By AUDREY FISCHER
One of America's most respected pediatricians, Dr. T. Berry Brazelton, and its most influential child psychiatrist, Dr. Stanley I. Greenspan, give the nation a checkup on how we are raising our children in their new book, The Irreducible Needs of Children: What Every Child Must Have to Grow, Learn, and Flourish -- and the diagnosis is poor.
"The United States is the least child-and family-oriented society in the civilized world," said Dr. Brazelton during a book discussion held at the Library on Oct. 10. "Our research and knowledge is way ahead of our commitment. We know that if children get what they need during the first three years of life, they will have a good self-image, an ability to care about others, an eagerness to learn and even a better sense of humor," observed Dr. Brazelton. "It is during these years that we have an opportunity for prevention."
Dr. Brazelton, one of 84 individuals honored as a "Living Legend" as part of the Library's Bicentennial celebration on April 24, 2000, has been a longtime advocate for working families. He has testified before Congress in support of the need for family and medical leave.
"We shouldn't put the blame on parents," warned Dr. Brazelton. Instead, he believes national, state and local governments, as well as businesses, must help to remove some of the many stress factors affecting working families.
Dr. Brazelton was joined by his co-author Dr. Greenspan. While the two do not always agree on how to solve the problem, they both concur on the scope of the problem and share a clear vision of the seven basic or "irreducible" needs of children. Through their work, they have identified the needs for: continuous nurturing relationships; physical protection, safety and regulation; experiences tailored to individual differences; developmentally appropriate experiences; limit setting, structure and expectations; stable, supportive communities and cultural continuity; and the need to protect the future.
The conversation, moderated by Washington Post family advice columnist Marguerite Kelley, focused primarily on the need for nurturing relationships.
"As the politicians often ask, 'Are we better off now than 30 years ago?'" asked Dr. Greenspan. From the perspective of an eight-month-old baby, his answer is decidedly no, given the number of children in day care, the state of public education and the overloaded mental health system. Of particular concern to him is the lack of time given to children in today's fast-paced society.
"These chains of interaction are building blocks of intelligence, self-esteem and ability to trust," said Dr. Greenspan. "The nurturing side of the equation is missing." Instead, he believes the trend is toward "survival of the fittest."
Dr. Greenspan seems to be committed to at least one parent staying home with young children, and discussed the impact on children of parents who are too stressed to be closely engaged in their children's lives. Dr. Brazelton recognizes the need to involve fathers and the need for improved day care. Both agree that the vast majority of institutional day care centers, and nearly as many family day care providers, offer substandard care.
"Our child care is deplorable," said Dr. Brazelton. "Many children are in situations that neither you nor I would tolerate." As a result, he observed that children do "grief work" in order to cope. This includes relying on defense mechanisms such as denial, projection and detachment -- none of which bodes well for society as a whole.
Dr. Greenspan wants parents to "cut back" on activities that take them outside of the home. He believes that if parents are educated about the critical importance of doing so, they will make the right choices. While Dr. Brazelton agrees that the first three years of life are a critical time in child development and ideally a time when they should be cared for by nurturing adults, he feels parents should continue to fight for better child care. "They will have to keep fighting because institutions are insensitive," he said. "Our public policy is driven by politics, not by science," echoed Dr. Greenspan.
Both share similar concerns about meeting children's needs in our over-crowded public classrooms. Neither believe that higher standards, more testing or even better teacher training will fix the problem if, as a society, we just pretend to be committed to improving education. It will take, in part, reduced class size so that teachers can nurture students and appreciate their individual differences and learning styles. That will take money, which both believe is worth spending.
"Stan and I stuck our necks out," said Dr. Brazelton, referring to the publication of their controversial new book. "We did it because it has to be done. If it works, it works, if not, we just have to keep trying."
T. Berry Brazelton, M.D., is professor emeritus at Harvard Medical School and founder of the Child Development Unit at Boston Children's Hospital. He is the author of many best-selling books, including Touchpoints, Infants and Mothers and To Listen to a Child. His Neonatal Behavior Assessment scale is used worldwide, and his research has influenced the entire field of child development.
Stanley Greenspan, M.D., is clinical professor of psychiatry and pediatrics at George Washington University School of Medicine. His pioneering works, which have been translated into more than a dozen languages, include The Growth of the Mind, Building Healthy Minds and The Child with Special Needs.
The Irreducible Needs of Children: What Every Child Must Have to Grow, Learn, and Flourish, a 176-page, hardcover book, is available for $23 in major bookstores and through Perseus Publishing.
Ms. Fischer is a public affairs specialist in the Public Affairs Office. Annlinn Grossman, of the Library's Conservation Division, contributed to this article.