Our youngest spent her first year in an orphanage in Hunan China, in a colorless, frigid in winter, broiling in summer, toyless 8’ X 8’ room, along with four other infants and her ayi (or nanny). Twenty-four seven. Her routine (as we later learned) most likely went something like this: baby wakes and is fed rice porridge (from bottle with large hole cut in nipple, propped up against side of cradle); ayi removes soiled clothing and holds baby under cold water spigot to wash away waste then dresses baby, sans diaper in “clothes” (4 layers if winter, hospital style Johnny if summer); ayi props baby in potty chair (think of a 1’ X 1’ wooden playpen, with a seat in the middle with a hole for waste material to drop though into a pot) and waits for bowel movement; aye props up baby in walker and puts her in hall with twenty other infants in same state of affairs; ayi takes baby from walker and feeds then diapers baby with small rag tied with string; ayi puts baby down for nap in cradle 1’ X 2’; baby wakes, ayi repeats morning cycle; ayi repeats noon cycle then wraps again in clean rag, and swaddles (tightly) in cotton quilt for the night; ayi repeats each and every day, day in and day out.
Our older two daughters spent their early days at home with me, or their sitter. Their routine went something like this: baby wakes and calls out to Mommy; Mommy appears with smile on her face calling “good morning baby-girl” in a sing-song voice; Mommy changes baby, taking care to keep baby warm and pick out soft clothing; Mommy nurses baby while rocking and singing songs and looking longingly into baby’s eyes; Mommy carries baby into her room, puts baby in bouncy seat and talks with baby while showering and dressing; mommy carries baby to kitchen, puts baby in swing and swings baby while mommy eats; mommy puts baby in sling and walks out in the sunshine; mommy points out the birds and the trees to baby; mommy stops to talk with a friend and friend admires baby; baby begins to fuss so mommy heads home to change, feed, and nurse baby, mommy reads baby a book and puts baby down in her crib for a nap; baby wakes and mommy puts baby on floor on soft cloth, baby pushes self up, then creeps forward on her tummy, trying to lift her body, baby works hard, mommy cheers her on; baby fusses, mommy soothes baby; mommy repeats cycle again and again, loving baby.
It was two years into her life with us (age 3) when we realized the profound effect such a difference in nurturing plays in emotional and physical development, and sadly, what E had truly missed. While E had been a very happy, outgoing (perhaps too much so) and active toddler, we had to admit there was something clearly something amiss. Faced with trying to understand her hypervigilence, developmental delays and increasing emotional outbursts, I began to read about brain development and neuroscience in infants, especially those faced with neglect and trauma. What I learned was fascinating and significant food for thought for any parent, biological or adoptive.
According to the newer research, when life begins the brain is only a blueprint of what could be. The pathways are “penciled in” so to speak, but are by no means set in stone. That comes later as the infant begins to take in their surroundings (sensory input) and begins moving (output). Even movements that seem trivial to the watching eye, such as kicking against the crib mattress, wiggling around on the floor or visually following mom as she walks about the kitchen cooking dinner, are developing neural pathways. In the womb and in the early months the pons, or lowest level, of the brain is being mapped. In the later months and into toddlerhood, it is the midbrain. It is this neurological integration that is so necessary for basic cognitive and physical skills such as filtering, focusing, accurate sensory perception, visual motor skills, midline awareness, visual tracking and alignment, upper/lower body integration, coordination, as well as appropriate emotional development.
When I sat and thought of all the stuff I had done with my older two children in the course of a single day, and compared that with the stark days that E had spent in a Chinese orphanage it suddenly made sense that her brain had not been given the chance it needed to build in a healthy manner, bottom to top. No wonder she had good executive functioning (higher brain) but was a mess when it came to pons level stuff (emotional regulation, feelings of safety and trust, etc) and midbrain (motor planning, sequencing, sensory management, etc)
Couple that research with perhaps one of the most positive scientific pronouncements of the decade - that the brain is actually more plastic than originally imagined - and you have the recipe for potential healing. If a child did not get the proper nurturing to build neural pathways and hook up synapses the first time around there is still hope. Much like a stroke victim who has suffered damage to the brain and can, through the proper movement therapy, create new brain pathways to take over for the old damaged ones, an infant or child who has suffered neglect and/or trauma can have a second chance in life; a “do over” so to speak.
So it is E’s “do over” that we have been working on for the past four plus years. First through weekly sensory based occupational therapy (remember her sensory experience was nominal at best so it needs lots of work) and finally graduating to what I fondly call “OT on steroids”, daily neuro-developmental movement (or in our therapist’s lingo – “neuro-reorganization”).
We (well really E with me trailing at a snail’s pace, my forty-seven year old body questioning loudly why I am down on all fours) creep around the house, looking for treats strategically placed under boxes, or play-acting a scene from Rudolph the Red-nosed Reindeer. Then she crawls along on her tummy (think combat crawl) back and forth through the kitchen and family room (I knew those hardwood floors would pay off) as I scoot in front of her on a scooter board, alternately cheering her on and feeding her the snack de jour. She rolls in a barrel, jumps on a supersize ball, spins on an office chair, or cartwheels across the kitchen in little fifteen second bursts of what her therapist likes to call “vestibular input”. (Did you know that the brain fires for fifteen seconds, working to create a neural pathway?) We do bear hugs (oh to be able to hug her finally and not have her squirm to get away!), massage and soft touch, “sensory input” in therapy jargon.
E has been a trooper through this all, though her cooperation level has definitely increased as she has become aware that this is building her brain (oh, and bribes help too). And we have been even more driven to complete our daily work as we have witnessed her emotional regulation improve, her stamina increase and her love of us expand exponentially. I can truly say that I now see the child that was always in there, but was too covered up with what we in the child trauma world like to call “the layers of the onion”. What we have now, instead of an onion is a loving, patient, cooperative, empathetic, motor-planning and almost reading (Yeah!) flower.
This is one of my passions (though I would have laughed if you told me 10 years ago I would give up practicing law to crawl around on my hands and knees pretending to be Rudolf). Giving E her “do over,” the time she missed, the time she needs, to be the best she can be is what I must do. So if you will pardon me, it is time for tummies!