The first day of the course we were asked what we know about Pikler Care and what we would like to learn.
The most outstanding answer came from Anja from Slovenia who said children are born to meet the world. If we give them the opportunity, the meeting of the world can be very pleasant. They just need time. It’s baby time, not adult.
This beginning session was led by Szusza, the director of the Pikler Institute.
Szusza made clear that the course was about physical and emotional care but first she gave us the little known history of Dr. Emmi Pikler.
Dr. Emmi Pikler 1902-1984 was a Hungarian Jew. Her father manufactures the boards you put the bread on to put in the oven. Her mother taught kindergarten. Emmi Pikler became the first Hungarian Pediatrician. Her attitude toward her mother was something she loved. She always remembered how her mother let her be herself. Emmi Pikler’s mother died when she was 12. While her mother was alive she was a very temperamental child. When she wanted something she would get on the floor and have a tantrum. She remembered her mother just standing over her looking at her with empathy.
Emmi would ask parents how would you feel when your child is doing that. Can you look on with empathy?
This is one of the experiences that inspire Emmi Pikler to look at things with open eyes. Other early experiences inspired her work. While Emmi Pikler was interning as a doctor working in Vienna there were a lot of new professionals who were thinking with new ideas. She was able to work in Dr. Salsa’s clinic. She learned a lot about how to be with children. All the doctor’s had to learn how to care for the children. That is something usually the nurses did but at that hospital the doctor’s had to learn. They had to learn how to prepare the child. They had a competition in the hospital, who could give the child a shot without making them cry. This was the 20s. They also allow the children to move around and play even with the one who is sick.
Another impactful experience came when she was working in a clinic where they had poor and well off children. Dr. Pikler realized the children who were poorer and unsupervised in the streets had different accidents from the children who were rich and closely supervised. The poorer children had fewer accidents and when they did they were less severe.
The war and being Jewish had a big effect on Dr. Pikler’s work.
Being Jewish in Hungary she could not find jobs in hospitals so she made her practice private. She was a very well known and respected physician. She got a lot of experience. Her marriage to a very famous Hungarian communist mathematician played a role in her professional direction. Her husband spent a lot of time in prison because he had a communist affiliation. Inspired by that he developed a way to teach math so children understood it.
Pikler lived for a while in Italy. When Emmi Pikler got pregnant there she spent much time on the beach looking for babies. She saw that the nanny’s were taking care of them on the beach. Putting them in sitting positions. The nanny always wanted something from the children. They wanted the children to sit up or try to walk. But when they forgot about the children that was when they would start playing. Dr. Pikler realized how the expectations of the children limited them in exploring and playing.
She experiments with her own daughter Anna.
When Anna was born in 1931 the Dr. Pikler and her husband let her develop on her own. Anna was a slow child that didn’t develop so quickly. Emmi was hesitant but Anna was happy. Emmi wanted to give up but her husband, who was a mathematician, said let us continue with this experiment. So they continue.
Dr. Pikler defined herself as the pediatrician who wants to understand the normal healthy development of the child. She wanted to know what health looked like. Doctor’s look for sickness and she wanted to look for health. What is a healthy child? If the development is good enough if the parent is taking good enough care it will show up in the child’s health.
Dr. Pikler saw more in looking for the healthy development of the child. She felt you could better help children if you knew what health looked like. In the 30’s she looked at the child and made things like almond milk and mixed oat cereal.
Dr. Pikler was interested in developing care routines that enhance the child’s development. In South America there is a circle of Pikler people.
When Dr. Pikler was practicing and she went to visit her family’s weekly. The children were not sick. She would sit with the mother talk about the child. Ask the mothers to observe the child. She was watching the child in their natural environment. Dr. Pikler was able to observe the child and document what a healthy child could do. She did this on a regular basis.
Emmi Pikler took responsibility for the development of the child. She was very strict. If a family worked with her the families had to agree to consult with Emmi Pikler before they made any changes to the routine. Like letting the children sleep outside. There are stories of the police being called on the families for neglect. She would go into all the details with the families and they had to strictly follow. She would instruct them on how to feed the babies, how to change the babies. When they worked with her they had to agree to take care of the babies themselves and not the nanny’s. She would like the parents to know that they needed to do these daily boring jobs. These are the relation building activities. Where you get to know the child and the child gets to know you.
Out of this work Dr. Pikler created a book. Her book is like an album; there are 64 pictures. Half of the book is a photo album. She asks parents what they think of the pictures. What do they tell you about the child?
The book was published in Hungary as; What can your baby already do and In German it is on the market as; Peaceful Babies Contented Parents.
There were four big ideas in the book
- You have to be there for the routines.
- You have to observe your own child in order to know them.
- Let him be.
- Their Healthy Development will let you know how they are doing.
During World War Two some of Dr. Piker’s clients hid them. Anna was 12-15 she was hiding with her mother in the home of a family. They were in the same household but they couldn’t speak. Only see each other. The family said that Anna was from Transylvania. Emmi was a servant. The father was in prison for being a communist. When the war ended there were many children who didn’t have parents. The communist government asked Dr. Pikler to take care of the children.
Because she was well known as a doctor she was asked to set up a place for the children with no parents. Dr. Pikler was so respected they allowed her to pick her own house for an institution. That house is the current location of the Loczy Pikler House for Children. Dr. Pikler had no previous knowledge about what an orphanage could be. The only thing she knew was the hospital for children from Germany and children being in homes with families from her practice. She just had the idea that all children have the same needs. So instead of making the home one large room with 60 or so beds. She said no, let us keep the walls to have small groups. She started with 10 children together but she saw that was too many and it went down to 8.
In 1946 she opened the Nursery Home. It was open until 2011.
Dr. Pikler paid attention to every detail. To make sure that the feeding experience was pleasant for the children and the caregiver she had a stool put under the caregivers feet. It is important for the caregiver to feel comfortable.
Dr. Pikler’s most important idea is that children need the least amount of adults to care for them.
Everything was done to prevent Hospitalized Syndrome which comes from newborns being in large institutions.
Emmi Pikler was working on how you can organize the life of children in an institution so they can grow healthy. When other babies were getting hospitalized Syndrome and dying. No child died in Emmi Pikler’s institute.
Dr. Pikler worked hard to find a way that children in institutions can be raised and developed like other children.
Dr. Pikler aligned her work with the French author who wrote, The unusual motherhood. This approach believed that when a child has a problem it is not the thing to invite an extra person. The best thing to do is in-able the person who has the primary relationship with the child. You want to help the person who has the relationship with the child. Not bring in another person.
There is another book that looks at building capacity and the community responsibility of raising healthy children. In socialism there are no orphans.
When Dr. Pikler took over the orphanage; the caregivers were more concerned with changing the beds and things like that. Dr. Pikler fired them all and hired young girls from the country. First she wanted to train them and then she sent them to the care courses. When she sent the trained nurses away she had to create a curriculum.
Dr. Pikler was jew who was a committed communist. She wanted a different kind of society.
She was a scientist. She observed the natural development of the child. She created data to show the natural development of the child if parents are not putting children in position. She created research on the natural development of the child. You just take notes on the development of the child. She did research from the data of the caregivers. Also the data was from her observations.
Dr. Pikler created a definition of Play
Play is what the child does in their spare time when they are not involved in care. It is what they do to entertain themselves.
The way to understand their play is to observe what the child is doing at this time when they are not involved in care routines.
Dr. Pikler observed not only what the child was doing but also what the child was looking at. She wanted to know what interested the child. Dr. Pikler believed that when you offer the environment the children will learn. She believed that from birth children have a very strong inner drive to explore what is around them.
They have a strong internal drive to explore everything in the world.
Dr. Pikler and her colleagues at the Pikler house researched children to find out small things like what was the best weight for a toy for certain ages like 14 grams for the young baby. In the institute they hired people to do that work. To observe and see what is best for the child.
Emmi Pikler took pictures of her hands. Not holding the children up by the legs but using the hand to move the legs to change.
The Pikler loczy house prides itself on being dynamic because they are able to see problems and seek ways to deal with them and acknowledge them and take complete and full responsibility for all things that support the complete healthy development of the child.
Anna Tardos From Technique to Attitude
Anna Tardos the daughter of Emmi Pikler started her lecture with this question:
When you learned this job, this profession, is there a part of this training that is about gestures? It is a given fact that you have to approach children with respect, compassion, that is something you learn and have to teach others. It’s a part of this kind of job. How much are gestures and the way you use your gestures is a part of your training?
She continued with, today we are going to deal with what is the significance of all these details. It is not the technique but why all techniques are important.
Not such a simple issue to talk about because not many people are willing to accept it. I remember when we were supervising infant homes in Hungary and we were explaining how the caregiver should hold the baby while feeding and all the caregivers said they were going to give up the job and leave. They were not going to listen to someone telling them what to do. Many people critiqued our approach for taking away the spontaneity.
Now I am going to talk about newborn babies and later we will talk about the generality of kindergarten children.
We watched a video of a caregiver. Anna explained.
This scene is the first meeting between an adult and child. She is changing her. This is her first day from the hospital. This is a purely professional meeting. This is not even the primary caregiver meeting the child.
The comments from the class on their first impression of the video: Slow, talked, gentle. Took her time, not in a rush. Paused between different actions, she positioned her face to the child’s face, when the child’s head was facing the side she positioned her face that way.
Anna pointed out that it was interesting that we didn’t mention the baby.
Anna then asked the group to watch the video from these different angles
- The baby: What do you see about the baby, what do you think about her apart from her loud crying. What is your impression of the little girl?
- Imagine a young trainee who is learning to do this. What do you think she can specifically learn from this scene? What are the things you can learn from imitating? What are some specific gestures or behaviors to take from this? Create a list.
- What are somethings in the behavior of the head nurse that you can not learn from imitating it.
What can you learn from imitation.
- Body positioning with the baby
- Undressing the baby
- Voice tone and loudness
- How to face and hold the baby
- To cradle the babies head
- How to pick the baby up with hand behind the head
- How to move the baby holding bottom and head
- How to change the baby
- How to lift the babies bottom
- The speed of each action
- How to handle the baby’s body
- How to respond to the baby’s gestures
- How to touch the baby
- How to read the baby’s signals.
- Trainees can learn not to panic when the baby is crying.
- Stay in touch
- Eye contact
- Learn the steps of the Pikler care routine.
When we discussed the baby in the video these were the comments.
The baby stopped crying when there was the back and forth contact with her and the caregiver. The baby’s cry in the beginning is an impersonal cry into the world although she feels the caregiver. The caregiver puts her finger on the baby’s arm so the baby knows there is another person there but somehow the cry is impersonal. The Pikler way of thinking is unknown to hospital workers. They use fast moves with babies. Infants who are treated in a fast impersonal way get depressed. For some reason this little girl has power. This is a guess on my side but the minute she was raised she got calm. Most probably she had some good memories. I suppose someone was nice to this little girl and cuddled her. Didn’t have to be a personal relationship. It takes a longer time to get in touch with a depressed child.
Newborns are social creatures. Whenever they are awake they are looking for people. If there is nobody around to receive this look or calm them down, they fall into a state of depression.
In the video when the baby calms down she is not looking at the adult she is looking at the wall so there is still room for development. It’s important to start with observing the infant. It is really important to notice the infant and how he or she feels. It is particularly striking when the adult is doing something we don’t like, we need to look at the baby how he or she feels. Is it a well-developed child?
Our focus has to be on the child first.
From Anna’s perspective there are specific movements you can learn.
They learn how to lift the head, how to protect the head. They only move the child as much as they have to. There are hand and body movements you can learn specifically. At the Pikler institute it was easier for them to teach new people who had only learned care giving in their families.
The things you cannot learn from imitation:
Peace of mind is not something you can learn. You need some maturity or self confidence. This is not what a beginner learns first. You need at least a year to become this self confident. Sympathizing with the child. Sympathizing is like an art. You can not learn the spontaneity which is the back and forth in the relationship which is led by the child.
Anna pointed out the facial expression of the caregiver in the video. She is always serious. She only smiles at the end when she sees the child has calmed down. It’s honest and automatic sympathizing which is not something you can always learn. Everyone is not suitable for this job. Taking care of an infant, a baby takes the whole personality.
The third time watching the video Anna asked the following questions:
Why is this technique and the details that have to be followed so meticulously so important in daycare centers and groups?
Are there some movements for older kids that are worth learning up to the age of 4 or 5?
Our group discussed whether there were movements for older kids that were worth learning. This was the list we created.
- Observing the child
- Being on the child’s level, eye level.
- Respecting: Following the child’s cues. If they say no, don’t touch the child.
- Reading their cues Tell them what’s happening
- Being slow, pace, the tempo of action.
- Stay calm, maturity of the caregiver, sympathizing, being fully present in what you are doing. Empathy and sympathy.
- Letting the child’s interest and curiosity drive the child’s development.
- Hand gestures, the open hand gesture
- Connecting, the emotional connection, connecting with empathy.
- Finding ways to make yourself open to the children. Planting ourselves for the children. Using non-judgement words and tones being open in the way that you speak. Tone, volume, calmness in voice.
Anna answered the questions: Why it is important to follow the specifics of this method. It’s really important to repeat things in the same way so children can prepare. In a group situation there is usually more than one person that deals with a child. That is why it is important to have uniform practices. It takes continuous monitoring, observing and conversation between caregivers to have consistent practice.
They asked the French how do we insure the right approach. They said start with the movement. Make the movement consistent. Not that you should be rough, we say be careful with the head and put it down slowly in a careful way. Even in beginner’s training when you talk about the routine you are not saying you didn’t pay attention. We don’t say don’t over feed the children or press food down their throat. What we say instead is hold up the spoon, wait till he or she opens her mouth and then give them the food. And if we make a comment like this it is less painful than saying you don’t pay attention and you forcefully feed the kids.
We have an upside down approach.
We specifically learn the movements to inform the right approach and the right attitude.
The fact that good technique doesn’t solve all the problems we experience in the infants home. It is on the caregiver whose status of the child depends. There was once a child who was in a bad mood, didn’t play. So we checked to see if there were the appropriate relationships. We watched and she was following the rules, but what we found out later was that the caregiver had emotional problems. The caregiver had good technique but we found out that the caregiver was not totally there for the child and the child did feel it.
They can have the right technique but they need to have the right attitude. To shape the attitude that has sympathy is something that can not be learned. It is something that comes with maturity.
The caregiver needs sympathy with calmness. If a child is in trouble we don’t go in the hole with them, we work to get them out.
When children cry they get help in solving the problem that is hurting them. In the Pikler institute children have photographs of their families.
Many people think it’s best to forget about their parents. We think the parents are the most important in their life. If they are longing for their parents it’s natural. We need to let them know it’s okay.
Anna introduces the concept of the open gestures. There are three gestures that are open
If adults learn these movement’s it helps to shape and attitude. If somebody’s behavior needs to be changed it’s good to explain the appropriate movement or ask what would it feel like for us.
To the new caregiver instead of saying don’t push the child from the back. We say how would you feel if someone pushed you from the back.
Would you push a minister or important adult from the back?