrote my paper in 2019 showing why I believe Neuroprotective Developmental Care is well-positioned for prevention or early intervention for siblings at familial risk of autism, I lent heavily on Shanker and Greenspan’s work. Possums & Co often refer parents to Professor Shanker’s Self-Reg website.
It is a great honour for us to have Professor Shanker presenting at the Possums Conference, coming up on 9 September, and I am very keen to hear what he has to say - in 2021 - about infant temperament!
Dr Pamela Douglas is a GP and Medical Director of Possums & Co. www.possumsonline.com, a charity that educates health professionals in the evidence-based Neuroprotective Developmental Care (NDC) or Possums programs, including the Possums Baby and Toddler Sleep Program. Please contribute to our movement for change in early life care by making a donation today. If you wish, you can refer to or upskill to become an NDC-accredited practitioner. There are lots of free videos and other resources for parents with babies here, and online parent peer support is available for a nominal fee. Pam is an Associate Professor Adjunct with the School of Nursing and Midwifery, Griffith University, and senior lecturer with the primary care clinical unit, The University of Queensland. She is author of The Discontented Little Baby Book: all you need to know about feeds, sleep and crying.