Week Three

It had been a long first year with Thomas. His colic lasted for what seemed an eternity, but that time seemed so long ago now that he was 18 months of age. For the most part, Thomas was doing what 18 month-olds do: he walked at 12 months of age and had some idiosyncratic language. He seemed to say "mama" and "dada," but Ian and Molly weren't exactly sure. Molly had particular expertise in the area of speech, and she wasn't concerned - at least, that's what she kept telling herself. Thomas also had tantrums that seemed to Molly and Ian to be overly intense. They weren't really sure. Thomas also seemed to be "in his own world" alot of the time, and he just didn't seem to "connect" with his parents. He didn't seem to imitate them very well, and he seemed not to like to make eye contact. Sometimes they wondered if he had a hearing problem. They tried to wean him off of breastfeeding at 9 months of age, and he didn't respond to that very well. They eventually were able to get him to take a bottle after a very carefully planned transitional period.

Molly worried that the stress of caring for Thomas during his colic had taken a toll on her. She knew that she was doing all the right things, and she also knew that Ian was a wonderful dad. Ian, for his part, was also concerned but trusted that things would work out OK - he had grown to trust a deep wisdom in himself as a result of the difficulties he had experienced in his life. Still, the two talked about whether or not to take Thomas someplace for a more extensive evaluation.  

* What are the typical developmental milestones for and 18 month-old child? How unusual is Thomas' language development?

* If Molly and Ian want to take Thomas to be evaluated for Autism, where would they go? What kind of assessment is done for an 18 month-old child? Is it too early? Are assessments like this covered under most insurance plans? How much does such an assessment cost?  

* What might Thomas' 18 month visit to the pediatrician look like in terms of his M-CHAT? In other words, indicate the items that Molly and Ian might endorse as "yes" on the instrument. 

* Go to the website "Autism Speaks" to learn more about the condition.

DECISION POINT ::: Do Ian and Molly take Thomas for an evaluation, or do they wait to see how things go?  If Thomas has autism, are there benefits to early identification? 

Week Two

Thomas was born to Ian and Molly as a healthy boy with a good APGAR score and no complications. They were overjoyed and brought him home after Molly spent one day in the hospital. Friends and family came to visit, and Molly and Ian tried to get as much rest as they could.  

In general, Thomas did what most babies do for the first several weeks – eat, sleep, and poop. Not ever having had a child before, Molly and Ian were slightly nervous. Molly found herself quite exhausted more often than not – it was difficult for Ian to get up with Thomas at night given his physical challenges, and Molly did the lion’s share of the “up all night with the baby” care. Additionally, Molly was helping Ian to get around as she always had.

At about six months of age, Thomas developed what the pediatrician called “colic.” He was inconsolable for hours on end, and neither parent knew what to do. Molly would put him in his car seat and take him out to drive around the block, and every once in a while that helped. Still, he just cried.   

* What is colic?

* Molly and Ian decide that Thomas will be breast-fed. Given the newly established work schedule that Ian and Molly have negotiated, what challenges does this present? What might Molly have to do in order to keep breast milk available, and what technologies are available to aid with that process? Is breastfeeding acceptable in public in the United States?

* What is typical in the United States with regard to breastfeeding? How many mothers breastfeed and for how long? What considerations do mothers and families typically make in order to decide how to proceed? Be sure to consider that realities of social class when answering this question: in other words, imagine a single mother with limited income, a married couple where only one partner works, a married couple where both work and have moderate income, etc.  

* What are the developmental milestones associated with the first year of life for the newborn? If his development is typical, what should Thomas be doing in his first year?

* What are the recommended immunizations for newborns? What immunizations are typically provided just after birth? Which ones in the first year? How frequently should the newborn visit the pediatrician in terms of what is recommended? What is the CHAT and when is it given to parents? Outline Thomas’ first year in terms of doctor visits. Provide rough information as to the fees associated with these visits.

DECISION POINTS :::

How long does Molly breastfeed Thomas? What considerations go into making this decision? Consult La Leche League (on the Internet) to learn more about breastfeeding.  

How do the Mahoneys pay for the hospital stay (birth) and the first year of shots and doctor’s visits? In other words, make a decision about what kind of insurance they have (if any). 

Week One

Ian and Molly Mahoney are thrilled to be welcoming their first child into the world. To be sure, they have both struggled through much, and they are now looking forward to starting a family. They know they are having a boy, and Molly had always liked the name Thomas. So, the two agreed that the child will be called Thomas Patrick Mahoney. Perhaps the only sticking point for Molly and Ian is what will happen when Thomas is born – they both feel strongly that one of them should stay home with Thomas for the first year of his life, but neither wants to take a leave of absence from work. Further, neither is sure that their job would be there after the hiatus with the recent budget cuts the school system has had to manage. That leaves them with the decision about what to do when Thomas arrives. Neither have family who are in a position to care for an infant at this point, and they don’t like the cost associated with day care. They seem to be stuck.     

·    1) What are the typical developmental milestones for the child in utero? Outline the stages of pregnancy and the threats to optimal development at each stage. When are teratogens most dangerous for the developing child?

·    2) Is there any evidence to indicate that children who attend day care at an early age fare better or worse than children who do not? Cite relevant research. Does it matter in terms of development whether or not one biological parent cares for the infant? What alternatives might exist for Molly and Ian?

·    3) Find examples from other industrialized countries of parents managing the issue of child care in creative and flexible ways. List at least 3 alternative social/economic arrangements which provide effectively for the needs of children and families. Be sure to indicate the countries in which you find the examples.    

 
DECISION POINT ::: How do Molly and Ian resolve the issue of day care versus one staying at home?