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The Fifth International Luria Memorial Congress
«Lurian Approach in International Psychological Science»
Volume 2018
Conference Paper
The Importance of Primary Prevention
Regarding Orientations Given to Babies´
Caregivers
Carla Anauate1and Edna Peters Kahhale2
1Centro Integrado de Neuropsicologia e Psicologia, São Paulo, Brazil
2Pontifícia Universidade Católica, São Paulo, Brazil
Abstract
Caregiver orientation is very important to promote neurodevelopment on babies.
Considering that relations are the key for this development of superior mental
functions, we believe that all caregivers, teachers and parents should be present and
paying attention to the children, providing opportunity for an ideal neurodevelopment
and humanization. It is important to orientate caregivers so that they can provide
qualitative conditions, which integrate affection, conscience and action to promote
development to occur according to the potential of the child. We believe that the
individual constitutes himself by means of social contact. This work has the goal to
approach the theory which orientates, with specific guidelines and practical work,
caregivers aiming a better child neurodevelopment. Bonds are necessary for a
better and trustful relation. When you are present in a relation nervous connections
are promoted and these lead to a more effective motor, cognitive and affective
development of the superior mental functions such as memory, attention, language,
psychomotricity and executive functions. It uses didactically the following principles
of the Social Historical theory of Luria and Vygotsky: mediation, functional units and
zone of proximal development. Interactions between the brain and the formation of
mental functions require the maturity of the nervous system as well as an active
process that emphasizes relations of two or more human beings.
Keywords: neurodevelopment, childhood, relation
1. Introduction
This work has the goal to talk about the importance of bonds in the construction of
the neurocognitive development of babies. We notice that nowadays with a boom on
technology and consumerism society has less quality time to share with their beloved.
This articles wants to point out some important updated researches that prove the
How to cite this article:Carla Anauate and Edna Peters Kahhale, (2018), “The Importance of Primary Prevention Regarding Orientations Given
to Babies´ Caregivers” in The Fifth International Luria Memorial Congress «Lurian Approach in International Psychological Science», KnE Life Sciences,
pages 71–79. DOI 10.18502/kls.v4i8.3264
Page 71
Corresponding Author:
Carla Anauate
carla@ramark.com.br
Received: 25 July 2018
Accepted: 9 August 2018
Published: 1 November 2018
Publishing services provided by
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Carla Anauate and Edna
Peters Kahhale. This article is
distributed under the terms of
the Creative Commons
Attribution License, which
permits unrestricted use and
redistribution provided that the
original author and source are
credited.
Selection and Peer-review
under the responsibility of the
Fifth International Luria
Memorial Congress Conference
Committee.
The Fifth International Luria Memorial Congress
importance of significant bonds, love and affection promoting the neurodevelopment
to occur on time and promptly. Therefore orientations will be given to help parents
and caregivers to facilitate through care and education the development of cognitive
functions because relation is the key to significant child development. Vygotsky (1994)
states that man constitutes himself within social relations.
Young babies already notice feelings of acceptation and rejection. These expe-
riences stay registered in their minds as lived experiences between them and the
world which surrounds. Tronick (1989) in the still face experiment reflects about the
sensibility of the baby to capture the behavioral attitude of the mother. If the mother
does not have conditions to take care of the baby it is important that another person
takes over, because the baby cannot stay long without assistance. ‘The fragility of
a baby does not admit delays, because the consequences of this distance, created
between mother and baby, which can take long, can become irreversible’. ( JERUSALIN-
SKY e CORIAT, 1983, pg. 80).
Experimental works indicate modifications on the neuroendocrine and behavioral
systems of the babies who suffered stress and privation on the beginning of devel-
opment. Early experiences influence the growth of the brain. Experiences of positive
affection related to pleasure and safety cause an increase of sinaptical communica-
tions. These studies correlate the mother´s depression after delivery to the high level
of cortisol on the saliva of babies who suffer from abandonment of mother affection.
Let us take a look at some of these studies which point out that there is an increase
on the level of basal salivar cortisol on babies of depressed mothers which cause a
decrease on the sinapses and on the serotonine (CUNHA, 2001). Motta (2002) explains
that the heart frequency of these babies is considered higher. Jones (2000) affirms that
these babies present in their EEG exam more activation of the right frontal region than
of the left – indicating emotions which reflect affect deprivation.
Cosolino (2013) mentions that when there is an abuse, negligence or when a child
is abandoned what is communicated is that the child has no value and is not accepted
as if the world is a dangerous and distrustful place, therefore, it must not be explored.
In this way the author emphasizes that the brain grows better within an environment
of support and low levels of stress. Affirms that safe relations are the key to healthy
growth of the brain as well as emotional regulation that stimulates learning.
Depressed mothers need family, therapeutic and social support so that they can
perform their essential maternity which is fundamental to promote the pattern of
neurological, neuroendocrinous and psychological development to their babies. This
should be a public health important issue because many cases are left unattended
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Bowlby (1956) considers that a child experimenting a positive maternity will have
an adequate brain structure, will develop a safe system of attachment and will have
trust internalized. In this way the child will be able to have a relation with the world in
a trustful way, with courage to face the challenges and dangers that will arise while
he is brought up... becoming resilient. Resilience suggests flexibility and elasticity to
deal with adversities and overcoming them reaching good results.
Leal (2003) points out to the existence of an innate impulse which looks for the
reaction on the other person. The baby relates to the other who seems to him like
a legitimate and responsive person. Fonseca (2013) mentions that a baby is a social
human being and that attachment is the first step to development and to learning.
Actual researches vastly explore this theme and consider it through various points
of views. I recently found more than 250 articles published about this theme in the last
five years. I will mention in this article just some of the recent researches published.
McMahon, C. et al. (2016) in an Australian longitudinal research published in 2016
suggests that women with a better representation of the fetus during pregnancy show
a more positive pattern of maternity establishing a more secure relational bond with
their babies.
Another longitudinal French research written by Gandiolo and Roskaw (2016) affirm
that family bonds are directly associated with co-parenting as well as with the con-
sciousness both parents should have regarding parenting. They conclude that co-
parenting is fundamental when considering both individual characteristics and family
itself functioning as a whole.
Saunders et al. (2015) focused on their work that healthy bonds are built within
dyadic relations. These relations do not depend only upon the emotional qualities and
availability of the mother but also upon the emotional quality and availability of the
baby. One has a direct influence upon the other.
Murphy et al.(2015) published a research which was based on a group intervention
done with people who had suffered trauma in their childhood. The group intervention
was based on the development of bonds and showed that it is possible to form safe
and protective bonds even after having passed through very bad experiences during
childhood. This intervention had the goal of preventing disorganization and helping
parents to resignificate past traumas so that they would not pass these problems to
future generations. The intervention was based on the following principles which were
worked in a group format together with individual psychotherapy: empathic function-
ing, emotional attunement, affective regulation, naming emotions, intergenerational
patterns and soothing.
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1.1. Orientations
In this moment we will propose some basic orientations to caregivers of babies. Not
that the caregiver, specifically the mother, does not instinctively knows about these
important orientations, but some are not conscientious that these orientations pro-
mote brain development and are fundamental to generate significant bonds. Let us
take a look to some of them.
Let us start from the beginning – Orientations to couples who wish to conceive a
baby:
• No use of alcohol nor drugs
• Live an organized life
• Do physical exercises
• Live in a healthy and tranquil environment
• Eat healthy food (avoid raw meat)
• Avoid contact with street cats and pigeons
• Guarantee a good relation within the couple
• Listen to music which arouses good feelings
• Prepare the ingestion of folic acid together with a doctor
• If necessary do therapeutic practices
Now we will propose some orientations for pregnant or recent delivered parents:
• Pay attention to the initiatives of this baby and respond to them showing that
you are present within this dynamic relation.
• Give holding. Hold the baby firmly and safely to pass security.
• Look the baby in the eyes when changing diapers, when breastfeeding and in
all occasions when together to create visual, tactile and auditory contact.
• Emphasize the emotions that appear nominating them.
• Be entire and complete in the relation.
• Touch your baby and nominate where you are touching and the tender feelings
that emerge.
• Talk to your baby. Establish a relation with him.
• When the baby does a gesture, nominate and do the same gesture back to show
that you are with him, following him.
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• When the baby emits a sound, baby talk back to the baby, nominate your and
his emotions. Communicate in a sensible way with your baby.
These orientations were used to compose a flyer – Enchant yourselves! You will
become parents! which was distributed freely in a city close to São Paulo to all pregnant
parents. The orientations serve as a guide to promote a better and healthier neuropsy-
chological development to the baby. This initiative could be done in different parts
of the world to reach a bigger population. As well as interventions in public squares
like the one I was honored to observe in a trip to Cuba. I was able to participate of
an important guided relational experience among caregiver and baby which happens
daily with no cost in a public square.
1.2. Methodology
A research in progress is being done in a city of São Paulo on a kindergarten school.
In this experience we suggest interventions to be done within the daily routine which
can also be used in other parts of the world. The participants of the experience were
divided in two groups:
The participants of this research were divided into: GROUP A and B. In GROUP A,
the intervention group, there were 19 babies, half boys, half girls ranging from 2 to
10 months and in GROUP B, the control group, only 17 babies, more girls than boys
ranging from 12 to 20 months. The parents, caregivers and educators of both groups
received a previous orientation about how the research would proceed and signed
the agreement term and answered a previous questionnaire about relational aspects.
All the babies passed through the evaluation scale: Schedule of Growing Skills II in
March and December. The parents of both groups received a resilience questionnaire
on December.
GROUP A received a weekly intervention (during 2017) + weekly parent and care-
giver orientations. GROUP B did not receive any intervention. GROUP B´s parents and
caregiver´s only received orientations in December of 2017.
The weekly intervention used on GROUP A was based on the following guidelines:
• Look the baby in the eyes during interaction.
• Use a tender voice and a smile on the face.
• Call the children by their name.
• Name the parts of the body of the baby.
• Repeat the gestures giving names to the actions and intentions.
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• Nominate everything the baby does and everything you do to the baby.
• Talk to the baby showing you heard him and that you two are in dialogue.
The intervention group participated of the following routine on a daily basis:
When the baby arrives say: Good morning... (name of child) How are you today?
Welcome to this beautiful day here at the kindergarten.
Sing a welcome music with all the babies of Good morning... calling each baby by
the name and attributing a motor signal for them, according to their possibility, do
together. The day would proceed with free play until all the babies arrived and were
fed. Then they would receive their fruit snack and right after start the intervention of
the day which could be according to the following possibilities:
Intervention using motor activities:
• Using a Bobath ball – put the baby on top of the ball and roll the baby stimulating
the vestibular functions.
• Roll the baby on a round pillow, stimulating the babies with toys so that they
have the intention to reach forward.
• Sit the baby on your legs close to your knees and hold him by the hand and go
up and down playing, singing and smiling at the baby.
• Put the baby on top of a blanket and push the blanket across the room with him
looking at you and also looking to the class.
• Slide the baby on a ramp.
Intervention using auditive activities:
• Use rattles and toys which make different noises.
• Music activities – select a music with associated motor activities. Repeat the
music 3 times together with the motor activity to stimulate coordination.
• Story telling activity – select books with big and colorful figures. Tell the story
emphasizing the iconic words. Try to do the words with the body in a theatrical
way.
• Use a glove with characters to play with the baby and tell a story.
Intervention using visual activities:
• Use a variety of colorful toys. Use pens with colorful lights. Show books and
flashcards giving names to the parts of the body, objects, characters, colors,
fruits, etc.
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Intervention using tactile activities:
• Use of massage balls and toys and rugs with different textures.
After this intervention activity it is time for the gustative and odor activity which
composes the lunch. The sleeping time after lunch should be motivated by a calming.
When the babies start waking up a free play activity will occur as babies wait for their
colleagues to wake up and have their milk. During the afternoon it is important to
repeat the intervention activity done in the morning to solidify the information and to
make the activity more complex. After this activity prepare dinner with a music which
emphasizes the need of eating healthy food. While the babies wait to go home they
can do a free play activity and sing a calming music.
On the intervention day it is fundamental to talk to the parents about the activities
which were done during that day and emphasize the importance of continuing the
activities at home.
As this is a research in progress it still does not have any conclusive results. As
seen in the methodology there is a pre and posttest with the use of Schedule of
Growing Skills II which will evaluate the functions of the baby plus questionnaires to
both parents and caregivers which will be able to prove or not the hypothesis that
relational bonds together with intervention activities, including naming the actions
and the world around plus talking to the baby with a sweet voice and looking them in
the eyes, promote development to occur.
2. Conclusion
We believe and suggest, for more profound comprehension of this theme, that more
research should be done to evaluate how relational bonds are created cross-culturally
and the importance to consider orientation as a very important tool when we think
about preparing a person to generate and promote a good and significant relation with
a child. We assume that this present research in progress has its limitations because
it is a small sample in just one kindergarten school not representing a population in
itself. It is an example, seen through a specific point of view, which surely would need
to be recreated, expanded and deepened to present reliable results.
Leal (2003) emphasizes that the communication which occurs back and forth is
observed in the early years of a babies´ life. She considers it is the root of the motor,
affective and cognitive development. Within this communication a relation of two or
more people is present which builds up the subjectivity of the human being.
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Vygotsky (1994) affirms that such instruments, actions and social relations are pre-
sented to the child, in first hand, in an interpsychological and social level and, only
afterwards, it will occur in an intrapsychological, internal and subjective level through
the process of internalization.
Aires (2010) affirms that time with quality promotes brain development and builds
up the personality of the baby. The nervous maturity occurs by means of social inter-
action.
Parents and caregivers serve as mediators, they are responsible for presenting the
world to the child. This responsibility involves the way the child will internalize the
world because his subjectivity will be built within the relations he has and his experi-
ences in life.
Therefore to avoid stress, neglect and sadness promoting development, based in
healthy bond we believe that the most important is not WHAT TO DO but HOW TO
DO. Parents and caregivers should establish a good relation with the baby, considering
each baby as an unique individual.
Bock (2002) affirms that man transforms and is transformed in a constant process.
Relationships involve exchange, in both ways, one constitutes the other, transforms
the other, in a process which focuses the best adaption to reality. We recognize that:
attention, tenderness and love are main tools in the relation between caregiver and
baby providing a better development to occur.
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