Hesperian Health Guides

Communicating with children as they grow

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HealthWiki > Helping Children Live with HIV > Chapter 4: Communicating with children > Communicating with children as they grow

A child from birth to 1 year old

a man talking to a baby
Here comes the giraffe!
She loves this game.

Babies communicate as soon as they are born. A baby cries, moves his body, smiles, gurgles and makes other sounds. These tell you he is hungry, sleepy, wet, uncomfortable, or not feeling well, or that he is happy or curious. As you care for a baby, you learn how his sounds and movements tell you about his needs.

When you think you know what a baby is telling you, and respond by giving her what she needs, you are communicating. If the first thing you try does not help, try something else. All this teaches a baby that her communication can make something happen, and she will want to keep exploring how to do it.

Communication is especially important for babies who were born early or small, or those who are malnourished. Both extra attention and feeding will help them grow.

Activities to help babies

  • Sing or talk to a baby while you work or care for her. Respond to a baby’s noises when she babbles at you. Babies like to copy sounds they hear.
a man talking to a baby
ga… ga…
ga…goo… ga…
  • Play with a baby and talk about what you are doing. Tell babies the names of things as you play.
a woman talking to a baby
Here’s your nose, Eka. Can you find mine?
a woman talking to a baby
Yes! You’ve got my nose!
  • Offer a baby the chance to breastfeed more often. This increases both nourishment and communication with the baby.
  • Ask others you trust to hold, play with, and talk to your baby.
a woman handing a baby to another woman
Can you and David play with Asha while I go to the store?
  • Clap to music, wave, and play hand games with babies.
a woman and a man talking to a baby
Wave bye bye to Papa.

Problems responding to a baby’s needs

a woman talking to a baby
Let's walk for a while.

Sometimes a baby may need something you cannot give him. He may be sick, and you cannot make his pain go away, or he may miss someone who has gone and you cannot bring the person back. Holding a baby, walking with him, and speaking or singing softly to him usually helps soothe him.

Babies around 2 to 4 months old sometimes cry and cry, and nothing seems to help. As another month or more passes, they cry less. No one knows why.

Try to stay calm. Walking, rocking, or sitting with a baby will comfort him, even as he cries. Sometimes when this kind of crying happens, mothers may be afraid they do not have enough milk and this is why the baby is crying. This is almost never true. If a baby is growing and gaining weight, and wetting 6 or more nappies each day, he is getting enough milk.

If you are ill yourself, you may feel worried, low, tired, or uncomfortable. This can make it difficult to have the energy and patience you need to respond over and over to a baby. Try to find support from others so you can rest each day, or do something that gives you pleasure. It will make you a better careg

a man talking to a woman
Let me take the baby. Go have a cup of tea with Louise.
Try to leave your baby with someone who will care for her kindly.

Sores in the mouth, common with HIV infection, can make eating, talking, and communication more difficult for both children and caregivers. See Sore throat, mouth sores, and thrush for how to treat and soothe mouth sores.

A child from 1 to 3 years old

Children this age do not easily understand and trust unfamiliar people. They do best and communicate more and better if they and their caregivers know each other well. By talking with and listening to their close caregivers and others, children age 1 to 3 learn to understand and begin to use at least 500 words.

a woman thinking while a child holds her leg.
Why is Anna so afraid to let go of me? Maybe she worries I will leave her like her Papa did when he died.

But even as they talk more, also watch how they look and act. This is still the main way they show how they feel and what they need.

Children who lose loved ones show grief in many ways. See Chapter 6: Helping children through death and grief.

a child holding a toy out to a baby

Age 1 or so is a good time to check if your child can hear. Does he respond to his name or a noise you make when he cannot see you? For more about finding out how much a child can hear, and what to do if she cannot, see Helping Children Who Are Deaf, from Hesperian.

Young children understand a lot of what is going on around them, even if they do not understand all the words people say.

a man hitting a woman while 2 children sit nearby thinking
Don’t you talk back to me!
Mama only asked a question. I’m scared!

Activities to help your child

a woman speaking to a small child
Now give me your other hand.
It helps a child understand when you talk about what you are doing as you care for him.
  • Talk about what you do or what you see as you go places. Encourage others to do so as well.
  • Tell children stories and sing to them and with them.
  • Encourage your child in her play and exploration.
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Play games that have... some back and forth... between you.
  • Ask simple questions and listen to your child’s answers. Answering your child’s questions helps her learn.
a woman and two children talking
Keesha wants to talk more. You can help her use more words. Don’t worry about correcting her. She will soon speak well.
What’s this Keesha? Can you say spoon?
Yes, spoon!
Encourage older children to talk and play with younger ones.

Problems communicating with your child

a woman speaking to a woman with many children
The families on Ogala Road are starting a shared childcare group. Maybe you can join them?

Children need a lot of attention. They are always asking questions and want to do things over and over again as they learn new skills. If you are ill yourself, or have to care for many children, you will be better able to manage if you can get help. Giving young children the attention they need can exhaust even a healthy, energetic caregiver.

A family member or friend may be able to watch the children sometimes. Or someone from an HIV support organization may be able to help you with problems such as not having enough food, or finding childcare. If you join a mothers group, other mothers may be able to help you better understand your child or find some household help. Any of these can keep you from overburdening older children with too much care of their younger siblings. When family responsibilities keep the older children from going to school, it is particularly harmful. See Working together to promote child development for information about community preschools.

Sometimes you may not know what your child is trying to say, either with his words or actions. Try different things to help the child. What is most important is to keep listening, watching, and trying to respond with love and patience.

a woman thinking and speaking to a small child
What do you want, Kofi?
What is wrong with him? He just ate and slept.
a woman speaking to a small child
Let’s go get some water and see who we can visit with.

A child from 3 to 5 years old

Children this age are learning to understand and communicate more and more. Most children learn and use about 2000 words by age 5 — and they prove it by asking a lot of questions! A child learns best when her family and others include her in activities of daily life, listen to her with interest, answer her questions, and talk with her freely. Keep hugging and holding children of this age to communicate love and acceptance without words.

Activities to help your child

  • Draw with your child, and ask him to tell you about his picture.
a man speaking to a small child
Who is this?
It's me.
a woman speaking to a small child
Brother fox!
There were 3 goats walking down the road… Who did the goats meet?
  • Ask children riddles and questions, or visit friends who like to do that. Let children tell parts of stories they know well.
three children playing and talking
Can I be next?
  • Let children play together. Teach them how to share and take turns, and how to communicate when they have conflicts.
  • Take children out with you and introduce them to others. Let them listen and talk. Continue to answer their questions and help them learn.
a man speaking to a small child
Hello, Alicia. Where are you going?
To the store.

Use good communication yourself. When adults talk about their feelings and show how to listen well, it helps children learn how to do these things.

a woman and child talking
Isaiah, I notice you have been quiet lately and you don’t go out with your friends when they come for you. Please help me with these potatoes and tell me what is bothering you.
I am okay, Mama.
a woman and two children talking
Isaiah, I know you. Something is not right.
Well… I am feeling a little sad…
Go on, honey, I am listening.
Isaiah is sad.

Problems communicating with your child

Children ages 3 to 5 become more aware of problems in the family. They often worry, and sometimes even fear they are responsible for a problem.

a woman and child talking
Where is Uncle?
Are you worried, Willy? He is sick. I will see how he is tomorrow, and tell him you miss him and hope to see him soon.
Reassure a child in a hopeful but honest way.

These years are sometimes called a time of “magical thinking” because children often believe they made something happen with their thoughts or unrelated actions. If they feel guilty or worried, we need to reassure them they did not cause bad things. See Helping children after a caregiver dies for more about this.

Worried or sad children may become very quiet or withdrawn. Gently talk with a child about what you think may be on his mind. If needed, help him name how he feels. Show you accept the child’s feelings,and let the child answer in his own way. Do not hurry the child if you ask a question.

Even if you cannot change the reasons a child is upset, you may be able to help him let his feelings out. This can help him feel better, especially if you show him you understand and accept his feelings. Boys, especially, need support to express feelings of sadness, loss, and fear.

a woman and child talking
What if the mama goes away?
Now the children fight because there is no mama to stop them.

If a child cannot talk directly about what he is feeling, he may be able to express it by drawing or play-acting. Because pretending can help children communicate feelings and ideas that are too difficult for them to communicate otherwise, “play” can sometimes be very serious.

Use puppets to learn about feelings

Puppets can help young children find words to describe and understand feelings. To make paper puppets, you need something to draw with, paper (or cloth scraps), scissors, sticks, and glue (or needle and thread). Sit with your child and ask her to draw the face of a person who is sad, a person who is happy, a person who is angry, and a person who is afraid. After the drawings are done, talk about them with the child. How do you know a person is happy? How does a sad person act? What does an angry person do? When do we have these feelings? Cut out each “person” and glue it to a stick. Then see if your child wants to make up a story using her new puppets.

a child talking to her doll
And then she ate the magic pill and she wasn’t sick any more.
a woman talking to a child
Remember your magic pill? This is a magic pill too.
The 2 lion cubs

Papa and William were walking to the store. William had been fighting with his brother. He would not talk and just kicked rocks on the road. They walked in silence for some time and then Papa began to tell a story.

a man talking to a child
Once in the savannah lived a lion pride…
In this pride there were many cubs including 2 brothers, Abas and Abdulla, who were very close in age and had the same mother. The 2 brothers played together and laughed and splashed in the river and rolled in the tall grass. And sometimes they would fight. When they fought they scratched each other with their claws, and how they would roar!

One day they had a big fight and scratched and roared until their mother came and told them to stop. Abas, the younger, ran and hid behind a rock. After a while, the mother lion came and sat with him.
The mother lion listened as Abas talked about his brother. Finally, she asked “How do you feel when your brother says these things?” “MAD! Really mad!” His mother then said, “Well, Abas, that would make me mad too. Have you told Abdulla how mad it makes you? He is your brother and he loves you. Sometimes what is a funny joke to a big brother is not very funny to a little brother. Would you like me to help you speak to Abdulla?”
How do you think the story should end? Do you feel like Abas?
What happened, Abas? I see you are so sad and angry!
I hate Abdulla! I hate Abdulla! He makes fun of me! He says my tail is too short!
Papa and William talked for a while. William told Papa about things that make him mad. And he told Papa about some things he does to make his brother mad too. Soon William was done talking, was not so angry any more, and ran ahead to play.

A child from 5 to 8 years old

Children ages 5 to 8 are more able to think, talk, and remember things. They want to know more about everything that happens around them, and want people they know and trust to talk with them. They can do more for themselves, but still need love and support from a main caregiver.

Many children this age who are affected by HIV want to know more about illness in the family, taking medicines, and why other people will not include them in activities. They may be upset about what happened to them or their family, and feel angry, sad, or afraid. Talking with them about why they are upset can help. For ways to talk to children this age about HIV, see A little germ.

Activities to help your child

a man talking to a child
How was school?
I won a race!
  • Spend time together, and show interest in what the child says and does. Listen more, and do not finish their sentences for them. Give children time to explain themselves.
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  • Show your child how to make or do things, and give him opportunities to help you and others. Praise his efforts to help.
  • Help your child find ways to let out her feelings. Drawing, music, games, and other activities can all help.
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  • Work together with children and others to build a playground, or plant and tend a vegetable garden.
  • Encourage your child to go to school. Teachers often know your child well, and may help you both understand how to get through difficult times.
  • Children this age are interested in right and wrong. They watch you and older brothers and sisters behave to learn what is right and wrong. You can also teach them with traditional stories, songs, and games.

Problems communicating with your child

a woman talking to a child
You must learn to control your temper.

As children get older we expect more from them — we want them to do more and behave well. But children this age are still learning. They make many mistakes, which are part of learning. And children who have suffered losses may struggle with feelings of anger and distrust. It takes patience and understanding to help these children, especially if they are defiant or fight with others. Try to avoid speaking harshly or being cruel to children. See Chapter 14 for more about why harsh treatment is not good for children. The rest of this chapter suggest some ways to handle difficult child behaviors.

Sometimes caregivers worry about how to respond to a child who is very sad. We often say, “Don’t cry, everything will be fine” to a crying child. But children need to know their feelings are normal and understandable. This is especially true for boys, who often learn that showing sadness or fear is shameful for boys, wrongly believing it means a boy is weak. In fact, boys who can express all their feelings are strong.

a woman talking to a child
I’m so sorry you had to go through that. It would make me upset too

Children are comforted simply when an adult stays with them while they cry, perhaps rubbing the child’s back gently. Try to accept a child’s feelings and reactions, rather than making fun of them or urging them away. It is fine to be sad along with your child. When a child sees an adult coping with their own painful feelings, this can help the child.

If you are ill, or struggling with some of the same problems and feelings your child has, you may need support in order to talk freely with your child about his feelings. If your child’s painful feelings or worries bring up too much of your own sadness, anger, guilt, or worries, try to talk to a friend or counselor about this, or see if you can find a support group.

This page was updated:27 Nov 2019