Special Sections - Healthy Living, September 2014

HEALTHY LIVING

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SEPTEMBER 2014 volume 10, issue 3

GROWING HEALTHY PROJECT PARTICIPANTS SEE BENEFITS Page 8

on the cover

Local diabetes, gardening project ends for season

Healthy Living Volume 10, Issue 3

■

SEPTEMBER 2014

Published by the PENINSULA DAILY NEWS/ SEQUIM GAZETTE Advertising Department Offices: 305 W. First St., Port Angeles, WA 98362 360-452-2345 ■ peninsuladailynews.com 147 W. Washington St., Sequim, WA 98382 360-683-3311 ■ sequimgazette.com

John C. Brewer, publisher and editor Steve Perry, advertising director Sue Stoneman, advertising operations manager

Patricia Morrison Coate, Sara Farinelli and Brenda Hanrahan, editors

< Diane Stollar, foreground, was an active Growing Healthy participant, and shows off an early harvest of radishes. BrandiAnn Harris, background, was a Growing Healthy volunteer.

Growing Healthy was a program designed to help persons with diabetes, or at risk for diabetes, eat healthier, get more exercise and feel better through gardening. < photo provided by Clallam County Master Gardeners

Articles and submissions

We’re always on the lookout for article ideas to include in our quarterly Healthy Living publication. If you have an idea for a story, please let us know.

Professionals in their field are invited to contribute informative and educational articles or columns for consideration in Healthy Living.

Send articles, columns and photos (jpegs at 200 dpi minimum) to special section editor Brenda Hanrahan at bhanrahan@peninsuladailynews.com.

We cannot guarantee publication due to space and content considerations.

If your submission is accepted, we reserve the right to edit submissions.

Submitted articles are the opinions and beliefs of the contributing writer and in no way represent an endorsement by Healthy Living, the Peninsula Daily News or Sequim Gazette.

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Take a fall hike

Visit the Sol Duc Valley for astounding autumn foliage, jumping salmon, more STORY AND PHOTOS BY BRENDA HANRAHAN, PENINSULA DAILY NEWS

Autumn’s arrival on the North Olympic Peninsula doesn’t signal the end of hiking opportunities.

In fact, autumn is a great time to stretch your legs on trails across the region. Weekday hikers will find nearly empty trails, more open camping spots and cooler, but still pleasant weather.

For those seeking a great fall foliage display, head to the Sol Duc Valley in Olympic National Park.

Sol Duc Hot Springs Road, located 30 miles from Port Angeles off U.S. Highway 101, travels along stands of big-leaf maples whose yellow, red and orange autumn leaves rival aspens in Colorado and the famous East Coast foliage display.

The Salmon Cascades are a great place to witness coho salmon making their way upstream to their spawning grounds. The run normally starts in October.

Amazing hikes to Sol Duc Falls, Mink Lake, the Lover’s Lane loop and more also await.

ABOVE LEFT — Big-leaf maples put on a colorful display along Sol Duc Hot Springs Road in autumn. ABOVE RIGHT — Trees starting to turn near an overlook area along the Sol Duc River.

RIGHT — A man photographs the river just above Sol Duc Falls.

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Maintaining wonder in the midst of chaos Tips from a lifestyle coach about how to beat seasonal blues during the transition to fall

BY KRISTIN HALBERG, A LIFESTYLE COACH IN PORT ANGELES

As we move into the transition period between summer and fall, life has a tendency to get more chaotic.

Children and teachers are back in the classroom, for those of us who garden, harvest season is in full swing and as the days begin to feel shorter again, we feel pressure to get outside as long as we can and finish projects that we’ve procrastinated on or postponed.

It is easy to get overwhelmed.

So what can you do?

Here are three tips to help you stay centered, while enjoying the transition to autumn on the North Olympic Peninsula.

No. 1 — Limit TV coverage of traumatic events There are plenty of studies that show that watching media coverage of traumatic and disastrous events can lead to higher levels of stress.

In a recent study during the aftermath of the Boston Marathon bombings, research suggested it is possible to get Post Traumatic Stress Disorder (PTSD) simply from watching media coverage of disaster. >> MAINTAINING WONDER CONTINUED ON PAGE 5

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Respondents with a prior history of mental health problems and those who had watched six or more hours of daily media coverage of the events surrounding the bombings were most likely to report high acute-stress symptoms.

Turning off the TV does not mean you don’t care.

In fact, you can actually do more good by focusing on positive energy, rather than obsessing, feeling helpless or angry and building stress levels in your body.

No. 2 — Start your day with five to 10 minutes set aside for positive emotion Set aside five to 10 minutes every morning to sit and bask in positive emotion.

When you feel pulled into drama or negativity, simply focus your attention in your heart and breathe, taking just a few minutes to appreciate the good in your life.

I know that for some of you, finding five to 10 minutes, especially in the morning feels impossible.

You might be rolling your eyes, telling me that I don’t know anything about your life.

True.

However, I do know that if you find those few minutes, and make this a practice, you will find that you have more energy to deal with your life; and because you’re not using up that time on drama and chaos, you’ll find that you actually have more time and energy in your day.

No. 3 — Radiate a positive emotion to the chaos happening around you This may seem counter-intuitive, but from the place of inner calm you created with tip No. 2, take a few more minutes and imagine that you are sending that calm, positive energy into the areas of your life that feel most chaotic and stressful.

Imagine that you are the sun, dissipating clouds. In your mind’s eye, imagine your positive energy melting away the chaos, stress, fear, anger or sadness.

Researchers at the Institute of HeartMath and other organizations are studying the effects of human coherence on the planet.

Coherence is a state of alignment in our autonomic nervous system, represented by a sine-wave like heart rhythm created when we focus attention in our hearts and breathe positive emotions.

You can see your heart rhythm in action with a biofeedback device called an emWave2.

This research suggests that one of the best ways to help create peace on the earth is to imagine and radiate peace and joy into your own electromagnetic field and to the people, places, and issues you care about.

Learning to change your emotional response from negative to positive may feel a bit like the ostrich burying its head in the sand to avoid taking action, or an inauthentic reaction in the face of real stress.

However, because stress is created by our perception of events and not by the event itself, mastering this simple technique can be very powerful.

When you see and experience results over time, it

can give you a sense of empowerment and control, and lead to higher levels of resilience.

Additionally, because this state of coherence balances your autonomic nervous system, takes you out of fight-flight or freeze-mode, and gives you access to the higher functioning part of your brain, it might also help you discover new possibilities you didn’t see before.

Try these three tips daily during the next seven to 21 days, and notice if you start to feel a shift in your perspective and your ability to handle chaotic times.

Kristin Halberg is a Port Angeles-based lifestyle coach focused on health, happiness and abundance.

She writes a weekly blog “Amazing Grace: Revealing the Wonder in Ordinary Life” at www.kiccoaching.com.

Private consultations can be scheduled via phone at 425-3432374 or by email at kiccoaching@gmail.com. < Halberg and her dog, Zeke.

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Five dietary habits of healthy children STORY AND PHOTO BY BRANDPOINT

With so much information available about children’ nutrition — what to eat, how to supplement and more — it’s hard to get a firm grasp on what it takes to raise a healthy child.

In the U.S., a significant portion of children are not getting enough essential vitamins and nutrients, including vitamins D, E and A, and omega-3 fatty acids DHA and EPA according to the 2010 National Health and Nutrition Examination Survey.

“It’s quite difficult to get all the essential vitamins and nutrients solely from diet — especially if you have picky eaters in your house,” says Elizabeth Somer, registered dietitian and author of The Essential Guide to Vitamins and Minerals.

“There are tips and tricks parents can follow to establish healthy eating habits for their kids, but it’s also important for parents to consider adding multivitamins to their child’s routine to fill in the gaps.”

Somer focuses on five important tips parents should follow to ensure their kids are getting adequate amounts of the essential vitamins and nutrients they need.

These nutrition tips can build the foundation for healthy habits long after children leave their family’s nest: 1. LOOK TO MYPLATE TO FILL YOUR PLATE — MyPlate is an updated guide to nutrition from the USDA and First Lady Michelle Obama — think of it as the new Food Guide Pyramid. Check out the tips for a well-rounded diet focused on fruits, veggies and whole grains.

2. Decorate your plate — Create a colorful plate of salads with spinach, strawberries and blueberries or other fruits and veggies for meal and snack times.

Children need at least five servings of fruits and vegetables per day.

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3. SPORT A MILK MUSTACHE — Children need two to three glasses of calciumrich milk or yogurt each day. Give them milk fortified with DHA — an omega-3 fatty acid shown to benefit brain development, eye health and even sleep — and you’ll add a punch of nutrition to each glass.

4. EAT YOUR ABCS — Listing essential vitamins is a lot like reciting the alphabet. According to recent research, though, kids are not getting enough of vitamins D, E or A as well as the omega-3 fatty acids DHA and EPA. Dark leafy greens, oily fish like salmon, sweet potatoes, peanut butter, milk and carrots are good examples of foods that can deliver these nutrients.

5. FILL THE GAPS — For both kids and adults, it’s difficult to achieve optimal nutrition through diet alone. It’s especially difficult for picky eaters.

Therefore, an age-appropriate, well-formulated multivitamin and mineral supplement provides extra insurance that your little one is getting all the nutrients he or she needs.

And, if your child is not eating multiple servings of fatty fish (like salmon) per week, consider a quality fish oil supplement for omega-3s DHA and EPA.

PENINSULA DAILY NEWS/SEQUIM GAZETTE

How to boost your pet’s health STORY AND PHOTO BY BRANDPOINT

Taking active, preventive measures to support your health is one of the most important things you can do to ward off serious illness.

You eat right, exercise, brush your teeth and make sure to get plenty of sleep, all to keep your body running at its very best.

But did you know that preventive health is important not only for you but also for the lifelong health of your pets? Instituting preventive health measures for your pets helps keep them in top physical shape and live healthier, happier lives.

Here are three key areas of preventive health for your pet:

Schedule, keep annual checkups You know you should see your doctor once a year for your annual checkup and the same applies for your pet. In fact, an annual checkup may be even more important for them than it is for you.

Dogs and cats age much faster than people so missing one yearly appointment for your pet could be comparable to missing five annual checkups for yourself.

The best way to prevent disease is to schedule regular checkups with your veterinarian.

Bringing your pet for an annual health examination allows your veterinarian to assess any risk factors and spot problems at their earliest stages. This will help your pet live a happier, healthier and longer life.

Make sure they get plenty of exercise Exercise has numerous health benefits not only for your body but for your pet as well.

If you have a family dog, walking him or her twice a day for 15 minutes is generally advised.

The number and length of walks may increase or decrease depending on the breed, health and age of your dog.

Make sure to brush and bathe your dog as well, especially if a recent walk has brought him or her in contact with tall grassy or forested areas or involved wading or swimming.

Cats, of course, do not need to be walked, but that doesn’t mean you can disregard their exercise.

Engage your cat in active play, whether it is chasing a stuffed toy at the end of a stick or batting a ball of catnip around the kitchen. Either way, your cat is being active and that is good for his or her overall health.

Offer a nutritious diet Proper nutrition is a cornerstone of pet health.

Your veterinary healthcare team is your best

resource for selecting the right food to feed your pet and will also provide education and guidance on the how much and when to feed your pet for optimal health.

Preventive care is just as important for your pet as it is for you. The good news is that the same preventive care principles that benefit you also benefit your pets.

Take a preventive approach for your pet with annual checkups, daily exercise and a nutritious diet, and both you and your pet will be feeling even better.

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Local diabetes, gardening program ends for the season STORY BY JEANETTE STEHR-GREEN, WSU CERTIFIED CLALLAM COUNTY MASTER GARDENER PHOTOS BY CLALLAM COUNTY MASTER GARDENERS

What happens when you combine the great outdoors, harvesting and eating the vegetables you grew and new friendships? The Growing Healthy project.

Growing Healthy was a 15-week pilot project developed by volunteers and staff from Volunteers in Medicine of the Olympics (VIMO) Free Clinic and Clallam County Master Gardeners.

Organizers designed the program to help persons with diabetes, or at risk for diabetes, to eat healthier, get more exercise and feel better through gardening.

Growing Healthy was based on research that shows that through growing their own food, children and adults become more invested in what they eat and are more likely to make nutritious food choices.

The program also took advantage of the fact that gardening is an excellent form of low-impact exercise.

VIMO was awarded a grant from the American Medical Association (AMA) Foundation to pilot the project, competing with hundreds of clinics from across the country.

By the time the grant was received, VIMO was already partnering with WSU Clallam County Extension (and Clallam County Master Gardeners), First Step Family Support Center and Port Angeles Community Gardens to start the project and had received contributions from local businesses and residents.

The Growing Healthy program Growing Healthy participants were recruited from VIMO, First Step Family Support Center and other local agencies and organizations including Clallam County Women, Infants, and Children (WIC); the Port Angeles Food Bank; Clallam County Head Start; Peninsula Behavioral Health; and Clallam County Family YMCA. All participants had the opportunity to talk with a nurse educator about diabetes.

Each week, Growing Healthy participants, volunteers and staff gathered at the Fifth Street Community Garden in Port Angeles for a 2-hour gardening or

Growing Healthy participant Scooter Rychlik, left, is instructed by Laurel Moulton, a Clallam County Master Gardener, about how to properly read a vegetable seed packet. Growing Healthy covered vegetable gardening basics including soil preparation, planting, transplanting, watering, fertilizing, weed and pest control and harvesting.

cooking session.

Gardening sessions, led by Clallam County Master Gardeners, covered vegetable gardening basics.

Participants worked in the community garden sideby-side with Master Gardeners and helped plant a spring, summer and fall/winter garden.

Cooking sessions revolved around using garden

produce (harvested by participants themselves) and demonstrated different methods of food preparation including baking, stove-top, stir-fry and grilling.

Growing Healthy ran throughout the summer with 11 gardening sessions and four cooking classes. >> GROWING HEALTHY PROJECT CONTINUED ON PAGE 9

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We’re always on the lookout for article ideas to include in our quarterly Healthy Living publication.

Professionals in their field are invited to contribute informative and educational articles or columns for consideration in Healthy Living.

Send articles, columns and photos to special section editor Brenda Hanrahan at bhanrahan@ peninsuladailynews.com.

We cannot guarantee publication due to space and content considerations. If your submission is accepted, we reserve the right to edit submissions.

Submitted articles are the opinions and beliefs of the contributing writer and in no way represent an endorsement by the Peninsula Daily News or Sequim Gazette.

PENINSULA DAILY NEWS/SEQUIM GAZETTE

<< GROWING HEALTHY PROJECT CONTINUED FROM PAGE 8

A total of 19 community members participated, with ages ranging from 10 to 65 years.

Some participants also brought their younger children to play in the garden. Due to safety concerns, “Growing Healthy Kids,” a concurrent program for the children and grandchildren (2-9 years of age) of Growing Healthy participants, was launched.

With both programs going, the Fifth Street Community Garden was alive with activity: Grown-ups digging, planting, watering and harvesting and children doing art and gardening projects and scavenger hunts in the garden.

The programs became so popular that new enrollment had to be limited.

Making a difference

Organizers hope to repeat the project next year.

To donate to or become involved in the Growing Healthy project, contact Zoe Apisdorf, VIMO development coordinator, at development@vimoclinic. org or phone 360-457-4431.

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Growing Healthy helped teach participants gardening skills and how to prepare the foods they harvested.

By the end of the project, most participants felt that they could start their own garden, given sufficient space and resources.

They also thought they were eating healthier, reporting an increase in the number of fruits and vegetables they ate each day.

The harvest from the garden added food to the tables of participants, with attendees harvesting seasonal vegetables (such as kale, radishes, broccoli, zucchini, and tomatoes) to take home each week.

“My kids were as excited about the program as I was and looked forward to the harvest, saying ‘What did you bring home this week?’ and ‘Make sure you bring home some groceries,’” said Amy Jensen, a Growing Healthy participant.

The garden was therapeutic for many. “Getting their hands in the dirt” was like a tonic (and the friendship surrounding them, a salve).

One of the participants, Scooter Rychlik, was off work due to a serious injury.

“The project got me out of the house for two hours each week. [With my injury] . . . the program gave me needed exercise and much more. It helped me to get out of my head,” Rychlik said.

Learning how to garden might have initially attracted the participants, but a sense of community or family seemed to be the key in bringing them back.

Participants and program organizers became friends and looked forward to seeing each other each week.

Participation in Growing Healthy became a source of pride. In the final evaluation, every single participant reported bringing others to the Community Garden to see the Growing Healthy plots.

Many shared plants and vegetables from the garden or gardening knowledge with neighbors and friends.

Project organizers summed up the experience with: “Growing Healthy led us on an amazing journey and helped us to think differently about the positive impact gardening can have on our community. And who would ever have thought that the free clinic would partner with local Master Gardeners and the community garden?”

The following businesses and individuals contributed to Growing Healthy: American Medical Association Foundation; First Federal; The Home Depot; Gibson

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SEPTEMBER 2014

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Paddling the

Boundary Waters

Retracing the passages of the French voyagers STORY BY SARA FARINELLI, PENINSULA DAILY NEWS

What do you do to make your 60th birthday memorable? Take your cue from Port Angeles resident Ann Nolan and consider a trip to the Boundary Waters Canoe Area Wilderness, a vast two million acre mosaic of land and water in northern Minnesota bordering Canada.

Growing up in Minnesota, Nolan has made about 10 excursions into the Boundary Waters with family and friends over the years. >> BOUNDARY WATERS CONTINUED ON PAGE 11

photo provided by Bonnie Rathod A recent photo of a group of women from the North Olympic Peninsula resting on top of Warrior Hill overlooking the Boundary Waters Canoe Area Wilderness. Front Row: Ann Nolan, Bonnie Rathod, Susan Smith (Ann’s sister) and Helen Freilich. Back Row: Marilyn Perkins, Patti Happe, Colleen Brastad, Sheri Crain and Amy Ward.

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<< BOUNDARY WATERS CONTINUED FROM PAGE 10

photo by Bonnie Rathod Canoeists making their way through the Boundary Waters Canoe Area Wilderness.

Based on this experience, she began planning for this trip last fall. She mapped the trip to make sure that first-timers would get a sampling of some of the best that the region has to offer.

Last winter, she began recruiting fellow travelers.

Eight women ranging in age from 48 to 66 answered the call.

“The 48-year-old was an outlier,” Nolan joked.

“Everyone else was in their mid-50s or older.”

The intrepid recruits were Colleen Brastad, Sheri Crain, Helen Freilich, Patti Happe, Marilyn Perkins, Bonnie Rathod, Susan Smith and Amy Ward.

All working professionals, their occupations included a physical therapist, a deputy police chief, a naturalist, a biologist, a school psychologist, a dietitian and three nurses.

Further, all are married with the average length of marriages well exceeding 30 years, and yet all put family, personal lives and jobs on hold for 11 days to take on this adventure.

The journey was staged from Ely, Minn., known as the canoe capital of the world, where Nolan’s family has a cabin.

A local outfitter provided all the gear, equipment and food. Additionally, the outfitters provided a taxi service with the women being transported to the drop-off site by van and left on their own for the next seven days. >> BOUNDARY WATERS CONTINUED ON PAGE 12

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<< BOUNDARY WATERS CONTINUED FROM PAGE 11

Packing all their equipment, food and canoes, the group made their way on foot to the Moose River, about a half-mile from the drop off.

Given the amount of gear and food necessary to sustain a group of nine for a week, each woman made two trips over the portages.

One woman carried the 49-pound canoe while another backpacker spotted her. They all then returned to the exit site to retrieve a second load. Each portage took about 20 to 40 minutes.

The party paddled up Moose River to Lake Agnes and headed for Lac La Croix, a large body of water bordering the United States and Canada.

Smith and Nolan navigated with assistance from Happe on a GPS. They proceeded east hugging the Canadian border following an 18th and early 19th century route used by French fur traders known as the voyageurs.

“We all put our heads together to figure out the route we were taking,” Marilyn Perkins of Port Angeles noted. “We’d pull up our canoes on the water to figure out where we were.”

Getting up-close looks at remotely located Indian pictographs, identifying the flora and fauna and viewing incredible waterfalls encountered along the way, the trip was a fantastic learning experience as well as an awesome outdoor adventure. The landscape was spectacular.

Campsites are on a first-come; first-served basis and are limited to one party at a time. Each site has a fire grate and latrine and is set on a rocky outcropping overlooking a lake with beautiful scenic views. >> BOUNDARY WATERS CONTINUED ON PAGE 13 photo by Ann Nolan Colleen Brastad of Port Angeles portaging during a recent trip to the Boundary Waters between Minnesota and Canada.

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<< BOUNDARY WATERS CONTINUED FROM PAGE 12

Except for the calling of loons, the group’s privacy was complete night after night.

Paddling three to a canoe, the women’s expedition covered roughly 70 miles of physically demanding terrain and water. With the waters flowing west from one body of water to the next, the party frequently found themselves paddling against the current.

“We did quite well,” Nolan said. “We are very proud of what we accomplished.”

Their success was not an accident. They had prepared with an extensive reading list to familiarize themselves with the environment and a workout schedule to condition themselves for the challenges of the journey.

Nolan stored a couple of canoes at East Sequim Bay for practicing canoe paddling technique and teamwork leading up to the trip. They also spent time working out in the gym.

The sense of history and the wonder of nature combined with the strong bonds formed by nine independently minded women living and working closely together proved a memorable experience for all.

Bonnie Rathod summed it up, saying, “It was the trip of a lifetime.”

If you are interested in planning a trip, be sure to plan ahead. Access to the Boundary Waters Canoe Area Wilderness is strictly regulated to preserve the wilderness and insure the safety of visitors.

For more information, check out the USDA Forest Service website at www.fs.usda.gov and search for “Boundary Waters.”

A variety of outfitters can also assist groups with route planning, gear and obtaining permits. photo by Ann Nolan Marilyn Perkins of Port Angeles carries gear at this portage during a trip to the Boundary Waters Canoe Area Wilderness.

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Serve and return: how early childhood interactions are crucial to learning PHOTOS AND STORY BY BRANDPOINT

Picture this common scenario: you are standing in line at the grocery checkout and a baby seated in the cart in front of you makes eye contact. She looks at you inquisitively, leans her body back and smiles.

You smile back, wave, and say “hello.”

The baby babbles, delighted by your attention. She continues to interact. She points to a balloon at the checkout aisle. You say to her, “Look. The pink balloon has a flower on it.” She claps her hands in happy response. And then you smile and wave again.

This brief interaction with this child is not just a friendly exchange. It is much more. You are actually supporting the development of her brain circuitry.

Serve and return “This simple interaction is called serve and return. It is this back-and-forth communication between children and responsive adults that builds a young child’s brain architecture,” said Dr. Elanna S. Yalow, chief executive officer of KinderCare Early Learning Programs.

Yalow is a strong proponent for the importance of serve and return for all young children, starting with infants.

“Serve and return is like a game of tennis between a young child and a caring, responsive adult,” said Yalow.

“A baby coos or cries, or a preschool child asks “Why?” The adult returns the child’s “serve” with interest, and the back and forth begins.

“Serve and return promotes learning because these interactions actually help to develop the neural pathways in a child’s brain,” Yalow said.

Because 70 percent of all brain development occurs within the first three years of life, consistent use of serve and return is essential to establishing a strong foundation for success in school and later life.

Open-ended engagement Simply giving children directions does not foster healthy brain development.

Children need rich, meaningful exchanges to develop the brain connections that pave the way for continued learning and growth.

Asking children open-ended questions is an easy way to start serve and return. If a child draws a picture, parents and teachers should do more than compliment the picture.

Asking the child “What is happening in your picture?” or “Why did you draw that?” creates an opportunity for back and forth dialogue. Praise is important for young children, but serve and return is essential to their development.

Serve and return and language development Serve and return also plays an important role in developing literacy skills.

Here’s an example: a baby points to a ball and a parent or teacher says, “ball.”

This helps the child make a connection between the word and the corresponding object.

Through this process, early literacy skills form. And as children grow older and adults read to them, asking children to react to what is being read or to predict what might happen next in the story also helps develop new connections in the brain. >> SERVE AND RETURN CONTINUED ON PAGE 15

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<< SERVE AND RETURN CONTINUED FROM PAGE 14

The absence of serve and return Without serve and return, the development of brain circuitry and learning can be impaired. And without meaningful interactions with responsive adults, even the youngest children show signs of distress.

Adults who simply satisfy a child’s physical needs without providing serve and return interactions don’t adequately support the healthy development of the child.

Neural pathways that may be important to a child’s future may never be formed or will fade away through a process called “pruning.”

The foundation for all learning Ensuring that children engage with caring adults who consistently engage in serve and return, beginning in infancy, builds the foundation for learning into adulthood.

“Serve and return is the fundamental difference between custodial care and high quality early childhood education,” said Yalow.

“Vibrant serve and return should be the goal in every home and classroom, something that every parent and teacher should practice.”

Engaging with young children in intentional, meaningful ways not only helps them build relationships, it impacts their ability to develop language and cognitive skills.

Serve and return is a crucial base on which all future development is built; it is the foundation for learning.

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