Friday, November 21, 2014

Consequences of Stress on Children's Development

“In a country that emphasizes the importance of family unity in the socialization and upbringing of its children, an immigration system that promotes family separation is a broken system.” (Kremer, et al, 2009)

“The President asked Homeland Security Secretary Johnson and Attorney General Eric Holder to undertake a rigorous and inclusive review to inform recommendations on reforming our broken immigration system through executive action.” (Homeland Security, 2014)

(I wrote this blog before President Obama announced the new amnesty program for the immigrants. It looks like only 4.4 million of them will benefit from the new amnesty, and that includes children which is good news.)

Immigration is a thorny issue in America and especially in the Southwest near the United States and Mexico borders. I never thought much about the immigrants and the living conditions they would endure. Today, I have been thinking biosocial, cognitive, and psychology impacts on those children.

When I was a child, I would see migrant workers passing through my Indiana hometown over the summers. They would find work on the numerous farms. Then, I would not pay much attention to them. Today, I wonder how many children fall through cracks from this kind of migratory lifestyle.

We have different kinds of immigrant families. There are families who have had been in the United States for years and have children. They live in constant fear that they would be caught and deported. They fear both work and home raids. Most of all, they fear separation from children as a result of raids. This has the most serious consequence on the children.

Kremer et al (2009) outlined the long-term biosocial and psychosocial harm to those children whose parents are deported:
1. The trauma experienced in the immediate aftermath of the enforcement deportation action;
2. The separation of the family due to the detention and ultimate removal of a parent;
3. Devastating and long-lasting financial and emotional harm on the children left behind;
4. Families left without their primary breadwinner, many consisting of stay-at-home mothers who themselves are undocumented and cannot work;
5. Those parents whose spouses have been deported have encountered significant difficulties providing even the basic necessities to their children;
6. Children who have been in school and doing well would become withdrawn and have setbacks in their academic progress; and
7. There would be significant increases in children’s anxiety, depression, feelings of abandonment, eating and sleeping disorders, post-traumatic stress disorder, and behavioral changes among children who have experienced the loss of a loved one or who witnessed the raids in action.

There’s a sizable Hispanic population in our small beach town. Their children go to our schools. The schools recognize that the children are under stress because of their parents’ poverty and medical or dental needs. In a school & church volunteer partnership, our community provides free medical and dental care at a local preschool for all of the Hispanic families living in our community. Our church provides after-school and evening tutoring not only for students but also English classes for the parents so that the families stay together. Our church also has a breakfast, homework, & mentoring club at the middle school.
I don’t know if all that compensates for the stress those children endure in their lives that should not be happening.

I am thinking of children who are suffering from the devastating spread of Ebola in Liberia and the surrounding countries. They are experiencing losses of their parents and extended family members. First, they try to take care of people who have Ebola and die from them. Then they experience people in protective clothing entering their villages and taking them away to unknown places.

There are 2.5 million children under the age of 5 living in areas affected by Ebola. (Save the Children, 2014) They are more able to survive the outbreak of Ebola. But they lose their parents to Ebola and the lives that they are familiar with.

Save the Children have a Ebola Relief Fund where we can donate. Although celebrities have donated a total of 354 million dollars, Bono, the singer, wrote in a blog:

The Ebola outbreak in West Africa -- and the world's inept initial response to it --shows how fragile we are on all fronts. Because the epidemic isn't just a failure of health systems in poor countries, or of leadership and coordination by wealthy ones, it's also a failure of our value system. If governments the world over had kept their promises to fight extreme poverty and diseases, the three countries most affected would have had stronger national immune systems.

In this region, they are suffering from more than just Ebola. They also suffer from war, poverty, natural disaster, hunger, chaos, disease, and violence. Those stressors impede the normal biosocial and psychosocial developments in ways that would be impossible to gauge.


Bono. (November, 2014) Ebola is what happens when promises are broken. The Huffington Post. November 20, 2014. Retrieved from:

Fixing our broken immigration system through executive action: key facts. (2014) Homeland Security. Retrieved from:

Kremer, J. D., Moccio, K. A., and Hammell, J. W. (2009). Severing a Lifeline: The Neglect of Citizen Children in America’s Immigration Enforcement Policy. A Report to the The Urban Institute. Retrieved from:

Save the Children’s Relief Fund. (November 2014) Retrieved from:

Saturday, November 8, 2014

Public Health Issue: Literacy Promotion

The American Academy of Pediatrics (AAP) is currently engaged in literacy promotion as an essential part of pediatric well-child visits.  AAP has engaged in a number of researches that shows that literacy is an important public health issue that involves literacy skills, brain development, and parent-child relationships. (American Academy of Pediatrics, 2014)  Reading statistics in the United States are not the best they can be when comparing with reading scores of other countries.  The Academy is also fully aware of the competing interests such as electronic media and limits such as parental awareness.

Although AAP is focused on literacy promotion, American Academy of Pediatrics (2014) also states:

 Promoting literacy with parents of children beginning in infancy supports the recommendations of the AAP that children younger than 2 years not view electronic media and that older children and youth have no more than 2 hours daily of media exposure by offering parents a positive alternative for entertaining young children, for nurturing early relationships, and for developing healthy bedtime routines. (p. 5)

When families with infants and young children visit the participating pediatricians, they will hear a discussion and encouragement that they read to their infants.  They also have partnered with a non-profit organization, Reach Out and Read (ROR) who is presently actively promoting literacy among underrepresented minorities such as American Indian, native Hawaiian, and Alaska native populations. They are also working with military families, libraries, and schools.

One in three American children start Kindergarten without language skills needed to learn how to read. (AAP, 2014)  Reading with infants and younger children are associated with improved preschool language and literacy skills.  Children at 3 years old are more talkative than those that were not read to.

We have seen statistics often.  Children from families of poverty know and speak fewer words than those children from well-off families.  Sometimes, even well-off families have plenty of books at home but do not read directly with their children.  AAP wants to encourage all families to sit down, read, and engage in one-to-one conversations.  It has been suggested that a students’ reading skills at third grade is an indicator of their future academic success.

We studied in this class how this type of conversation with an adult stimulates brain development.  The more fully developed a brain is, the better the adult can function in the world. Another reason why literacy is important for adults is when they can read about their own health issues. If they are not literate, they are unable to read medical information that can save their lives.

Ultimately, every person wants a healthy relationship with one’s parent. When parents and children are engaged in book reading, it promotes a healthy relationship where they can both communicate their emotions, dreams, and expectations.  This communication between parent and child can be extended to family members and into the community when children become adults and participating as full members of the American society.

5,000 pediatricians have voluntarily participated in field-testing and created a set of recommendations for the literacy promotion. They came up with the following 5 recommendations:
1.     Advising all parents that reading is healthy;
2.     Counseling parents about developmentally appropriate reading activities;
3.     Providing developmentally and culturally appropriate books
4.     Providing additional information about libraries, materials and tookits that could help parents without resources.
5.     Partnering with other child advocacy organizations to promote literacy.

In support of school readiness, they also promoted with their patients the following 5Rs:
1.     Reading together as a family
2.     Rhyming, playing, talking, singing, and cuddling together
3.     Routines and regular times for meals, play, and sleeping which help children to know what to expect and what is expected from them.
4.     Rewards for everyday successes;
5.     Relationships that are reciprocal, nurturing, purposeful, and enduring.

Those are the foundation of a healthy early brain and child development. (AAP, 2014)

When the reading scores of the United States compare with the rest of the world, we are not performing up to par. The top seven countries are in Asia.  The top is technically not a country but a city in China.  Shanghai has a mean reading score of 570.  The United States ranked 36th with a mean reading score of 498. (Sedghi et al, 2014)

I had always believed that language and literacy are two of the important springboards to personal and life accomplishments.  In 1997, I was one of the four founders of an organization that promoted language and literacy.  We called it Alliance for Language and Literacy for Deaf Children (ALL for Deaf Children).  We sponsored a monthly book reading at libraries and bookstores, a quarterly lecture series with professionals, and holiday parties for all families with Deaf children and with Deaf parents with hearing children.

Language acquisition, language development, and literacy of Deaf children are critically important, and yet, those are polarizing issues between the proponents of spoken English and supporters of American Sign Language (ASL).  I would love to find ways to make both groups of supporters to collaborate more to benefit the Deaf and hard of hearing children who deserve to be in the center of the debate.


American Academy of Pediatrics. (2014) Literacy promotion: An essential component of primary care pediatric practice. PEDIATRICS. 134(2), 1-.6 doi: 10.1542/peds.2014-1384

O’Keefe, L. (2014) Parents who read to their children nurture more than literary skills. AAP News. doi: 10.1542/aapnews.20140624-2)

Sedghi, A., Arnett, G., and Chalabi, M. (November 2014) Pisa 2012 results: which country does best at reading, maths, and science? The Guardian. Retrieved from:

Saturday, November 1, 2014


I appreciate the opportunity to go down the memory lane. Both of my children love hearing about their different birth experiences.

I was 36 when giving birth to my son, Matthew. I was the kind of parent who read everything in preparation for the birth. I gave up both coffee and wine.  I was 38 when I gave birth to my daughter, Tory. By that time, I was more relaxed and decided it was okay to have coffee during pregnancy. A funny thing happened as a result of that. Tory suggested that she’s smarter because I drank coffee during her prenatal development! It has become an ongoing debate between my two children – who is smarter and why!

During my first birth, after a few hours of labor, my doctor recommended that I get a cesarean birth.  By that time, both my husband and I were too tired to fight back.  The c-section was without complications. 

Two years later, pregnant with my daughter, I figured that I would be getting a c-section.  But, while in labor at the hospital a different doctor who was on call and was Vietnamese, urged us to consider a vaginal birth. I became petrified at the idea of having a VB. The doctor was persuasive, and we decided to brave it. Twenty minutes later, my daughter was in my arms. And, just one more fact, my husband fainted, and the medical staff had to tend to him.

A cesarean birth is different from a vaginal birth in many ways.  When I had my c-section, it was treated as a medical issue. I stayed at the hospital for five days while recuperating from my surgery. My baby boy was brought to me whenever I asked and not kept in the same room as me.

Whereas after giving birth to Tory in the afternoon, it was decided to keep me at hospital for an overnight. But early next morning, my doctor suggested I go home, and that was less than 24 hours! This was the last thing I wanted to do because, with my firstborn, we stayed at the hospital for five days.

During both births, neither my family nor my husband’s family was available to stay with us so we were practically all by ourselves. This was a little scary and hard, but we bonded as a family.

We also decided to read to our babies nightly from the day they both got home. This decision was a huge factor in my children’s excellent reading development.

My son is now 23 years old and teaching English in China. So, I decided to check out how women give birth in China.  It is awfully hard to keep my American cultural views at bay while researching for how babies get born in China.

I googled birth practices in China, and mostly I found blogs on the topic of expats giving birth in China. And some other blogs were more of an opinion. I questioned the validity of the information in most blogs. It did appear from further research that most of the world's births in the bigger cities of the developing worlds have adopted the Western notion of a cesarean birth. Seems like most births in China are cesarean. In more rural areas, there seems to be a lack of information about their birth practices.

There are both Western-style and Chinese hospitals. The first decision an expat would make is to decide which hospital you prefer to give birth. Then there is a list of advice for expats who opt to give birth at a Chinese hospital. “Cultural differences mean that expectant parents may need to be forceful to ensure that they get what they want.” (Giving Birth, 2014).  Then there is a list of  “what to take to hospital: food, bed linen, painkillers, entertainment, blankets and towels for the baby.” From another blog, at a birth at a Chinese hospital, the husband cleaned up his wife. Ugh.

One of their customs for Chinese women is to Zuo Yue Zi (“lay-in) where women follow rules for a month after giving birth. The rules include no hair washing, no shower nor washing of any kind. Food has to be brought to her in bed. She must wear a hat to keep her head warm for a full month. She’s not allowed to expose her hands and feet. Women undergo Zuo Yue Zi so that “I will have less diseases in the old age.” Usually, the mother or mother-in-law will stay with the new mother.


Giving Birth. (October 2014). Angloinfo. Retrieved from:

Selin Davis, L. (2012). The best and worst places to give birth. CNN Health. Retrieved from:

Woods, J. (January 2013). 8 Lessons Learned about Giving Birth in China. Vagabond Journey. Retrieved from: