The Ultimate Secrets of Healthy Development For Your Baby— Bir th to 3 years
A World Changing Guide By Occupational Therapists Paula Tarver, OTR/L & Jeanne Martin, OTR/L
Copyright Š 2011 Advance My Baby, Inc. All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including emailing, photocopying, screen capturing, recording, or by an information storage and retrieval system, without written permission from the publisher. The authors and publisher disclaim any liability arising directly or indirectly from the use of this book. It is the intention of the authors to educate and guide moms, dads, grandparents, and other care givers by sharing with them the skills and knowledge necessary to promote optimal overall growth and development of their child. This book is not intended to replace skills or therapy services or medical advice from your healthcare provider. Published by Exclaimit!, Inc., Valrico, Florida Visit us @ www.AdvanceMyBaby.com Advance My Baby is a trademark of Advance My Baby, Inc. Printed in the United States of America. Photos by Jeanne Martin, Christine Reynolds Photography, Laurie Altmann, Michele Milligan. Stock photography from istockphoto.com. Design by Exclaimit!, Inc. Paula Tarver and Jeanne Martin AdvanceMyBaby: the ultimate secrets of healthy development for your baby — birth to 3 years / by Paula Tarver, OTR/L and Jeanne Martin, OTR/L ISBN: 978-0-615-42045-5 13 12 11 10 9 8 7 6 5 4 3 2 1 First Edition
Dedication To my Mother, Bonnie Jean Coelho, who was my inspiration. She believed in me and provided the unconditional support and encouragement I needed throughout my journey in life. I love you, Mom! — Jeanne Finally, this book is dedicated to my father, Kenneth Hansen, who was the icon of the family and a living example of unconditional love and dedication to family that went above and beyond the call of duty. He was my rock that I could always lean on. I love you, Dad! — Paula This book is dedicated to Elks everywhere, the Florida Elks Children’s Therapy Services, Inc., and to Ben Brown Jr., administrator, for giving us this opportunity to serve the children of Florida.
Acknowledgments With much thanks to Mikey, Billy, Ashley and Amanda, Jeanne’s beautiful nephews and nieces. Also, to her brothers-in-law, Mark and Bill, her sisters, Laurie and Michele, and her cousins, Jessica, Selena and spouses, for allowing use of their children’s photos and Sandy Chiellini for photo editing. We are grateful for those who edited the book led by Dan Martin and supported by Carol Shaefer, David S. Berger, M.D., Michael Barton and Linda Carroll. Much thanks to our husbands, Steven and Hewett, for their patience and support. This book reflects the profound influences in our profession, starting with the Hawaii Early Learning Profile and Early Intervention Developmental Profile Vol. 2. We also draw upon the work of Jean Ayres and Lucy Miller for their ground-breaking work in the area of sensory processing disorder, along with Sheila Frick, OTR, and Mary Kawar, OTR Developmental milestones established over the years by those in the medical and occupational therapy arenas have been synthesized with our own 35 years of observation and experience to bring you this life-changing book. Finally, this work is made possible by the participation of caregivers: i.e., moms, dads, grandparents, uncles and aunts, medical practitioners, foster parents, daycare personnel, and others. Your desire to provide the best for the baby in your life, motivates us to provide user-friendly instruction, education and information for the joy of hearing you say, “Advance My Baby.”
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Publisher’s Note As you read this manual, you will note the adoption of a gender-neutral writing style referenced as “casual,” in “The Chicago Manual of Style.” Instead of the historical “he,” we have opted for “they,” “them,” “theirs,” and “themselves,” when referencing the “infant,” “baby” or “toddler.” While old-school grammarians may have trouble with our crossover of mixing singular and plural, we have done so to minimize the offensiveness of a mother reading “he” when she has a beautiful little girl and “she” when a mother has a burly boy.
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Contents Preface
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About the Authors
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How to Use This Manual Introduction
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Chapter 1
Sensory Integration
1
Chapter 2
Premature Babies
11
Chapter 3
Birth to 2 months
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Chapter 4
3 - 5 months
43
Chapter 5
6 - 9 months
63
Chapter 6
10 - 12 months
83
Chapter 7
13 - 15 months
103
Chapter 8
16 - 19 months
117
Chapter 9
20 -22 months
131
Chapter 10
23 - 25 months
145
Chapter 11
26 - 29 months
159
Chapter 12
30 - 32 months
173
Chapter 13
33 - 36 months
187
Glossary
201
Bibliography
203
Advance My Baby Services
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Preface Babies are not born with a how-to manual, but with parents asking why they had never before this is what you have with Advance My Baby. been shown these techniques, the two women believed it was their duty to take this message You now can put into place the building blocks to the world. This manual you hold is designed that lead to academic success, athletic prowess, to advance the baby of every caregiver. You are emotional balance and social acceptance. For on the cusp of a trend to transform the world — the first time, instruction is provided for the first one baby at a time. 36 months of life that create the ultimate founThe Advance My Baby manual can be used indation for your baby. dividually in the home. It can be used in small The greatest discoveries are accidental and this groups. Those with the ability to lead can do manual is no different. Authors and occupational so in a larger setting in their community. Local therapists, Jeanne Martin and Paula Tarver, support groups and online interaction provide were forced to come up with better systems additional knowledge and methodology. to work with children after time constraints compromised the program in which they were www.AdvanceMyBaby.com, the companion operating. Their answer was to train the parents website, offers an assessment to measure progress of your baby and leads you to chapters in something called “Sensory Integration.” in this book to enhance development of your Sensory integration relate to the brain’s ability baby. to interpret senses, organize them, and respond to the information for functional behavior. Our AMB Monthly Home Checklists helps you stay brain receives sensory messages and turns them on track daily with activities and exercises to into responses. This helps us orient ourself to promote the development of your baby. the world around us. When you are finished with this manual you Thousands of cases prove the merit of sensory will know you have created the ultimate enviintegration intervention. Ms. Martin and Ms. ronment for your baby to thrive and grow. Tarver watched their own success skyrocket as parents took an educated, active role in the Are you ready? sensory development of their children. After so many dramatic stories of transformation, and Let’s begin to advance our babies!
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About the Authors Jeanne Martin and Paula Tarver graduated in 1998 from Barry University in North Miami, FL, with their Bachelor’s of Science Degrees, majoring in Occupational Therapy. They have over 35 years of experience between them with specialized training in sensory integration and child growth and development. After graduation, they were selected as two of the 20 therapists hired to provide in-home therapy for the Florida Elks Children’s Therapy Services throughout the state of Florida. The Elk’s program provides free in-home occupational therapy and physical therapy services to children who have developmental delays and live in Florida. Most parents believe their child is developing normally, until their child is forced out of day care, not talking by age three, not toilet trained by age four, or starts having serious emotional and social problems between ages five to 12. Often, these were the children that were
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assigned to Paula and Jeanne and they determined the sensory system that needed to be targeted. When the two discussed their patient case loads with each other, they noted a common theme among the families — 80-90% of the children’s parents did not know basic growth and develop-
Paula Tarver OTR/L
Jeanne MarƟn OTR/L
mental milestones (i.e. when a baby should be off two therapists had provided. The parents bea bottle; when the baby should be potty trained; came part of the solution in the effectiveness of their baby’s development. the appropriate age to button a shirt, etc.). They developed a specific plan for each child and trained the parents on a daily home program of exercises and activities selected to address the child’s individual needs. They believed that parent education had to be a major priority if the therapists were going to make a difference in the child’s life within six months or 24 treatments.
The two therapists continued to monitor national trends showing an increase in developmental discrepancies, and the idea to write a book was born.
The principles have since been perfected on Jeanne’s own daughter, who was born during the writing of this manual. Today, her daughter, They spent 50% of their time working with par- is up to 10 months advanced compared to other ents to educate them on sensory integration and children of the same age. their child’s development. They came to see an informed parent was an empowered parent. Jeanne and Paula’s intention is to now share their As parents understood what was causing their knowledge and working expertise with as many child’s delays and what needed to be addressed families as possible. They want parents to have to catch the child up with health care norms, the a source to which they can turn for guidance and parents were proactive using the education the answers.
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How to Use This Manual When Jeanne and Paula work with children, The AMB On-Line Assessment reveals the they first evaluate the child to see where they performance levels of your child in all six are functioning developmentally, and create developmental categories: their treatment plan around the child’s specific strengths and weaknesses. Language Gross Motor: They focus on building the foundational framework from which other skills emerge. They take a sensory approach to improve the efficiency of the child’s processing skills, build muscle, promote balance and coordination, and develop eye-hand integration. After catching the child up with gross motor skills, they focus their attention on developing the visual/fine motor skills.
Fine Motor
Self-Care
Cognitive
Emotional & Social
The Assessment provides a printout that serves as a guide to assist in the use of this book. It can be used to improve communication between doctor/patient, therapist/client, as well as, teacher/student. Parents will be able to track their Both, the AMB On-Line Assessment and the children’s progress and address any delays that Advance My Baby manual allow you to take come along before they become larger issues. the same work approach with your child. The first chapter on Sensory Integration explains You will have a hard time teaching a child to the importance of a healthy central nervous walk if they do not have the following: system which is the foundation for all growth 1. Trunk strength to hold up their body and development. A healthy vestibular system 2. Balance through their hips to maintain (the inner part of the ear that connects with the upright standing balance brain) is the key component to highly efficient 3. Bilateral coordination (the use of both processing of the seven senses: sides of the brain to communicate back • Smell and forth to work together to move the • Touch legs in a fluid manner) • Taste 4. Properly functioning vestibular system • Vision / Visual Perception to know where they are in space and • Hearing / Auditory Processing whether they are moving forward/ • Movement / Balance backward/upward/downward or around • Kinesthesia / Muscle Tone in a circle, and 5. Adequate visual perception to know If you have a newborn, proceed to Chapter 3 where they are going — “ 0 to 2 months,” after reading Chapter 1 — Sensory Integration. You will learn as you go. It is recommended that you start by Read one chapter at a time or jump ahead to the next chapter to see what you can expect to work completing the AMB On-Line Assessment at www.AdvanceMyBaby.com. on in the next three months of development.
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All stages of development are important and should not be skipped if you want your child to progress in a normal sequence. If your child is struggling in a certain area, you can give that area a little more focus and attention until you see the emergence of the required skills. When that skill is acquired, the stage of development is reached. Various play activities and exercises should be provided to the child on a daily basis for optimal skill development.
difficulty with coloring, drawing, cutting, and completing simple shape puzzles. Another example is a baby that is 10 months of age who does not have the head/neck/trunk strength, and shoulder/hip stability (3 to 5 month development) required to hold their body up into the crawling position; they will not be ready to work on crawling and may even have difficulty maintaining upright sitting balance.
If you have a child that you are concerned may You will need to work on the 3-5 month level of skills have a developmental delay, start with Chapter until they have mastered these milestones and are 3, “0 to 2 Months,” and make sure that your ready for the next level, which is 6 - 9 month skills. child has met all the milestones in that chapter. A secret to achieving higher proficiency levels For example, you may find that your 3-year-old is to focus on building a strong foundation of sensory integration skills. This is done through child is functioning at the following: stimulation of the vestibular system, which is • 22-months gross-motor skills enhanced by the following activities: • 8-months fine-motor skills • Spinning • Rocking • 18-months self-care skills • Walking • Swinging • 9-months social/emotional skills • Running • Jumping • 10-months speech and language skills • Balancing • Bouncing Start at those levels of development, work on the set of skills that comes next, and work your Each chapter in the manual has activities and way up until they have caught up developmen- exercises for each stage of development. tally in all areas. If you are uncomfortable playing and interacting with your child for any reason, then it is If your toddler is 24 months (2 years of age) and recommended that you seek out a professional you immediately start working on 24 month old therapist to guide and direct you until you feel skills when they need to be working on 15-month- comfortable on your own. old skills, you are setting your toddler up for failure. The activities and exercises will be too hard, which This manual is not intended to replace seeking out could cause them to feel badly about their skills and professional intervention from a local occupational therapist, physical therapist, or speech therapist; they may not want to participate in the activities. however, is a complement to these therapies. An For example, if your child’s hand movements educated parent or caregiver is the best advocate are not developed or they are not processing for their child and will have a better understandthrough their eyes efficiently, they will have ing of their overall growth and development.
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Introduction Advance My Baby is the first parent-friendly, professional, comprehensive manual to address all areas of development. Each chapter covers developmental areas of gross motor, fine motor, cognitive, language, emotional, social, and selfcare skills along with activities and exercises that the parent can do with the child to promote the various developmental skills for optimal overall growth and development. The reader will encounter blue boxes and red-framed boxes along the way that share information of key points that will help the reader grasp core concepts of development.
Advance My Baby, the book, is a self-help manual for parents that will empower them with knowledge and expertise to develop beautiful healthy babies no matter their socioeconomic situation. The book is structured in three- and four-month developmental stages so that the reader learns as they go. This information is powerful. It gives parents the knowledge and skills to make the most of their time with their child. You will learn to assess normal development so that you will be able to recognize abnormal development if it should occur. This allows early detection and intervention. You will be taken through an exploratory journey through the “Secrets of Healthy Development� which are the very foundation of life itself.
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Chapter 3 Birth to 2 months Gross Motor:
While Lying on Stomach While Lying on Back Supported Sitting (holding infant at waist) Supported Standing (holding infant at waist)
Fine Motor
Cognitive
Language
Self-Care
Emotional & Social
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Bir th to 2 months
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Gross Motor - While lying on stomach • • • • • •
Turns head to breathe Lifts head up off the floor for 1-2 seconds While lying on side, rolls to back Holds head up 2-3 inches off the floor for 4-5 seconds Straightens both legs Rotates/turns and lifts head up
Holds head up 2-3 inches off the floor for 4-5 seconds
Turns head to breathe
Rotates and lifts head up
These milestones listed above are the beginning of head, neck and trunk strengthening which is needed for upright sitting.
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Activities and playtime
Birth to 2 months
Promoting gross motor skills while lying on stomach Lifts head up off the floor for 1-2 seconds: Holds head up 2-3 inches off the floor for 4-5 seconds:
or reach for the toy as it moves from one side to the back. The reach and/or head movement as the toy changes position will naturally elicit the change in the infant’s position.
Place infant on your stomach, face to face. Encourage your infant to lift up head and look at you while you rattle toys, speak and make faces. Place your infant’s stomach over a yoga ball. Gently and slowly bounce, rock and circumduct the ball (roll the ball around in small circle to the left and right), to encourage an upward lift of the head. Place infant on stomach on the floor with musical and lighted toys in front. Or use rattles to encourage the infant to lift up and look for the noise. This strengthens the shoulders, neck and back muscles. Rotates/turns and lifts head up: Place your infant over a rolled towel or Boppie. Use toys or rattles for infant to look at. Move the rattle to the sides to encourage head turn. While lying on side, rolls to back: Place infant on the infant’s side and present a toy to them. Rattle and shake the toy moving it up above. You want the infant to watch the toy
It is important that parents provide an hour of tummy time once a day. Lie with your infant on your chest, or place them face-down in your lap, for about 15-20 minutes at a time. This is great for massaging the stomach and internal organs, it lowers the rib cage for proper breathing, and strengthens the neck and shoulder muscles. This can be done routinely throughout the day.
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Bir th to 2 months
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Self-care skills • • • • •
Sucks, swallows and breathes in a coordinated manor Successfully sucks from a breast or bottle Sleeps approximately four to 10 hour intervals Cries to communicate hunger or being uncomfortable Brings either hand to mouth
Sleeps approximately four to 10 hour intervals
Brings either hand to mouth
Cries to communicate hunger or being uncomfortable
Sucks, swallows, and breathes in a coordinated manor
Activities and playtime
Birth to 2 months
Promoting self-care skills Brings either hand to mouth: Allow and encourage infant to bring hands to mouth. This helps them orient to midline (center of body). This engages both sides of the brain to communicate back and forth, stimulating the growth of new neuro-pathways. Sleeps approximately four to 10 hour intervals: Place infant in an infant sleeping wedge on their right side. Switch to the left side the next time they sleep, then to their back. Follow this sequence every time they lie down to sleep. This will insure they will develop a well formed skull. Babies that sleep primarily on their backs or only one side, will develop malformed skulls.
Sucks, swallows, and breathes in a coordinated manner: Allow infant to suck on a pacifier. This will promote a strong suck, swallow, breath sequence that will help with bottle feedings. It exercises the muscles around the mouth that will promote good articulation for speech and helps to center and calm infant to facilitate regulation of arousal states. Pacifiers should be tossed in the garbage at 12 months of age. If you prefer your child to suck on their thumb, just remember that the thumb is attached to the body. The thumb is always there, which makes it harder to stop sucking and can lead to roof of mouth and teeth malformation over time.
25 years ago, experts started to encourage parents to put their babies to sleep on their back to reduce the risk of Sudden Infant Death Syndrome. This was a campaign promoted by the American Academy of Pediatrics and the National Institute of Child Health and Human Development. The campaign was a success and the number of SIDS cases has dropped significantly since 1994, however, parents misunderstood this to mean that they should never put their babies on their stomachs, not even in play. This has led to numerous developmental delays in fine motor skills, gross motor skills, raised rib cages, weak back muscles, and flat heads. The cases of reflux has increased over the years with more infants on reflux medications than ever before. Babies don’t lift their heads or turn over as early as they should and sitting upright and crawling become delayed.
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Activities
Mon. Wake Up Activities: Week # 1 2 3 4 Rock and cuddle while receiving bottle or breast Bath, followed by lotion rub. Give lotion massage, including massage to hands and feet. Swaddle infant Brush gums/tongue with rubber infant brush 10-minute therapy ball: slow rocking and gentle bouncing while lying on belly and on back Tummy time 20-minutes. Place mirror and toys in front of infant and play and talk to infant Rock, sing and talk to infant Swing in infant swing Afternoon Activities: Week # 1 2 3 4 Tummy time 20-minutes. Place mirror and toys in front of infant and play and talk to infant Swing in infant swing Carry infant in front loading pouch and walk around house doing housework or go for a walk 10-minute therapy ball. Slow rocking and gentle bouncing while lying on belly and on back Work on infant visually tracking toy/objects Hold infant on lap, talking and singing to him/her Massage hands and encourage infant to bring hands to mouth Rock, gently bounce, talk, read and sing to infant Evening Activities: Week # 1 2 3 4 Work on infant visually tracking toy/objects Rock, gently bounce, talk, read and sing to infant Place infant on your chest while lying down for extra “tummy time� Encourage infant to lift head up Bath. Follow with a lotion rub, including massage to hands and feet Brush gums/teeth/tongue with rubber infant brush Do bedtime routine: i.e., swaddle, song, bottle, prayers, and say goodnight
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123412341234123412341234
123412341234123412341234
Tues. Wed. Thur. Fri. Sat. Sun. 123412341234123412341234
Use the checklist below to record activities with your infant. Place a check mark in the appropriate box as it is completed.
AMB monthly home checklist
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AMB On-Line Assessments AMB On-Line Assessments — The perfect companion to the Advance My Baby Manual Designed to track your baby’s development from birth to 36 months, AMB On-Line Assessments measure your baby’s grasp of developmental milestones in six categories: Research shows most mothers do not know when their babies should reach significant developmental milestones and wait longer than they should to seek a doctor’s evaluation. AMB On-line Assessment provides an objective program to help you gauge your baby’s developmental progress. They are designed to help identify developmental delays early, and show you where in the Advance My Baby manual you can find ways to overcome those delays.
Gross Motor
Fine Motor
Cognitive
Language
Self-Care
Emotional & Social
Additionally, you may print out your baby’s personalized developmental report to help your doctor make more informed decisions about your baby’s care.
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Premium Membership Advance My Baby Premium Membership — The most comprehensive approach to giving your baby a developmental boost Give your baby all the best tools
You will receive weekly, monthly, quarterly and annual advisories that include suggestions for promoting your baby’s healthy development. Advance My Baby Premium Membership includes: • Advance My Baby Manual • 4 AMB Assessments • 12 AMB SI Reports • 12 AMB Webinars • 50 weekly e-mail • Unlimited Mp3s • Unlimited Talk-with-the-Expert Events • Free Entrance to Annual Seminars
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Reports, Webinars and More SI Reports Every month, you will receive a comprehensive Sensory Integration report keeping you up-to-date on 18 vital sectors that every parent should know about. In an educated world, the knowledgable parent wins.
The Owner’s Manual for Baby Development
Webinars
For parents who want the very best for their babies.
AMB Webinars Expert online presentations offer insights into the issues and research into early childhood development, all in the comfort of your own home. See live demonstrations of recommended techniques, learn how to use them yourself, and ask questions in real time so you can use these techniques immediately.
AMB mp3s When you are on the go, your mp3 player lets AMB go with you! Never be far from your baby’s developmental resources with this extra-convenient way to stay up-to-date.
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Enhanced Audiobook Also Available!
Take Advance My Baby with you wherever you go. Hear the voices of authors Paula Tarver, OTR/L and Jeanne Martin, OTR/L, as they read the audio version of their results-oriented manual. Hear inspirational anecdotes and success stories from parents just like you. The specialedition audiobook resounds with possibilities for your baby!
Also on Advance My Baby.com
• Free downloadable resources and home checklists give your baby an edge in reaching one important milestone after another. Buy a book today and get your unique password. • Share Advance My Baby with others you know. Special discount pricing is available for bulk orders of the book, and also financial incentive are available through our Word-OfMouth Partner Program (WOMPP).
Advance My Baby Speakers Bureau Authors Paula Tarver and Jeanne Martin will speak to your group about the principles presented in Advance My Baby. To schedule an appearance, send an email to Speaker@AdvanceMyBaby.com. For additional information, visit the website www.AdvanceMyBaby.com. Connect with Advance My Baby and a community of like-minded, responsible parents who want to change the world — one baby at a time!
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Do you want your baby to reach his or her greatest potential? Join us, and change the world — one baby at a time! Advance My Baby is a self-help manual for parents that will empower them with knowledge and skill to raise beautiful healthy babies no matter what their socio-economic standing. This Advance My Baby Manual teaches what developmental milestones to watch each month. Stop wondering if your baby is developing “normally.” Use this manual to gain the confidence to help your baby progress with techniques that will help you make the most of every minute you spend with your baby. Learn to recognize signs of normal progress, and signs that your baby needs a little more reinforcement to get up to speed. Advance My Baby helps you avoid the regret of unnecessary delays in taking remedial action that can make a lifetime of difference for your baby. Advance My Baby will guide you on an exploratory journey through the “Secrets of
Healthy Development,” which provide the foundation for developmental progress. Advance My Baby is a parent-friendly and professionally comprehensive manual that addresses all areas of development. Easy-to-read chapters address all developmental categories: gross and fine motor skills, cognition, language, emotional growth, social interactions, and self-care skills. Advance My Baby prepares parents with activities and exercises to enjoy with their babies that draw on these developmental skills for optimal overall growth and development. The manual also makes use of special visual cues (blue boxes and red-framed insets) to highlight key points to help you quickly and easily grasp the core concepts being presented. The information presented in Advance My Baby will provide benefits throughout your child’s life.
Discover the secrets to success that can help your child excel—as a student, as an athlete, as a productive and successful member of society. You can provide your baby with these benefits in as little as 30 minutes a day using the techniques found in Advance My Baby — the Manual. The results-oriented system we’ve designed allows you to create the ultimate platform for your baby’s developmental progress. You’ll chart that progress with our Home Checklists, keeping you on track every day for the first 36 months of your baby’s life. Your baby is a miracle, and you are not alone in wanting that miracle to unfold in the best way possible. We’ll be with you every step of the way.