Psychological issues in children in crèches, day centres


DR. MANEESH GUPTA
Consultant Psychiatrist
(Psychiatrist & Psychotherapist
MD (PSYCHIATRY) (Gold Medalist)
DNB (PSYCHIATRY)
Completion of Specialist Training (CST)
(Adult Psychiatry) London
M: 9873887737

Rapid urbanization is one of the consequences of India’s rising income. As an offset though, life in cities has become costlier and busier. Both parents are more often than not working and young children are cared for in crèches, day care centres or preschool/play school.

The question I am addressing is how the psychological and mental development of children is affected by this practice.

The western world has long had day care centres for children in their towns and cities. Public health experts especially from the US and UK have always defended the need and presence of such establishments. Mental health professionals and activists have raised pertinent questions about this practice, though. Concerns about the emotional craving of such young children, (lack of) bonding with the family esp mother and their exposure to an urban materialistic culture so early in life have been defended by presenting the benefits of such practices on the cognitive, social and intellectual development of children brought up at day care centres.

In India, however, we have no such debate. Most working couples with young children consider proxy care services as essential in modern life. Some rationalize their decision by pointing towards the west-‘If they do it, then why can’t we?’ Others are a little defensive and justify their decision as having been taken at age 2-3 yrs, when the child is ‘more mature’! Pragmatic couples accept that to make ends meet double income is essential and they are investing in their child’s future itself by working hard. The downsides of leaving your child in the care of ‘an other’ person are rarely thought off.

Your child’s individual needs are important. Parents identify these little desires of their young ones early on. That helps begin the bonding of a child and his/her parents. The child feels understood and comforted without having to ask. Within this milieu, a child develops rapidly and wholesomely. At a centre, your child is one of many. The staff’s key aims are to help keep things peaceful, and enjoyable. Individual needs, goals, aspirations are not a priority. Herding together children into groups and involving them in group activities is common in such centres. Thus, at 2 yrs of age, your child is part of a group. Many parents understand this and accept it as an offset of our schooling system. But if you are one of those who values individuality, then you may want to give your child more space and time for his/her unique behaviors and emotions to develop.

Staff to child ratio is rarely satisfactory, and staff training is woefully inadequate. Many centres employ ‘teachers’ with no qualification in child development. As long as you speak good English and are presentable, you can be a teacher/ma’m at a play school. Ayahs and maids are employed to help clean up the mess and keep an eye on the children while they play. They also function as proxy disciplinarians if the ma’m is busy with admin work. Parents rarely have control over what to discipline for and how. Thus when a child comes home or is at home on weekends, the response from parents does not match what happens at ‘school’. This leads to confusion in the child’s understanding of what is right and what is wrong. Behavioral problems begin and fester because of lack of a consistent response from care givers. Avoid this by asking your child’s school about what desirable behaviors s/he is exhibiting and what we should be doing to help extinguish undesirable responses. Or else, you can tell your child’s ma’m how you deal with defiance and tantrums at home and that you would like the same to be followed at the centre.

Food habits are inculcated in childhood. Except for food allergies, all foods are important and your child should be exposed to and helped to accept a variety of food items. Many centres have their own kitchen and provide meals and snacks from their own pantry. You need to check and advise a wide variety of menu to be presented as well as to vary it for individual children as well. Thus, not all children should be served rice on one day and dosa on another day. Allow them to make choices from the platter and help them share and respect other children’s choices. Table etiquette and manners are of course helpful and most schools would help your child excel in them! Do continue to practice the same at home. By feeding your child while he is sitting in front of the TV at home is a big disservice to the learning he is gaining at school.

Some centres provide sleep time and spaces for children to doze off when they need to. Does your child need his/her daytime nap? How long should it be for? Remember it would have an impact on the sleep time at night with the potential to override into your sleep time! You wouldn’t want your child asking for a game of hide and seek at 11pm, if you have to finish a project! Don’t let your child’s school decide whether he should sleep or not. Let your child choose and ensure you are able to enforce a consistent sleep time at night.

I hope the above tips will help you and your children.

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