Abuse shows up in an infant's eyes

Nursing, Sep 2004

RETINAL HEMORRHAGE

In a study published in Pediatrics, researchers say you should consider retinal

hemorrhages in a young child to be a sign of abuse until proven otherwise. Some
clinicians believe retinopathy may also occur during bouts of severe vomiting, but this
study's findings don't support that assumption.

Researchers studied the medical records of 100 infants treated for hypertrophic pyloric
stenosis, a cause of forceful vomiting. Most of the infants had several instances of
projectile vomiting before undergoing surgery to correct their condition. None had retinal
bleeding.

Although acknowledging that something other than child abuse may cause retinal
bleeding in infants, the researchers say these unusual conditions can be ruled out through
history, exam, and lab tests. They recommend routine dilated eye exams for children
being evaluated for complaints that may reflect child abuse, such as vomiting, lethargy,
and irritability.

Source: "Does Valsalva Relinopathy Occur in Infants? An Initial Investigation in Infants

with Vomiting Caused by Pyloric Stenosis," Pediatrics, S. Herr, et al.. June 2004.

Early Crusade Planted Seeds for NHC Infant-and-Toddler Teacher Education

Initiative
Montessori Life, Winter 2004 by Miller, Darla Ferris

In 1968, I had some time on my hands because I had learned very abruptly at that point
that in Dallas, TX, pregnant women were not welcome in the public school classroom. As
I waited for our first child to be born, I discovered Montessori's wonderful writings.
Maya Pines (1967) published a groundbreaking book, Revolution in Learning: The Years
from Birth to Six. I sought out Jerome Bruner, J. McVicker Hunt, and others referenced
in Pines's book, and soon became fascinated with Burton White's studies of infants from
birth to 3.

In 1974 when my husband and I and our two small daughters moved to Houston, it was
my good fortune to become part of the dynamic Houston Montessori community and to
join forces with my very dear friend and colleague Marge Ellison. As Montessori
teachers, we worked, and crusaded, at Palmer Montessori School, to assure that
Montessori full-day care was available for the children of working parents. This was the
era of equality for women. We preached that Montessori was not just a lesson sitting on a
rug but a life experience that infused nap, play time, and snack. Children needed
appropriate guidance all day that could not be replaced by untrained aides. Marge and I
were born crusaders!
One problem nagged at my heartstrings, though, and I just couldn't let go of it. I
remember getting 3-year-olds whose verbal and reasoning skills seemed rather poorly
developed given their middle-class social and economic background. Often these children
had been cared for since infancy by a rotating string of housekeepers who spoke little
English, and whose goal had been to keep the child clean and safe, not to enrich the
child's mind and expand the child's skills. These housekeepers knew little or nothing
about child development. Routinely, parents-okay, let's be frank, back then it was always
mothers-would come in begging us to admit toddlers into the early childhood program
and, of course, we had to say no. I knew that there had to be a Montessori full-day
childcare option for infants and toddlers in Houston!

Palmer Montessori School had a morning infant class for children from 18 months to 36
months. I loved observing this class. It was set up very much like a miniature version of a
3-6 early childhood classroom except that the shelves were lower, fewer pieces of
material were displayed, and fewer objects overall were in the room. The 2-hour session
was divided so that the children had 45 minutes of interaction with the classroom
environment, 15 minutes of circle time, and 1 hour of outdoor time. The environment was
visually aesthetic, the teachers delightful, and the program socially, emotionally, and
cognitively enriching; but as I watched the harried teachers restoring the trashed
environment after the toddlers had gone home, I felt sure this was not an environment
that would work effectively as full-day childcare for toddlers.

Montessori had identified the secret of childhood, but she had focused much of her
attention and writing on strategies for teaching preschool-aged children. A new
theoretical approach was needed to analyze the day-to-day infant-and-toddler experience
and to rethink the essential elements of their special environment. Montessori focused on
creating an environment that was within the child's control, filled with materials that were
contingent on the child's actions. We needed to figure out how to create a similarly fluid
space that perfectly matched the very young child's rapidly escalating and dramatically
changing cognitive development while fully expressing Montessori's philosophical
perspective of dignity and respect for the child.

We knew the answer was to be found in creating Montessori infant and toddler programs
that were qualitatively different from early childhood programs, not just "watered down"
versions. We had lots of opportunities to practice creating our vision of that perfect
environment. Marge and I moved to Southampton Montessori School.

She created their first Montessori school there. I developed their first toddler program.
After a few years, Marge was itching for adventure, so she decided to open her own
school. She asked if I would join her. I had moved on by then to a position at the
University of Houston. I said, "Of course I'll come work for you, Marge. Can we open an
infant-and-toddler program?"

In the early 1980s, the late Marcella Dawson and I and a lot of other terrific members of
the Houston Montessori community gathered around Marge Ellison's swimming pool,
shared a bottle of Merlot, and decided we needed an AMS Infant-and-Toddler Teacher
Education Program. Marcella was director of the Houston Montessori Center back then,
and she helped us get a program up and running, but only for a couple of years. The first
class started with 17 students; the second class started with 10 students. Grace Hively,
one of the two full-time faculty members at North Harris College in Houston, was one of
the stellar graduates of this program. Unfortunately the program was just a bit before its
time. There was not yet momentum to supply a steady stream of students for inf ant-and-
toddler teacher education. Providing training was not economically feasible. We also
found that applicants who explored infant-and-toddler certification were less likely to
have a strong educational background. Formany, English was a second language. Many
of the teacher trainees needed more than we could provide given the meager external
resources we had to offer.

The teacher education program stalled, but Montessori Country Day School was
developing a reputation for innovative inf ant-and-toddler programs. I completed my
doctorate and moved on to teach child development at North Harris College. After a few
years, Marge and I, along with Sue Thornton, Grace Hively, and others, hatched a new
scheme. What if we reincarnated the AMS training program through the college? I called
the training center and talked to Marcella. She said that Houston Montessori Center
wasn't really prepared to sponsor an infant-and-toddler program and that we should
proceed. She wished us the best of luck. I met with Marge, Sue, Grace, and the college's
"powers that be" and we looked at the rather impressive resources that a community
college could bring to the table:

* academic assessment and basic skill remediation (even help getting a GED if
necessary),

* cutting-edge laboratory with hundreds of Internet-accessible computers,

* library with thousands of volumes and myriad other resources,

* financial aid department with counselors available,

* English as a second language classes,

* disability support including fully accessible technology laboratory.

The flexibility of the community college seemed to be a perfect match for persons
seeking infant-and-toddler teacher education because of the range of backgrounds such
students bring. In my classroom at North Harris College, I once had a student with a GED
and a student working on a doctorate in curriculum and instruction at a local university in
the same class. They were sitting side by side one evening, both equally caring and
passionate in their discussion of how best to respond to some hypothetical guidance
problem. The GED student had traveled a bumpy life road, dropped out of high school,
and bottomed out on drugs along the way. The community college gave her a chance to
get her life back together. It was inexpensive, it offered her a peer support group,
financial aid, a counselor she could go talk to now and again, a part-time job, even a
place to hang out. Yet she held her own in a discussion with a doctoral student. She, like
many others in many other community colleges, went on to finish her associate degree
and to continue in her own self-education and self-improvement.

Both of these two women, in spite of their diverse academic backgrounds, had a special
passion and creativity to bring to infant-and-toddler teaching. The years from birth to 3
are not insignificant in the development of human beings. They may yet turn out to be the
most significant for the development of human cognitive potential. To gain credibility in
the world of academe, as well as in the Montessori community, infant-and-toddler
educators must strive for higher standards. Adults who have the privilege of teaching and
caring for infants and toddlers should be the cleverest rather than the least clever among
us. These should be articulate, highly skilled people who can interpret the nuances of
infant and toddler behavior then respond creatively and appropriately. These must be well
educated individuals.

It was an exciting day for all of us when we finally opened the doors of our own North
Harris College lab school, and it was especially exciting when we achieved approval for
our infant-and-toddler teacher education program. It continues to be exciting every time a
new student becomes a passionate new Montessori educator. If I had a magic wand, there
would be a dynamic Montessori teacher education program in every community college
in this country. And, of course, each one would include an infant-and-toddler program!

References

Pines, M. (1967). Revolution in learning: The years from birth to six. New York: Harper
& Row.

DR. DARLA F. MILLER recently retired as a vice-president of North Harris College and
now lives in Fresno, CA.

Copyright American Montessori Society Winter 2004

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