Early Childhood Development Parental Coaching Level - II: Based On November 2023curriculum Version II

Early Childhood Development
Parental Coaching Level – II

Based on November 2023Curriculum Version II
Module Title: Early Childhood learning and

stimulation
Module code: HLT ECD2 M05 1122
Nominal duration: 70 Hours
Prepared by: Addis Ababa City Administration Health Bureau
December, 2023
Addis Ababa, Ethiopia
Acknowledgment
The Ministry of Labor and skill wishes to thank and appreciation to MoLS leaders and
experts, Addis Ababa City Administration training and technology development bureau and
industry experts who contribute their time and professional experience to the review of this
Training module for Early Childhood Development Parental Coaching Program level II. We
also thank Ministry of Health, AACA Mayor Office, Addis Ababa City Administration Health
Bureau, Big Win, BVLF, Yekatit 12 Hospital Medical College and PATH for their technical and
financial support.
Ministry of Labor and Skills Early Childhood learning and Version -II
Page 2 of 57 Author/Copyright stimulation. December, 2023
Table of Contents
Acknowledgment ............................................................................................................................ 2
Introduction to the module .............................................................................................................. 4
One: Stimulation and early learning assessment ........................................................................... 6
1.1. Introduction to simulation ................................................................................................ 7
1.2 Knowledge and practice of simulation ................................................................................. 8
1.3 Methods of stimulation................................................................................................... 10
1.4 Early learning activity .................................................................................................... 11
Self-check-1 .............................................................................................................................. 13
Unit Two: Counseling on stimulation during pregnancy............................................................. 14
2.1. Stimulation during pregnancy ........................................................................................ 15
2.2. Counseling on parent-fetus stimulation.......................................................................... 17
Unit Three: Daily routine activities and plays for stimulation .................................................... 20
3.1. Daily activity routine ...................................................................................................... 21
3.2. Shared engagement with the child ................................................................................. 23
3.3. Support during shared engagements .............................................................................. 25
Self-check ..................................................................................................................................... 30
Unit Four: Stimulation and early learning after birth ................................................................. 31
4.1. Stimulation in the immediate postnatal period ............................................................... 32
4.2. key priority behaviors of stimulation and early learning ............................................... 39
4.3. Critical period of brain development ............................................................................. 47
4.4. Importance of stimulation on early learning .................................................................. 47
Self-check ..................................................................................................................................... 49
Operation sheet 1: ......................................................................................................................... 50
LAP Test: 1 ....................................................................................Error! Bookmark not defined.
Operation sheet.2: ......................................................................................................................... 52
LAP Test: 2 ................................................................................................................................... 53
Reference ...................................................................................................................................... 54
Developer profile .......................................................................................................................... 55
Introduction to the module
Children do not start to learn only when they begin kindergarten or pre-primary classes at the age
of 3 or 4, and are taught colors, shapes and letters. Rather, learning is a built in mechanism for
human beings, ensuring our successful adaptation to changing circumstances. It begins at
conception, initially as a biological mechanism called epigenesist. In the earliest years, we
acquire skills and capacities interpersonally, in relationship with other people, through smiling
and eye contact, talking and singing, modeling, imitation and simple games, like ―wave bye-
bye‖. Playing with common household items – like tin cups, empty containers, and cooking pots
– can help a child learn about objects‘ feel and quality, and what can be done with them.
Even a busy caregiver can be given the motivation and confidence to talk with a child during
feeding, bathing, and other routine household tasks. These interactions help the child learn about
other people. Children need affectionate and secure care giving from adults in a family
environment, with guidance in daily activities and relationships with others. This gives young
children their important early experiences of social learning.
This module covers the units

 Stimulation and early learning assessment.
 Counseling on stimulation during pregnancy
 Daily activity routines and plays for stimulation.
 Stimulation and early learning after birth
Learning objectives of the module

 Assess the knowledge of parents on stimulation.
 Deliver information on stimulation to parents.
 Demonstrate methods of stimulation
 Identify gaps in stimulation.
 Facilitate stimulation when gaps are identified.
 Counsel on parent-fetus communication
Module Instruction
For effective use of this module trainees are expected to follow the following module
instructions:
1. Read the information written in each unit.
2. Accomplish the Self-checks at the end of each unit.
3. Perform Operation Sheets which were provided at the end of units.

4. Do the ―LAP test‖ giver at the end of each unit and
5. Read the identified reference book for Examples and exercise.
One: Stimulation and early learning assessment
This unit is developed to provide you with the necessary information regarding the following content
coverage and topics:
 Introduction to simulation
 Knowledge and practice of simulation
 Methods of stimulation
 Early learning activities
This unit will also assist you in attaining the learning outcomes stated on the cover page.
Specifically, upon completion of this learning guide, you will be able to:
 Discuss what stimulation is.
 Assess knowledge and practice of stimulation.
 Demonstrate methods of stimulation
 Provide information on early learning.
1.1. Introduction to simulation
Refers to any opportunity for the infant or child to interact with a person, place, or object in
their environment. Recognizes that every interaction (positive or negative) or absence of an
interaction contributes to the child‘s brain development and laying the foundation for later
learning. It is to ensure that young children are given the opportunity for learning and education
through play and to explore their environment throughout early life. Early learning involves
stimulating the baby‘s brain gently, through touch, voice, or simply close contact.
Since conception, the foetus and children need to have mental and physical stimulation. They
should have opportunities to play, learn, and communicate. However, there are no institutions
that offer or consult on the services. Instruments or teaching aids to enhance children‘s mental
and physical stimulation are also not available in health facilities. Consequently, early
stimulation and opportunities for early learning through play were not integrated with early
childhood programs.
In Ethiopia, pre-school education has gotten due attention since 2011. In relative terms, some
commendable achievements have been registered. In the sub-system, all kindergartens and
primary schools have pre-grade one (‗O‘ class). In areas where there are no kindergartens, a
child-to-child learning program is implemented. There also is another scheme called
―Accelerated School Readiness Program‖ whereby children will be able to obtain pre-school
education. Accordingly, general participation in preschool education has reached 40.7% although
problems of access and quality remain rampant.
1.1.1 Aims of Early Stimulation
1. To activate euro synapses interconnection

2. To make the child learn through play
3. To help the child develop full potential in language, motor, social interaction, and
cognitive.
4. To encourage the development of emotional bonds between parent and child.
1.2 Knowledge and practice of simulation
All in all, different activities have been carried out to realize early childhood development and
education through health, nutrition pre-primary education, and security services. However, the
responsive care giving and early stimulation domains have been missed in the differenthealth
services. This is mainly due to a lack of knowledge related to child stimulation. Even. Therefore,
it is advisable to carry out integrated activities to speed up the physical, mental, emotional, and
social development of children as much as possible.
1.2.1 Parental Role
1. The greatest single contributor to early stimulation is the MOTHER (the key stimulator).
The real foundations regarding stimulation are building upon her mind and her love.
2. Her interest and happiness in discovering new skills for her baby are the basic building
blocks.
3. The parental attitudes especially that of the mother have the greatest influence on early
childhood personality development.
4. In terms of time spent with the baby, the mother has more opportunities than the father to
influence her child‘s psychological growth and behavior.
5. The maximum influence is exerted by the mother or primary caregiver in the first three
years of life before the child has an opportunity for play-school or pre-school experience.
6. The primary caregiver literacy status, lifestyle, adolescent motherhood, drug abuse, etc.
are the factors that greatly influence development.
7. Parents need the skill to understand and interact with their small infants appropriately.
8. Parent participation in decision-making and actual hands-on experience in caring for
their child in preparation for their role as full-time parents is recommended as essential
and is the key to successful developmental intervention.
1.2.2 Stimulation is needed for:
A. All normal babies: Need stimulation to grow physically, socially, emotionally, and even
more for cognitive and intellectual development by arousing their feelings.
B. All at-risk babies: It is necessary to provide more frequent early stimulation for at-risk
babies to arouse their feelings, through interaction with the mother and the environment.
.
 At-risk babies are babies who have had problems during the pre-natal, natal, and
post-natal periods, i.e. before, at, or after birth, and are at risk for developing some
sort of developmental problems later on.
 Inability to deliver normally and easily, hospitalization immediately after birth or
within one month are the usual factors to put the child arise.
 A risk baby needs more attention from the family members to prevent mental sub
normality. For them, stimulation must be started from the moment of delivery.
1.2.3 Improper stimulation
A. Babies cannot comfortably handle different modes of stimulation all at once.

B. For all babies, their neural system has to be mature to receive the stimulus given to
them. While giving stimulation it should be essential to note that the stimulation is
not beyond their capacity. There are clues to watch for overstimulation of the baby
 The baby may close his eyes and try to go to sleep.
 May starts to stick out his tongue in a dislike response, then yawns.
 Finally, starts to show agitation in his body movements; arching his back,
struggling to get away, fussing, crying, etc.
Playing with one‘s baby in ways that both parent and child enjoy is the best way to stimulate his
senses and thinking. How much the parent enjoys the activities shared with the baby is the best
stimulation for the child. When the parent is emotionally involved in the play and not feeling
bored or anxious, the infant will be more involved
1.2.4 Precautions
Things to be Remembered While Giving Stimulation
1. Monitored stimulation with an awareness and willingness to decrease environmental

hazards is necessary.
2. The stimulation provided must be developmentally appropriate.
3. The smallest babies need the quietest of places for stimulation.
4. The quality of stimulation given is more important than the quantity of time spent.
5. Stimulation should be introduced gradually followed by developmental assessment.
Safety Measures to be Taken While Giving Stimulation

 Stimulation should be given under strict supervisionincase of an unsafe environment.
 Care should be taken to prevent the baby from swallowing any of the small things used
during stimulation.
 Avoid giving paint-coated toys, as they may be toxic, and avoid toys with sharp edges.
 Stimulation in material needs to be safe, and attractive, keep the child active, harmless,
and cleanable locally made materials.
Assessment steps for stimulation
1. GREET the caregiver with a friendly face. Look her in the eyes
2. ASK: Can you show me how you play and talk with the child?
3. OBSERVE: How the caregiver is stimulating the child?
4. PRAISE caregiver for any stimulating action: ―I noticed that you …‖.
5. Help the caregiver TRY a new play activity with the child. Praise the caregiver
6. EXPLAIN how responding and playing help the child develop.
7. Help the caregiver SOLVE PROBLEMS and make a PLAN for a home for further and additional play and
stimulation
1.3 Methods of stimulation

Things that can do to Stimulate Babies
1. Love—first, remember love and affection are very real needs. Your baby is never trying
to manipulate or control you; he/she simply has a biological need for your love therefore
never deny your warm affection. This unconditional love also creates a strong self-
esteem and increased development of brain circuitry.
2. Talk to your baby often with a kind voice, a wide range of vocabulary imitating baby
sounds, and repeating their sounds with a lot of expression. The so-called ―meaningless
talk‖ (baby talk) of the parents/caregiver with the baby has a lot of positive effects on the
baby's development.
3. Respond to your babies‘ requests without hesitation. This teaches your baby that he/she
can communicate with other people and gives her a strong sense of trust and emotional
stability.
4. Touch your baby. Researchers discovered that premature infants who were massaged
were found to grow faster, cried less, and were released earlier from the hospital than
those who weren‘t.
5. Encourage imitation. Your baby is constantly analyzing you and figuringout ways to
mimic your voice and facial expressions.
6. Let your baby experience different surroundings—go for walks, take him/her places,
and show him/her the sites!
7. Let your baby explore different textures and temperatures (not too extreme, of course).
Provide a safe environment for your baby to explore. S/he also needs time to discover
things for herself.
8. Read books—even though your baby can‘t follow the story, she loves the pictures and
the sound of your voice.
9. Play music, and tell stories for your baby.
10. Play: Let the child play with homemade harmless attractive play materials if they are
interested.
11. When you get frustrated because your baby keeps dropping objects or pouring the box of
cereal on the floor, remember, that she is trying to figure out how the world operates.
1.4 Early learning activity

As the brain develops to 50% during pregnancy and 80-90% in the first 3 years, allowing early
learning will help the child to stimulate brain development which will further facilitate all
domains of development (language, socio emotional, physical, and cognitive) to develop to the
maximum potential
Early learning activities extend beyond responsive interactions. Playing with objects on one's
own is inevitably responsive because objects respond to the child's actions. Playing with adults
may be responsive, guided, or instructional. Guided and instructional play with adults may also
result in learning. Attending to another's activity and instruction is not considered responsive.
Children learn their first language mainly through responsive talk with adults and possibly by
listening to others' conversations, not through instruction.
Early Learning Activities encompass many forms of stimulation, experience, and exposure
that lead to learning something new (e.g., incidental learning, learning through free play, learning
through adult-guided play, learning through instruction). It includes activities such as playing
with household objects, talking, singing, imitating, and "simple games like wave bye-bye". The
definition we use is stimulating engagement with objects (e.g., playthings) and/or people (adults
and peers) where responsiveness may not occur. The term "engagement" is used rather than
interaction because learning can take place with or without social interaction. Early learning may
occur under the following conditions:
• Playing with interesting, challenging objects on one's own

• Playing with playmates with/out objects
• Playing with adults with/out objects where the adult guides and scaffolds learning
• Watching or listening to someone whether the child imitates
• Instruction; i.e., told what to do, ―say this‖, ―do this‖
Self-check-1
1. What is simulation?
2. Children with developmental problems don‘t benefit from stimulation.
A. True B. False
3. One of the following isn‘t true about stimulation and early learning.
A. Stimulation should be age-appropriate.
B. Giving different modes of stimulation at the same time will help a child to develop
fast.
C. Early learning can happen without social interaction
D. The response of a caregiver during stimulation should be guided by the interest of the
child
4. Discuss the three-step process of stimulation
5. List five methods of stimulation
Unit Two: Counseling on stimulation during pregnancy
 Stimulation during pregnancy
 Counseling on parent-fetus stimulation
 Explain stimulation during pregnancy
 Counsel on a parent to fetus stimulation
 List types of stimulation
2.1. Stimulation during pregnancy
For centuries, newborns were not been considered to be active social beings from a medical
point.
Given our growing knowledge of the development of the fetus, it is well known that the
ability and the motivation to socially engage does not simply appear at birth, but develops
earlier. Newborns preferentially respond to the mother‘s voice hours after birth, and research has
found that responses to maternal voice begin in the fetus, and these fetal responses change with
experience. Newborn infants were found to prefer human faces, and foetuses were also found to
prefer human-like faces research found that Fetuses at 32–36 gestational weeks showed
increased lip and mouth movements resembling the shape required in the particular sound
stimulus when the mother‘s voice was heard, compared to a no sound condition. investigated
fetal facial expressions and found that smiling and cry-like expressions were already present
before birth, and fetuses showed an increased ability to display facial expressions as their
gestational ages increased.
Although the fetus interacts with different objects within its surroundings, a mother‘s touch is
arguably of the highest importance. Different studies measured the behavioral responses of
fetuses during pregnancy, and the results showed that fetuses displayed more arm, head, and
mouth movements when the mother touched her abdomen and decreased their arm and head
movements in response to maternal voice. They also differentially responded to the touch of the
father.
Taking into consideration the continuity of development pre- and postnatally, the social
responsiveness of the newborn baby, and the development of sensorimotor competence in the
fetus, it is plausible to assume that communicative readiness emerges before birth. We all know
how important bonding is between you and your baby following birth. But bonding begins
before birth, especially in the final two to three months of pregnancy. Even before birth, babies
are learning. By six months of pregnancy, the baby can already:
 Hear music and voices.

 Start to recognize the familiar voices of mum and dad
 Learn and remember.
Stimulation during pregnancy consists of different modes of stimulation, such as:
 Auditory (talking to the fetus and stimulating music),

 Tactile (kicking games, movement of mother)
Sensory-focused stimulation refers to selected sensory interventions presented at critical pre-

determined periods during pregnancy as opposed to randomly presented stimuli in a non-specific
stimulation program. The two most common external stimulation for a fetus includes
1. Sound
2. Touch
Table 2.1: The Baby Bond Sensory Focused Stimulation program
Fetal Senses The type of stimulation specified by The Baby Bond program
Chemosensory The mother‘s diet should be rich in protein, vitamins, and minerals.
system
hearing Auditory stimulation such as the mother‘s low-pitched voice and music should be
provided during the day. Music should be played twice or three times per day while
sitting, lying, or rocking.
Touching Tactile stimulation includes the mother touching her abdomen, massaging her
abdomen lightly, playing the kicking game, and tapping on the abdomen twice
daily during different sessions. When the mother rocks or moves up and down in a
harmonious pattern, the fetus is also stimulated by the womb and amniotic fluid, a
form of tactile stimulation.
2.2. Counseling on parent-fetus stimulation
When a baby is born: They will already know your voice is special and will be calmer when
they hear you talking to them. Your baby will start to communicate with you from the time they
are born. They will:
 Cry to show they are tired, hungry, sick, need a hug, need diaper change…etc
 Show you that things are interesting by looking and reaching.
 Wriggle their arms and legs to show excitement.
 Coo and babble to get attention.
 Watch your baby‘s mouth and copy your face - sticking their tongue out, opening
their mouth wide.
 Enjoy parents copying the noises they make and taking turns with
Talking, Singing & Reading
 The unborn baby loves to hear the sound of the parent's voice. It calms them and
helps them to start to build the connection between feeling safe and secure. They
are not worried about what parents say or how they sound.
 Talk about anything to them; what you are doing, how you are feeling, what you
need from the shops!
 Parents better Sing favorite songs, nursery rhymes, or something you‘ve made up
– you sound great to your baby.
 Read a magazine, a children‘s book - anything at all. It will give you and thebaby
the chance to tune into each other and all the time your baby will be getting to
know familiar and safe voices.
 Encourage your partner to get involved – your baby can get to know their voice
and will be able to recognize it when they arrive. Siblings will also really enjoy
talking to the bump and sharing songs and stories with them.
Touching and other physical stimulation
From the 27th week of pregnancy, the touch receptors at the terminals of the sensory neurons
can convert mechanical pressure into electrical waves, and the fetus begins to understand the
sense of touch. Thus, the best time for the first tactile stimulation is from the 27th week of
pregnancy. Touching and tapping the womb together with the kicking game of the fetus are
among these techniques. Because of these stimulation programs, children become habituated to
their environment faster and grow more effectively. Habituation means that neonates gradually
reduce their response to a repetitive stimulus and allow that stimulus to be ignored and, in doing
so, their energy is stored for physiological needs. The following are some of the tactile
stimulations.
 Responding to fetal kick with belly touch

 Dancing
 Physical exercise(stretching, walking)
 Meditation
Self-check
1. Responsiveness in a child begins after birth
A. true
B. false
2. What are the two most common ways of stimulating a child?
3. One of the following isn‘t tactile stimulation of a fetus
A. Dancing
B. Singing
C. Walking
D. Yoga
4. Discuss the importance of external stimulation of a fetus
Unit Three: Daily routine activities and plays for stimulation
 Daily routine activities
 Shared engagement with the child
 Support during shared engagements
 Guide engagement in daily routine activities
 Promote shared engagement with the child
 Provide support during shared engagements
3.1. Daily activity routine
 A ―routine‖ transforms play activities or daily household activities into learning
opportunities.
 A routine is:
 A play or home activity that the adult and child do together (You and your child are
partners in the routine, with each person having an active role);
 Made up of a set of clear, small steps that make sense and make up a story;
 Restarted and repeated many times in the same way to help your child have fun and
learn the steps.
 Build play and home activity routines to help your child spend time in shared engagement
and learn new skills.
 You can build routines when you play and when you do other everyday activities.
Activities are “routines”, because:

 They have a set of clear small steps that make sense and make up a story.
 They can be restarted and repeated many times to help your child have fun and
learn the steps.
 Both the child and the adult participate: you and your child are partners in the
routine, with each person having an active role.
 Over time, you can add new steps to the routine.
Table 3.1: Characteristics of routine
What is a routine?
1. A set of clear small steps that make sense and make up a story
• A small step is a teachable step that is part of the larger routine.
• Our goal is to link small steps together to make a story.
• The steps make sense together.
2. Small steps you can repeat and add to the next time you practice
 The routine can be done the same way the next time – all children learn through
repetition.
 You can add new steps over time to make your routine longer and more complex.
 You can add new steps to help children stay flexible.
3. Something the adult and child do together
• You and your child are partners in this routine: you both have clear active roles.
• You take about 50% of the actions in the routine and your child takes about 50%.
Table 3.2: Example of routine

What makes a Play routine example:
routine?
Build boxes to make a house and put cups (ስ ኒ ) inside
1. Clear small Step 1: build a house with boxes
steps that make Step 2: put cups inside the box structure
sense or tell a Step 3: take the cups out
story Step 3: crash the structure.
2. Repeat and Repeat steps 1–3: start building again

add more steps Add new steps (when appropriate)
next time Examples:
– Change Step 1: Build something different (stack boxes to make a car, a
castle, etc.)
– Add a step after Step 2 (add coffee in a cup).
3. There are Both children and adults take turns putting boxes on the building and putting
clear active roles animals inside.
for child and
adult
3.2. Shared engagement with the child
Level of engagement:
Figure 3.1: level of interaction
• All children will spend some time at each level, but children with developmental
difficulties spend more time alone and interact with objects than other children do.
• Our goal is to help children spend more timesharing engagement with others.
• When children share engagement, there are more opportunities for them to learn.
Shared engagement
 Shared engagement means that the child is paying attention to two things at the same time:
1. Parent, and
2. The activity parent and child are doing together.
 When parents are sharing engagement, They have the chance to:
 Respond to your child‘s communication about the activity.
 Show the child new words to use in the activity.
 Respond to the child‘s actions.
 Show the child new ways to use the materials.
 Shared engagement is best for learning.
 Children learn best during activities that are fun, positive, and full of praise.
 Parents can help make activities fun and positive by:
 Speaking to a child in a positive and kind tone of voice.
 Relaxing and celebrating child‘s skills, attempts and appropriate behavior.
 Being physically gentle.
 Showing affection.
 Praising the child.
GOAL: To spend more and more time sharing engagement.
Figure 3.2: shared engagement
Other times children may be:

 Not engaged: wandering, showing repetitive behavior, staring off into space or
looking around;
 Object-engaged: looking at objects, lining up objects, repetitive play with objects.
Remember:
• No child spends 100% of the time-sharing engagement.
• Children will spend some time at all three levels – our goal is to help them spend more time
sharing engagement each time parent do the activity.
• For some children we will start by spending a few seconds sharing engagement during an
activity
3.3. Support during shared engagements

Set up the space:
 Remove distractions and make a safe place to interact.
 Help the child to focus on the shared activity and on parent by clearing a space on
the table or floor right in front and around the child.
Figure 3.3: setup the space

 Help the child pay attention to the activity by moving away distractions.
 Move away or cover extra furniture, household objects and other favourite objects.
 Remove distractions by turning off telephones, television orradio. Ask other adults
and children to move away or watch from behind your child.
Parents should Start with 2 or 3 motivating choices and follow child’s choice.
 We can give choices between items (e.g. two shirts, two books, two snacks) or a
choice of which activity to do first.
 Parents can give their child a choice of which task to do first if they have two tasks
and they need to do both. Good choices are tasks that can be done in any order (e.g.
wash face or brush teeth first).
 Choices give children some control over the activity.
 Choices help parent understand which activity will be motivating for the child.
 Choices make the activity more interesting and motivating for the child
 If the child does not make a choice, parents can make a choice for the child.
Figure 3.4: giving option

Move in front of child; get down to child’s level, and have the activity between you and the
child
 Move in front of child.

 Sit directly in front of child with the activity in between you and the child.
 If your child sits on your lap, try to turn the child around to face you and bring the
activity materials between you and the child.
 It is easier for your child to share the activity with you when both you and the objects are
in front of the child.
Look and listen– Notice what the child is motivated by and interested in
 Take a couple of seconds to notice what the child is interested in.

 Responding to child‘s choice is a way to notice her/his interest. Follow only
appropriate and safe choices.
 If a child regularly does not seem interested in choosing certain options, it may be
because these are too easy or too difficult for the child.
Look and listen – Notice when the child is being good and respond with praise
 Engaging in play in and home activities is hard work for your child! Watch for skills
and appropriate behavior that you can praise.
 Be a detective! Find as many moments as you can to praise your child.
 Praise helps a child to understand that you know she/he is trying to participate.
 Praise encourages a child to try again.
 Praise helps your activities be fun and positive.
Join in the routine – Take your turn by imitating what your child is doing.
 Look and listen to your child‘s actions and join in the routine by doing the same thing as
your child.
Figure 3.5: Join in the routine
 By imitating, you are rewarding your child’s play ideas.

 Only imitate appropriate actions that you want to see again. Do not imitate challenging
behavior (throwing) or repetitive behavior without any interaction between you and your
child (such as lining up the items or looking at the items).
 To share a routine, it is best to have multiple items – e.g. 2 cars or 2 dolls. Use your own
toy or materials to take your turn. That way, you will not upset your child by taking
her/his item to demonstrate play actions.
Show and help – Give the child a new step for your routine.
 Show and help when:

 the child does not know what to do next;
 the child is ―stuck‖ on a repetitive action;
 The child is not engaged and you need to get back into the routine.
 Adding steps makes your routine longer and gives more time to share engagement.
 Many children need help to learn how to play appropriately with toys.
 Show and help helps the child to develop more complex play skills.
Play materials:
Play materials are encouraged to be affordable, easily made and by parents or children
themselves where they can.
Criteria of play materials
1. Homemade, affordable by family
2. Cleanable
3. Harmless
4. Attractive and keeps the child active.
Home work activity:

Prepare 2-3 play materials for next section and come with it.
Role play: Using the prepared play material engage child in play:
1. Put colored papers on the floor with the following age groups: 0-6 months, 6-12 months,
1-2years and 2-3 years. Leave 3-4 meters between the papers.
2. Let the trainee put the household objects and homemade toys they brought in the
respective age groups on the floor.
3. Stop as a group by the toys for each age group, examine them together and discuss:
• Are all the playthings here safe? (any sharp parts sticking? Any small parts that can
be swallowed?)
• Are all the playthings here appropriate for this age?
• What can the child do with … (select 1 household object, and then one homemade
toy, and
4. Which of these toys could be used in your consultation room? Why? (washable, no small
parts etc…)
5. Conclusion: both household objects and homemade toys are great for helping children
Role plays one
1. Let two volunteers come to front,
2. One as a child, one as a parent and one as a ECD PC worker.
3. ECD PC workers help the parent to engage the child in play using play materials you
have brought for homework activity.
Self-check
1. What is a routine?
2. Only play activities will be considered as a daily activity routine?
A. True
B. False
3. Which one of the following is true?
A. Children don‘t need to be in shared engagement all the time
B. Children learn best, if the shared activities are fun and full of praise
C. The caregiver needs to engage as much as the child during shared engagement
4. Discuss the levels of engagement?
5. Discuss three support during shared engagement?
Unit Four: Stimulation and early learning after birth
This unit is developed to provide you the necessary information regarding the following content
 Stimulation in the immediate postnatal period
 The four key priority behaviors of stimulation and early learning
 Critical period of brain development
 Importance of stimulation on early learning
This unit will also assist you to attain the learning outcomes stated in the cover page.
 Advise talking and massaging a new born
 Promote the four key priority behaviors
 Deliver information on critical period of brain development
 Explain the importance of stimulation on early learning
4.1. Stimulation in the immediate postnatal period
4.1.1 Newborn Stimulation at Home
Keep in Mind that

1. New born babies are surprisingly alert. When the stomach is full, the bottom is dry and
the body rested, newborns are busy looking, listening, and learning about their new
world.
2. Babies are hard-wired to learn. If parents understand the wiring a little better, they can
target teary play to help their new born learn and develop. Keep the play gentle and the
play time short—just a few minutes‘ times is probably plenty.
3. Subtle environments; pastel colors, a feather on a string spinning in the breeze, a fish
tank to watch, curtains blowing, lying under a tree, a candle flame, these foster deep
attentiveness, long curious staring and wondering, which is good for development.
The Following are some ways to begin playing with a newborn. Remember though that it is easy to over
stimulate a newborn.
A. Vision
Because vision develops so quickly and so dominates the human sensory experience, it
soon becomes the major means through which children learn about the people and properties of
their world. The following are some ideas to stimulate the baby‘s developing sense of vision.
Bold Patterns with Strong Contrast
1. Newborns are attracted to the edges of patterns where light and dark meet.
2. Babies tend to look at the edges of shapes, so a baby is likely to scan one‘s hairline
rather than gaze into one‘s eyes.
3. Start with simple shapes—squares, circles, and bold black and with face shapes. Paste
these shapes by the changing table, or cut them out and make a ―Nursery Novel‖, a little
book made up of different patterns.
The newborn‘s eyes examine the edges and his brain learns to process simple visual
information.
Making Faces
– The most intriguing object of newborns is the mother‘s or father‘s face. Try to catch the
baby‘s attention and make a face one can stick about the tongue, make an ‗O‘ with
one‘s lips, or raise and lower one‘s eye brows. New born scanmimic expressions.
– Remember to vary the expression: new babies have very short attention spans.
Moving Objects
1) 1) Vision involves the complex process of tracking objects as they move through
space..
2) Lay the baby on the lap. Take a toy, small picture, or one‘s hand and slowly move it
in an arc from your baby‘s left to right, and then back again. Newborns cannot track
the object as it moves across their center line—this will develop in the first few
months.
B. Hearing: At birth the sense of hearing is considerably more advance than vision.
Although it is more advanced, hearing develops gradually.
Playing Music
1) 1) Music stimulates more than just the auditory brain centers and connects
powerfully to the baby‘s emotions.
2) Test how music affects the baby—play a lively, fast-paced children‘s song, then
slow, soothing one.
3) Babies have an innate response to music, which can be very useful when trying to
soothe an over tried, over stimulated or colicky newborn.
Classical music (those music only played with a specific musical tradition)is particularly good
for the baby‘s developing brain; it is closely-linked with an improved ability to solve spatial
problems. Playing classical strains to the newborn could help lay down important spatial
reasoning pathways, as well as connections within the auditory system
Talking and Imitations
1) Language development begins from the moment the baby first hears voices..
2) Talk to the baby often when changing him, feeding him, or walking with him. Listen
carefully to his little noises and repeal them; one can have baby ‗conversation‘ this
way, each taking a turn.
3) Read to the baby—look for books with rhythmic, rhyming language.
4) Even tiny babies will listen attentively to the sing-song cadences of poems and
nursery rhymes.
C. Touch
Every time a baby is touched or cuddled, it shapes his growing brain. Touch experience is essential
not only for the development of touch sensitivity but for general cognitive development as well.
Baby/Body Massage-Touch therapy
Touch therapy is purposive, repetitive, non-contact‘s bare skin administered with a view to
stimulating nature and stimulating normal growth and development. It is recommended that
mothers and fathers participate for best results. In its broadest sense, it involves massage (tactile-
kin aesthetic stimulation), non-nutritive sucking, and skin-to-skin contact in any form. Routine
massaging the baby is essential for her/his optimum growth and development. Ideally, it should
be done by the mother, father, or grandparents. Newborns like massaging for about 2–5 minutes,
and children over 2 months of age will like even more time.
Technique
Foot massage: Smooth a few drops of baby massage oil into your warm hands and massage the
soles of baby‘s feet. Use firm, gentle, slow strokes from heel to toe. Always keep one hand on
baby.
Figure 4.1: Foot massage
Leg massage: Do long smooth strokes up baby‘s leg. Massage from ankle up to thigh and over
hip. Massage both legs at once and one at a time. Avoid the genital area. Hold baby‘s leg under
the knee and gently press it towards the tummy to help release wind.
Figure4.2: leg massage

Upper body massage: Start upper body massage with your hands on baby‘s shoulders. Make
gentle strokes in towards the chest.
Figure4.3: upper body massage
Arm massage: Massage baby‘s arms by stroking from shoulders down towards wrists. Try not
to get oil on baby‘s hands. If you do, wipe her fingers clean before she sucks them.
Figure 4.4.: arm massage
Belly massage: If baby‘s stomach feels soft, massage it with circular, clockwise strokes. If she
gets unsettled, go on to the next step. Avoid the belly button area if baby‘s cord hasn‘t healed.
Don‘t put pressure on the area between baby‘s nipples and tummy
Figure4.5: belly massage

Face massage: Use your finger pads to massage baby‘s face. Stroke from the middle of baby‘s
forehead, down the outside of his face and in towards his cheeks. Massage the scalp in small
circles.
Figure4.6: face massage
Back massage: If baby is still relaxed when you‘ve finished massaging the front of his body,
you can turn him onto his tummy and use long, smooth strokes from head to toe.
Figure 4. 7: back massage
Key massage Tips

 Choose time when the baby is awake and alert, not too hungry or too full
 Ensure the room is warm and lightening not too bright or too dark.
 Make the necessities ready: baby massage oil or lotion, towel, clean diapers and cloths
 Wash hand and remove jewelry
 Find a comfortable place to massage so the baby can see the face of the caregiver clearly
 Have a brief relaxation with breathing exercise before the start— this can help the baby
too relax too
 Use baby oil or lotion and glide comfortably over the baby‘s skin
The Basic Lesson sa llP arents has to Understand

 Early experiences affect how brains are ―wired‖.
 The young brains work-in-progress.
 Every child is unique.
 Children learn through relationships.
 Children need many kinds of stimulation.
 Prevention is crucial.
Playing with your baby in ways that you both enjoy is the best way to stimulate her senses and
thinking. How much you enjoy the activities you share is the best stimulation for your child.
When you are emotionally involved, you‘re neither play, nor feeling bored or dutiful or anxious,
your infant will be more involved too.
Class Demonstration:
 Let one trainee comes to the front with a baby doll

 Demonstrate massaging for new born of 3 days whose umbilicus is painful.
 Let the other trainee observe
 Comment on: eye contact, talking and communication with baby, reading cues and
changing procedures, and comment at last.
4.2. key priority behaviors of stimulation and early learning
4.1.1 Motor Development.
Reaching for Objects
 Place the child on belly on the floor and start speaking to divert his attention.
 Suspend a toy from ceiling.
 Play with colorful toys in front of baby, e.g. blocks, ball, rattle.
 Demonstrate these activities so that the child gets the idea of reaching.
 Help the child to reach and grasp the object.
Rolling (6 month of age)
 Place the child on back in the crib or floor. Talk to him ring the bell to get his
attention.
 Physically guide the child enrolling from back to side.
 Place a musical toy close to side of the head so that the child will roll over.
 Help to roll back and forth to imitate movement.
Sitting (7 months of age)

 Grasp the child‘s hand and help to sit up.
 Place pillow around the child and keep pillow high on sides/put the child in baskets so
that he can get support. Place the child between your legs and place the arms on your
legs for support.
 Gradually reduce the support by giving a toy in hand.
 Once the child sits in any corner, give a toy in hand and keep talking to him to maintain
sitting during a variety of daily activities (bathing, eating, dressing and playing).
Crawling (8 to 9 months of age)
 Place the child on your extended legs so that his tummy is touching your legs.
 Help to move by moving the child‘s arms in a swimming fashion.
 Place the child on the floor and move one of the child‘ smarms forward.
 Keep a colorful toy in front of him and pull him towards you.
 Gradually increase the distance between the toy and the child.
Standing (10 to 12 month of age)
 Place a toy on a low chair, table, or bed. Physically pull the child up and place his
hands on edge.
 Let the child put one foot flat on floor and weight on one knee.
 Show a toy above child‘s head so that he is able to pull himself.
Walking and Running (12 to 24 month of age)
 Support the child‘s shoulders from behind and help him to alternate his feet.
 Hold both hands of the child‘s and encourage him to walk forward.
 Encourage the child to push walker.
 Hold a toy and ask him to come to you. Make the child stand against the wall. Be ready
to catch him.
 Encourage the child to walk independently and run.
Eye-Hand Coordination
For babies, try:
 Placing objects of interest within reach
 Shaking a rattle or plastic keys
 Building a tower for baby to knock down
For toddlers, try:

 Throwing and catching a ball  stringing beads
 Coloring in activities  tossing a small bean bag into a
 Connect-the-dot activities hula hoop
 rolling a ball to hit down bottles
For children five years+, try:

 bouncing a ball on a racquet  wall ball
 kicking a ball into a goal  juggling
 baking (e.g. measuring a cup of
flour)
Jumping (2+ years)
 Stand in front of child and hold both  Reward him and verbalize jump.
his hands.  Use bed as base of jumping.
 Bend his knees and lift his hands  Encourage him to jump a number of
up. times.
Imitate Circle (3 years), Square (4 years), and Triangle (5 years)
 Showa child how to make a circle.
 Take the child‘s hand and guide homemaking the circular movements.
 Help the child to trace the square and triangle.
 Use newspaper to draw and trace all the figures in large size and gradually reduce the size.
Walk up
 stairs and down stairs (2+ years of age)
 Hold the child‘s, begin with the two bottom steps.
 Walk up the step and gently pull child‘s one hand placing his other hand on railing and
encourage him to step up.
 Move his legs up and down in a marching fashion.
 Place one legona step, your hand behind his knee and move his leg up to the other step.
 Walked own stairs back wards to avoid fall, encourage him to move one foot down.
4.2.1 Adaptive development
Feeding
 Offer the baby a breast (birth+)
 Give the child a spoon to feed(11+month
 Provide textured food to encourage chewing(6+month)
 provide liquid food with a cup(11+ month)
 Place a solid food on the hand of the child(8 month)
Toilet training: The average age of toilet training is 27 month, bowl control precede bladder
control. Night time bladder controls my go up to 7 years of age in normal children.
Signs that your child may be ready for toilet training include the following:
 Asks to have the diaper changed or tells you a bowel movement or urine is coming
 Shows discomfort when the diaper is wet or dirty
 Enjoys copying what parents or older children do
 Follows you into the bathroom to see how the toilet is used
 Wants to do things (like going to the potty) to make parents happy or to get praise
 Has dry diapers for at least 2 hours during the day or is dry after naps or overnight
Sits on Potty
 Allow the child to watch you use the toilet.

 Watch the time carefully, when the child may be ready to do.
 Place the child on the potty.
 Do not make the child sit for longer time.
 Use the same words each time such spotty. Encourage and praise if the child is
successful.
Dressing
 Start by encouraging them to sit on the floor or bed as they learn to dress as this will help
with balance.
 Give your toddler 2 or 3 choices of what to wear. Limited choices will help to
prevent tantrums, which are more common when toddlers feel overwhelmed.
 Break down dressing into separate tasks which are done in order. Talk your toddler
through what they need to do. For example, ―Push your head through this hole, reach
your arms up,‖ and so on.
 Lay clothing out so it‘s in the order it needs to go on. For example, dress or pants and T-
shirt, then jacket, then socks and shoes.
 Give your toddler clothing that is easy to get in and out of. For example, elasticized
pants, simple T-shirts and tops with an image on the front (to learn front from back).
 Make sure your toddler has comfortable clothing that allows them to move freely.
 Let your toddler do what they can, then help them with the harder tasks.
 Remember to praise your toddler‘s attempts at dressing. Name what you see, such as,
―Good job putting your arms through the sleeves‖.
4.2.2 Language development
Repeats Sound Made by Others
1) Choose the sounds

a. Spontaneously made c. Various vowel sounds
b. Sound that goes with physical d. Sounds like Ha, Aa, Ba, Da
activity and game
2) Say it with him and reward the child with praise and clap hands.
3) Say each one several times and allow the child to repeat.
4) Smile and make the activity enjoyable.
5) Pick up, hug while doing the activity
Carries-out Simple Directions
 Give the child your direction in  ―Give me your hand‖
words.  ―Throw the ball‖
 Show him what you mean.  ―Close the door‖.
 Repeat the directions and show him  Praise the child on performance of
again. activity.
 Activities might include
Answers Simple Questions with Non-verbal Response
 Teach the body parts by touching and  Place his hand or finger on his nose.
pointing to the child.  ―Here is your nose‖, ―Very good‖.
 Take the child‘s hand and, ask where  Reduce the help given as the child
his nose is. learns.
Use a Single Meaningful Word
 Name two to three familiar objects find them and name the object.
(mild, water, toy).  Repeat this activity several times.
 Ask the child to name them when you  Praise and reward the child when it is
point to them. done independently.
 Hide objects in the room and ask to  Say Five Different Words
 Name different objects which child  The child may point to the object and
often sees. say Pa you say ―Yes‖ that is Papa‘ s
 Encourage the child to use the shoe.
words.  Encourage the child to use the words
 When the child says ―Pa‖ you say; again and again.
―Yes‖ that is Papa.
 Child may point and say Pa you say
―Yes‖ Pap is there.
Follow Three-step Directions
 Begin with direction using one object, e.g.  Gradually increase the difficulty.
get your shoes, sit down, and put on.  Add activities to the request.
 Ask the child to repeat the direction before  Praise the child each time when the
he starts. directions are follow
Points to Three Body Parts

 Begin by showing mothers‘ nose,  If the child is having difficulty, give him
clue that involves action of the body
similarly with the child‘s nose.
part.
 Ask where is the Doll ‘snose?
 Teach new body parts.
 What is that pointing at the nose?
Use Simple Sentences
 Hold up the familiar objects?  If the child does answer, for him and
ask to repeat.
 Ask the child what is this?
 Continue until the child begins to use
 Give him time to answer?
simple sentences.
Answer Simple Questions
questions.
 During daily activities ask the child
questions such as how to open the door,  Use stories and pictures and ask questions
how to go to the toilet. on various points.
 If child does not answer, answer for him.

 Childs hold answer in two to four words.
 Grads easily increase difficulty of
Tells Sex and Name
 Give toy and clothes to the child to  Ask child about this sex while you
play and tell the sex. give candy/toy to him.
 Tell the child here is boy like daddy,  Keep on asking the same
girl like mama.
 Say things like you are nice boy or a
pretty girl.
4.2.3 Emotional and social development.
Watches Persons
 Make the child sit so that he is able  Talk to child or use noises which
to view the surroundings. stimulate looking behavior.

 Grads usually move across and try
 Walk across she‘s line of vision and
to maintain eye contact.
see if the child follows your
movement.  Keep praising the child.
Smiles
 While feeding, playing, changing,  Physically prompt the child by
talk softly and smile off. gently aping his nose or lips.
 Gently tickle the stomach to evoke a  When the child smiles respond back
smile. by smile.
 While picking the child after nap or
going to someplace, always give a
smile to the child.
Reaches for a Familiar Person
 Hold your arms out to the child and  When he start to reach for it give a
ask him if he wants to come to you. smile.
 Encourage all the family members to
do the same.
 Talk to the child and offertory.
Claps Hands and Says Ta Ta
 Take child‘ and clap them. sequence independently.
 Encourage the child to imitate you.  Take the child ‘ and, wave and say
 Encourage the child to imitate clapping ―TaTa‖.
Responds to His Own Name
 Say the child‘s name often.  Reward the child for turning in your
 Use puppet to talk to the child. direction..
 Place the child in front of the mirror.
 Have one person call the child‘s
name.
Drink from Cup
 Use one cup with handle.  Praise the child a she improves.
 Help the child to bring the cup towards  Use a regular plastic cup—when the
his mouth. child becomes perfect.
 Encourage him to take a drink.

Brushes Teeth
 When you brush your teeth, take the  Use child-size toothbrush and hold it
child with you. under. the water.
 Help him to brush his teeth at the same  Encourage him to do it regularly.
time.  Reward him for good brushing
Hold-out Arms and Legs While Being Dressed
 Use a big size dress and begin with as  Gradually reduce the support.
short sleeved.
 Help the child to put one arm reach
behind with other arm.
Pulls-off Socks and Takes-off Trousers
 Show the child how to pull off socks and  Help him whenever he has difficulty.
take out trousers.  Gradually reduce the support as he
 Help the child as he tries to pull off becomes perfect.
socks and take off trousers.  Praise him whenever he does correctly.
After going through and using these manual parents must have realized that the stimulation
exercises are simple and flexible. More so parents can use their own modifications for the same
purpose and no special materials are required. The aim is to take the child from his/her levelto
the maximum level which can be achieved. Patience and repetition of the tasks is the key and
success will always bring smile to you and your baby.
Auditory Stimulation
Two-to-Four Months
Sound producing toys are suitable for this age. Noisy toys/squeakyrubbertoysetc.canbegiven.
Parents should spend more time with child; keep on talking with the child, pointing out the
nameofobjectsshownwillhelpthechildtousemorewordswhenhestartstalking
Four-to-Six Months
Babies will turn their head towards the source of sound at this age. Shake a bell or a squeaky toy
over his head. Then slowly shake it near to the side of his head. Encourage him to turn his head
and find the sound. Repeat on the other side also.
Visual Stimulation
Two-to-Four Months
Hang brightly-colored objects/shiny mobiles about 12–15 inches above the crib, this will
Enable the child to watch it constantly and slowly starts to babble.
 Maintain eye contact while talking with the child
 Show brightly-colored clothes when the child is awake.
4.3. Critical period of brain development
Brain plasticity is maximal at specific time windows during early development known as critical
periods (CPs); which is the first three years of life span, during which sensory experience is
necessary to establish optimal cortical representations of the surrounding environment. After CP
closure, a range of functional and structural elements prevent passive experience from eliciting
significant plastic changes in the brain. The transition from a plastic to a more fixed state is
advantageous as it allows for the sequential consolidation and retention of new and more
complex perceptual, motor, and cognitive functions.
However, the formation of stable neural representations may pose limitations on future revisions
to the circuitry. If sensory experience is abnormal or absent during this time, it can have
profound effects on sensory representations in adulthood, resulting in quasi-permanent
adaptations that can make it nearly impossible to learn certain skills or process certain stimulus
properties later on in life.
4.4. Importance of stimulation on early learning
Early stimulation is important both for the growing brain and body. Adequate nutrition and the
presence of both parents during the early years are also crucial to a child‘s being. All these
factors contribute towards a normal healthy adult. The stimulation the child receives depends on
life at home the family structure.
A newborn baby‘s life may appear to be nothing but a cycle of sleep and feedings. From this age
itself, a baby‘s personality begins to evolve. Some babies are very lively, others are slow to react.
But all need to be cuddled, spoken to gently and stimulated. Stimulation plays an important part
in child development. Various easily available age appropriate toys are advised and the optimum
time for stimulation is when the child is most active and playful. Stimulation should be given to
normal babies as well.
Proponents of early interventional therapy are suggesting that multidisciplinary structured

intervention by highly-trained interveners should be provided for infants who are at risk for
neuro motor disorders as soon as possible to minimize future handicaps and successfully
rehabilitate the child. Early stimulation and early intervention can be applied remarkably to
infants in order to arouse their actions and feelings ultimately giving them a normal experience
of development.
Parents of newly diagnosed children with mental retardation often refuse to accept that their
child is not ―normal‖. This leads to a delay in instituting early therapy and often results in the
child developing some set patterns, which are difficult to change. Therefore, special schools
prefer to start a program by age 3 or 4 and may not accept children at ages above 6 or 7. The
need therefore is to approach institutions in your vicinity at the earliest.
TIPS FOR SIMULATION:

• When praising, mention specific things you notice caregiver do, for example: ―I
noticed how you looked your child in the eyes and responded to his sounds. Well
done!‖
• When inviting caregiver to try a new activity, use COUNSEL FOR CARE FOR CHILD
DEVELOPMENT poster, find the age of the child, and let the caregiver choose one
activity s/he would like to try in your presence. If the caregiver is shy, you may
demonstrate to her first and then let her continue.
• When helping solve problems and make a plan, ask the caregiver: ―Do you think you
can also play and talk with your child like this at home? What would be the best time
during the day for you to do that? What can you use as things to play with, that you
have at your home?”
Self-check
1. Which one of is part of body massage for a baby?
A. Applying oil
B. kneeing and squeezing
C. Causing tickling sensation
D. None
2. Which one of the following isn‘t stimulation for emotional and social
development
A. Draw a person
B. Smile
C. Watches person
D. Hold out arms and legs while being dressed
3. What is critical period of brain development
4. Discuss stimulation for early learning
5. We have to wait for a few months after birth to start stimulation
A. False
B. True
Operation sheet 1:
Operation Identify parent who are in need of more support.
N.B some care givers need special attention and more counselling on stimulation:
These care givers are:
• Caregivers of children with risk factors (LBW, malnutrition, depressed caregiver,
adolescent caregiver)
• Caregivers of children showing delayed milestones or delayed child development.
Operation Title: Assess parents stimulation activity
Purpose: To selectively identify parent who need more support
Conditions or situations for the operations:
 Privacy securing working environment
 Properly set questionnaire/ data set /
 Appropriate working cloths
Equipment Tools and Materials:
 Registration book/note
 Play materials
 Counseling card
Steps in doing the task
1. Great parents with polite words
2. Introduce your-self (your full name, what you work, where you work)
3. Ask for demographic data like age, mothers feeling of having baby, weight and
gestational age of baby at birth, weather the primary care giver uses drugs including how
frequent and types.
4. Determine if the parent or primary care giver is adult, old age >65, drug abuser, baby
premature or LBW.
5. Ask the parent to show you how they engage the child in to play, sing for the baby, tell
story, read book and observe how do the parent communicate during the activities.
Provide play materials to the family to observe them use it.
6. Appreciate for each good activities the parent has shown the baby, which you observe.
Don‘t forget to mention the good thing specifically and by name.
7. Classify stimulation practice of the family or parent. (Parent in need of special
counselling, Parent in need of regular follow up).
8. Explain for the parent, what are the benefit of early stimulation for the child? Use
Advantages of responsive care giving posture
9. Using counseling card Counsel the parent on how they can help their child
10. Ask if they can do that while you are not with them
11. Plan how can they overcome the challenges alone
12. Appoint next visit together, If the parent are parents who needs special attention or more
counseling shorten your appointment and increase frequency.
13. Stimulation activities need to be added gradually, no need to rush and tell all activities at
a time, to avoid information overflow and loose of main point.
14. Register and report.
Quality Criteria: Assured performing of all the activities according to the procedures
Precautions:
 Respect mother for any answer she is giving
 Implement CRC in each step.
 Don‘t forget registering the mother and pregnancy status on your note book, mobile,
tablet….etc at the end of assessment
Operation sheet.2:
Operation Title: Counsel on responsive care
Purpose: Promote responsive care
Conditions or situations for the operations:
 Privacy securing working environment.
 Neonates is not in emergency/ disease.
 Appropriate working cloths
Equipment Tools and Materials:
 ECD counseling Poster
 Advantage of responsive care posture
 Note book, tablet, mobile...etc
 Locally made play material
Steps in doing the task
1. Great mother/ parent with polite words
2. Introduce your-self (your full name, what you work, where you work)
3. Explain what are you going to assess and why you assess
4. While explaining yourself and communicating parent observe how parents are
understanding child gesture, cues, body language, sound or word.
5. Ask the parent How they do understand the newborns need and how they respond
6. Make a note on gaps parents have to address it later
7. Ask what methods of disciplining methods they do use to discipline the child, have a note
8. Praise for good responsive cares and appropriate disciplining methods that family used
9. Using Counseling poster and advantage of responsive care posture counsel parents in step
wise for; importance of responsive care, how they can fill any responsive gap they have
that have identified and for any none positive disciplining methods used.
10. Demonstrate responsive care and positive disciplining using locally made play materials
11. Help the family having plan for any identified gap and discuss on how to implement it
12. Address any confusion or question that the parents have
13. Record and report, appoint for next time.
Quality Criteria: Assured performing of all the activities according to the procedures.
LAP Test: 2
LAP Test Practical Demonstration
Name: _____________________________ Date: ________________

Time started: ________________________ Time finished: ________________
Instructions: Given necessary templates, tools and materials you are required to perform the
following tasks
Task 1: Assess parent/guardians‘ stimulation practice.
Task 2: Identify stimulation practice gaps of parents/guardians.
Task 3: Provide stimulation counseling for parents
Task 4: provide counseling on responsive care.
Reference
1. Emese Nagy, Paula Thompson, Lauren Mayor, Heather Doughty. Do fetuses
communicate? Fontal responses to interactive versus non-interactive maternal voice and
touch: An exploratory analysis. Elsevier. 2021; 3: 1-12.
2. WHO Caregiver skill training 2017
3. National health service UK
4. MahboubehValiani, Samira HadiAlijanvand. The Effect of Fetus Stimulation Techniques
on Newborn Behavior.Iran J Nurs Midwifery Res. 2021; 26(6): 550–554.
5. Cerebral palsy and early stimulation.
6. Welma L., Sarah M., Heleen C. Prenatal stimulation programmes used for enhancing
postnatal bonding. Africa journal of nursing and midwifery. 2016; 18(1):1-123.
7. https://raisingchildren.net.au/newborns/health-daily-care/massage/baby-massage
8. https://www.johnsonsbaby.com/baby-tips/massage
9. Carruth BR, Skinner JD. Feeding behaviors and other motor development in healthy
children (2-24 months). J Am Coll Nutr. 2002 Apr;21(2):88–96
10. https://www.hopkinsmedicine.org/health/wellness-and prevention/toilet training.
11. https://www.pregnancybirthbaby.org.au/toddler-development-getting-dressed.
Reviewer profile
No Name Institution Position/title Telephone Email
1. Sindu Mekuria AACAHB MCD Director 0913276961 sindu.mekuria@yahoo.com
2. Woynishet Kerebih AACA ECD coordination 0911462606 woynishetkerebih52@gmail.
com
3. Dr.Abebe Negesso MOH National child health expert and ECD 0923978395 abebe.negesso@moh.gov.et
focal abe.nagi47@gmail.com
4. Mr. Amsalu Tilahun AARHB Capacity building & training advisor 0911702617 amsaluyeshi@gmail.com
5. Mr. Samuel PATH ECD Coordinator 0911944936 sabebe@path.org
Yeshewawork Abebe samiwhzhd@gmail.com
6. Mr. Girmaw Tilahun A.A TVET bureau OS and curriculum development team 0937460296 girmawdesta@gmail.com
leader
7. Mr. Yonas Biset Lideta Sub City H o ECD focal 0910519796 yonasbiset2012@gmail.com
8. Mr. Faris Ahmed AARHB ECD PC Coordinator 0913006360 farisahmed20016@gmail.com
9. Mr. Abreham Fikru Selam fire h.c ECD focal person 0921799762 fikiruabraham@3gmail.com
10. Mr. Michael Solomon Gulele A.G.H.C Health center reform team leader 0913679304 msd.michael1@gmail.com
11. Mr. Solomon Tariku Kolfe keraniyo MCD Department head 0929306560 solishman143@gmail.com
woreda 01 HC
12. Sr. Dagmawit Sisay Saris health center Midwifery 0912463501 dagi12sisay@gmail.com
13. W/ro Debrework Mesfin MOLSE Curriculum Expert 0911710753 dibor5399@gimail.com
14. W/ro Kidist Gululat MOLSE Curriculum expert 0913440017 kidgulilat@gmail.com
15. Mr Engdaye Mersha MOLSE OS Expert 0963128468 engd98@gmail.com
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Early Childhood Development Parental Coaching Level - II: Based On November 2023curriculum Version II

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Early Childhood Development

Parental Coaching Level – II

Module Title: Early Childhood learning and

Prepared by: Addis Ababa City Administration Health Bureau

This module covers the units

Learning objectives of the module

1. Read the information written in each unit.

2. Accomplish the Self-checks at the end of each unit.

3. Perform Operation Sheets which were provided at the end of units.

1.1.1 Aims of Early Stimulation

1. To activate euro synapses interconnection

1.2.1 Parental Role

1.2.2 Stimulation is needed for:

1.2.3 Improper stimulation

A. Babies cannot comfortably handle different modes of stimulation all at once.

Things to be Remembered While Giving Stimulation

1. Monitored stimulation with an awareness and willingness to decrease environmental

Safety Measures to be Taken While Giving Stimulation

1.3 Methods of stimulation

1.4 Early learning activity

• Playing with interesting, challenging objects on one's own

• Instruction; i.e., told what to do, ―say this‖, ―do this‖

 Hear music and voices.

Stimulation during pregnancy consists of different modes of stimulation, such as:

 Auditory (talking to the fetus and stimulating music),

Sensory-focused stimulation refers to selected sensory interventions presented at critical pre-

Table 2.1: The Baby Bond Sensory Focused Stimulation program

Talking, Singing & Reading

Touching and other physical stimulation

 Responding to fetal kick with belly touch

Activities are “routines”, because:

Table 3.1: Characteristics of routine

Table 3.2: Example of routine

2. Repeat and Repeat steps 1–3: start building again

Figure 3.1: level of interaction

GOAL: To spend more and more time sharing engagement.

Figure 3.2: shared engagement

Other times children may be:

• No child spends 100% of the time-sharing engagement.

3.3. Support during shared engagements

Figure 3.3: setup the space

Figure 3.4: giving option

 Move in front of child.

 Take a couple of seconds to notice what the child is interested in.

Figure 3.5: Join in the routine

 By imitating, you are rewarding your child’s play ideas.

 Show and help when:

Home work activity:

4.1.1 Newborn Stimulation at Home

Keep in Mind that

Figure 4.1: Foot massage

Figure4.2: leg massage

Figure4.3: upper body massage

Figure4.5: belly massage

Figure 4. 7: back massage

Key massage Tips

The Basic Lesson sa llP arents has to Understand

Name: _____________ Date: