It Takes a Village

by Hillary Rodham Clinton

  One of my pet theories is that learning to tie shoelaces is a good way of developing hand-to-eye coordination in small children. Every adult around Chelsea spent time watching her struggle with her shoes. Her grandmother Virginia thought my theory led to wasting a lot of time that could have been spent playing, and she bought Chelsea a pair of shoes with Velcro fasteners; but I refused to let Chelsea wear them until she mastered the laces. It may sound silly now, but I loved the look of accomplishment on her face when she showed us all what she could do for herself.

  To encourage these earliest discoveries is to help children develop not only specific skills but, just as important, the personality traits that are essential to later learning: confidence, motivation, effort, responsibility, initiative, perseverance, caring, teamwork, common sense, and problem solving. These “megaskills,” as Dorothy Rich, founder of the Home and School Institute, calls them, are also the foundation of self-respect and the moral, ethical, and spiritual codes that guide us through life.

  Children should be encouraged to learn in all sorts of ways, not just scholastic ones. They have a natural sense of curiosity and a love of discovery that needs to be nurtured to sustain itself. Applaud and encourage learning for learning’s sake, whether it’s cloud-watching or understanding what keeps a kite in the sky or mixing paints to make new colors. Helping kids to identify and explore their passions will prepare them to get the most out of not only school but life.

  This is especially important for teenagers. Developing mutual interests with older children is an important way of keeping lines of communication open as well as establishing an ongoing influence on their intellectual and moral growth. Too often parents fail to understand that while teenagers need some space, they also need to know that adults are available and interested in the things that are important to them.

  Young kids love repetition and the comfort of recurring patterns. I can’t count the number of times that I read Goodnight Moon to Chelsea or watched The Sound of Music with her, in a nearly catatonic state. Whenever Julie Andrews got ready to launch into “Doe, a deer, a female deer,” Chelsea’s eyes would light up and she would say, “Here it comes, Mommy, my favorite song!”

  Knowing what to expect next gives children a sense of security. Familiar stories, music, toys, and routines are the everyday landmarks that make them feel they belong. And repetition is one of the most important tools they use to learn.

  Still, for many parents the repetition can be a little trying at times. I found that it was better to acknowledge the tedium than to feel guilty about it. I tried to bear in mind my own mother’s admonition that what might seem trivial and repetitious to me could be the highlight of a child’s day.

  Routine—structured, ritualized time—is as essential to kids as unstructured play time. Dr. Brazelton describes a simple routine that works wonders. He recommends that when parents get home from work, they take some time to focus on their children right away. That may sound like a tall order if you feel the way I do at the end of a workday. But if you walked in the door and discovered you had unexpected adult company, you would probably pull up a chair and make conversation. And if you needed fifteen minutes at work to finish an important task, chances are you would make time for that too. Why should we consider spending time with adults and on work (even when they bore or annoy us) more crucial than spending time with our own children?

  Family meals are a time-honored and important ritual of daily life, one that is, sadly, disappearing from the American landscape, a casualty of television, fast food, microwaves, and overtime. But it is precisely because our lives are so hectic that Bill, Chelsea, and I try to sit down to at least one meal a day together, usually dinner. After grace, which we take turns saying, there is no better time to catch up on what we have been doing all day, what we are excited about, and what troubles us. This evening, for instance, Bill talked about the budget debate in Congress and Chelsea talked about her history paper. Together, we talked about plans for Thanksgiving.

  We’re lucky that we “live above the store,” the way a lot of families used to. On the other hand, we have had to give up the easy mobility and daily activities we used to take for granted. When Chelsea was small, I took her to ballet class every Saturday. On the way home, I took her to lunch or on errands, which gave us a chance to talk and be together. Now we have to work harder to find that kind of informal time. We make a point of taking breaks from our respective homework in the evening for a chat or a quick game of three-handed pinochle.

  I admire the way Mormons set aside one night a week for family activities. When Chelsea was small, Bill and I adopted this idea. We took turns deciding what we would do. We went miniature golfing (guess who picked that?), rented movies, took long walks, played in parks, and did other simple activities.

  One memorable night, Chelsea wanted us to go buy a coconut. She had never tasted one, but they were featured frequently in the Curious George stories she loved. We walked to our neighborhood store, brought the coconut home, and tried to open it, even pounding on it with a hammer, to no avail. Finally we went out to the parking lot of the governor’s mansion, where we took turns throwing it on the ground until it cracked. The guards could not figure out what we were up to, and we laughed for hours afterward.

  MOST CHILDREN have bedtime rituals, and Chelsea was no exception. From the time she was a baby, Bill and I took turns reading to her and praying with her. We promised ourselves that we would not skip this routine, no matter how tired we were. There were nights when one of us had to wake the other for “your turn.”

  But I don’t think we fully appreciated the importance of this ritual to Chelsea until she was in first grade. Bill and I, concerned that she seemed reluctant to read to us at home, mentioned it during a conference with her teacher, a sensitive and insightful woman. She, too, had noticed that Chelsea was not enthusiastic about reading. Something seemed to be holding her back. The teacher urged us not to pressure Chelsea but to wait for her to decide on her own that she was ready to read.

  Worried as we were, we took her advice. Eventually we realized that Chelsea herself was worried. She feared that we would stop reading aloud to her if she learned to read all by herself. When we assured her we would keep reading to her as long as she wanted us to, she relaxed and started to enjoy her own increasing skill.

  Reading together is a wonderful pastime for parents and children, at any time. Just think: If you spend only twenty minutes reading to your child, that is more uninterrupted time than most fathers spend talking with their children each day. (Getting older siblings to read to younger children gives them valuable practice too.)

  The village can encourage this all-important activity. The American Library Association is currently administering a three-year national demonstration project whose goal is to help low-income parents and those with poor literacy skills to raise children who are “born to read.” The program works with adults to improve their own reading skills and emphasizes the importance of reading to children. The Association of Booksellers for Children is promoting a program called The Most Important Twenty Minutes of Your Day…Read with a Child. One aspect of the project has been getting pediatricians to “prescribe” reading aloud for parents, and for children as well when they reach reading age.

  In addition to being read to, children love to be told stories. Storytelling has the advantage of convenience. You can do it in the car, in the doctor’s office, in the bathtub, waiting in line. The stories don’t have to be elaborate or even very good to engross a child. Bill made up episodes for Chelsea featuring characters from her life who performed heroic feats. A sailboat she saw when we visited the beach became “George the Sailboat,” who had adventures all over the world. I told her stories whose heroines were brave little girls who rescued unicorns or slew dragons. Bill and I often paused to ask her what she thought happened next, drawing her into the storytelling role.

  Children learn how to treat others from how they are treated themselves. If
we want them to grow into attentive, affectionate, generous, and respectful adults, our treatment of them must embody those qualities. And if we also want our children to become inquisitive, independent thinkers who will find creative and productive outlets for their unique characters and talents, we would be wise to demonstrate those qualities in our earliest dealings with them.

  Parents discover that this modeling of behavior is a two-way street. How many times have you watched a child playing and thought: If only I could bottle that energy? Children throw themselves with gusto into whatever they do. Not only are their bodies flexible and unwearied, but in some ways their lives are better integrated than ours. Because they are more attuned to the present than the future, the process than the product, they are not afraid to fail or to make fools of themselves, until we teach them otherwise. Spending time with children elevates our perceptions and energizes us.

  As we get older, many of us abandon the activities we enjoy. The teacher who secretly writes fiction gives up after several magazines reject her work. The weekend artist puts away his watercolors. The former competitive swimmer can’t tolerate the natural deterioration of her body and stops doing laps. Somehow we convince ourselves that to spend time doing these things, which don’t pay the electric bill or look impressive on our résumés, is childish.

  It is. Children teach us to see things in their most elemental forms. They teach us about uncluttered joy. Natural clowns, they remind us that life is full of comic moments. Whether they are making sand castles or dreaming up new kinds of people and animals, they are always looking at novel ways of putting things together. In all these ways, they remind us what is really important, and in so doing, they renew our spirit.

  Not long ago, on a trip to Arkansas, I ran into a man whom Bill and I had known some years earlier. He had never graduated from high school but was a hard worker who made a living cooking, catering, painting, and doing odd jobs. He had recently become a father, and I asked him if he was enjoying talking to his baby daughter. He reminded me that he was quiet and shy by nature, not one to converse much with anybody, let alone an infant. “I’d feel like a fool talking to someone who wouldn’t understand a word I was saying,” he said. “Anyway, I wouldn’t know what to talk about.”

  I suggested that he and his wife tell their daughter about their experiences during the day, or what they were watching on television, or even the trees, flowers, cars, and buses they could see as they walked down the street.

  He looked a little uncertain, but he promised to try.

  I could understand his uncertainty. Much as he loves her, his baby will not consciously remember the details of his earliest attentions to her. Even older children remember selectively; the details we treasure are not always those that made the greatest impression on them. But the time we spend with children—and what we do with it—is more than an indulgence for parents. It is an investment in children’s future—an investment we can’t make up later. As psychiatrist and writer Robert Coles has said, “Children who go unheeded are children who are going to turn on the world that neglected them.” But children who get the early attention they need, from the family and the village, will repay our efforts a thousandfold, in the strong bodies, minds, and characters they carry into the future.

  An Ounce of Prevention Is Worth a Pound of Intensive Care

  Health is number one. You can’t have a good offense, a good defense,

  good education, or anything if you don’t have good health.

  SARAH MCCLENDON

  Dr. Betty Lowe, the medical director at Arkansas Children’s Hospital, who has been president of the American Academy of Pediatrics and, most important, one of Chelsea’s doctors, taught me many lessons during the past two decades. Her medical expertise and down-to-earth manner reassured me, and her common sense about preventive health care changed how I thought.

  Years ago, we were both speaking to the Little Rock Junior League about children’s needs. After our speeches, a woman in the audience asked Dr. Lowe what she would do to improve the health of children. Without hesitating, she replied that she would guarantee them clean water and good sanitation; nutritious food, vaccinations, and exercise; and access to a doctor when they needed one.

  Dr. Lowe explained that the vast majority of children she saw in the hospital ended up there because of adults’ failures to take care of them: the town that failed to clean up the sewage ditch behind some houses; the parents who failed to immunize a baby or to feed a toddler properly; the doctors who failed to accept Medicaid or treat the uninsured; the welfare worker who failed to protect a child from abuse or neglect; the landlord who failed to provide the heat promised in winter or to haul away garbage in summer; the teacher who failed to refer the belligerent or depressed teenager for help.

  There’s probably no area of our lives that better illustrates the connection between the village and the individual and between mutual and personal responsibility than health care. Every one of us knows we should take care of our bodies and our children’s bodies if our goal is good health, and many of us try to do that. We also know, though, that we are dependent on others for the health of our environment and for medical care if we or our children become ill or injured. Knowing these things, however, does not always lead either individuals or societies to take action.

  The effort to immunize children against preventable childhood diseases is a good illustration of the challenges before us. The American Academy of Pediatrics recommends that babies be taken for preventive checkups and receive appropriate immunizations when they are one, two, four, six, nine, twelve, and eighteen months old, then again at two, three, and four years. We’ve come a long way toward these goals from where we were a few years ago. Our national rate of immunization is higher than it has ever been, and as a result, we are at or near the lowest incidence ever recorded for every vaccine-preventable disease.

  Some of this improvement may be due to the increased funding for immunizations and the outreach and education campaigns we have embarked on since my husband took office. We know that when funding for immunization decreased in the past, the incidence of serious disease increased. After the federal government’s immunization funding was cut in the 1980s, a measles epidemic between 1989 and 1991 struck 55,000 people and killed 130 of them, many of them children. Medical costs of the epidemic exceeded $150 million, more than was “saved” by the cutbacks.

  Providing funding for the inoculations themselves is key, because the vaccines are expensive and getting more so. In 1983, the private cost for a full series of immunizations was $27. Today the cost is ten times that much for just the shots themselves, and nearly as much again in administrative fees. Although nearly all managed care policies cover immunization costs, about half of conventional health insurance policies do not.

  I will never forget the woman from Vermont whom I met at a health care forum in Boston. She ran a dairy farm with her husband, which meant that she was required by law to immunize her cattle against disease. But she could not afford to get her preschoolers inoculated as well. “The cattle on my dairy farm right now,” she said, “are receiving better health care than my children.”

  Convenience is also a factor. Until recently, private doctors referred patients without adequate cash or insurance to the public health clinic, the only place families could take their children for free inoculations. But that doesn’t mean the families went. Faced with a hodgepodge of providers, clinics’ inconvenient hours and locations, and long waits, many parents delayed having their kids immunized.

  In 1993, as part of a larger initiative to improve immunization rates, Congress adopted the Vaccines for Children program, which provides free vaccines to needy children through private doctors as well as clinics. The initiative also includes state funding to improve outreach and education, lengthen clinic hours, hire additional staff, and expand services. But these advances are already under grave threat from budget cuts.

  We have a lot of ground to cover as it is. In immun
ization rates, we still trail behind a number of other advanced countries and even some less developed ones. And although three out of four of today’s two-year-olds have the proper immunizations (up from about one in four in 1991), that leaves almost 1.4 million toddlers who have not received all the vaccinations they need.

  Most parents are aware that immunizations are required for a child to enter school, but many of them, and even some health care providers, don’t know that 80 percent of the required vaccinations should be given by the age of two. That is why the village needs a town crier—and a town prodder.

  Kiwanis International, the community service organization, has been both, working to promote the needs of children from prenatal development to age five through an international project called Young Children: Priority One. Among other efforts, the project has launched a national public education campaign, which features my husband on billboards and in public service announcements calling for “all their shots, while they’re tots.”

  Two women I greatly admire have campaigned for more than two decades to make sure that children get the vaccinations they need, on time. Rosalynn Carter, a distinguished predecessor of mine who is compassion in action, and Betty Bumpers, the wife of the senior U.S. senator from Arkansas and an energetic advocate for children, have worked with spirit and dedication to persuade Americans to invest the money and energy necessary to ensure that all children receive their immunizations on time. When the measles epidemic began in 1989, they started a nonprofit immunization education program, called Every Child by Two, working with community leaders, health providers, and elected officials at the local, state, and national levels to spread the word about timely immunizations and to establish and expand immunization programs around the country.

  We know that requiring children to show proof of immunization before they enter school guarantees that children get their shots by five or six. States and cities looking for similar ways to ensure compliance for toddlers are linking immunization efforts to social service programs. A program in Maryland requires families on welfare to show proof of immunization in order to receive benefits, a requirement I have long advocated. Recent studies in Chicago, New York, and Dallas show that coordinating immunization services with the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) significantly improves immunization rates.