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1. Ohio’s
Infant & Toddler
Guidelines
Early Experiences Last a Lifetime

2. The six developmental domains at the heart of school and life success.
Physical Health Motor Development
Physical health is optimal when safe health Motor development is the increasing ability to use
practices and nutrition are combined with one's body to interact with the environment.
nurturing and responsive caregiving. Protecting
children from illness and injury, and providing
them with individually appropriate nutrition and
a sanitary environment that reduces the risk of
infectious disease, is important for all caregivers.
Emotional Development Language & Communication
Emotional development is the child's emerging Development
ability to become secure, express feelings,
Language and communication development is the
develop self-awareness and self-regulate.
increasing ability to communicate successfully with
others to build relationships, share meaning and
express needs in multiple ways.
Social Development Cognitive Development
Social development is the child's emerging Cognitive development is the building of
development of an understanding of self and thinking skills.
others, and the ability to relate to other people
and the environment.
Early Experiences Last a Lifetime

3. Purpose Statement: Why are these guidelines important?
Because early experiences last a lifetime and infancy is the morning of life…
The guidelines are seen as the critical first step to ensuring that all Ohio children, birth to three, have responsive, reciprocal and
respectful care. And as a result of that care, children will be ready for both school and life. There are 1,892 days from the time
babies are born until they enter school. This 1,892 day journey is remarkable, complex and far reaching. Approximately 150,000
babies are born every year in Ohio. Who they spend time with and how they are cared for affects who they will become. Ohio’s
Infant and Toddler Guidelines are meant for three diverse yet profoundly important groups of people in the lives of infants and
toddlers: parents, providers and policy makers.
Parents Policy makers
You are your child’s first and best teacher. The guidelines are To have prepared children and productive adults, Ohio must have
meant to assist you in your understanding of infant and toddler state policies that strengthen the developmental trajectories of its
development. Within the guidelines document, posters for each youngest citizens, babies and toddlers. It has been estimated
age range (birth-8 months, 6-18 months and 16-36 months) that every three-year-old that becomes a productive adult will 1
provide a snapshot of potential milestones for each of the contribute approximately $600,000 in taxes over the course of
developmental domains (physical health, emotional, social, motor, a lifetime in taxes. There are more than 48,000 three-year-olds
language & communication and cognitive). If you want to learn currently in child care programs across the state. When you
more about where your child is developmentally in relationship to calculate the revenue potential, it is more than $28 billion.
a particular domain, you can tab to that domain. Each domain Ultimately though, we want it said that Ohio takes care of its
has guidelines with indicators and examples of behaviors that infants and toddlers because it is the right thing to do.
you might see your child demonstrate across the three stages
of infancy.
What a responsibility! In our hands and under our influence,
Providers there is the ability to shape experiences that last a lifetime.
In Ohio, approximately 90,000 infants and toddlers are cared for
Ohio believes that babies truly are the nicest way to start
outside of their homes. The only requirement to care for children
is a high school diploma. These two facts make it imperative that people. Babies are ready for us, are we ready for them?
those caring for our most valuable and vulnerable resource have
the knowledge necessary to do this work well. When used
effectively, the guidelines can assist programs and care teachers
in focusing on early development and learning in order to
support and strengthen the developmental outcomes of the
children they serve.

4. Ohio’s Guiding Principles
The following were absolutely essential to the writing team members —
The guideline must be evidence-based. The guideline must link to best practices
To ensure that each guideline was evidence-based, a thorough that support children’s optimal development.
review of research was conducted. In addition, widely used To ensure that each guideline linked to best practices, each
assessment tools were reviewed to determine the alignment guideline was reviewed for its developmental appropriateness.
of relevant developmental milestones with each guideline.
The guideline must be useful to parents,
The guideline must take into account differences providers and policy makers.
in temperament, development and culture. To ensure that each guideline was useful to parents, providers and
To ensure that each guideline was inclusive of individual policy makers, information was presented in an easy-to-use format
differences in temperament, development and culture, each with examples from the child’s point of view.
guideline was examined from these perspectives.
The guideline may be assessed or measured 2
The guideline must be sensitive to both throughout the birth to three-year period.
cultural and linguistic differences. To ensure that each guideline can be assessed or measured from
To ensure that each guideline was sensitive to both cultural and birth to three years, each guideline was written to allow for
linguistic differences, each guideline was thoroughly reviewed to observation and documentation.
see if the way a behavior might be expressed would be different
depending on a child’s cultural and/or linguistic background.
The guideline must be inclusive of children
with special needs.
To ensure that each guideline was inclusive of children with special
needs, universal design was utilized. Universal design means that
each guideline was written to be as inclusive as possible.

5. Ohio’s Path to Creating Infant & Toddler Guidelines
In 1965, Bruce Tuckman published his Forming, Storming, Norming, Performing Team Development Model. In the 1970’s,
he added a fifth stage, adjourning. In 2006, this model aptly describes the process of how Ohio’s Infant & Toddler
Guidelines were born.
Forming
Forming — Team members need guidance and direction, as roles The team’s second decision was to create guidelines that would
and responsibilities are unclear. reflect the best thinking of every profession that works with infants,
toddlers and their families in Ohio. With this purpose in mind,
Build Ohio, an organization aimed at supporting early care and the leadership team identified the developmental domains that
education systems building, identified the need to create infant and would be included in the guidelines and then widely distributed
toddler guidelines. A leadership team from Build Ohio, composed applications to find the best people to create the guidelines.
of representation from the Ohio Department of Education (ODE), “Best” with regard to this work was defined as having content
the Ohio Department of Health (ODH), the Ohio Department of expertise, experience and a demonstrated passion to work on
Job and Family Services (ODJFS) and the Ohio Child Care Resource behalf of infants and toddlers. The team members listed on 3
and Referral Association (OCCRRA), collaboratively mapped out a the next page represent the organizational, educational and
planning process and timeline. experiential diversity that the leadership team envisioned.
Ohio is very fortunate to have been able to assemble
The leadership team’s first decision was to enlist the expertise a team such as this one.
of WestEd’s Center for Child and Family Studies. The Center is
nationally and internationally known for its work in creating the
Program for Infant/Toddler Care (PITC), the training approach that
is being implemented in Ohio as part of First Steps: Ohio’s Infant
and Toddler Initiative, as well as in other states across the country.

6. Ohio’s Infant & Toddler Guidelines: The Writing Team
Physical Health Motor Development
Connie Bacon Child Focus Jane Case-Smith Ohio State School of Allied Medical Professions
Shannon Cole Ohio Department of Health Sherri Guthrie Corporation for Ohio Appalachian Development
Tami Jaynes Coshocton County Board of MRDD Sophie Hubbell
Bethany Moore** Ohio Department of Health Adrienne Nagy Ohio University
Michelle Moore Child Care Choices Linda Pax-Lowes* Columbus Children's Hospital
Marie Vunda Pashi Cincinnati-Hamilton County CAA Debra Riley Stark County Board of MRDD
Julie Piazza Berea Children's Home & Family Services Holly Rine Coshocton County Board of MRDD
Linda Primrose-Barker Council on Rural Service Programs Chris Stoneburner** Build Ohio
Ellen Steward* Columbus Children's Hospital Millette Tucker Center for Families and Children
Cindy Wright Coshocton County Board of MRDD Christine Wisniewski Medical College of Ohio Early Learning
Emotional Development
Jeanine Bensman Council on Rural Service Programs Language & Communication Development
Heather Childers Ellison The Children's Home Kristi Hannan Lucas County Help Me Grow
Judee Gorezynski Portage Children Center Julie Hartwick Help Me Grow of Cuyahoga County
Jamie Gottesman** Ohio Department of Job & Family Services Jane Haun Eastgate Early Childhood
David Hunter Athens County Help Me Grow Carla Kossordji YMCA-North Educare
Sara Kuhlwein Hancock County Help Me Grow Program 4
John Kinsel* Samaritan Behavioral Health Inc.
Jane Pernicone Starting Point Alicia Leatherman** Ohio Child Care Resource and Referral Association
June Sciarra Debra Loyd Community Action Wayne/Medina Early Head Start
Sherry Shamblin Tri-County Mental Health and Counseling Services, Inc. Ginger O'Conner* Ewing School
Cindy Sherding Ohio Department of Job & Family Services Amy Rudawsky The Compass School
Jane Sites Cincinnati Children's Hospital Medical Center Holly Scheibe Action for Children
Sonya Williams Akron Summit Community Action Agency
Social Development
Ann Bowdish Positive Education Program Cognitive Development
Michelle Figlar Invest In Children Becky Evemy Creative World of Child Care
Diane Frazee The Family Information Network of Ohio Kimberly German NC State/OSU Mansfield
Sandy Grolle WSOS Community Action Commission Sheila Jenkins Cincinnati-Hamilton County CAA
Marla Himmeger Ohio Department of Mental Health Avalene Neininger Coshocton County Board of MRDD
Laurie Kennard Coshocton County Board of MRDD Angela Parker* Cognitive Early Childhood Resource Center
Michelle Koppleman Apple Tree Nursery School Beth Popich Clermont County Board of MRDD
Dannette Lund Early Childhood Resource Center Willa Ann Smith Akron Summit Community Action Agency
Marla Michelsen Medical College of Ohio Early Learning Michelle Wright Community Action Wayne/Medina Early Head Start
Kelly Smith** Ohio Department of Job and Family Services Yu-Ling Yeh Akron Summit Community Action Agency
Kathy Vavro Lake County Crossroads Barbara Weinberg** Ohio Department of Education
Kim Whaley* COSI
State Level Leadership Team
Jamie Gottesman Ohio Department of Job & Family Services
* Team Leader
Terrie Hare Ohio Department of Job & Family Services
** Facilitator Alicia Leatherman Ohio Child Care Resource and Referral Association
Bethany Moore Ohio Department of Health
Chris Stoneburner Build Ohio
Barbara Weinberg Ohio Department of Education
Debbie Wright Ohio Department of Health

7. Ohio’s Path to Creating Infant & Toddler Guidelines
Storming
Storming — Team members have increased clarity but The second day with writing team members was spent
uncertainties still persist; decisions don’t come easily. discussing overarching goals of the leadership team including —
The launch of Ohio’s Infant and Toddler Guidelines project in • linking the infant and toddler guidelines to Ohio’s Early Learning
February 2005 began with a two-day meeting facilitated by Drs. Content Standards in order to have a seamless pathway from
Ron Lally and Peter Mangione, co-directors of WestEd’s Center for birth to school entry
Child and Family Studies. On the first day, key stakeholders from
the fields of early childhood education, infant mental health, health • creating a design that attracts interest as well as content that
and early intervention, as well as higher education faculty, child is easily understood and relevant to three distinct audiences:
care resource and referral staff, parent educators, funders and parents, providers and policymakers
policymakers participated in a series of discussions. These
centered on — • defining guiding principles that would lay the foundation
for guidelines
• the three distinct ages of infancy: birth-8 months, 6-18 months
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and 16-36 months (the overlap reflects the impact of individual • implementing a writing team process that would be fluid,
differences on the rate of development) flexible and adaptable to incorporate the latest and best
thinking from research and practice
• the developmental drivers (security, exploration and identity)
associated with the various ages of infancy
• the significance to infant and toddler development of the six
developmental domains for which guidelines would be written:
physical health, emotional development, social development,
motor development, language & communication development
and cognitive development
• the need to organize the work around six domains in order to
write guidelines, while recognizing that research demonstrates
that all of the domains of development are of equal importance
and work synergistically

8. Ohio’s Path to Creating Infant & Toddler Guidelines
Norming Performing
Norming — Team members’ roles/responsibilities become clear; Performing — Team members have a shared vision, make
big decisions are made by group agreement, and consensus forms. decisions based on agreed-upon criteria and work autonomously.
The writing teams met once a month beginning in March 2005. During the spring of 2005, domain drafts began to take shape.
Each meeting started with the leadership team providing updates As the writing teams completed their preliminary work in the
and clarifications for all the teams in a large group. The group then summer of 2005, WestEd thoroughly reviewed the content
broke into the respective teams for the remainder of the day. and provided each team with key questions to consider. By August
WestEd staff were present at the monthly meetings to provide 2005, each writing team incorporated WestEd’s feedback into a first
content expertise as well as to lead writing team members through complete draft and submitted it to the leadership team. WestEd
a reflective inquiry process. Between each of the monthly meetings, then focused on editing the guidelines to make them consistent
the leadership team met with WestEd about the unfolding process. across domains. WestEd worked with the leadership team to
The decision points along the way included — ensure that the multi-disciplinary perspectives of the writing team
members and the content were preserved as the presentation of
• the leadership team’s putting in place a plan to create companion the different guidelines were standardized and organized into a 6
documents that clarified the role of the caregiver, the importance coherent document. A revised draft of the guidelines was submitted
of the environment and the accessibility to resources for parents to the writing teams in December 2005 for their review and
and providers feedback. In January 2006, the leadership team and WestEd
considered every question, comment and suggestion from the
• the emotional and social development writing teams’ agreeing to writing team members. The following feedback was incorporated
present their two domains separately into the guidelines —
• the defining of a guiding principle that identifies the important • Definition of terms — in this document, ”the person I’m
influences of infant temperament and cultural experiences on attached to” is identified as people to whom a child is emotionally
individual differences in development attached. “Caregivers” may be parents, grandparents, other
relatives, a family child care provider, a caregiver in a child care
center or anyone else who consistently cares for the child.
• Gender — use of he/she is meant to be inclusive of both genders.
In some instances, one gender was used to refer to children or
adults of both genders for readability purposes only.

9. Ohio’s Path to Creating Infant & Toddler Guidelines
• Jargon — an attempt was made to use everyday language in the • Children with special needs — although the principle of universal
definitions of guidelines, descriptions of indicators and examples. design was utilized in creating the guidelines, it should be noted
A technical term or jargon was used when the meaning of a that children develop in different ways and at different rates.
concept being presented would have been compromised if an The content of the guidelines may not apply to every infant or
everyday term were used. Special effort was made to present toddler. If there is concern about a child’s development, the best
simple, straightforward examples from a baby’s point of view. course of action is to talk to a professional. In Ohio, families may
share concerns with their pediatrician, nurse practitioner or other
• Order of domains — physical health was placed first in this medical professionals. Families may also call Help Me Grow, a
document because it plays a prominent role in a child’s overall statewide program that helps identify child development issues
functioning. Emotional development follows because emotion and coordinates supports and services to eligible children and
is the root of all action. Motor development works hand-in-hand families, at 1-800-755-GROW.
with the child’s emerging language and cognitive abilities.
Unfortunately, one of the six domains had to be last but that Finally, the guidelines were put out to the field for feedback in
placement in no way is meant to diminish its importance. early February 2006. In an effort to be responsive to this feedback,
The age posters were added to the overall presentation of the the leadership team and WestEd finalized the guidelines. The
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guidelines to illustrate the synergistic nature of the domains. leadership team then supervised the copy editing and formatting
of the document for release to the field in March 2006.
• Teasing apart emotional and social development — the writing
teams decided to treat the emotional and social development Adjourning
domains separately to draw attention to the importance and Adjourning — Team members have fulfilled their purpose
uniqueness of each. The emotional development domain focuses successfully and are moving on to new things.
on the child’s understanding of self. In contrast, the social
development domain refers to the child’s understanding of the The hope of the leadership team is that the guidelines will be
connection between self and others, and the ability to relate widely distributed and seen as a valuable support for parents,
to other people and the environment. Because attachment providers and policymakers. We especially want to thank the
relationships are at the center of the emotional as well the social writing team members for working to make the world a better
development domains, attachment is a guideline under both of place for Ohio’s babies.
these domains. As a result, the definition of attachment, along
with the indicator and examples under this guideline, is the
same for both.

10. Ohio’s Path to Creating Infant & Toddler Guidelines
Special Acknowledgements
There was an overwhelming interest from around the state to be • Joan Lombardi, whose demand for quality infant and toddler care
part of this process. For people who could not serve on a writing sparked what would become First Steps: Ohio’s Infant Toddler
team, thank you for your comments, guidance and enthusiasm Initiative.
about the completion of this work. Our appreciation extends to
all who participated and especially to the following — • Thelma Harms and Debby Cryer (Honorary Ohio residents),
thank you for your pure, honest and supportive feedback on
• Ron Lally and Peter Mangione, whose day-to-day work with the all of the work we do in Ohio.
Program for Infant Toddler Care (PITC) inspires us all to honor
infants and toddlers and all those that care for them. • Susan Rohrbough and Lori Connors-Tadros, from the National
Child Care Information Center (NCCIC), who are always willing
• Cathy Tsao and Amy Wagner, from WestEd, thank you both for to provide guidance and support for all of our work here in Ohio.
being such “geeks” about infant and toddler development. Your
unwavering support throughout the process and the incredible • Paul Noski, from the Federal Child Care Bureau, who has
patience you exhibited was inspirational, even with all of the supported this work from the beginning. 8
surprises along the way.
• Zero To Three, for the example it sets every day for all
• Wendy Lapuh and Kathleen Murphy of MurphyEpson, thank you of us who care for and about infants and toddlers.
both for making our dreams for babies come to life on paper.
• Jeanne Lance, from the Ohio Department of Education, whose
• The family child care providers, infant/toddler teachers and former life as a college English professor was resurrected to edit
infant/toddler specialist in Franklin County who came out on the final document.
short notice to provide invaluable feedback.

11. Birth to Eight Months
During the early days and months of my life, I am primarily focused I often don’t have to cry. She knows what I need by watching me
on security. In essence, I am learning about what I can expect and by listening to me. She puts me in places where I can move
from life. around. That’s exciting! I keep learning how to move my body — 9
my head, my arms, my legs, my whole body. I can count on her to
When I feel discomfort, I cry. Someone comes to help me. She help me when I need help and to play with me when I’m ready to
helps me — when I’m hungry — when I’m tired — when I’m out play. I feel great knowing she is with me when I need her.
of sorts. When she helps, I feel everything is going to be all right,
and I can relax. I like to look at her face. I like to listen to her voice. All of this is very important! I have to feel emotionally secure in
I feel her warmth. I feel the care she gives me — time after time. order to have the confidence to learn new things. My level of
I feel content. I coo. As I get older, I smile when I see her face and confidence will influence how I approach the opportunities coming
hear her voice. I try to make the sounds she makes. I try to move my way. I know it seems like a long way off, but my ability to take
my arms the way she does. I learn so much from her. Her responses chances and adapt to change will allow me to be successful in both
make me feel so good. I’ve learned to expect her to come when school and in life.
I call.

12. Six to 18 Months
During this middle period of my development, I am now primarily When I say, “Mama,” she smiles. I love when someone looks at me
focused on exploration. Get ready, because I am ready to move that way. When I point at something, my caregiver says what it is.
out. In essence, I am learning how things in the world work, I point and point and point. That’s one of the ways I learn. I do this 11
including myself. with books too. I look at things with my caregiver. I like to listen to
her. I like when she listens to me. Most of all, I like to be in a place
When I know where my caregiver is, I feel safe. I feel I can move where I can move to my heart’s delight, where I can play with
away from her to explore things. Not too far — I stay close enough anything I can reach and where I can easily see my caregiver’s
so I can get back to her quickly. That’s what I do if something scary smiling eyes.
happens, or if I feel sad or if I feel like cuddling. That feels good.
But after a while, I want to explore some more. I roll my body. I All of this is very important! My drive to explore the world and
also creep and crawl. Eventually I figure out how to sit up, pull to figure things out helps me build knowledge and get ready for the
standing, take a step — and walk! I like to fiddle with things, over world of ideas. I know it seems like a long way off, but my being
and over again. It’s fun to see how things work. I keep making intellectually curious and motivated to learn will help me be
sounds my caregiver makes. I discover that each sound has a successful in both school and in life.
different meaning. When I say, “Dada,” he smiles.

13. Sixteen to 36 Months
During this final stage of infancy, it is all about ME. I have a sense When I try to solve a problem, sometimes an idea just pops in my
of who I am and how I am connected to others. In essence, I am head. I pretend to be different people — and animals, too. I pretend
learning to make choices, and it can be difficult sometimes for me with other children. We play with dress-up clothes, kitchen utensils, 13
and for you. puppets — just about anything. Playing with other children is
great! I often think about one or two or three special people.
I feel powerful. I can run. I can do so many things. I know what’s It may be my mom, my dad, my grandma or grandpa, or my
mine and make sure other people do, too. I like to be in charge caregiver in child care. When I think about someone I feel close
and do things by myself. If someone tells me what to do, I often to, I feel good. Even if they are not with me, I know that person
say, “No.” But sometimes I don’t feel so big. I can get out of sorts will take care of me. I feel that person loves me. That’s the best
and be quite loud. I may need help. I may need comfort. I may feeling of all!
need to know what I’m allowed to do — and what I’m not allowed
to do. Then I feel big again and am excited about everything I can All of this is very important! I have to know myself before I can
do. I know where I belong, who I am and who my family is. I use learn how to get along with others and to appropriately express
more and more words to express myself. As I get older, I ask a myself when I’m frustrated. I know it seems like a long way off,
lot of questions. I look at books and listen to stories. I talk with my but my ability to communicate and interact positively with peers
caregiver about books. Singing and rhyming games are a lot of and adults who will one day be colleagues and supervisors, along
fun. I think about ideas all the time. with my ability to negotiate conflict, will help me be successful in
both school and life.

14. Physical Health
Babies need good health and nutrition right from the start. This is Frequent well-child visits allow health professionals to monitor the
essential in laying the foundation for a baby’s optimal growth and child’s physical health, behavioral functioning and overall development.
development. Infants and toddlers depend on their caregivers to These visits create opportunities for giving age-appropriate guidance
make healthful choices for them. They also need adults to help to parents. In addition, health professionals should screen young
them learn how to make good choices for themselves. children for common concerns, including lead poisoning, hearing
and vision problems, behavior concerns, communication disorders
Physical health affects functioning in all the other domains. and general development (language, cognitive, social, emotional
This point becomes clear when a child’s health or well-being is and motor domains). Screening is important because the sooner
compromised. For example, a child who is chronically ill may not a child’s need for early intervention can be identified, the more
be able to learn through active exploration and movement. Or a effective that intervention is likely to be. Well-child care benefits
child who is poorly nourished may not attend to learning. Frequent all children, including those with disabilities or other special needs.
ear infections may hinder a child’s ability to communicate and learn
language. A child exposed to violence may not know how to form
positive social relationships. Each of these negative conditions can
have lifelong consequences.
Each day, adults caring for babies can positively influence a 15
child’s health and well-being. All infants and toddlers need
regular health and physical exams, preventive care, screening,
immunizations and sick care. They all should have a primary
health and dental care provider, regardless of their families’
economic status. A primary provider facilitates timely and
appropriate preventive and sick care.
Physical health is optimal when safe health practices and nutrition are combined with nurturing and responsive
caregiving. Protecting children from illness and injury, and providing them with individually appropriate
nutrition and a sanitary environment that reduces the risk of infectious disease, is important for all caregivers.

15. Physical Health
Guideline: Health Practices
The child will display signs of optimal health consistent with appropriate primary health care and caregiver health practices.
Birth - 8 months 6 - 18 months 16 - 36 months
• Health care: I need to receive regular check-ups I need to receive regular check-ups I need to receive regular check-ups
The child will have that include appropriate screenings, that include appropriate screenings, that include appropriate screenings,
access to care from a immunizations and guidance immunizations and guidance immunizations and guidance
primary health provider, about my development. about my development. about my development.
regardless of economic
status and geographic …check-ups at birth and at one, …check-ups at nine, 12, 15 and 18 …check-ups at 24 and 36 months
location. two and four months of age. months of age. of age.
…an evaluation within 48 - 72
hours following discharge from
the hospital, if I am a breast-fed
baby, to check my weight gain,
to evaluate breastfeeding and to
provide caregiver encouragement 16
and instruction.
• Handwashing: I will receive handwashing at With assistance from a caregiver, I With assistance from a caregiver, I
The child will be exposed appropriate times. (If I am unable will wash my hands once I am able will wash my hands once I am able
to and assisted with to stand or too heavy to hold to stand safely at the sink. to stand safely at the sink.
frequent and proper safely, my hands can be washed
handwashing. with a damp paper towel …upon arrival at my child care setting. …upon arrival at my child
moistened with a drop of liquid …before and after eating. care setting.
soap, and then wiped clean with …after diapering. …before and after eating.
a clean, wet, paper towel.) …before water play. …after diapering.
…after playing on the playground. …before water play.
…after diapering. …after handling pets. …after playing on the playground.
…before and after eating or having …whenever my hands are visibly …after handling pets.
a bottle. dirty. …whenever my hands are
visibly dirty.

16. Physical Health
Guideline: Health Practices
The child will display signs of optimal health consistent with appropriate primary health care and caregiver health practices.
Birth - 8 months 6 - 18 months 16 - 36 months
• Diapering and toileting: I will be appropriately diapered. I will be appropriately diapered. I will be appropriately diapered
The child will be and, toward the end of this
appropriately diapered …changed when I give signs of …changed when I give signs of period, I may show signs that
or assisted with toileting needing to be changed, or needing to be changed, or I am ready to learn to use
to prevent the spread checked at least every two checked at least every two the toilet.
of illness. hours when awake, for signs hours when awake, for signs
of wetness or feces, and of wetness or feces, and …changed when I give signs of
immediately after waking. immediately after waking. needing to be changed, or
…changed near a water source for …changed near a water source for checked at least every two
quick handwashing to prevent quick handwashing to prevent hours when awake, for signs
the spread of infection. the spread of infection. of wetness or feces, and
…remain secure on a raised chang- …remain secure on a raised changing immediately after waking.
ing surface with my caregiver's surface with my caregiver's hand …changed near a water source for 17
hand placed on me at all times. placed on me at all times. quick handwashing to prevent
the spread of infection.
…remain secure on a raised changing
surface with my caregiver's hand
placed on me at all times.
…show through gestures, expressions,
body language or words that I
am about to urinate or have a
bowel movement.
…help with undressing myself.
…ask to use the toilet or potty
chair.

17. Physical Health
Guideline: Oral Health
The child will display growth and behaviors associated with good oral health.
Birth - 8 months 6 - 18 months 16 - 36 months
• Tooth eruption: I will display appropriate tooth I will display appropriate tooth I will display appropriate tooth
The child will display eruption. eruption. eruption.
appropriate tooth
…drooling, irritability and sore …drooling, irritability and sore gums …drooling, irritability and sore
eruption.
gums caused by tooth eruption. caused by tooth eruption. gums caused by tooth eruption.
…eruption of the lower and upper …eruption of the lower and upper …eruption of the lower and upper
incisors. central and lateral incisors, canines lateral incisors, canines and first
and first molars. and second molars.
• Oral health: I will display good oral health. I will display good oral health. I will display good oral health.
The child will display
…pink, firm gums. …pink, firm gums. …pink, firm gums.
good oral health.
…smooth, white teeth. …smooth, white teeth. …smooth, white teeth.
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• Dental care: I need to have my first oral I need to have my first oral I need to have my second oral
The child needs to examination from a dentist examination from a dentist examination, as recommended
receive appropriate within six months of the first within six months of the first by my dentist, based on my
dental check-ups from a tooth eruption and by 12 tooth eruption and by 12 individual needs or risk of disease.
dentist and appropriate months of age. months of age.
dental treatment.

18. Physical Health
Guideline: Positive Nutritional Status
The child will display growth and behaviors associated with a positive nutritional status.
Birth - 8 months 6 - 18 months 16 - 36 months
• Physical growth: I will display appropriate increases I will display appropriate increases I will display appropriate increases
The child will display in length, weight and head in length, weight and head in length, weight and head
appropriate increases circumference. circumference. circumference.
in length, weight and
head circumference. …lose about six percent of my …triple my birthweight by 12 to 18 …quadruple my birthweight by
body weight immediately after months of age. 24 to 36 months of age.
birth because of fluid loss and …increase in length at the rate of …gain approximately 4.5 to 6.5
some breakdown of tissue, but approximately one-half inch per pounds per year.
then regain my birthweight month between six and 12 …increase in height at the rate of
within 10 to 14 days months of age. approximately 2.5 to 3.5 inches
following birth. …grow without major deviations per year.
…double my birthweight by four in growth chart percentages. …grow without major deviations
to six months of age. in growth chart percentages. 19
…increase in length at the rate
of approximately one inch per
month during the first six
months of life.
…grow without major deviations
in growth chart percentages.

19. Emotional Development
Babies experience emotions right from the start. From their first cry The infant’s emotions are nurtured in relationships with parents,
of hunger to their first giggle of delight, their emotional experience grandparents and child care providers. Studies of attachment show
grows. Young children learn many ways to express emotions such that children who are in emotionally secure relationships early in
as happiness, sadness and anger. As they interact with their caregivers, life are more likely to be self-confident and socially competent.
they come to understand and appreciate the uniqueness of their Sensitive caregivers who read the child’s cues and meet emotional,
emotional experience. Eventually they gain some control over their physical and dependency needs help the child become securely
sometimes strong emotions. Positive early experiences help a child attached to them. Caregivers who gently stimulate a baby’s senses
become emotionally secure. and share emotional states provide the baby’s brain the experiences
it needs to grow. Because sensitive, responsive care leads to
The child’s evolving sense of security and well-being has a profound attachment security, its impact is profound. Secure attachment
effect on all areas of the child’s development, including cognitive relationships have a positive effect on every aspect of early
and language development. For example, an emotionally secure development, from emotional self-regulation to healthy
infant will more readily explore and learn than an insecurely brain development.
attached infant. In a secure relationship, the child engages in rich
back-and-forth interaction. The “dance” between the caregiver
and child fosters increasingly advanced communication and
language development. 21
New research shows how emotions are key in organizing the
experience and behavior of young children. Emotions drive early
learning. For instance, the pleasure an infant experiences when
making a discovery or mastering a motor skill inspires the child to
continue to learn and to develop skills. Emotional experiences affect
the child’s personal health, well-being and school readiness.
Emotional development is the child's emerging ability to become secure, express feelings,
develop self-awareness and self-regulate.

20. Emotional Development
Guideline: Attachment
The child will develop an attachment relationship with a caregiver(s) who consistently meets the child's needs.
*Special Note: Because attachment has developmental relevance to both the emotional and social domains, it is shown identically in both places.
Birth - 8 months 6 - 18 months 16 - 36 months
• Attachment: In the beginning of this period, In the beginning of this period, I In the beginning of this period, I
The child will form I respond automatically to both signal to caregivers to stay close. spend more time playing farther
relationships with caregivers and unfamiliar adults. Later, I develop an attachment away from the person I'm attached
consistent caregivers. By the end of this period, I signal relationship with one or a few of to than I did in the earlier age
to caregivers in order to stay these caregivers, whom I use as a period, and I use gestures, glances
close, and I may have formed an secure base from which to move or words to stay connected. By
attachment relationship with one out and explore my environment, the end of this period, I am beginning
(or a few) of these caregivers. checking back from time to time. to understand that the person I'm
By the end of this period, I spend attached to may have a point of
For example, I may… more time playing farther away view (including thoughts, plans
…turn toward the sight, smell or from my attachment figure(s), and feelings) that is different
sound of my mama over that of and am more likely to use gestures, from my own.
an unfamiliar adult. glances or words to stay connected, 22
…stop crying upon seeing a face though I still need to be physically For example, I may…
or hearing a voice. close when I'm distressed. …call, "Papa!" from across the room
…grasp my caregiver's sweater while I'm playing with blocks to
when she holds me. For example, I may… make sure that my Papa is paying
…cry out or follow my mom when attention to me.
…lift my arms to be picked up by
…feel comfortable playing on the
my papa. she leaves the room.
other side of the yard from the
…be more likely to smile when …seek comfort from my favorite person I'm attached to, but cry to
approached by a caregiver than blanket or toy, especially when the be picked up when I fall down
by an unfamiliar adult. person I'm attached to is absent. and hurt myself.
…babble back and forth with a …turn excitedly and raise my arms …say, "I go to school, mama goes
caregiver. toward the person I'm attached to to work," after my mom drops
…seek comfort from the person at pick-up time. me off in the morning.
I'm attached to when I am crying. …display anxiety when an unfamiliar …gesture for one more hug as my
…cry out or follow after my mom adult gets too close to me. daddy is leaving for work.
when she leaves the room. …reconnect with the person I'm …say, "you do one and I do one,"
attached to by making eye when asked to put books away
before separating from my mom
contact with him or her from
in the morning, in order to get
time to time.
her to stay a bit longer.
…play confidently when my attach- …bring my grandma's favorite book
ment figure is in the room, but to her to see if she will read it to
crawl or run to her when I'm me one more time after grandma
frightened. says, "We're all done reading.
Now it's time for nap."

21. Emotional Development
Guideline: Expression of Emotion
The child will experience and express a variety of feelings.
Birth - 8 months 6 - 18 months 16 - 36 months
• Expression of emotion: In the beginning of this period, In the beginning of this period, In the beginning of this period,
The child will express I express contentment and I express a variety of primary I begin to express complex (self-
feelings through facial distress. By the end of this period, emotions (contentment, distress, conscious) emotions such as pride,
expressions, gestures I express a variety of primary joy, sadness, interest, surprise, embarrassment, shame and guilt.
and sounds. emotions (contentment, distress, disgust, anger and fear). Later By the end of this period, I can
joy, sadness, interest, surprise, in this period, my emotional use words to describe how I am
disgust, anger and fear). expressions become clearer and feeling, although sometimes my
more intentional. By the end of feelings are so strong that I have
For example, I may… this period, I begin to express trouble expressing them in words.
…smile at my caregiver when he complex (self-conscious) emotions
rocks me and sings to me. such as pride, embarrassment, For example, I may…
…show distress by crying, kicking shame and guilt. …hide my face in my hands when
my legs and stiffening my body. feeling embarrassed. 23
…coo when I'm feeling comfortable. For example, I may… …express guilt after taking a toy
…cry intensely. …be more likely to react with anger out of another child's cubby
…express joy (by waving my arms than just distress when someone without permission.
and kicking my legs) when my accidentally hurts me. …express frustration through
dad comes to pick me up. …show affection for my caregiver by tantrums.
…express sadness (by crying) hugging her. …express pride by saying, "I did it!"
when my caregiver puts me …express fear of unfamiliar people …use words to express how I am
down in my crib. by moving near my caregiver. feeling, such as, "I’m sad."
…spit out things that taste "icky" …knock a shape sorting toy away …say, "I miss grandma," after I get
and make a face of disgust. when it gets to be too frustrating. off the phone with her.
…laugh aloud when playing …show my anger by grabbing a toy
“peek-a-boo” with my caregiver. that was taken from me out of the
…get angry when I am frustrated. other child's hands.
…be surprised when something …express fear when I hear a dog bark.
unexpected happens. …express sadness when I lose a
…exhibit wariness, cry or turn favorite toy and cannot find it.
away when approached by an …smile with affection as my sibling
unfamiliar adult. approaches.
…be more likely to react with …cling to my dad as he says,
anger than just distress when "good-bye," and express sadness
someone accidentally hurts me. as he leaves.
…express fear by crying when I see
someone dressed up in a costume.

22. Emotional Development
Guideline: Self-Awareness
The child will develop an understanding of and an appreciation for his/her uniqueness in the world.
Birth - 8 months 6 - 18 months 16 - 36 months
• Self-awareness: In the beginning of this period, In the beginning of this period, I In the beginning of this period,
The child will recognize I am not aware that you are a begin to understand that I am my I recognize myself in the mirror
herself or himself as a separate person from me. By the own separate person. By the end and in photos. Later in this period,
person with an identity, end of this period, I begin of this period, I recognize myself I use pronouns like "I," "me" and
wants, needs, interests, to understand that I am my in the mirror and in photos. "mine" when referring to myself.
likes and dislikes. own separate person. By the end of this period, I can
For example, I may… describe who I am by using
For example, I may… …recognize that I am a separate categories such as girl or boy,
…not experience distress when my person from my caregiver. big or little.
mommy leaves the room. …recognize my own body.
…experiment with moving my …begin to identify parts of For example, I may…
own body. the body. …point to myself in a family
…watch my own hands with …understand that the reflection photograph. 24
fascination. in the mirror is actually my …point to different body parts
…use my hands to explore own image. when you name them, and name
different parts of my body. a few body parts by myself.
…be able to tell the difference …say, "big girl," when referring to
between when someone touches myself.
my face and when I touch my …begin to make comparisons
own face. between myself and others.
…smile at my mirror image, even …claim everything I want as
though I don't recognize it as an "mine."
image of myself. …refer to myself by name, or with
…react to hearing my own name. the pronouns "me" and "I."
…cry when my caregiver leaves …say, "No!" to express that I am an
the room. individual with my own thoughts
and feelings.
…point to and name members of
my family in a photograph.
…say, "I'm the big sister," when
my caregiver meets my new
baby brother.

23. Emotional Development
Guideline: Self-Awareness
The child will develop an understanding of and an appreciation for his/her uniqueness in the world.
Birth - 8 months 6 - 18 months 16 - 36 months
• Awareness of emotions: In the beginning of this period, I In the beginning of this period, In the beginning of this period,
The child will recognize respond reflexively or automatically I express a variety of primary my emotional expressions become
his or her own feelings. with emotions of distress or emotions (contentment, distress, clearer and more intentional.
contentment. By the end of this joy, sadness, interest, surprise, Later, I express complex (self-
period, I express a variety of disgust, anger and fear). By the conscious) emotions such as
primary emotions (contentment, end of this period, my emotional pride, embarrassment, shame
distress, joy, sadness, interest, expressions become clearer and and guilt. By the end of this period,
surprise, disgust, anger and fear). more intentional. I use words to describe my feelings
and I show an understanding
For example, I may… For example, I may… of why I have these feelings.
…show satisfaction or dissatisfaction. …be more likely to react with anger Sometimes, however, my feelings
…cry to indicate that I'm distressed. than just distress when someone are so strong I have trouble
…show pleasure and joy when accidentally hurts me. expressing them in words. 25
interacting with a caregiver. …show affection for my caregiver by
…show displeasure or sadness hugging her. For example, I may…
when my caregiver suddenly …express fear of unfamiliar people …express jealousy when my
stops playing with me because by moving near my caregiver. caregiver holds another child
another child needs him. …knock a shape sorting toy away by trying to squish onto the
…become anxious when my family when it gets to be too frustrating caregiver's lap too.
for me. …show delight by clapping to
child care provider leaves the
…show my anger by grabbing a toy
room. myself after stacking some blocks
that was taken from me out of the
…smile joyfully in response to my into a tower.
other child's hands.
caregiver's interesting facial …use one or a few words to tell my
…express sadness when I lose a
expressions. caregiver how I am feeling.
favorite toy and cannot find it.
…smile with affection as my sibling …act out different emotions during
approaches. pretend play by pretending to
…cling to my dad as he says, cry when I'm a sad baby and
"good-bye," and express sadness pretending to coo when I'm a
as he leaves. happy baby.
…express fear by crying when I see …say, "I'm sad," and then respond,
someone dressed up in a costume. "I miss Mommy," when my
…exhibit a play smile while playing caregiver asks why I'm sad.
chase. …say, "I'm mad," after another child
…express jealousy when my caregiver takes my toy, and then say to the
holds another child by trying to other child, "That's mine," as I
squish onto her lap too. take the toy out of his hands.

24. Emotional Development
Guideline: Self-Awareness
The child will develop an understanding of and an appreciation for his/her uniqueness in the world.
Birth - 8 months 6 - 18 months 16 - 36 months
• Sense of competence: In the beginning of this period, In the beginning of this period, I In the beginning of this period, I
The child will recognize I respond automatically and understand that I can make things experiment with different ways of
his or her ability to do explore my own abilities. By the happen. By the end of this period, I making things happen and take
things. end of this period, I understand experiment with different ways of pride in what I can do. By the
that I can make things happen. making things happen, and I take end of this period, I have an
pride in what I can do. understanding of what I can do
For example, I may… and what I'm not able to do yet
…explore my own abilities through For example, I may… by myself. I can also describe
movements. …understand that I can get my myself in terms of what I can do.
…shake a rattle over and over caregiver to play “peek-a-boo”
again to hear the sound. with me if I look at her and then For example, I may…
…touch a toy to make the music cover my face with my hands. …say, "Did it!" or "I can't."
come on again after the music …smile at my mom and giggle in a …insist, "Me do it!" when my 26
has stopped. playful way as I crawl by her, to caregiver tries to help me with
…look at my caregiver when I cry entice her to chase me in a game something I already know how
so she can meet my need. of "I'm gonna get you." to do.
…try to roll over and over again, …point at a toy that I want and …say, "I climb high" when telling
even though I may not roll smile with satisfaction after my a caregiver about what I did
completely over. caregiver gets it down for me. outside during play time.
…roll a toy car back and forth on …say, "Look what I made you" and
the ground and then push it hold up a picture I painted for
really hard and let go, to see my mommy with a big smile
what happens. on my face.
…clap to myself after I climb up the …describe myself to my caregiver
stairs on the inside climber. by saying, "I'm a helping boy"
because I know I am a good
helper.

25. Emotional Development
Guideline: Emotional Self-Regulation
The child will develop strategies to control emotions and behavior.
Birth - 8 months 6 - 18 months 16 - 36 months
• Self-comforting: In the beginning of this period, In the beginning of this period, In the beginning of this period, I
The child will manage I depend on my caregiver to I use simple strategies to use more complex strategies for
his or her internal states comfort me. By the end of this comfort myself, and I am able making myself feel better. By the
and feelings, as well as period, I use simple strategies to to communicate my needs more end of this period, I anticipate
stimulation from the comfort myself, and I am able to clearly to my caregiver. By the end the need for comfort and try to
outside world. communicate my needs more of this period, I use more complex plan ahead.
clearly to my caregiver. strategies for making myself feel
better. For example, I may…
For example, I may… …continue to rely on adults for
…cry when I'm hungry, tired or wet. For example, I may… reassurance and help in controlling
…settle down and be soothed …move away from something that my feelings and behavior.
when my caregiver picks me up is bothering me and move toward …reenact emotional events in my
and cuddles me, feeds me or a caregiver who comforts me. play in order to gain mastery. 27
meets my other needs. …shift attention away from a …ask for food when I'm hungry,
…kick my legs and wave my arms distressing event onto an object as but get my blankie and lie
when in distress. a way of managing my emotions. down in the quiet corner
…turn away from interactions that …try to control my distress by when I'm sleepy.
I find to be too intense, then biting my lip or hugging myself. …say, "Can you rub my back?"
turn back to continue interacting …use gestures or simple words to when I'm having trouble settling
when I'm ready. express distress and seek specific down for a nap.
…calm myself when I'm upset by kinds of assistance from caregivers …put my blanket on my cot before
sucking on my fingers or hand. in order to calm myself. sitting down for lunch, because I
…turn my head away or yawn …use comfort objects, such as a know I'll want it during naptime.
when I'm feeling overstimulated. special blanket or a stuffed animal, …ask, "Who will hold me when
…focus on a nearby toy that I find to help myself calm down. I'm sad?" as I talk with my mom
interesting when something else …play with a toy as a way to about going to a new classroom.
is making me feel overwhelmed. distract myself from my own
…have different kinds of cries to discomfort.
tell my caregiver what I need to
make me feel better.
…move away from something that
is bothering me and move toward
a caregiver who comforts me.

26. Emotional Development
Guideline: Emotional Self-Regulation
The child will develop strategies to control emotions and behavior.
Birth - 8 months 6 - 18 months 16 - 36 months
• Impulse control: In the beginning of this period, I In the beginning of this period, I In the beginning of this period, I
The child will manage depend on my caregivers to show very early signs of controlling am aware of my caregiver's wishes
his or her behavior. meet my needs and comfort me. some impulses when my caregiver and expectations, and sometimes
By the end of this period, I show guides and supports me. By the choose to comply with them. I
very early signs of controlling end of this period, I am aware also have some simple strategies
some impulses when my caregiver of my caregiver's wishes and to help myself wait. By the end of
guides and supports me. expectations, and sometimes this period, I have internalized
choose to comply with them. some of my caregiver's rules so I
For example, I may… I also have some simple don't always need as much support
…cry when hungry, until my strategies to help myself wait. when trying to control my behavior.
caregiver feeds me.
…sleep when I'm sleepy. For example, I may… For example, I may…
…explore how someone's hair feels …refrain from exploring the way …use self-talk to control my 28
by pulling it. another baby's hair feels when behavior; e.g., say "no, no" while
…crawl too close to a younger you remind me to be gentle and considering taking a cupcake
infant who is lying on the show me how. from the plate before it's time
same blanket. …respond to limits that you set for the birthday party.
…reach for a snack out of the bowl with your voice or gestures. …begin to use words and dramatic
before it's snacktime and then …recover quickly and be able to play to describe, understand and
pull my hand back when you play soon after a tantrum. control my impulses and feelings.
ask me to wait. …use self-talk to control my behavior; …begin to turn tantrum behavior
…refrain from exploring the way e.g., say "no, no" while considering on and off with less adult assistance.
another baby's hair feels when taking a cupcake from the plate …throw a tantrum when I'm really
you remind me to be gentle. before it's time for the frustrated.
birthday party. …push or hit another child who
takes my toy.
…begin to remember to follow
simple rules as a means of
controlling behavior.
…understand or carry out simple
commands or rules.
…yell, "mine, mine!" when another
child picks up a doll.
…begin to share.

27. Social Development
Babies are social right from the start. Attachment relationships are In order to fully understand social development, the role of culture
at the heart of social development. In secure relationships, the baby must be recognized and respected in definitions of “appropriate”
eventually learns to follow social rules and be respectful toward social interactions, social skills and social abilities. Different cultural
others. As infants grow, they also gain the necessary social skills communities may have different definitions of social competence.
(turn taking when communicating, negotiation, etc.) to get along For example, one culture may look upon a child’s behavior as shy
with others. Infants begin to show concern and empathy toward and inhibited, while another culture may regard the same behavior
others. They also start to see themselves as belonging to social as respectful.
groups, in particular their families.
Support and guidance from caregivers are essential for infants’
The ability to relate with adults and other children and to learn positive social development. Caregivers support social development
from others influences the infant’s development in all of the other in three major ways: providing an appropriate environment,
domains. As the child’s interaction skills grow, the child learns from creating opportunities for responsive social interactions and
others through imitation and communication. Language learning, building stable relationships. The environment should make it easy
problem solving, fantasy play and social games all depend on social for caregivers to be available to the children and responsive to their
development. Through social guidance and imitation, the child needs. Above all, the program should foster relationships between
learns safety rules and basic health procedures, such as hand caregivers and infants, and between infants. Continuity of care,
washing before meals. With proper support, the infant eventually ample time for caregivers and children to be together, guidance 29
develops the ability to participate in a social group. Successful from caregivers and consistent, predictable social experiences
social development during the first three years prepares the child all contribute to stable, strong relationships and positive
for both preschool and school. social development.
Just as healthy attachment relationships support emotional
self-regulation, so do these relationships contribute to the
development of the child’s social understanding and skills.
In an attachment relationship, the infant looks to the adult for
guidance. Because attachment relationships are critically important
for emotional as well as social development, the same attachment
guideline appears in both of these domains.
Social development is the child's emerging development of an understanding of self and others, and the ability
to relate to other people and the environment.

28. Social Development
Guideline: Attachment
The child will develop an attachment relationship with a caregiver(s) who consistently meets the child's needs.
*Special Note: Because attachment has developmental relevance to both the emotional and social domains, it is shown identically in both places.
Birth - 8 months 6 - 18 months 16 - 36 months
• Attachment: In the beginning of this period, In the beginning of this period, I In the beginning of this period, I
The child will form I respond automatically to both signal to caregivers to stay close. spend more time playing farther
relationships with caregivers and unfamiliar adults. Later, I develop an attachment away from the person I'm attached
consistent caregivers. By the end of this period, I signal relationship with one or a few of to than I did in the earlier age
to caregivers in order to stay these caregivers, whom I use as a period, and I use gestures, glances
close. I may have formed an secure base from which to move or words to stay connected. By
attachment relationship to one out and explore my environment, the end of this period, I am
(or a few) of these caregivers. checking back from time to time. beginning to understand that
By the end of this period, I spend the person I'm attached to may
For example, I may… more time playing farther away have a point of view (including
…turn toward the sight, smell or from my attachment figure(s), and thoughts, plans and feelings)
sound of my mom over that of am more likely to use gestures, that is different from my own.
an unfamiliar adult. glances or words to stay connected, 30
…stop crying upon seeing a face though I still need to be physically For example, I may…
or hearing a voice. close when I'm distressed. …call "Papa!" from across the room
…grasp my caregiver's sweater while I'm playing with blocks to
when she holds me. For example, I may… make sure that my Papa is paying
…lift my arms to be picked up by …cry out or follow my mom when attention to me.
my dad. she leaves the room. …feel comfortable playing on the
other side of the yard from the
…be more likely to smile when …seek comfort from my favorite
person I'm attached to, but cry to
approached by a caregiver than blanket or toy, especially when the be picked up when I fall down
by an unfamiliar adult. person I'm attached to is absent. and hurt myself.
…babble back and forth with …turn excitedly and raise my arms …say, "I go to school, mama goes
a caregiver. toward the person I'm attached to to work," after my mom drops
…seek comfort from an attachment at pick-up time. me off in the morning.
figure when I am crying. …display anxiety when an unfamiliar …gesture for one more hug as my
…cry out or follow after my mom adult gets too close to me. daddy is leaving for work.
when she leaves the room. …look for cues from the person I'm …say, "You do one and I do one"
attached to when I'm unsure if when asked to put books away
something is safe. before separating from my mom
…play confidently when the person in the morning, in order to get
I'm attached to is in the room, her to stay a bit longer.
but crawl or run to her when …bring my grandma's favorite book
to her to see if she will read it to
I'm frightened.
me one more time after grandma
says, "We're all done reading.”
“Now it's time for nap."