Dispatches from the Field: The Power of What We Already Do Well

“The world simple was likely inspired by something that Mr. Rogers used to say: ‘deep and simple is far more essential than shallow and complex.’ The premise is that we can talk about policy, we can talk about programs, but ultimately the rubber meets the road when a caregiver or a helper—whether it’s a teacher or a family member—comes face-to-face with a child. Something happens in that little space of connection.” – Dr. Junlei Li

Interview with Dr. Junlei Li

Tell us about your background and how it inspired the work you do?

Dr. Li: I was trained as a research psychologist in child development and my early interest was in how children learn in classrooms, particularly science. It’s actually pretty far from what I do today. I was led to the work I do today almost by accident. As an adoptive parent, I encountered the orphanage environment in China, the country of my birth. And I was driven by the question of how do you improve a place like an orphanage?  The orphanage exists because everything else has gone wrong. So how do you improve a place like an orphanage and how do you support children’s development within that context? Those questions eventually led to all of my work that’s tied to appreciating human beings and the human connections people have.

In your field work, you discovered that the quality of care and services offered in early child development settings, like classrooms and childcare centers, fundamentally depends on human relationships. And while people might assume quality is tied to a setting’s material resources, that actually isn’t as critical a factor. Can you elaborate on this? What did you see in the field that led you to understand the primacy of human relationships in positive child development?

Dr. Li: What I saw in the field was how incredible many of these caregivers are in places like orphanages or in childcare deserts where they are the only operating family childcare provider for blocks around. For me, it really started on a personal level of just having a tremendous sense of respect for people who care for children under the most difficult circumstances. And then it was driven by a sense of unfairness. In research, as well as in state systems, we often equate quality with resources, whether they’re financial, physical, or professional resources, such as the credentials you can mount on the wall. But whether in China or in the United States we have had a terrible and inequitable work system. Often, caregivers who work in the most difficult contexts have the least access to credentials, to material resources, and so on. Not only do they have to manage with limited access, but because of it, they also tend to be regarded as “low quality,” which is just terribly unfair. And yet, when I looked at the research, it seems that the kinds of things we traditionally associate with direct indicators of quality, such as materials or credentials, turned out to be indirect indicators of quality. I’m not saying that we don’t need space or furnishings or credentials. All those things are important, but they’re indirect in the sense that they matter if, and only if, they help support the quality of the human interactions that are happening.

You are well known for your Simple Interactions approach to foster positive child development. What is this approach and how it should be used?

Dr. Li: I’d like to start with the word “simple” for a second. By that we mean ordinary or everyday as opposed to simplistic. The word was likely inspired by something Mister Rogers used to say: “deep and simple is far more essential than shallow and complex.” The premise is that we can talk about policy, we can talk about programs, but ultimately the rubber meets the road when a caregiver or a helper—whether it’s a teacher or a family member—comes face-to-face with a child. Something happens in that little space of connection. That little space exists day-in and day-out, during diaper changes, through teaching, through walking around the neighborhood or spending time at the playground.

Early in the development of Simple Interactions we were just trying to capture what that moment looks like in a way that was culturally inclusive and universal. These two things – inclusive and universal – sometimes seem like they could be contradictory, but we wanted to design something that could provide a common language or a lens that helps us see better—but what we see from that lens is going to acknowledge what is unique in each setting. It’s a little bit like putting on glasses. The glasses don’t dictate what you see, they just help you to see a little clearer, so that you can see the full vibrancy of color in front of you. And that’s what we were hoping to develop: something that allows people to see the full beauty and richness of what these ordinary, everyday interactions are really about.

When we first developed this work, rightfully so, we worked with caregivers who cared for orphans. Many of these caregivers had educational levels that were somewhere between middle school to high school, so we weren’t going to cite research or Western attachment theories. Instead, we wanted to offer something simple that people could put into their own words. Our tool ended up being a single piece of paper, one side only, printed with 12 pictures. People could adapt it to their own language and talk about what’s inside their interactions with children. We recognized over time that this approach was simple but never simplistic. When we work with people who work in hospitals, or are graduate students here at Harvard, there is a lot to learn for all of them even within this simple tool. I guess you could say that was the goal: to develop something that caregivers in a rural community with limited access to education can use to have sophisticated conversations about what they do with children, and also for graduate students at Harvard to have sophisticated conversations about what it means to be a teacher, and what it means to be a leader in the field.

How long did it take to develop the Simple Interactions tool, and did it go through several iterations?

Dr. Li: I would say it took about two to three years within the orphanage environment for something to emerge. We never went there with the goal of developing a tool, but we realized that in order to support the learning and development of the caregivers, we needed a tool that was a little unconventional, but culturally inclusive. Over time it has evolved, not just because we read more research, but because we encountered more settings and more people who serve children and understanding what they do provided greater clarity to our work.

I’ll give one very simple example. Within our 12 diagrams, there used to be a diagram of two little stick figure faces smiling at each other, and we called it “connections.” Coming from where we were at the time, we thought that a human connection came from people being really happy with each other. And then we worked in lots of settings, including hospitals and foster care group homes, and it was clear that people are not happy all the time. A lot of times people are sad or angry or serious or neutral. It made us question whether we were saying that when people are sad or angry, they’re not connected anymore. You can easily imagine a scenario where an adult is trying to connect with a child who’s sad and angry and neither of them look particularly happy. But you see a sense of connection that comes out of their interaction nevertheless.

When it comes to connection, the vast majority of classroom evaluation tools seem to specify happiness — this surface happiness factor. But for our tool, we knew we needed to broaden how we defined it. So today the “connections” diagram has the original two happy faces, and right under it, two faces that look at each other seriously without the big smiles. And this is more rooted in real, everyday experiences.

You’ve identified four key dimensions that underlie healthy interactions: Connection, Reciprocity, Inclusion, and Opportunity to Grow. Do you think some of these dimensions tend to get overlooked by caregivers and others interacting with children?

Dr. Li: I think what’s most overlooked is the interdependencies and interconnections between these dimensions. We live in an evaluative system, so at every level we have a checklist-like approach. These dimensions easily can become a checklist, as well as in: Did you include the child? Check. Are you reciprocal with the child? Check. But the problem with a checklist approach is that it treats these dimensions as if they’re separate things as opposed to being connected. You know when we talk about how a teacher connects with a child it’s pretty common to say things like, “this teacher will always know your name,” or “that’s the teacher who always gives you a hug in the hallway.” That’s beautiful, but that’s not the only way that a teacher connects. Sometimes even by identifying those teachers that always give you a high five on the playground, it’s as if the connection must happen outside the classroom. But for example, when a teacher hands back a test to a student who got a D, and the teacher leans over to the student and says: “I want you to come and see me about this. You didn’t do very well and I’m surprised. But I want to show you the places where you did pretty well and showed progress. So I need you to see me after class,” – that to me is as much about “connection” as it is about “opportunity to learn.” Connection isn’t something that’s disembodied from everything else. Instead, in between any of these dimensions, any two of them, any three of them, any four of them, you’ll see this kind of interdependency.

If you think about a young baby learning to walk, what motivates that young baby? It’s someone with outstretched arms to catch them, someone they love, someone that loves them. So walking is an opportunity to learn, but what motivates us to learn when we’re struggling is someone’s outstretched arm that promises acceptance and safety. If you dial this up for a couple of years into school when a child is learning to read but is struggling, what keeps that child going is that metaphorical outstretched arm of a teacher who’s ready to receive the child no matter the child’s reading level—that incorporates all the dimensions: the reciprocity, inclusion, connection, and opportunity to grow. That will ultimately be potent for a person’s development.

You have talked about how important it is for parents to have “communities of support.” How would you say pediatricians and other healthcare providers fit into that equation and how can parents build trust with their child’s healthcare providers?

Dr. Li: Pediatricians are respected and trusted by families across all kinds of communities and because of that, pediatricians’ words and gestures mean a lot to parents. We may have this impression that pediatricians’ greatest value comes from their ability to prescribe medicine and provide suggestions about what parents ought to do, but any affirmation and reassurance coming from the pediatrician can be just as important as a prescription.

Families often go to pediatricians for affirmation and reassurance that their child is doing all right and that they are doing all right as parents. For so many parents, if anything goes “wrong” with their child, whether it’s a developmental delay or a health condition, they immediately blame themselves, thinking they did something to cause it or could have done something to prevent it. And so having someone you trust, reassuring you that your child is doing okay, and that this is because you are doing fine as a parent is incredibly powerful.

I don’t mean to imply that pediatricians should skirt the truth. There are times when a child is really struggling, and it’s helpful for a pediatrician to focus on the things parents can do and also reassure them that they are not alone. Not only that there is a team of health care providers who can support them, but also that they’re not the only parents struggling. Pediatricians see thousands of families and have credibility when they say you’re not the only parent facing this kind of challenge.

To quote my colleague Dr. Dana Winters from the Fred Rogers Center, I think many health care professionals include affirming “descriptions” of what’s going well in a family along with their technical skills to dispense “prescriptions.”

To close, what kind of advice might you give to people who have been parenting during the pandemic, and how should we think about the transition to school for our kids in the Fall?

Dr. Li:  I think the message for parents is that they have done much more for their children than they would believe they have. This is obviously a difficult time and parents who struggle with health issues and financial distress may find themselves just completely scattered. They feel like they’re not as present with or available to their children. They may feel helpless. They don’t know how to support their children when their children are frustrated with Zoom schooling. Many parents would describe this past year as a constant reminder that they were not being good enough parents. But my hope is that parents are reminded that they’ve done a lot for their children. What we know to be true from the science and everyday experiences is that when the world around us is crumbling, what we need is one or two or three people around us that we can turn to, that we know care about us. I think children very much understand that adults are doing their best, even if their best is a struggle.

As far as going forward, I hope that we would do our utmost to make sure children can take their time to grow and reconnect with school and with their peers. There’s this tremendous sense of urgency regarding what our kids lost, and we want to hurry up and jam in all of the missed learning content in a short amount of time. But I think this approach would make children feel less connected and will disempower teachers from taking the time to get to know the children, to help children heal, and help children readjust to the classroom. As it has happened in educational policy in the past, that sense of urgency, that sense that we can’t afford to take time and slow down will be particularly pronounced for the children from low-income communities. Children from well-off communities will be afforded the privilege of time, but the children who are actually struggling more and who need the most time to recover, to heal, to reconnect — and to learn and grow together — will likely be deprived of that privilege.

I also hope that one thing parents and teachers can focus on, in addition to what’s been lost, is what children have gained. So many children have learned all sorts of things. Maybe they’re not the kind of things we typically measure on a test, but they’ve learned a lot from being at home. They’ve learned about taking care of each other, taking care of the elderly, and how to cope as a family. And then, of course, last year wasn’t just the pandemic. There was the social justice movement as well. From elementary school all the way through high school, children have all kinds of ideas about what’s fair and what’s just, and we can connect through that. Part of that process starts by taking the time to listen to children and think about what they need from us, even if what they need from us is just time to grow.