10. The Motor Opportunity Program for Your Newborn, 38
11. Your Baby's Second Evaluation, 50
12. Expanding Your Sensory Program, 57
13. Expanding Your Motor Opportunity Program, 66
14. The Language Development Program from Birth to 12 Months, 71
15. The Third Evaluation: Meaningful Appreciation and Response, 81
16. The Sensory Stimulation Program for Stage III, 88
17. The Motor Opportunity Program for Stage III, 103
18. The Fourth Evaluation, 110
19. The Sensory Stimulation Program for Stage IV, 117
20. The Motor Opportunity Program for Stage IV, 125
21. What To Do and What Not To Do, 133
22. The Gentle Revolution, 138
About Our Babies, 140
About The Institutes, 141
About the Authors, 141
For my wife, Katie Massingham Doman,
who has lovingly taught thousands of mothers
the world over how to teach their babies —
and will continue to do so, through this book,
for as long as there are mothers who want to teach
and babies who want to learn.
There are no chauvinists at The Institutes, either male or
female. We love and respect mothers and fathers, baby boys
and baby girls.
To solve the maddening problem of referring to all
human beings as "grown-up male persons" or "tiny female
persons," we have referred most often throughout this text
to all parents as mothers, and to all children as boys.
This book has been many years in the making. It is the product of the search and discovery of many courageous, thoughtful, and determined people over the past half-century. Many of these people are still hard at work today; some are here no longer. Some have made lasting and gigantic contributions; others may have offered a critical insight at the perfect moment.
First we must acknowledge a host of mothers who were keen observers of their babies and who knew that babies are much, much smarter than we were raised to think they are. Their certainty and their persistence helped us to keep climbing higher and looking further. Their insights were our inspiration and their frustrations spurred us on.
Secondly, a host of babies, both brain-injured and well, who patiently helped us to learn who they really were and who forgave us our mistakes along the way. We especially thank Maria, Olivia, Isolda, and Caleb for their patience and their sparkle.
The great ones whose own love of learning made them superb teachers:
Temple Fay, a dean of neurosurgeons, who had a monumental curiosity and a unique ability to question whether accepted "truths" were true or not, and who first set us on fire.
Shinichi Suzuki, one of the greatest teachers of all time, who not only loved mothers and babies but, what is equally important, he respected them. His contribution is beyond measure or description.
William Johntz, the founder of Project SEED, who took Socratic teaching and transformed it into the more civilized and elegant and effective Discovery Teaching. He did for the teaching of mathematics what Dr. Suzuki did for the teaching of music, and he did it equally well.
The pioneers of Child Brain Development:
Katie Doman, who began this adventure by teaching mothers of brain-injured children and proving that brain-injured children are highly intelligent, frequently brighter than their well peers.
Douglas and Rosalind Doman, who are really co-authors of this book. Every word on mobility is theirs. They know more about babies and mobility development than anyone on earth. Also, the staff members of The Institute for the Achievement of Physical Excellence: Leia Coelho Reilly, Rumiko Ion Doman, Jennifer Myers Ñànåðà, Nati Tenacio Myers, and Rogelio Marty.
Susan Aisen, one of the editors of this book, whose knowledge of mothers and babies and The Institutes Developmental Profile has helped make this book a reality. Miki Nakayachi, whose insights on language and communication in babies have influenced us greatly. Teruki Uemura, a superb evaluator, who has taught a generation of parents and staff how to evaluate their babies. Also, the staff members of The Institute for the Achievement of Intellectual Excellence: Olivia Fernandes Pelligra, Kathy Myers, Yoshiko Kumagai, Mitsue Noguchi, Eliane Hollanda, and Susanna Horn.
Ann Ball and the entire staff of The Institute for the Achievement of Physiological Excellence, whose knowledge and experience in physiology and especially the development of respiration and nutrition has been vital to the well-being of our babies: our medical director Dr. Coralee Thompson, Dr. Leland Green, Dr. Ernesto Vasquez, Dr. Li Wang, Yukie Kamino, and Dawn Price.
The board of directors of The Institutes for the Achievement of Human Potential: Dr. Ralph Pelligra, Dr. Roselise Wilkinson, Dr. Richard Klich, Stewart Graham, and Philip Bond, in addition to the members named elsewhere.
Dr. Mihai Dimancescu, outstanding neurosurgeon, father, and board member, who has spent his life making certain that coma arousal is the order of the day.
Dr. Denise Malkowicz, highly skilled neurologist and experienced mother, who did a careful critique of the book and initially alarmed us by not changing a word. We are grateful for the additional information she provided.
Sherman Hines, world-famous photographer, father, and board member, who has devoted a significant part of his life to photographing the mothers, fathers, and children of The Institutes. His beautiful images will endure not only on these pages but in our hearts.
This book had a prolonged labor before it was delivered. Those who helped make it happen cannot be thanked enough. The first editor of the book, J. Michael Armentrout, who spent many hours getting the first manuscript into shape. The primary editor, Janet Gauger, who has meticulously poured over the book so many times that she can probably recite it. Donald Barnhouse, superb teacher and equally superb writer, who edited the book and kindly made many invaluable suggestions. We are very grateful for the illustrations done by our artist, Jim Kaliss, whose legendary patience and kind-heartedness must have been stretched to the limit by our requests.
Our assistants—Nest Holvey, Cathy Ruhling, and Tammy Cadden— who helped by keeping us organized and holding down the fort so well that we could find the time to write, edit, and rewrite the book.
Our administrator, Linda Maletta, and our director of finance, Robert Derr, who do their jobs so well that we could steal the time needed to complete the book. This is no small accomplishment for a small nonprofit organization.
Our publisher, Rudy Shur, president of Square One Publishers, who loves books and makes sure that venerable and important works stay in print, so that each new mother has the opportunity to teach her baby.
Children are the greatest gift that we will receive. The world over, we cherish our children. Mothers have performed heroic acts and displayed incredible physical strength to protect their children from physical harm. Universally, parents want their children to accomplish more in life than they ever accomplished.
The suffering of children evokes greater emotion in each and every one of us than any other of mankind's misfortunes.
From the earliest days of humankind, parents have taught their children the skills that they know will help them become better hunters of food and better in turn at nurturing and protecting their children.
The battle from the beginning has always been for the survival of the fittest. In prehistoric times that meant having the physical fitness to run fast and the strength to carry heavy loads; it also required the skills to build shelter and to find food, and the ability to fend off animal or other human predators.
In the overpopulated, rapidly changing, highly technological world of the twenty-first century, survival of the fittest demands that each individual be physically fit, have a sound physiological constitution, and develop the intellectual and emotional capacity to succeed in an economically, geopolitically, and biochemically threatening environment. If we can give our children a solid educational foundation today, they will become the leaders of a better and safer world tomorrow.
How to best prepare our children to survive and to excel in the modern world has been the subject of scores of volumes of writings by educators, pediatricians, politicians, child psychologists, and psychiatrists. Notably, the list of well-meaning advisors and authors does not include "mothers"!
The expectations upon reading erudite proclamations about the right way to educate your child usually start with the child as school age or kindergarten age, arbitrarily set at about five years old. Any exploration of what to do with the child before that time tends to deal with "what kind of diapers to put on your child" or "for how long you should breastfeed your baby" or "what store-bought prepared formulas give your baby the best nutrition"!
The developmental strides of the newborn from birth through the first years of childhood were first described in detail by Dr. Arnold Gesell, cited in Chapter 2. His work led to the widespread use of the "time-clock" notion of developmental readiness for certain activities. The authors of this book underscore the fallacies and the pitfalls of the "time-clock" developmental timeline. If the notion were true, then why are some children reading well before they even start school, and why are some children speaking in full sentences or expressing themselves fluently in more than one language before the time-clock says that they should be? Why do babies enjoy listening to Mozart just as much as they do to "Twinkle, Twinkle, Little Star" and why do they take in stories of volcanic eruptions and of the movement of earth's tectal plates as easily as they take in Big Bird's adventures on "Sesame Street"?
In a comprehensive and exhaustive study of thousands of babies in all kinds of cultures and societies, and through a half-century of experience in their Institutes, the authors have derived a compelling story of why babies soak up information like sponges, and how they develop the way they do. The authors then proceed to explain how to take advantage of the newborn's remarkable abilities to begin teaching your baby from birth onward in a loving and enjoyable setting. Teaching your baby when he or she is the most receptive to learning, able to acquire knowledge without effort, and enjoying every moment of learning gives your baby the very best opportunity to develop the physiological constitution, the fitness, and the intellectual skills to excel in our highly complex world. Never again in life will your baby's brain have the learning capacity that it enjoys in its first three years after birth.
—Mihai Dimancescu, M.D.
The majestic organ that is the brain starts developing in utero. Although learning continues throughout life, there is a special window of opportunity for permanent brain growth and special learning that occurs in the first year of life.
The newborn period, or first few weeks, is a remarkable time and incredible things are occurring. This is not just a passive beginning; it is the explosive start to learning and brain growth.
During the first year the baby's amazing growth and learning continues. The baby's brain is rapidly growing, which is reflected in the astonishing changes in head circumference.
This period is vitally important for brain development. Doctors, scientists, and educators now acknowledge that the first several years of life is a critical time for the acquisition of skills—and that appropriate stimulation and experience is critical to optimizing a child's growth and development.
These early years are extremely important. It is now recognized that the sooner the baby receives sensory stimulation and opportunity for mobility and language expression, the more likely that brain growth, development, and skills will be optimized.
It is important to understand how this occurs in order to maximize your understanding of the programs in this book. The baby in utero is creating billions and billions of brain cells prior to birth. Those brain cells only await stimulation to create networks of function that will allow the child to see, hear, feel, taste, and smell, and the experience that develops mobility, language, and manual ability.
The normal newborn will have some basic functions at birth, but must incorporate sensory stimulation and motor experience in order to grow or enhance these functions and learn or make associations. When an object is perceived by the five sensory pathways and gains meaning for the baby, a type of learning has taken place.
The newborn must also learn to integrate sensory information in order to produce coordinated mobility, sounds, and manual competence. Sensory pathways must supply information to association areas, to primary sensory decoding areas, and to memory and planning areas of the brain in order to produce proper output (such as motor action). The motor pathways (mobility, language, and manual competence) must be monitored by the sensory pathways to refine output.
In the healthy "normal" newborn, this is a wonderful cycle that reinforces learning. In the brain-injured newborn, this may be a vicious cycle in which poor sensory input will result in poor or inappropriate output.
A premature newborn has earlier access to sensory stimulation than the term infant who is still in utero. For example, the premature baby has the advantage of seeing light-dark contrast while the baby in utero does not have access to such stimulation. Visual maturation begins immediately for the premature infant.
In the newborn, the brain is undergoing three natural but important processes that we can call pruning, learning, and myelination. Pruning is an interesting and basic brain phenomenon. In the young baby, billions and billions of brain cells are in place at birth. However, only those brain cells that are used and properly stimulated with sufficient frequency, intensity, and duration early on will be reinforced and become permanent neurological connections functioning as important circuits or networks. Those that are not sufficiently used are "pruned." That is, if they are not used they die away.
Unfortunately, there have been cases of children who were born with essentially "normal" or uninjured brains who have been placed in environments of sensory deprivation and lost the opportunity to develop significant abilities. Some have been in overcrowded orphanages. Others have been in caring homes, but due to a lack of knowledge on the part of the parents or caretakers these babies have been placed in bland, uninteresting, quiet, unstimulating environments and received little sensory stimulation or motor opportunity. They may have been confined to baby carriers, cribs, walkers, or other restrictive devices that do not permit free movement and appropriate sensory-motor stimulation and integration.
Studies have shown that children placed in walkers can be developmentally delayed compared to children who are allowed to crawl, creep, and walk in a safe environment. In addition, devices like walkers are a leading cause of injury in young children. To the degree that a newborn is deprived of sensory stimulation or motor experience and opportunity for expression, the baby will lose the opportunity for some function.
While the pruning of brain cells may appear to be a harsh or unproductive phenomenon, it represents the realities of brain-body economy. The brain requires a constant, high-quality source of energy and nutrients, and an astonishing twenty percent of all incoming oxygen. Those areas that are not used are shut down to send these resources elsewhere as needed.
At the same time pruning is occurring, its opposite, learning, occurs. This reinforcement of brain neural circuits allows the permanent acquisition of neural networks if proper stimulation is given.
Myelination is also occurring. This process, in which neurons develop the insulated covering on their processes, helps establish connections and speeds up information exchange. Simply put, the rain grows by use and one must "use it or lose it."
But how does the brain work?
Can it be influenced for the better?
Why are the newborn and infancy periods so special?
How does the brain and nervous system develop?
What does the brain and nervous system do?
How does it function?
What can a mother do to help the process of sensory and motor development?
Could mother unknowingly do something that might inhibit or stop optimal development of the brain? Is your child well?
Is your child normal?
What is normal?
If your child has an injury to the brain, how can you recognize this?
How can you help your baby if he does have a problem?
These and dozens of other questions run through the minds of concerned parents. The Institutes for the Achievement of Human Potential, founded in 1955 by Glenn Doman, has been posing these questions and finding the answers for a half-century.
This book explains exactly how to evaluate the sensory and motor pathways of the baby and exactly how to design a program that will enhance the growth and development of these pathways. It is an inspired guided tour of the first twelve months of brain growth and development.
All of the information in this book is presented so that any mother and father, without a medical background, can benefit from it. In it we gain a sense of what the world may look like and feel like to our newborns. We acquire a better understanding of the challenges and frustrations the newborn experiences. Armed with this knowledge, we know what our baby needs and wants and we can have the great joy of creating an ideal environment for him.
Every day is precious, and your baby is hungry for knowledge about the world around him, starting from the moment of birth. To feed your child's brain is as important as feeding his stomach.
The goal of this book is to help parents understand the brain and nervous system. Parents may then follow a clear pathway to enhance the abilities of their child. This is not only an extremely important process—it is also a very joyous one for mother and baby.
—Denise Malkowicz, M.D.
1. What Mothers Know.
From the moment a baby is born, a struggle begins. Mother does her best to keep her baby close to her, and the world does its best to separate mother from baby.
This is a mistake because mothers are the best teachers in the world for their babies.
It starts with the well-meaning hospital staff who often whisk the baby away to a nursery far from mother. Later, there are the professionals who are certain that a two-year-old is better off in a day center than home with mother. On their heels comes the school system where the child will spend the better part of his life to age 18. Educators now say they want the child at the age of five, four, or even three.
There are strong forces at work to separate mother from child, and most people have come to regard each of these encroachments : on mother's domain as normal. It is as if that is the way it has always been.
But hospital nurseries, day care centers, and even compulsory education are not the way it has always been for mothers and babies. They are newfangled notions, and a radical departure from the age-Id human tradition of children being with their mothers until they ready, willing, and able to handle life on their own.
In contrast to these patterns of modern society, all mothers know intuitively that the first six years of a child's life are the most important.
In this they are absolutely correct.
Most mothers know that the first few months of life are vital to the life-long well-being of their children.
Again they are correct in this belief.
Unfortunately the vast majority of mothers are not equipped with the information they need to use these first few months to their child's best advantage, and to make the first six years of life as stimulating and rewarding as they could be—and should be.
New cars come with owner's manuals—new babies do not—and yet we all know that babies are a great deal more important than cars. To be sure, there are manuals for the feeding and changing of babies. There are books about the general stages of development that can be observed in average, healthy children.
But these aids are based on two main underlying assumptions. The first is that baby's needs are primarily physiological and emotional. The second is that baby's development is triggered by the ringing of a series of genetically preset alarm clocks that go off on schedule regardless of what does or does not happen to him.
These assumptions are false.
It is perhaps because of these false assumptions that modern babies are being raised by accident instead of on purpose. That is a great shame because the growth and development of the human child is much too important to be left to chance.
It is also because of these false assumptions that mothers have increasingly been persuaded, against their better judgment, to let their babies be cared for by others.
A baby's natural, inborn human potential is enormous.
If it were true that babies simply need to be fed and changed and cuddled a bit, and nothing more, then society could safely put babies together like so many little sheep with one caretaker for many babies. This model was in fact established and used by the Soviets.
But babies are not little sheep. It is true that they have physiological and emotional needs, but beyond these they have enormous neurological needs as well. This neurological need is the need of the brain for stimulation and opportunity.
When these neurological needs are fully met, the child's physical and intellectual abilities are enhanced.
If, on the other hand, the baby's neurological needs are not met, and if barriers that may stop or slow brain growth and development are not noticed and eliminated, the child will not achieve that enormous natural human potential.
Every baby arrives equipped with a mother—there is good reason for that. Every mother, whether she is new to the job or highly experienced, has a marvelous ability and opportunity to observe her baby, and then to act intuitively based on her observations.
On her worst day she will do this better with her own baby than most others would do on their best days.
This helps to explain why mothers have always been suspicious of the preset alarm clock theory
of development. They have seen their babies defy its supposedly unalterable schedule.
Mothers have been equally skeptical of the notion that human ability is predetermined by one's genetic make-up. From time immemorial, mothers and fathers have helped their children develop abilities that neither father nor mother nor grandparents ever had.
Mothers have known more about babies than anyone else since the world began.
It is mothers who have successfully brought us from prehistoric to the present.
However, the modern mother faces a very large problem: her own possible extinction.
She has the same powers of observation, the same intuition, the same instincts, and the same love for her baby that mothers have had throughout human history. But she is threatened by a world in which it is no longer safe to be a mother. In this world she must battle to keep her baby by her side from the instant he is born. In this world she is often told that her baby is better off in a nursery than in arms.
It is a world in which it is no longer considered fashionable or useful to be a mother.
Mothers know that there is something very wrong with a society that no longer respects mothers and has little time or interest in the development of its youngest and most vulnerable members.
When a new mother does win that first battle, and finally gets her hands on her own newborn baby with everyone else out of the room, she does what all mothers have always done. She starts counting: ten fingers, ten toes, two ears, one mouth.
She begins an inventory to evaluate her own baby. She makes certain that he has arrived with everything he should have and that he is functioning as he should function.
Since she knows how to count she does not need any help with her first inventory. But once that is completed, she is on her own. She looks into the eyes of her baby and to her utter astonishment and amazement she sees an intelligence for which no one has prepared her.
Father sees it too. For a moment they are stunned. They are overwhelmed by the potential they sense in the baby, and by the responsibility they have undertaken. They make a thousand unspoken promises to their new baby.
They will more than likely keep the majority of those promises. Sadly, the most important promise, the one about helping the baby to become the best he can be, may elude them, simply because mother and father do not know how to help bring this about.
They have been told about how to provide for the physical growth and health of the baby, and something about his emotional needs, but the world has little awareness and hardly any respect for the real potential of the baby.
"Feed 'em and love 'em," a better-than-average doctor may have told them, but probably no one told them about helping the baby learn. They have been told that there is plenty of time to think about that when the child goes to school. Some have even told them they are damaging the baby if they help him to learn too soon, before the baby is "ready."
The truth is that such delay wastes his six most important years. Sadly, many mothers and fathers have been intimidated by the world around them. Our goal is to help parents provide for the growth and development of their babies in the fullest sense. Parents need to know what is important and what is not important.
Armed with this knowledge, mother and father can combine it with their unique knowledge of their baby to create an environment that addresses both the baby's basic survival needs and the needs of his developing brain.
This book is the story of how to give a baby a running start at achieving his full potential. Its aim is to help parents understand the process of brain growth and development in the newborn baby, so that parents are able to create an environment that enhances and enriches that growth and development.