5Rs to Healthy Brain
Development
Meet
Lily 1. Relationships
2. Responsive
Interactions
3. Respect
4. Routines
5. Repetition
Lily was adopted by the Smith family after being born with substances at birth and
being in one other foster care home until she came to their home at 3 months old.
Lily is unsure of new people and stays on her mother’s lap. She has a four-year old
brother.
Reason for referral: Lily is 2 years old and has about 10 words and occasionally walks
on her toes. . Her mother, Susan, is really worried because she does not adjust well to
new environments or people.
Lily began child care this week and cried all day. The child care told Susan they will
give it a week and see if Lily adjusts. Susan just started a new job a few months ago
and can’t keep missing work. Lily’s father, Mark, just deployed three weeks ago for six
months. During the assessment, Lily smiled occasionally but would cry if Susan tried
to get Lily to sit away from her.
You are the service provider and just began services. Lily cries less at child care and
participates in some activities. However, the child care provider is still concerned. The
child care provider will not allow a provider to come into the home because they have
disagreed in the past on what to do.
Think about the 5R’s of Healthy Brain Development. How can we help support Lily
and her family?
5R’s to Healthy Brain Development
Child Goal Lily will use 2-3 word phrases to share her feelings (sad, tired, happy), ask for what she
or Outcome: wants (doll, snack, mom, play), and/or talk about things in her home, child care, and
community.
5Rs Reasons of Impact Strategies to Support Child
1.
Relationships Father just deployed, 4- Support secure attachment by focusing on Lily feeling safe to explore
year-old brother may be (support independence in baby steps).
impacted by deployment
new child care provider, Support father’s relationship while deployed (ask mother about what
new friends, she does and build on it; book, videos, deployment doll, talking about
her dad).
History of one
attachment at birth for Find out more how deployment is impacting Lily’s brother. Any
three months, then behaviors can impact Lily. Both should be supported.
change.
New child care provider & friends – find out about relationship.
Support Susan in making relationship stronger (social story).
2. Responsive
Interactions Pressure of child care Lily feels more secure near her mother. Support transition to child
only giving a week may care (book, Susan’s shirt or scarf).
impact stress, in turn,
responsiveness Check in with Susan on her stress level, balancing work and home,
and two small children without her husband.
Provide calming techniques to Susan. Parent education on responsive
interactions, serve-and return, and learning opportunities.
3. Respect Lily may feel a lack of Increase opportunities for choices and preferences.
control over her
environment. Discuss empathy with Susan and how she can share this information
with new child care provider.
4. Routines New child care,
adjustments are hard, Help maintain consistency in routines to create a sense of safety and
mother has a new job, calming the bottom functioning of the brain.
dad just deployed.
Brainstorm easy and quick routines with Susan. (song before bed,
morning hugs and cuddles, discuss using consistent language).
5. Repetition
Change in routines is Problem solve ways to incorporate with Susan to share with child care
disrupting normal provider (Lily bringing favorite book at home to read for story time or
learning opportunities Susan sharing Lily’s favorite nursery rhyme to sing at school, giving
choices).