2 Acknowledgements I would like to thank my husband most of all for the sacrifices he has made to give me wings to accomplish this dream of mine. Without him, I could not have done it. His domestic engineering skills, hard earned money, patience with my lack of technology skills, listening ear, errand running and efforts to support me got us through. Upon receiving my diploma, I will add his name right under mine! I also feel I was gifted the greatest thesis advisor, Dr. Katarina Pantic and know that her patience, efforts, attention to detail and endless hours of help allowed me to have a project I am super proud of. Her skills and talents have truly blessed my life and I consider it a privilege to have worked with her and had her guide my process. My oldest child started kindergarten in 1996 and my youngest child graduated high school in 2021. For 25 years I have supported my children in their education and helped with homework, and projects and been involved in their schooling. The tables have turned and they gave it right back to me and I could not have done this without them and their encouragement, patience, help and support. I wish to thank Nicole Gottfredson for her willingness, diligence and expertise in developing the app, of course this project would not have been possible for me without her! Lastly, I wish to thank Heavenly Father for giving me strength beyond my own and guiding my path every step of the way and putting people in that path that have made this possible. 3 Table of Contents Table of Contents 3 Table of Figures 4 Problem Statement 5 Literature Review 8 Theoretical Framework 8 Waiting 10 Attention Span 11 Executive Function 13 Screen Use and Brain Development 18 Parental Influence on Helping Children be Successful at Waiting 23 Methods and Design 31 Mobile App Contents and Rationale for Activities 31 Design Process 33 Content Design and Transfer 36 Recruitment Process 38 Results 41 Usability Testing Feedback 41 Discussion 46 Limitations 48 References 49 Appendix A: App Activities 61 Appendix B: WHILE WE’RE WAITING APP USABILITY ASSESSMENT 87 Appendix C: Post- Assessment 89 4 Table of Figures Figure 1 ......................................................................................................................................... 13 Figure 2 ......................................................................................................................................... 15 Figure 3 ......................................................................................................................................... 32 Figure 4 ......................................................................................................................................... 34 Figure 5 ......................................................................................................................................... 35 Figure 6 ......................................................................................................................................... 36 Figure 7 ......................................................................................................................................... 38 Figure 8 ......................................................................................................................................... 39 Figure 9 ......................................................................................................................................... 43 Figure 10 ....................................................................................................................................... 44 Figure 11 ....................................................................................................................................... 45 Figure 12 ....................................................................................................................................... 45 Figure 13 ....................................................................................................................................... 45 Figure 14 ....................................................................................................................................... 46 5 Problem Statement Young children, birth to six years, are developing the executive function network, which refers to the complex cognitive processes required for performing challenging goal directed tasks, such as waiting (Rymanowicz, 2015). As a result, they are unable to physiologically wait longer than a few minutes (Knapp & Morton, 2013; Wilson et al., 2009). The ability to wait is an important life skill and is a method of self-control. It requires training and practice, and it is a psychological state (Prisco, 2019). Dr. Megan Kaden explains that many people in society never learn how to tolerate the discomfort and unknown of waiting and that one of the most essential skills for adult development is learning how to regulate one’s feelings while waiting (Kaden, 2017). In this study, I define waiting as the act of remaining stationary until an expected event happens. Being in a state of watchfulness, pause or delay also constitutes this act. Child development experts agree that an average period of time a child can successfully wait or maintain focus on a given task is two to three minutes per year of age (Altun et. al., 2016). And yet, we all know children spend much of their life waiting in lines, at restaurants, doctor’s offices, sporting events, theaters, car rides and amusement parks, which can be a stressful experience for them as a result of their underdeveloped anterior attentional network (Hood et. al., 2009). Stress for a child can be brought on by over- or under-stimulation, and or subjection to excessive expectations (Bullock, 2002). Attentional processes are exhibited by external behaviors, physiological and neural responses and psychological engagement (Gaertner et. al, 2008). When a child encounters experiences that bombard their sensory impressions, they do not have the brain development needed to determine when they have had enough and this can lead to a child feeling out of balance and they react with attention problems, distracting behaviors, repetitive movements, and an inability to sit still (Hunter, 2014). A child is compensating for uncomfortable feelings in their body and their surroundings. 6 Additionally, temper tantrums, crying, whining, and aggressive outbursts are typical physiological reactions to the stress of waiting for a young child (Rymanowicz, 2015). Immobilizing their body for a period of time, therefore, is a tedious, tiring and difficult task in this stage of development (Moyer & von Haller Gilmer, 1954). In addition to being governed by their limited attention span, young children’s ability to wait is also influenced by one of the core elements of executive function, called inhibitory control (IC) (Elton et al., 2014). According to these authors, inhibitory control is located in the pre-frontal cortex and is defined as one’s ability to inhibit their impulses and habitual, natural or prevalent behavioral responses to stimuli, in order to display appropriate behaviors consistent with one’s goals. IC includes self-regulation, which is defined as a state of being able to manage emotions and impulses, as well as control one’s behavior (Anzman-Frasca et al., 2015). According to the same author these abilities have been emphasized as powerful predictors of adaptive development. They influence a child’s ability to wait, because children may not have developed the cognitive skills required to regulate behavior expectations during the waiting period (Rymanowicz, 2015). In the preschool years, children become increasingly more able to execute purposeful and effortful behaviors, because the frontal cortex underlies these capabilities (Davis et.al., 2002). The waiting period may appear to be a time of inactivity, but for a child it is a time of active pursuit (Rymanowicz, 2015). They use energy as they exercise the ability to control impulses, actions and behaviors, regulate thoughts and respond to stimuli. Positive and emotionally supportive parenting has been found to improve children’s capacities to be successful in waiting situations, as well as encourage self-regulation (Altun et.al., 2016). However, parents are not always familiar with young children’s neurological capacities, and they often lack the training and tools to enhance executive function development. This can lead to negative interactions during stressful times, such as waiting, interactions that negatively influence the development of positive relationships between the child and their parents. Developmental research also suggests that 7 negative emotions have the potential to disorganize attentional processes (Gaertner et.al., 2008). This is because attentional processes are developed as children practice cognitive skills with support and understanding. Parents need to understand the relationship between inhibitory control and the development of executive function, because cognitive strategies are further developed as they are practiced in challenging situations with patience and support from a caring adult (Taylor et al., 2018). Parents who understand that by guiding children patiently through experiences beyond their physical capabilities, they are helping children acquire tools needed to gain power and control over their bodies and mind (Rymanowicz, 2015). Studies show that disruptions to the development of inhibitory control networks from birth to age six may impair executive abilities in adolescence and adulthood resulting in risk factors for later drug use and/or other disorders (Elton et al., 2014). For that reason, high response inhibition abilities for a child represent a protective factor (Elton et al., 2014) from limited self-control, addictions, failure to think ahead about consequences and lack of suitable restraint (Scholastic Parents Staff, 2021). Early IC is further linked to later psychosocial outcomes, such as adjustment and self-competence, and it appears to affect academic outcomes (Anzman-Frasca et al., 2015; Elton et al., 2014). Knowledge of these possible outcomes may encourage parents to implement and support valuable opportunities to strengthen cognitive function and create growth promoting environments. As we can see from the previously stated argument, there is an objective need for parents to develop appropriate expectations about a child’s ability to wait. There is also a need to educate parents in their understanding of the developing attention span and the harmful effects of screen use to sustain attention while waiting. Research suggests that supportive relationships buffer the effects of a child’s heightened stress responses in challenging situations (e.g., Hostinar & Gunnar, 2015; Mentalhelp.net, 2021). In order to provide parents with training and tools to help children increase their abilities to be successful at waiting, I will create a mobile app called While We’re Waiting, that parents can access any time on their cell phone. This app will be designed to provide them with screen free activities to do with 8 their children while they wait. These activities aim to foster relationship building between parent and child, and enhance a child’s executive function development. Literature Review During early childhood, attentional capacities for young children are ever increasing for efficient, flexible and voluntary control of attentional resources (e.g., Gaetner et al., 2018; Grabell et al., 2019; Raz, 2004). This attentional ability is critical for initiating and maintaining transactions with a child’s environment and to their learning and competent functioning (e.g., Altun et al., 2016; Grabell et. al., 2019). Executive function development plays a key role in attentional capacities and is required for goal directed behaviors such as being able to wait successfully (e.g., Altun et al., 2016; Calderon, 2020). Screen use is often used by parents to occupy their children during waiting situations (e.g., Sigman, 2012). However, there is much research that suggests parents should use extreme caution in relying on screens to relieve boredom and pass time as screen use can negatively impact cognitive function (e.g., Cytowic, 2015; Hutton et al., 2020). Parents can help young children be successful in stressful situations such as waiting by fostering strong relationships with their children and providing a positive environment that influences executive function development (e.g., Meryem et al., 2016; Stiles & Jernigan, 2010). In this chapter, I provide a detailed overview of literature on children’s brain development and how that affects goal directed behaviors such as waiting and all the related concepts than I mention in this preview. To begin with, I will discuss the theoretical framework that guided my study. Theoretical Framework Scientific theories that situate this project and research are Bronfenbrenner’s Ecological Theory (Smith & Hamon, 2017) and Dynamic Systems Theory by Ester Thelen, Kurt W. Fisher and Thomas R. Bidell (Newman & Newman, 2020). 9 Bronfenbrenner’s Ecological Model explains how children are affected by the influences of their environment and how the systems of that environment are all interrelated (Ashiabi & O’Neal, 2015). Developmental outcomes are affected by the patterns of interactions within the systems. The most influential level for a child is the microsystem, or their immediate environment and relationships, such as parents, siblings, peers and the school setting. In the exosystem, the child is not an active participant but is still indirectly influenced and developmentally effected. An example of this is the parent’s work place. The macrosystem consists of the societal conditions, cultural values, opportunities and economic conditions in which the family lives (Ashiabi & O’Neal, 2015). Parents can use this theory to provide a framework for building effective relationships and to surround a child in an environment of positivity especially during stressful experiences such as waiting. Through quality interactions encountered in a child’s environment, physical and cognitive structures grow and mature. Humans are dependent upon their environment to meet their biological needs and develop capacities as they interact with each other. Hence, a child’s ability to wait and use cognitive skills to create patterns for increased success are brought about by these constant interactions of the related systems. Doherty’s research (1997) situates this theory as well, in regards to waiting, by explaining that the intentionality of parents in the small, seemingly insignificant moments in time create a ritual or habit that then creates meaning. Every day experiences (such as waiting with a child) can become ritualized and if positive can become meaningful and special and definitive to the family as a unit (Doherty, 2017). Bronfenbrenner’s theory explains that development takes place as positive interactions occur on a regular basis over extended periods of time and these have a powerful influence on developmental outcomes (Ashiabi & O’Neal, 2015). Waiting for a child could be construed as part of the exo-system, as it encompasses settings that a child interacts with and this environment influences behavior which is dependent on brain growth and development. Dynamic systems theory (DST) (Thelen & Smith, 1994) explains that interactions among multiple components drive behavior and developmental change. One of the foundational concepts of this theory 10 is multicausality, which is defined as multiple forces converging together to create behavior. A person’s body, age, mental state, emotional state, social context, and personal history are some of contributions to behavior in a certain moment (Perone & Simmering, 2017). Self- organization is another foundational concept of DST describing how the behavior of a system emerges as multiple components interact through time and these interactions are context dependent (Perone & Simmering, 2017). The last main foundational concept of DST is nesting of time scales, defined as changes of time from one point to the next and overall patterns of change (Newman & Newman, 2020). In Dynamic Systems theory no one factor is more important than another and changes in the person, environment and task can potentially contribute to emerging behavior-positive or disruptive. New capacities and behaviors are produced as a child experiences forces within and outside their environment resulting in cognitive growth that allows for new levels of functioning. Waiting puts a child in a situation of uncertainty or change. An interaction of variables and processes combines and the goal for a child would be to ultimately achieve a stable state of equilibrium if the child has developed the cognitive skills and strategies to do so (Newman & Newman, 2020). Parental guidance and positive interactions provide confidence in the problem-solving skills necessary for a child to be successful in waiting situations. While waiting, a child is affected by their environment and the interactions that take place. These theories explain the stabilizing and destabilizing of behavior patterns wherein relationships develop. When parents respond sensitively, a child is able to view their parents as dependable and their capacities are improved and developmental outcomes are positively affected (Newman & Newman, 2020). Waiting As human beings our behavior is goal-oriented. Waiting becomes the barrier that prevents one from immediately reaching his/her goals (Houston et al., 1999). According to Houston et al. (1999), this sort of barrier produces negative emotions, because it impedes attainment of a nearly reached goal. The 11 closer one gets to the goal, waiting brings out increased negative emotions. Kim and Maio (2011) found that waiting generates three different types of emotions according to research: 1) feeling uncertain, unsettled, uneasy and other anxiety responses, 2) feeling annoyed, irritated and frustrated which often induces anger responses, and 3) regret. Being able to wait successfully requires emotional regulation abilities, as they monitor, evaluate and modify emotional reactions to accomplish one’s goals (Kim & Maio, 2011). These same authors suggest that shifting attentional focus towards or away from particular aspects influences emotional responses by allowing one to redirect attention in any given situation, thus requiring the skills of executive function. Attention Span Attention is defined as the centering of focus on one thing and ignoring or tuning out competing information or stimulus in the environment (Cherry, 2021). According to the same author, attention is a basic component of human biology from birth and is limited in duration and capacity. Attention allows the body to determine what information and events in the environment need to be attended to, while attention span is the length of time one is able to concentrate or remain engaged and it requires higher level control and executive ability. Child development experts agree that an average attention span for children is two to three minutes per age/year (Altun et al., 2016). Control over attentional processes is credited to being crucial for self-regulation. This attentional control allows one to pursue goals, adapt to environmental demands and regulate emotional activity (Crouch et al., 2012). A key milestone of deliberate modulation, or being able to willfully adjust to emotional experiences, begins to develop rapidly in the second year of life (Anzman-Frasca et al., 2015; Kochanska et al, 2009). This ability of deliberate emotion regulation, to hold in the mind and effortly control emotions, is a crucial skill that forecasts later functioning in the social environment (Grabell et al., 2019, Kochanska et al., 2009). As intentional capacities increase in the early years, children gain abilities to regulate negative emotions such as irritability (Grabell et al., 2019) and 12 frustration, both of which are felt during waiting. Paired with the development of selective sustained attention, which is an ability to process parts of the environment, while excluding others over a period of time, these vital components of higher order cognition are linked to the maturation of the prefrontal cortex (Erickson, 2015). The activation patterns in the anterior attentional network of the brain, which are neural circuits (Raz, 2004) in the prefrontal cortex, are what allows children to develop self-regulation. Self-regulation is important, because it inhibits inappropriate behaviors and controls emotional reactions in any given situation (Anzman-Frasca et al., 2015). A child’s attentional system progresses with increased sophistication across early childhood stimulating capacities for flexible, efficient and voluntary control of resources of attention (Gaertner et al., 2008). This same author suggests that children demonstrate increasing levels in duration and frequency of attentional control in the first four years of life and exhibit focused attention in increased amounts and development of their frontal system during ages three to five. Focused attention describes the state of being sustained and actively engaged with a stimulus or task. Cognitive information processing (i.e., learning) occurs during these periods of focused attention and children exhibit increasing levels of focus attention abilities across the first four years of life (Gaertner et al., 2008). Attention development is influenced within the context of social and environmental interactions and is constantly affected by these experiences. Negative emotion disorganizes attentional processes (Gaertner et al., 2008), which is problematic, because attentional process plays a critical role in a child’s external behaviors, psychological engagement, and neural and physiological responses. Additionally, attention span capacities affect a child’s performance on tests of ability, problem solving and effortful control (Gaertner et al., 2008). An increase of attention abilities occurs at around six to seven years of age, when systematic strategies are further developed (Altun et al., 2016). As children hit this age, their attention behaviors can be more rational, systematic, active, and goal oriented. As a child’s ability to concentrate increases, so does their 13 ability to wait (Altun et al., 2016). Figure 1 is a visual representation of the information presented in this section. Executive Function In all mammals, the brain begins to develop from the tip of a three-millimeter-long neural tube, and only weeks after conception the tube closes off to form three distinct regions: hindbrain, midbrain and forebrain (Ackerman, 1992). The same author explains that after three months gestation, the brain Figure 1 Attentional Processes Development based on literature presented in this paper. Created by Lisa Ferguson Ferguson 14 has increased in size several times and the forebrain dwarfs other regions. In contrast, after birth the human brain matures from the back forward (Gengler, 2018). In other words, beginning in infancy, the brain continues to develop from the brainstem at the base of the neck to the prefrontal cortex, which is the frontal part of the frontal lobe of the brain. This area is among the slowest regions to develop, continuing to do so well into the second decade of life (Gengler, 2018; Knapp & Morton, 2013). The basic function of this region of the brain is to orchestrate thoughts and actions that are consistent with internal goals (Dahlitz, 2020). It is a place where connections are continuously being built based on frequent experiences and it eliminates connections that are related to infrequent experiences (Gengler, 2018). The cortex is the outer layer of the cerebrum or neural tissue that is made up of thin, folded gray matter and is essential for effectively interacting and navigating with one’s environment (Psychology, 2021). According to the same website, gray and white matter make up the outermost layer of the brain, but gray matter contributes the most consequential part in allowing normal daily human functioning allowing signaling of neurons to be more effective. This gray matter allows for processing of information and release of new information through the white matter. It is what enables a person to control memory, movement and emotions (Mercadante & Tadi, 2021). Studies have demonstrated that there are vast sex differences in how the girls’ and boys’ brains develop (Sax, 2016). Gray matter develops earlier and faster in girls with girls exhibiting two years more mature gray matter than boys at the same age (Sax, 2016). This difference in brain maturation may help parents understand why requiring or expecting a child, particularly young boys, to wait or be still is physiologically difficult. Executive function (EF) (see Figure 2) is housed in the prefrontal cortex and is the basis for higher order cognitive functions and refers to the management system of the brain (Martins et al., 2020). These functions are similar to an orchestra conductor supervising and coordinating a multitude of 15 mental tasks and skills which are essential to controlling emotion and behavior and achieving goals, as well as predicting outcomes and managing daily routines (Calderon, 2020; Carlson, 2018). Figure 2 Executive Function Illustration Based on Literature Presented in this Paper 16 According to Carlson and Wang (2007), “Executive function is required for goal-directed behaviors, to solve problems, particularly those calling for the inhibition of automatic or established thoughts and responses” (p.490). Additionally, the cognitive processes of planning, focusing, adapting to new and unexpected situations, remembering, filtering distractions, thinking flexibly, and prioritizing tasks are duties of EF, carried out, or as the name denotes, executed by the prefrontal cortex area of the brain (Calderon, 2020, Carlson, 2018; Martins et al., 2020). Through EF processes, the brain intercepts a barrage of thoughts and impulses and steers them toward safe and productive outcomes. The first years of life are a window of great opportunity and vulnerability for the development of EF (Martins et al., 2020). Studies show that executive functions begin to develop shortly after birth, with the most favorable time for growth in these skills during ages three to five (Anzman-Frasca et al., 2015; First Things First, 2021). By age seven, some of the aptitude and brain circuits critical to EF abilities are similar to those existing in adults (Matijasevich et al., 2020). There are three core dimensions of EF and they can be subdivided as such; updating, the ability to keep relevant information in working memory, inhibition, avoiding dominant or automatic responses and shifting, updating and inhibition combined to constitute the ability to change among multiple tasks, operations, perspectives and rules (Carlson, 2018; Egger et. al, 2019, Martins et al., 2020). Working memory is the ability to keep information and put it to use when needed (Black et al., 2011). Cognitive flexibility is the ability to see problems from many different angles and find contrasting solutions, while also having the ability to sustain or shift attention (Cragg & Natron, 2008). Inhibitory control is the ability to stop before responding to an impulse, while also controlling attention and behaviors, and managing emotions (i.e., response inhibition) (Liu et al., 2015). Inhibitory control is essential for negotiating and effectively interacting with one’s environment (Psychology, 2021). It is suppressing the activation, processing or expression of information that would obstruct attainment of cognitive or behavioral goals (Liu et al., 2015). According to the same author, the development of inhibitory control depends on the 17 functional maturation of the frontal cognitive system or cortex. This maturation of the frontal system, the home of executive function, allows children to gain skills in waiting which requires inhibiting impulses and being able to execute effortful behaviors (Knapp & Morton, 2013). When children manage their impulses, their capacity to make choices and understand consequences increases, as well as their ability to connect with people and their environment (Psychology, 2021). In a situation where an attentional demanding task must be performed, self-regulation and executive function share effort as a resource for doing so (Egger et. al, 2019). Consciously controlled and working in coordination with each other, the three key components of executive function: inhibitory control, working memory and cognitive flexibility, allow for the mental tasks of emotion control, task initiation, planning and prioritizing, organization and focus, and allow one to adapt to new and unexpected situations (Calderon, 2020; Knapp & Morton, 2013; Martins et al., 2020). Together they pave the way for self-regulation (Davis et al., 2001; Gaertner, 2008). Children are not born with these skills, but they develop them in growth-supported environments. In other words, the brain is shaped by the quality of a child’s experiences, positive or negative, in the first few years of life (First Things First, 2021, Stiles & Jernigan, 2010), which makes the quality of children’s experiences extremely important. Additionally, from birth to age five, the brain will develop more than at any other time of life. It doubles in size in the first year and by age three, the brain is approximately 80% of its adult size, and 90% of brain growth will be accomplished by the time a child enters Kindergarten (First Things First, 2021). For that reason, these are crucial years for brain connections to occur which impact health, capacities and success for adulthood (First Things First, 2021). For young children the immature development of the prefrontal cortex and the ongoing development of EF make it difficult for young children to wait in line, take turns, be in close proximity to others, walk for long stretches of time or focus on required tasks for more than a short period of time (Greenberg, 2012; Belsky, 2020). Children also exhibit problems in social interactions, as they seem to 18 lack the ability to refrain from touching objects or people impulsively (Heffron & Drobnjak, 2021). Waiting successfully requires control of one’s impulses; it requires meeting social expectations and an ability to solve problems and find solutions to boredom when there is a decrease in stimuli (Cherry, 2021). Waiting requires adjusting behavior to unexpected changes or situations, such as length of time required to wait, and it requires storing, using and adapting information from previous and similar experiences (Gaertner et. al., 2008). EF combines the mental tasks that children are developing that will allow them increased physiological capacities for waiting. Screen Use and Brain Development Many parents have grown to rely on screen use as a way to occupy their children (Sigman, 2012, Carlsson-Paige, 2018), which includes any situation that requires waiting. Screen time is anecdotally known as “the electronic babysitter”. Unprecedented technological advances over the last many years have made it difficult for scientists to keep up with the controversy among parents and teachers over the effect of screen use on a young child’s brain (Hutton et al., 2020). Because of rapidly emerging technologies, particularly hand-held devices, the landscape of childhood has become digitized (Hutton et al., 2020). There are many researchers and medical professionals attempting to fill the gap of evidence suggesting that screen use for young children impacts their brain development and health in negative and harmful ways (e.g., Cytowic, 2015; Hutton et al., 2020; Li et al., 2020; Martins et al., 2020; Sigman, 2012). Some scientists have even labeled the concern over screen use, whether it be inappropriate or appropriate content, as a medical issue with relationship to disease risk (Sigman. 2012). In regards to a child’s neurobiological development, the rise of screen use for preschool aged and younger children, poses great concern, as some cross-sectional studies and meta-analysis of relevant studies, indicate that screens affect how children play, learn and form relationships (Hutton et al., 2020). However, evidence also suggests that screen use for young children can be positive and beneficial from an educational standpoint, as it encourages word learning, math and reading skills and other trained 19 learning abilities, as well as providing a wide variety of information and rapid communication (Li et al., 2020). For the purpose of this paper, I will focus on the neurobiological risks associated with screen use for young children. Screen use is defined as viewing or using anything with a screen, such as TV, DVDs, movies, computers, phones and video games (Sweetser et al., 2012). In 2019, MRI evidence showed that preschooler’s microstructural integrity of white matter in the brain was endangered with screen use (Hutton et al., 2020). Using diffusion tensor imaging (DTI) to quantify white matter integrity in the brain, these researchers explored the associations between screen use and white brain matter tracts that support language, executive function and literacy skills in children ages three to five. They recruited 69 preschoolers and measured their access to screens, frequency of use, content viewed and viewing with a caregiver. The results indicated that structural markers for language performance were associated with lower neurocognitive skills in those with higher screen use. Similar negative associations were seen in regards to emotion integration and lower scores on corresponding behavioral measures (Hutton et al., 2020). Further research is needed to establish causation for these results whether these neurobiological differences were a direct result of the screen use itself or the differences in human interaction affected by screen use (Hutton et al., 2020). In a similar study by the American Academy of Pediatrics Council on Communications and Media, it was found that children who did not follow the recommendations for time limitations of screen use for children ages two to five to no more than one hour per day, had delayed white matter development (Beal, 2020). Several systematic reviews and meta-analyses suggest detrimental effects were also seen in regards to cognitive, behavioral and emotional outcomes as well with screen use for infants, toddlers and preschoolers (Li et. al., 2020). In contrast, recent findings demonstrated that children with lower screen time use exhibited better executive function abilities (Martins et. al., 2020). Screen use for young children has significant neuro-biological risks, including a delay in language development and 20 vocabulary, impaired or delayed fundamental motor skills (Martins et. al., 2020), a decrease in parent child relationships (Hutton et al., 2020, Sweetser et al., 20), obesity, short sleep duration (Li et al., 2020) and abnormal oxygen uptake, as unnatural images flash too fast for the brain’s persistence of vision (Cytowic, 2015). According to Dr. Nancy Carlsson-Paige (2018), a child’s social and emotional development is built over time and learned through many experiences and interactions while screen use limits those opportunities. The cumulative effect of technology replaces social interaction. Screens are most commonly used to distract a child from the experience they are having at the moment whether that be stress, anxiety, frustration, a hard transition or boredom and the goal is to amuse, occupy or end distress-to take them somewhere else emotionally. It does work for the short term because screen interaction bypasses those emotional experiences. However, NOT going through those challenging emotional moments is detrimental to development and wellbeing (Carlsson-Paige, 2018). Dismissing opportunities for a child to confront an emotion, such as frustration, prevents them from working through feelings in the present tense and gaining coping tools from life experience. Instead of looking inward for mental resources to cope, they turn to external sources to solve their negative feelings. Such practice in these moments, accumulated over time, fails to produce emotional resilience (Carlsson- Paige, 2018; Hunter, 2020). The While We’re Waiting app can provide an opportunity for emotional skill development needed to deal with emotions in the moment and provide tools for a lifetime. When a child is on a screen there is a profound shift from acting to re-acting, moving to looking. This impacts a child’s initiative. Initiative is an important human capacity and propels a young child to further their progress of development whether that be with grabbing, crawling, standing or walking. Early screen use undermines this sense of action and produces a sense that action does not come from inside oneself but from an outside source therefore causing a child’s attention to shift from the initiative 21 and ideas they construct themselves. This prohibits optimal brain development as full body, mind, senses and emotions are unnaturally inhibited (Carlsson-Paige, 2018, Hunter, 2020). Carlsson-Paige (2018) explains that play is the engine of development and provides a child with open ended, undefined parameters for cognitive processing as they bring their own needs and imagination to the experience. Screens give defined parameters, remove active participation and are composed of confined boundaries that do not promote creativity. Images and characters from screens do not allow a child to access their own inner psyche, because outer influences have no reciprocal relationship with the child’s needs, life and emotions. Children are active learners who construct their ideas through interacting with materials while screens are a passive experience. With screen viewing the inner life of imagination and emotion are affected by outside direction. Information cannot be poured into a child as one would an empty vessel. Genuine learning takes place as children build knowledge through conceptualizing information, not from repetition and rote methods (Carlsson-Paige, 2018). The human brain only accounts for two percent of total body weight and yet, for a child the brain expends 50 percent of the daily energy burned (Cytowic, 2015), meaning early development requires much from the brain. The rapid content shifts of screen viewing do not allow the brain time to make out details before a switch is made causing strain to both eyes and the visual processing system, which consequently depletes energy (Cytowic, 2015). The unnatural images of a screen require more neurons to analyze, which in turn forces the brain to be less efficient (Cytowic, 2015). Furthermore, blue light from screens disrupts melatonin levels in children, which in turn changes circadian rhythms causing night time alertness and reduced duration of rapid eye movement sleep (Li et al., 2020). Additionally, some studies have indicated the relationship between screen time and inattention, self-regulation and emotional disorders (Martins et al., 2020). The hormone, dopamine, which is related to the ability to pay attention, is produced in response to screen novelty, and excessive screen use may result in long-term changes in the reward circuitry of the brain (Sigman, 2012). A longitudinal study of over 2000 children 22 found that children ages one to three who had high screen use also had significant risk for developing attention problems by age seven consistent with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) (Sigman, 2012). Other researchers found that screen viewing of a fast-paced program for nine minutes showed immediate impairment to a four-year-old’s executive function (Sigman, 2012). A similar association was found with the amount of screen use and inhibition measures and their whole-body coordination (Martin et al., 2020). Irrespective of value, whether educational or content based, the cause for concern from researchers is the amount of daily screen time for young children (Sigman, 2012) and how that impacts the development of executive function. A distinction between passive screen time and active screen time also plays into the variables of the research (Martins et al., 2020). Screen content that requires little to no interaction from the user would be considered passive. Current studies indicate that most children spend the greatest amount of time as passive screen viewers (Martins et al., 2020). The associations between screen time and health risks are reported to occur when screen use exceeds two hours a day (Sigman, 2012). Because of negative associations with screen time and brain development, and the detrimental effects it may have on young children, the World Health Organization (WHO), the specialized health agency of the United Nations, has developed global recommendations and guidelines for screen use for children (WHO, 2018). These guidelines provide the greatest health benefit outcomes for infants and children based on research from scientists worldwide and should be a major element of national and international response for optimal health and development of children (WHO, 2018). The American Academy of Pediatrics (AAP) concurs with these recommendations (Hutton et al., 2020). Screen time for infants and toddlers, children ages one and two, is not recommended, while for preschoolers, ages three to five, no more than one hour is recommended (WHO, 2018). Current researchers have found low compliance from parents worldwide for these screen time recommendations, particularly in families 23 with low socio-economic status (Hinkley et al., 2013, Martins et al., 2020). They strongly encourage parents everywhere to use screens with great caution, particularly during stages of dynamic brain growth, such as ages birth to six years old (Hoehe & Thibaut, 2020; Hutton et. al., 2020, Medina, 2014). Deferred imitation is skill children naturally develop early on. This allows them to remember events, experiences or images even after one time of exposure. It is how children acquire information and profoundly influences their perception of reality. What children view on screens, influences their expectations about the world and their behavior and severely effects attention spans and focus abilities, all processes of executive function (Medina, 2014). Lack of these processing abilities will compound the difficulty of waiting for children. It is important for parents to have access to and be educated about alternatives to screen use to occupy young children, particularly during waiting, that allow families to stay within the guidelines recommended. The While We’re Waiting app will provide screen free activities that can be done together, parent and child, while passing the time of any waiting situation or time when a child may feel bored. These mind-stimulating games are designed to build positive relationships, strengthen cognitive development and executive function with problem solving, memory, attention, motor control and sequencing activities. They will also promote self-regulation abilities and help families pass the time screen free while strengthening bonds, and deepening connections through fun and laughter. Parental Influence on Helping Children be Successful at Waiting With regards to attention span and helping children be successful in situations that require the developing cognitive skills of executive function, research suggests that young children can be trained to wait more patiently and that their attentional capacities can be improved by supportive and nurturing parents (Altun et al., 2016, Center on the Developing Child Harvard University, 2021). Theorists have emphasized that the importance of caregivers’ emotional support experienced within learning moments or problem-solving contexts, is linked to a child’s persistence at tasks and the promotion of engagement 24 with the child’s environment (Gaetner et al., 2008). In contrast, other research suggests that unfavorable early environments, marked with harsh discipline and low levels of support, were associated with lower levels of attentional control and higher child physical abuse as adults (Center on the Developing Child Harvard University, 2021, Crouch et al., 2012,). This study was also first to demonstrate that parents reporting low levels of attentional control and ability to concentrate, had higher levels of negative emotion and interpersonal problems (Crouch et al., 2012). This same author suggests that this is because when young children experience lack of support in challenging situations, they do not learn to respond flexibly to competing demands of attention and to adapt negative thoughts and feelings to more productive solutions, therefore the quality of a child’s early environment affects the development of higher order attentional abilities and may have long term connections to social and emotional adjustment. Petersen and Posner (2012) report that because parenting and other cultural factors interact with a child’s genes to influence their behavior, it is possible to develop particular training techniques that can be used to shape underlying brain networks. Attention training has been shown to improve executive function and produce changes in attention related brain areas (Petersen & Posner, 2012). Self-regulatory capacities are modifiable as well, in early childhood, according to robust evidence from scientific research, making the years from birth to age six a significant window for preventative interventions (Anzman-Fransca et al., 2015). Furthermore, environmental factors such as early childhood stress, family structure and educational opportunities can significantly foster or hinder executive function skills (Calderon, 2020, Center on the Developing Child Harvard University, 2021). It is suggested that it is fortunate for parents that children’s executive function skills are extremely malleable and capable of improvement. However, in the absence of biological composition and essential environmental input, a child’s brain does not develop normally (Stiles & Jernigan, 2010). During gestation and the first few years of life, organism intrinsic factors play a critical role in development, but 25 over the course of early childhood, a wide variety of factors in the external world influence the course of brain development in prominent ways. At each point of development, environment provides essential input (Stiles & Jernigan, 2010). Research suggests that parent-child relationships are the key to cognitive training and executive function development (Calderon, 2020) and children’s attention can directly relate to adult behaviors in the immediate context (Parrinello & Ruff, 1988). Additionally, negative emotion and interactions disorganize attentional processes (Center on the Developing Child Harvard University, 2021, Gaetner, 2008; Kim & Kochanska, 2012). Cognitive skill development can be seriously delayed or impaired and brain architecture disrupted when children do not get what they need from relationships with adults and the conditions of their environment (Center on the Developing Child at Harvard University, 2021). Constant support, shared experiences and time spent together are what helps build the cognitive scaffolding that allows for the development of self-regulation skills and the foundations of executive function (Calderon, 2020). Scaffolding refers to the passive, natural process through which new concepts are formed and how the brain integrates incoming information with existing knowledge structures, particularly in early childhood (Williams et al., 2009). As a child’s intentional capacities increase, their emerging deliberate emotion regulation skill set becomes revisable to scaffolding from adults (Grabell et al., 2019). This interpersonal scaffolding must involve a caregiver and a child engaging in conversation about emotions, social function and delivery of information that shapes understanding. A study by Kochanska et al. (2001), found that how mothers assist their child during negative emotion challenges predicted the child’s ability to endure the same negative challenge by themselves one year later. Similarly, Gaertner et al., (2008) multimethod study on focused attention in toddlers, showed that maternal praise and positive evaluations of effort, during a task where visual attention was measured, predicted higher levels of observed attention capacities. The level of positivity in the parent-child relationship is a strong predictor of a child’s self-regulatory skills, executive functioning, attention 26 span, academic achievement and child’s ability to be persistent in day to day tasks (Kim & Kochanska, 2012; McClelland et al., 2006; McClelland et al., 2000). Substantial research also suggests that one’s ability to successfully navigate a challenging task begins in infancy and through early childhood and the relationship with caregivers acts as a key context for reparative interactions during these tasks and this may be the foundation for developing emotional and behavioral regulation skills (Kemp et al., 2016). A common theme in developmental literature suggests that, for young children, experiencing challenges that include emotions of distress, anxiety or conflict, positive consequences may surface when such experiences are repaired on a consistent basis with a parent that coordinates problem solving techniques and positive interpersonal interactions (Kemp et al., 2016). Dr. Martin Seligam, a pioneer of positive psychology, explains that parents cannot teach their children without having connections and relationships. According to him, this can be achieved by focusing on human well-being which is a focus on their strengths (Seligam, 1996). Clinical researchers suggest that the real-time, moment-to-moment interactions parents have with their children are the immediate engines of development (Granic et al., 2007) and these day-to-day direct experiences are the substance out of which antisocial outcomes materialize. Therefore, Granic et al. (2007) argue that these experiences must also be the context through which these outcomes are changed with positive parenting strategies. Research supports the correlation between a young child’s poor emotional regulation to externalizing outcomes (Southam-Gerow et al., 2002). Parent-child interactions provide the context for which regulation skills are learned and practiced (Kim & Kochanska, 2012). Flexibility (being able to shift from one emotional state to another, according to context demands) is a key factor in these interactions for healthy development and allows for negative emotions to also be experienced and recognized (Granic et al., 2007). Parents facilitate the development of executive function when they establish routines, model positive social behaviors and create and maintain supportive and reliable relationships (Center on the 27 Developing Child at Harvard University, 2021). Spending time together and providing activities that foster creative play and human interaction, social connection, vigorous exercise and teaching children to cope with stress, builds the cognitive scaffolding for increased attentional abilities and emotional and self-regulation (Calderon, 2020; Center on the Developing Child at Harvard University, 2021; Kim & Kochanska, 2012). Physical activities, such as organized sports, can also promote the development of executive function as they require children to carry rules and strategies in their mind and adapt to other’s actions, be mentally flexible, monitor their own behaviors and performance, and increase blood flow to the brain (Calderon, 2020). It is important for parents to understand the effects of stress on a child. Because stress “freezes” a child’s ability to apply executive functions appropriately, it is a risk factor for dysfunction especially to young children as their cognitive capabilities have not yet matured (Calderon, 2020). Waiting is a stressful situation for human beings (Kim & Miao, 2011). Over- or under- stimulation from a child’s environment, such as boredom, is one of the predominant causes of stress for children (Marion, 2003), which could be associated with any type of waiting. We know from personal experience that when children are given a task they view as challenging or difficult, they are likely to act out. Children typically exhibit stress with a physical reaction; crying, sweaty palms, aggression, defensive outbursts, rocking and self-comforting behaviors, headaches, stomach aches, nervous fine motor behaviors such as hair twirling or biting, toilet accidents or sleep disturbances (Stansbury & Harris, 2000). Research suggests that mindfulness training and meditation have been shown to improve executive function, as they enhance prefrontal activation, and reduce stress. These mental exercises allow children to bring their attention to the present moment, examine feelings and emotions, identify coping strategies, breathe for calmness and express gratitude and kindness towards self and others (Calderon, 2020; Petersen & Posner, 2012). 28 More than ever, due to increasing competition and educational stressors, some parents take extreme or unethical measures to advance their children academically (Abeles et al., 2011). However, there is substantial research suggesting that executive function is a greater predictor of success than test scores, IQ and socioeconomic status (Diamond 2013; Diamond & Ling, 2016; Egger et al., 2019; Zelazo et al., 2016). For parents this research may bring an increased focus to the long-term benefits of fostering executive function development with regards to these kinds of societal pressures. Researchers also found that measures of executive functioning determine academic performance for first year college students in applied sciences and have significant influence on the outcome of the educational process (Baars et al., 2015). The following research aligns with other studies emphasizing the importance of the early childhood window to strengthen executive function. When inhibitory control networks are disrupted early in life, it may impair executive function abilities in adolescence and adulthood serving as a risk factor for later life drug use and other disorders (Elton et al., 2014). Additionally, the skill of willfully controlling one’s emotions is crucial and forecasts later functioning across academic, social and behavioral domains (Grabell et al., 2019). The same author suggests that there is a long-standing impact on mental health functioning and human capital with the capacity of humans to regulate negative emotions, such as irritability and frustration. These are natural emotions brought on by waiting (Kim & Miao, 2011). Therefore, waiting can provide an important opportunity for children to practice controlling emotions with parental guidance and positive interactions. Children can thrive in these types of challenging situations, work toward goals and recognize the power of their efforts which results in a growth mindset (Boylan et al., 2018). A growth mindset allows children to become active problem solvers in all situations, especially ones of stress, and occurs when abilities are increased over time and opportunities for challenging experiences are given, and effort is celebrated (Boyett, 2019). 29 From the research given in the preceding paragraphs, parents can better understand the profound significance of their responsibility and impact of nurturing cognitive development, building relationships, providing an environment of growth and teaching children positive ways to deal with stress. While young children may not have the physical capacity to wait longer than a few minutes, parents who focus on what they can do and help them be successful in all situations, allow for relationships to grow and learning capacities to be optimized during times of stress. For example, when children have personal interest in an activity, their attention span can double in length (Seefeldt & Wasik, 2005). Children also develop improved concentration and attention span when engaged in activities that are age appropriate (Mcilroy, 2021). When a child will be experiencing a waiting period, a parent influences executive function development when they explain to the child the situation that they will be experiencing beforehand, and provide an estimate of the duration of the wait (Kim & Miao, 2011). This author suggests that providing this kind of information reduces uncertainty and uncertainty is what often forecasts a negative experience. When waiting periods are extended beyond what was anticipated, anxiety is intensified (Kim & Miao, 2011). This same author suggests that when individuals have information about what is to be expected in a potentially emotional situation, emotional regulation tends to be more effective by decreasing the emotional relevance. Parents build executive function during waiting when they set appropriate expectations, are clear using specifics, empathize, provide frequent practice and try distractions with games or stimulating activities that involve problem solving, memory, attention cues, motor control or sequencing (Brain Balance, 2021; Rymanowicz, 2015). Also, identifying potential stumbling blocks and discussing solutions beforehand, providing exercise and movement, trying activities of physical manipulation while focusing on another task such as fidgets (Anunsen, 2021; Kim & Miao, 2011; OTFC, 2021), and providing brain breaks when attention span limits are met, allow children to gain lifelong problem-solving skills (Anunsen, 2021). 30 Attentional deployment strategies (distractions) are an important negative emotion regulator (Kim & Miao, 2011) and can help parents relieve the stress of waiting as well. When children receive a high proportion of effort and strategy praise, they exhibit strong increasing motivational frameworks in desired challenges (Gunderson et al. 2018). In a study conducted by Cole et al. (2009), young children who were able to verbally produce strategies for regulating anger, sadness or other emotions, and had high maternal supportiveness during distress, exhibited higher self-regulatory behaviors. In contrast, when parents were rigid, aggressive, harsh, insensitive or negative in their attempts to prevent or curtail misbehavior that may accompany stress or boredom, detrimental effects such as problem behaviors were shown in children later down the road, along with a smaller range of coping strategies and emotional intelligence when asked to problem solve (Granic et al., 2007). This same author suggests that healthy parent-child interactions need to be emotionally flexible and reparative to prevent aggressive childhood behaviors. Parents can help children be successful in accomplishing stressful tasks, that extend beyond their attention span capabilities by instituting brain breaks (Anunsen, 2021). Brain breaks can be as short as one minute and consist of physical activity that increases blood flow and oxygenation to the brain, thereby boosting neural connectivity and stimulating nerve cell growth (Terada, 2018) in the area of our brain responsible for learning (Merriam-Webster, n.d. Cerebrum). Brain breaks provide a reset to attention span and decrease stress, improve productivity and boost brain function (Godwin et al., 2016). These breaks reset focus using movement and keep the brain healthy, play a key role in cognitive abilities and actually improve attention and memory, as they change the structure of the brain (Terada, 2018). Brain breaks can reduce disruptive behavior and reset capacities to stay on task and increase effort after waning (Terada, 2018). 31 Parental influence cannot be underestimated when it comes to a child’s ability to wait. Including brain break resets frequently during any waiting period, that extends beyond the developmentally appropriate time period expectation, can make a positive difference in cognitive capacities. Methods and Design Mobile App Contents and Rationale for Activities Research suggests that interventions that support healthy outcomes for young children are feasible and necessary (Hinkley et al., 2018). Conversely, research shows as well that parents are largely unconcerned about their child’s screen use and this could be due to lack of knowledge of the outcomes (Martins et al., 2020; Sigman, 2012). For that reason, interventions that target outcomes for children’s well-being by educating parents may prove to be effective (Hinkley et al., 2018). Most parents want to reduce health risks for their children provided they understand the rationale behind the advisory and recommendations and are offered a clear course of action to accomplish it (Sigman, 2012). For these reasons and understanding that it is developmentally inappropriate for adults to expect young children to be able to wait longer than a few minutes, due to their limited attention span and under-developed executive function skills, as explained in the previous section of this proposal, I created a mobile app called While We’re Waiting. This app has 100 prop-free (except in restaurants where things on the table can be used), screen-free activities that parents can access in the palm of their hand during any waiting situation. The waiting situations include: restaurants, traveling/traffic, shopping, appointments (e.g., doctor, dentist etc.), amusement park lines, parks, sporting events, theaters/performances and churches. The activities in the app are designed for parents and children to pass the time of waiting with attentional deployment strategies (Kim, 2011) that reduce negative emotions, all while strengthening children’s cognitive abilities, enhancing executive function, fostering strong relationships, increasing family bonds, developing a growth mindset and creating positive interactions during the often stressful experience of waiting. Using the research from previous sections, activities have been compiled, 32 developed and organized (see Figure 3 for details) in a way that regardless of the waiting situation, parents can make it a positive, growth building experience. An app has been chosen because it gives parents an alternative to screens and relying on screens to pass the time. It provides tools for an “intentional parenting” philosophy (Huerta, 2018), one that uses strategies that build healthy parent-child relationships requiring effort, planning and prioritizing how time is spent together. Figure 3 App Content as Informed by Literature 33 Design Process After conducting a literature review, recognizing a problem worth solving, and generating a list of activities I wanted to include in this app, I hired a web developer to create the app. Therefore, this project will be conducted as a collaboration between myself, a subject matter expert (SME), a professional who has advanced knowledge in a field of study or an authority in a particular subject and who is uniquely qualified to provide strategy and guidance (indeed.com, 2021), and a web developer (McKenzie, 2021). I also investigated the apps available and found nothing already existing on the market with the features and content that I wanted to include in my app. I found a couple apps with waiting games or activities to do while waiting, but in those apps, all the activities were screen-based interactive activities. In my first meeting with the web developer, we brainstormed about the key functionalities the app would need, target audience, cost, usability and timeframe for construction. This is when we decided that the features of the app must include: simplicity, speed, good image resolution, clear and succinct instructions, search options, bright and fun color scheme, security, user feedback, updates and push notifications. We also decided that the app needs to be an Android app, because it is easier to create, it costs less for developers and users, and Android use is more popular outside the US and for lower income families (Wallen, 2021). Other things I also needed to consider were the upkeep of the app, costs to the creator and users, new features, updates that can be weekly, monthly or yearly, bug fixes and general upkeep. To be a successful app, it had to be user-friendly and simple to navigate. I also found that Google will review the app before making it available to users and that their process is less thorough than Apple process (N. Gottfredson, personal communication, September 11, 2021), which made it easier for launching. After deciding on the main features, the web designer created a paper prototype of the app (see Figure 4) (Hall, n/a). I felt that the prototype illustrated my vision. We discussed adding an introductory 34 screen with an explanation on how it will benefit users. This was important as, in my opinion and based on my professional experience, most parents recognize and appreciate the simplicity and lack of effort it takes to put their children in front of screens while waiting, and will need some enticement to make the effort to engage in these activities with their children. In addition, I decided to name the waiting situations screen “Waiting Whereabouts” with instructions for finding the activities for the situation the user is in. Figure 4 Paper Prototype of the App Next, we decided to create a simple wireframe. A wireframe is a simplified outline of the product containing boxes, words, lines and sometimes descriptions (Hall, n/a), which was meant to help 35 us visualize the end product (see Figure 5). According to the same author, the wireframe is meant to lay a framework of where the developer will take the app rather than its final look and feel. As you can see from this wireframe, the app was created to have different waiting situations indicated at the top of each square. These options can be scrolled through, top to bottom, until the one needed is found. The user will click on the situation and ten to 15 activities, specific for that waiting situation, will then come up and be categorized by age group. Each activity can then be clicked on for detailed instructions, such as how to play or do the activity, how many people are needed to play and if there are any props from around the room needed. Each activity will also indicate how it is helping with cognitive development (memory games, problem solving, sequencing), tactile sensory, attention span reset, relationship enhancement or mindfulness and meditation. Figure 5 Simple Wireframe of Waiting Situation Screen In our third meeting, the web developer and I discussed the next phase. From the wireframe the developer created a basic prototype to share with a target audience (Hall, n/a). We agreed that this will be done on a website called Figma (https://www.figma.com/) and although created on the computer with not quite the same feel as the app, this prototype allowed testers to have a real feel for what it 36 would be like to use the app (See Figure 6). This allowed the developer to have a better sense of the intended user experience, before she began the final design. Figure 6 Basic Prototype Content Design and Transfer Upon creating the basic prototype of the app, I proceeded to content development. The content for the app came from many years of waiting with my own children and creating activities we could do as a family to pass the time with fun, laughter and less stress. Most of the 100 activities (see Appendix A for a full list) are my own creation and the few that are not, are common household games and songs. 37 As I would consider inputting an activity into a Google Sheets, which is a document I created for my app developer so she can transfer content, I would test it out with my grandchildren who are ages four, three and two. We tested them in real life waiting situations, and if the activity worked successfully, meaning waiting was a positive experience with little to no stress and our relationship was strengthened by having fun together, I moved forward with including them in the Google Sheet. The Google Sheet has the following categories: activity title, instructions, materials needed, age best for, waiting location (situation) and mental and physical benefit to the activity. Upon considering what activities to include, I would determine if they met criteria established in literature to build executive function by providing opportunities for memory practice, sequencing, and problem solving, and cognitive flexibility (Carlson, 2018; Martins et al., 2020). The activity was included if it provided a mind stimulating distraction and an adequate brain break with physical movement or mindfulness (Anunsen, 2021; Kim & Miao, 2011; OTFC, 2021). Additionally, if the activities provided an opportunity for positive familial interactions thus strengthening relationships, it was included as well thus meeting research findings regarding parent/child relationships and their outcome to nurturing cognitive development and attentional capacities (Calderon, 2020; Altun et al., 2016). Therefore, I defined mental and physical benefits to child development, family relationships and screen free parenting practices based on literature presented in this thesis. I then spent January and February of 2022 inputting the information to the Google Sheets, which I then sent to the web developer once it was final, which was at the end of February of 2022. I spoke with the web developer weekly during the input process and met with her in person to discuss expectations and timeframe for completion. During this development phase, I shared the app idea with a friend who had young children and she was eager to test out some of the activities. She reported back to me that their restaurant experience had never been better and her sister who dined with them wanted to know where she had come up with the activities as she felt they were a “game changer” when waiting with children. 38 Figure 7 Criteria Graph Recruitment Process Once the final design was complete with Figma, we wanted to proceed to usability testing (Krug, 2014) with ten families in five different waiting situations. The children in these families varied in age, but were not older than ten. Families had to have at least one child under six to participate, as children under six were my target audience from this app development. A cultural and socioeconomic diverse group of families were invited to participate in the usability testing. Once they tried the app, I got feedback on what they liked or disliked about the app design, ease of use and any improvements that they wanted to see made before final launch. 39 On April 21, 2022, I was able to begin testing the prototype with families (see Figure 7 for how the app interface looked like in this phase). It took several weeks to enlist ten families who met the criteria I had determined in my proposal and who had an Android phone. These ten families were compiled of friends and local Headstart (https://www.davis.k12.ut.us/academics/early-childhood/head-startearly- head-start-and-title-i-preschool) participants. Figure 8 Final Interface of the App 40 The participants were ethnically and socioeconomically diverse and had at least one child under six years of age (see Table 1 for more demographic information). Each family was given a pre-assessment (see Appendix B) before beginning the testing and a post-assessment (see Appendix C) after using the app for two to three weeks, which provided general demographic information and feedback about app usability respectively. The app prototype was sent to participants via email to download to their Android phone, which required approval from the web developer. An Android phone with the app previously downloaded was made available to three participants who did not own one. Table 1 Demographic Information Usability Participant Race & Ethnicity Socioeconomic Status Highest Level of Education for mother Children under the age of 6 Children over the age of 6 Family 1 Latino Low N/A N/A N/A Family 2 White Low High School 2 5 Family 3 White Low High school 2 0 Family 4 Black Low N/A N/A N/A Family 5 White Low High School 2 0 Family 6 White Medium High School 2 1 Family 7 White High Master’s 2 1 Family 8 White Medium Bachelor’s 2 2 Family 9 White High Bachelor’s 1 4 Family 10 White Medium Bachelor’s 2 1 41 Results Usability Testing Feedback The feedback from the users was overwhelmingly positive. All the participants indicated that they had never thought about the opportunity that waiting can be to strengthen relationships and build cognitive capacities. Most of them did not know about or understand executive function development and how attentional capacities can be improved with parental support during the specific experience of waiting. One parent indicated that “it is an app they never knew they needed and now cannot live without.” One parent who used the app phone provided for non-Android users, informed me that her children refer to the app phone as “the fun phone” and ask her every day when she is going to get it back. All participants indicated that they would “most definitely” be interested in using the app that provided 100 screen free activities and would be “very likely” to use it after learning more about executive function development and how screens can negatively impact cognitive function. Overall, BEFORE app use, parents felt their ability to wait with their child for longer than 15 minutes without giving them a screen was at a five on a scale of one to ten, ten being most capable. However, after using the app for two to three weeks, participants felt their waiting experiences with their children improved markedly. On a scale of one to ten, ten being most improved, the average was eight. Participants felt that their family benefitted from the app use with strengthened relationships, increased attentional capacities, improvement in behavior during stressful situations, more positive parenting practices (less yelling, threats and punishments), increased problem-solving abilities, less negative interactions and less automatic responses to use a screen. It was also reported that, time seemed to pass more quickly, children and parents were happier, mothers felt less stress about waiting and children were remembering the activities and asking to do them at other times together and doing 42 them on their own with friends. Children started requesting certain activities while in waiting situations without parental suggestions instead of asking for the phone, while siblings practiced cooperation and enjoyed participating together, not just with parents. In general, it was reported that amusement park lines became more doable and less frustrating with young children and filled with fun while using the app activities. I tested six of the app activities on a family with five children that I did not know, while waiting at a restaurant for 45 minutes. The parents allowed me to take their children to a nearby table and teach the children some of the activities. The children ranged in ages from 12 years to 18 months and it was 45 minutes of laughter and fun as those children waited without any negative behavior and learned activities to pass the time patiently. The children gave raving reviews to all the activities and said they would use them next time they had to wait. I tested the app activities with another family whose parents informed me they never take their three children, ranging in ages from seven to two, to restaurants, because of difficult behavior displayed by the children whenever they do. I recorded them standing in line at a restaurant without using the app and then having them use some of the activities half way through the line. The difference was visible and encouraging. When using the app activities, the children were engaged together and focused and the time of waiting in line passed with no negative behavior or parental frustration. Once seated at the table, the family continued the app activities and for the 25 minutes of eating there was laughter, communication, and fun and the dining out experience passed with no negative interactions. Suggestions for Improvement Participants felt the improvements to the app should include: adding appealing images and color icons, with more visual elements (See Figure 8 for current interface colors) (see Figure 9 for visual changes we introduced), adding a “favorites” option, so that users can go directly there, when in a hurry. This would allow them to have the activities that they have used and children have particularly enjoyed 43 readily available. They also suggested to organize activities in blocks for youngest to oldest children, provide video instructions for those with reading challenges, having a random selection of activity once waiting situation and age was chosen and finally, get it for Apple users! Figure 9 Visual Improvements Introduced after First Phase of Research 44 The specific functions and features that were particularly liked about the app were: the way it was organized by situation and age, and that the directions were clear, concise, and straightforward. Participants found it easy to navigate and understand, when trying to quickly come up with an activity. They also found it was simple to use, it filled the mind with possibilities and allowed one to see how waiting could be fun. The variety of ideas and activities met a broad range of ages, the tips for helping parents prepare for a waiting situation were extremely helpful, the number of activities provided ample opportunity to change, if one wasn’t working or didn’t take long enough, no props were required, there were activities that met special needs children, children over age six were engaged as well and enjoyed the activities as much as the younger children, all stages and abilities were represented for young children and the activities provided an opportunity for interactions not thought of during waiting. Figure 10 Children Using App Activities (Permission granted by parents to use these photos): Straw Soccer/Hockey, What’s Gone and Once Upon a Time 45 Figure 11 Children at amusement park waiting for food WITHOUT the app activities Figure 12 Same children minutes later using app activity: Colors All Around Figure 13 Children and father using app activity: Arm Wrestle 46 Figure 14 Two-year-old using app activity while waiting at restaurant: Lid and Straw Balance Discussion Participant feedback about the app prototype is consistent with the literature provided in this thesis. As Calderon (2020) suggested, parent-child relationships are key to cognitive training and development and while using the app, 70% of the parents felt their relationships with their children had been strengthened. Additionally, 80% felt it contributed to improved parenting practices while waiting with less negative responses, such as yelling, threats and punishments for behavior consistent with boredom. The impact of these seemingly inconsequential interactions between parent and child, appeared to contribute to a child’s ability to wait successfully and develop executive function, as suggested by Altun et al. (2016). The app provides much needed support to children as they experience challenging and problem-solving situations (Crouch et al., 2012; Gaetner et al., 2008), which in turn provides them with productive solutions to negative feelings and promotes self-regulation without screens (Hoehe & Thibaut, 2020; Hutton et al., 2020). Consistent users of the app felt that there was an increase in attentional capacities and executive function skills due to the nature of the activities 47 targeting the specific capacities of working memory, inhibitory control and cognitive flexibility, as suggested by research (e.g., Calderon, 2020; Knapp & Morton, 2013). All participants testing the app were unaware of the recommendation by child development experts regarding a child’s ability to wait or maintain focus, the average period of time they can be successful in that pursuit and the negative impact of screen use in the early years (Altun et al., 2016; Cytowic, 2015; Sigman, 2012). As stated by Sigman (2012), “any guidance on screen time would benefit from the inclusion of suggestions for developing constructive practical alternatives to screen time” (p.5). In my opinion, this app provides the “constructive alternative” that he recommended. Sigman’s research suggests that once parents understand the rationale behind advisements from scientific research, they want to reduce any health risks posed to children. The work done in this thesis provides parents with an increased understanding of child development and the crucial nature of the first six years of life and the effect of positive interactions during challenging experiences, such as waiting, and screen use during that critical time frame of development. Once the app is officially available to a worldwide audience, it will be interesting to continue receiving feedback from parents about the effects of the app on their family and how and if it is changing their experiences while waiting. It is estimated by some that Americans will spend 37 billion hours each year waiting (“How Much Time”, 2017) and that provides parents with a significant and critical opportunity that should not be overlooked to strengthen relationships and build executive function. According to the Center on the Developing Child Harvard University (2021), executive function skills enable positive behavior and lead to abilities to make healthy choices. The While We’re Waiting app, based on comprehensive theory and research, provides parents with an easy to use, always accessible tool that has big impact for helping develop these decisive cognitive competencies. Additionally, with its ability to increase positive interactions during challenging situations, it aids parents striving to incorporate intentional parenting 48 practices (Huerta, 2018) that can contribute to children of the 21st century having improved attentional and problem-solving capacities that will have lifelong benefits to individuals and society. Limitations One of the limitations of this study was lack of literature about the topic of waiting as a noun and the physiological effects of it on human beings and particularly waiting with children. Little research and studies exist in regards to waiting, specifically as it refers to remaining stationary until an expected event happens, but using research about attention span development, executive function, parental influence on children during challenging experiences and screen use made it possible to create a solid framework for waiting, as it pertains to my subject. Another limitation that has been frustrating is that the first edition of the app is designed only for Android users. Android use is more prominent in all countries other than America and is less expensive to use. Additionally, my web developer’s skill set was for that of Android creation. I look forward to reaching many Android users across the world, however, most people that I know use iPhones and many have expressed great interest in the app and look forward to the IOS version. 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The first person to laugh in the pair is out and the group continues pairing up with the 'winners" until a grand winner is determined by being the last to laugh in every match. eyes and silly faces 2 and up Restaurants, Lines, Appointments, Relationsh ip building, Brain Break Do As I Say, NOT As I Do Choose one person to be the leader. Leader instructs group to do an action but does the opposite trying to trick the others into following their actions not their words. Example: "Touch your nose." Leader touches their elbow. Whoever follows the leader's actions instead of their words is out. Continue playing until one person is left who has always followed words. None 3 and up Restaurants, Lines, Appointments, Executive Function Developm ent, Problem Solving Shoe Tying Contest Everyone unties shoes, on the word "GO" first person to get both shoes tied, is winner Shoes with ties, can do it as well with velcro shoes 3 and up Restaurants, Lines, Appointments, Brain Breaks, Hand activity, Relationsh ip building Race Walk to Bathroom door Each member of family takes a turn walking as fast as they can from the table or line to the nearest bathroom. They touch the door and return to initial spot. Someone runs the timer on the phone and keeps track of each person's time. Winner is one who could do it the fastest WITHOUT RUNNING. Caution: Restaurants will not want people running through their restaurant so speedy walking is only recommended. Timer on phone 2 and up Restaurants, Lines, Appointments, Sporting Events, Shopping Brain Breaks, Relationsh ip building, Problem Solving 20 Questions Each family member gets a turn to pick a category and choose in their mind one thing others will try to guess in that category. Ex. Category: Animals Person chooses Bear. Family gets 20 YES or NO questions to get the correct answer. Ex. "Is it a mammal?", "Does it live in the mountains?" , "Can it be a pet?" etc. None 3 and up Restaurants, Lines, Appointments, Travel/Traffic, Shopping, Memory, Problem Solving, Executive Function 62 What's Gone Have the group look at the table or counter. Choose one person to close their eyes. Choose another person to remove something from the table and hide it out of sight. The person with their eyes closed looks at the table and tries to determine what object is gone. Continue play until everyone gets a turn. If there are not objects on the table find some napkins, lids or straws or items from a purse or pockets to add to the table. See instructio ns 2 and up Restaurants, Appointments Executive Function Developm ent, Problem Solving, Sequencin g, Memory Games I Spy With My Little Eye Each person takes a turn choosing an item in their surroundings and gives the group one clue about it. Ex. "I spy something red." The rest of the group makes guesses about what it could be. Play proceeds as each person in the group takes a turn choosing an item and giving a clue. None 2 and up Restaurants, Lines, Appointments, Travel, Sporiting Events, Shopping, Performances, Church Problem Solving, Memory, Attentional Capacity Developm ent Make It Out of Napkin Each person in the group takes a napkin and tries to create something. Instructional video of creating a swan is included. Napkin or tissue 3 and up Restaurants, Appointments Hand activity for attention reset Code Word Group determines a "CODE" word which has to be something that is on the table or counter or within reach (Example: "Salt"). During the course of conversation, whenever someone says the established code word everyone has to reach for the salt. Whoever is the first to grab it wins. Parents should purposefully try to use the "code word" in their conversations to keep the game lively. Continue play throughout the meal or appointment. Objects on table 2 and up Restaurants, Appointments Memory, Attentional Capacity Developm ent, Hand activity, Relationsh ip building Code Word Restaurant Group determines a "CODE" word which is often used during normal family conversation or while eating. Whenever that word is said by anyone during normal conversation over the course of the meal, everyone grabs their fork and holds it up in the air. The last one to hold up their fork is out. Play continues through meal until winner is established. Example of a word that would work well for this game is, "GOOD" or "YUMMY"or one family member's name etc. None 2 and up Restaurant Memory, Attentional Capacity Developm ent, Hand activity, Relationsh ip building Code Word Action Group determines a "CODE" word that is used in every sentence like "and," "the" etc. Whenever that word is said by anyone during the course of conversation, everyone claps their None 2 and up Lines, Appointments, Shopping, Travel/Traffic Memory, Attentional Capacity Developm ent, Hand 63 hands or touches their nose. Last one to touch or clap is out and continue play until winner is established. Parents should try to emphasize this word in their conversation to keep the game lively. activity, Relationsh ip building Going On A Trip First person in group begins with saying, "I'm going on a trip and I'm going to take my (fill in the blank). Ex. "my pillow." The next person goes and repeats what the first person said and adds their own item. Ex. "I'm going on a trip and I'm going to take my pillow and my toothbrush." Play continues going through as each person adds on to what each previous player said then adds their own. When one person gets the order incorrect they are out and play continues until their is a winner. None 3 and up Restaurants, Lines, Appointments, Travel/Traffic, Sporting Events, Shopping Executive Function developm ent, Memory, Sequencin g, Relationsh ip building My Favorites Each family member takes a turn choosing a topic (Explain to young children that a topic is a subject or the one thing that everyone will think about . Then each family member shares their favorite thing of that topic. Ex. Topic: Cereal Go through until each family member has had a turn to pick a topic None 2 and up Restaurants, Lines, Appointments, Travel/Traffic, Shopping Mindfulne ss, Relationsh ip building, Attentional Capacity developm ent, Odd One Out Gather 3-4 objects from your surroundings (table, counter top) and put in a pile, ask, "which is the odd one out?" Meaning after thinking, looking and discussing, try to figure out the one object that would be LEAST related by color, characteristic, how you use, etc. The one least related is out. Repeat as waiting time allows. Objects from surroundi ngs 3 and up Restaurants, Appointments, Shopping Problem Solving, Executive Function, Mindfulne ss, Telephone One member of the group is picked to whisper a sentence or phrase into the ear of the person sitting on their right. That person then whispers what he/she heard the first person say into the ear of the person on their right and so forth until all the group has had the phrase whispered in their ear. The last person to get the message then tells out loud what they heard. The first person who picked the phrase or sentence then tells what the original message was. Group determines how close the final message was to the beginning. None 2 and up Restaurants, Lines, Appointments, Traffic, Sporting Events, Theater Memory, Sequencin g, Executive Function, Relationsh ip building, Mindfulne ss 64 Silent Do As I'm Doing One member is chosen to lead the group in following every action they do. They trick is NO SOUND can be made. First person to laugh or make any kind of sound is out. Play continues in rounds as each person gets a turn to lead. None 2 and up Restaurants, Lines, Appointments, Sporting Events, Shopping, Traffic, Theater, Performances Brain Breaks, Problem Solving, Meditation , Mindfulne ss, Hand activity, Executive Function Lid Race Each person will need a plastic lid (drink cup lids available at most restuarants) and a straw. Set the lids on the table in a row. On the word "GO" each family member will blow their lid and see who can get their lid to the end of the table first. VARIATION: teams can be made start their lids at opposing sides of the table and on "GO" which ever team can blow their lids across the opposite end first are the winners. TIP: It is helpful to have one person be on the opposite end to act as goalie and keep all lids from landing on the floor. Lids and straws 2 and up Restaurants Relationsh ip building, Hand activity, Brain Break Lid and Straw Balance Each person needs a plastic drink lid and a straw. They place the straw on the edge of the lid and on "GO" everyone in group balances their lid (without putting it through the slits made for straws) and whoever keeps it up in the air the longest is the winner. If this is too easy for group, have each participant move their lid and straw from side to side, up and down, stand up with it and turn around. Lids and straws 2 and up Restaurants, Sporting Events Problem Solving, Relationsh ip building, Hand actviity, Brain Break What I Like About YOU One person in the group is chosen to be "it". Each person in the group then takes a turn and tells one thing they love about the "it" person. Every person in the group gets a turn to be the "it" person. None 2 and up Restaurants, Lines, Travel/Traffic, Appointments, Sporting Events, Shopping, Theater/Perform ances Relationsh ip building, Mindfulne ss When You Were Born A parent (or both if present) tells each child one or two details about the day they were born. Then they tell their children one or two memories from their childhood. VARIATION: Parent asks questions like "Which child was born in (name city)", "which child weighed the most?" "Which child had the most hair?", "What was my favorite None 2 and up Restaurants, Lines, Travel/Traffic, Appointments, Sporting Events, Shopping, Theater/Perform ances Relationsh ip building, Mindfulne ss, Memory, Attentional capacity developm ent 65 thing to eat while I was pregnant ?" etc. Penny Balance Each person gets a penny (or any coin will work). The penny is placed on the fingertip (palm facing up) of the index finger (pointer finger) and on the word "go" the contest begins who can keep it on their finger the longest without it falling. After a few seconds if no one has dropped the penny, everyone must stand up and turn around. If in a place where you cannot stand up, the finger holding the penny must move across the body from side to side. Last person to keep penny on finger without falling is the winner. Pennies, or coins of any kind 2 and up Restaurants, Lines, Travel/Traffic, Appointments, Sporting Events, Shopping, Theater/Perform ances Brain Breaks, Hand activity, Meditation , Relationsh ip building See How Much $ Each family member makes a guess as to how much money (coin and cash) the parent has in their wallet. The wallet is then brought out and all the money is counted by amount. The person closest in the winner but does NOT get all the money :) Then take the money and sort it by size, and value, then make a line starting with smallest size to largest size and have the child determine if the line is as long as their finger, foot or hand. If standing in line this can be done just by holding the money and using kids hands to sort or practice learning the value of each coin. Money from a wallet 2 and up Restuarants, Lines Executive Function, Attentiona l capacity developm ent, Problem Solving, Hand Activity, Relationsh ip Building, Sequencin g Tie Shoe Contest Anyone in the group wearing shoes with ties unties them. Each person gets a turn to see how fast they can tie the shoes. Use timer on phone to time each person. If everyone in group has tie shoes then whole group will compete at the same time. Children who do not know how to tie can cheer or be the timer. Ties on shoes 4 and up Restaurants, Lines, Appointments, Sporting events, Memory, Problem Solving, Hand activity, Relationsh ip building Where Could It Be Find an item; a coin, lipstick or chapstick or another item from a parent purse or pocket OR an item from the table, or desk/countertop (cotton ball or tongue depressor from doctors office counter) and have one member of the group hide it while all the rest of the group closes their eyes. When it is hidden the group opens their eyes and the first to spot it is the winner and it is then their turn to hide the item while everyone else closes their eyes. Small item that can be hidden 2 and up Restaurants, Lines, Appointments Memory, Problem Solving, Relationsh ip building 66 Hand Puppet Show Make a fist with one hand, on index finger draw two eyes with a pen. Thumb will be the mouth of the puppet. Each person gets to tell a story or saying using their hand puppet. After each person has had a turn create a story using all the hand puppets. Remember to help children create a beginning, middle and end to their story. Pen for drawing eyes, hand 2 and up Restaurants, Lines, Appointments, Sporting events, Traffic, Travel Hand activity for attention reset, Memory, Sequencin g, Relationsh ip Building You Saw What? Assign one person to be "it." They make "glasses" with their fingers by bringing the index finger and thumb together to form a circle. They lift the circles to the eyes. The "it" person then says, something like this (using an animal or object) "I saw a duck run by." The first person in the group to make a duck sound or waddle like a duck then becomes the "it" person. They make glasses with their fingers and say a new object or animal, EX., "I saw a racecar speed by." First person to make a racecar sound or motion with the body or hand is now "it." Fingers 2 and up Restaurants, Lines, Appointments, Shopping, Traffic Hand activity, Brain Break, Attentional Capacity developm ent, Relationsh ip Building Mixed Up Story Tell one of your child's favorite stories but make up new names for the characters and tell it all wrong. When story is over have them tell it correctly. VARIATION: Make up new names and characters and settings and a different ending to their favorite story. None 2 and up Restaurants, Lines, Appointments, Memory, Problem Solving, Sequencing, Relationship building, Executive Function Mixed Up Song Sing one of your child's favorite songs all wrong. Everyone take a turn changing the words or tune. VARIATION: Sing the words of one song to the tune of another EX. Tune:Twinkle, Twinkle Little Star but words of Row, Row, Row, Your Boat (this is difficult by really good for executive function building) None 2 and up Restaurants, Lines, Appointments, Memory, Problem Solving, Sequencing, Relationship building, Executive Function Name That Tune Pick one member of the group to choose a song in their mind and hum or la la the first 5 notes. Whoever guesses first gets to be 'it'. VARIATION: One member of the group is picked to choose a song. The rest of the group then gets to tell how many notes they need to guess the song. The person predicting the fewest None 3 and up Restaurants, Lines, Appointments, Travel/Traffic, Shopping Memory, Problem Solving, Relationsh ip Building, Mindfulne ss, 67 notes gets to go first. If they miss they are out. Go to next person who predicted fewest notes and so forth until song is guessed. Executive Function How Will You Sing It? The group decides on a song everyone knows, Example: Twinkle, Twinkle Little Star. Then each person must choose a different genre (musical style) or accent to sing it in; Rock, country twang, opera, soprano, blues, etc. etc. This game is so funny it is rare for one person to get through a whole song! None 2 and up Traffic/Travel, Lines, Appointments, Memory, Problem Solving, Relationsh ip Building, Mindfulne ss, Executive Function Guess What They Do? Have the group look around the room and pick someone. Each member of the group discreetly points to the person they chose and tells the family what they think that person does for a living. After each person has gone, they then tell what that person did for the entire day and how they think they ended up whenever you happen to be at the moment. None 3 and up Restaurants, Lines, Appointments, Shopping, Traffic/Travel, Sporting Events, Theater/Perform ances Problem Solving, Executive Function, Relationsh ip building Newspape r Reporter Choose one person to be the "reporter." He/She can then say something like a reporter would say; Example: "Good evening, I'm (name), reporting live from ____________ and I have (name of person) here with me and we are finding out just what happened in their day." He/She then asks one person to tell the best thing about their day, craziest thing, scariest thing about their day and reports back to the pretend audience. Take turns being the reporter until everyone has had a turn and had a turn to be interviewed. None 3 and up Restaurants, Lines, Appointments, Shopping, Travel/Traffic Relationsh ip building, Mindfulne ss, Sequencin g, Memory Peek A Boo Parent covers their eyes with their hands while looking at baby or toddler. Then removes hands quickly and says "Peek a Boo!" Vary times that you keep your eyes covered to keep the anticipation going.Then see if baby or toddler will mimic covering their eyes. None Baby/Tod dler Restaurants, Lines, Appointments, Shopping, Church Relationsh ip building, Memory, Problem Solving, Attention Capacity developm ent This Little Piggy Parent gently grabs and wiggles each toe of child and says in an excited, interesting voice beginning with the big toe, "This little piggy went to market (big toe), this little piggy stayed home (2nd toe), this little piggy had roast None Baby/Tod dler and up Restaurants, LInes, Appointments, Shopping, Sporting Events Relationsh ip building, Sequencin g, Executive function 68 beef (third toe), and this little piggy had none (4th toe), and this little piggy cried wee, wee, wee all the way home" (pinky toe). developm ent Not Old McDonald s Regular Farm Parent sings traditional tune but changes words as such, "Old McDonald Had a farm eee i eee i oh, and on that farm he had a snake (move hands like a snake) eee i eee i oh, with a ssssss, here and sssss here, here a ssss, there a ssssss, everywhere a ssssss, sssss, Old McDonald had a farm eee i eee i oh. And on the farm he had a airplane" etc. etc. (use different animals and objects not usually in the song but be sure to add actions for whatever it is you're singing about. None Baby/Tod dler and up Restaurants, Lines, Appointments, Travel/Traffic, Shopping Relationsh ip building, Attention capacity developm ent, Executive function developm ent, Sequencin g Ride a Horsey Parent places child on their lap and takes their hands in theirs. Parent says while bouncing knees, "Ride a horsey, ride a horsey all the way to town, if you are not careful you will fall right down!" The parent opens their knees and gently lets the child fall through a little ways while still holding their hands. Repeat it fast and slow and with a low and high voice. Be prepared to do it over and over again, it's a big hit! None Baby/Tod dler and up Restaurants, Appointments, Sporting Events, Church Relationsh ip building, Memory, Attentional capacity developm ent Where is Thumbkin Child and Parent holds up all fingers on both hands and puts them behind their back. Song: To the tune of Frere Jacques "Where is thumbkin, where is thumbkin? Here I am (bring out right hand with only thumb sticking up), here I am (bring out left hand with only thumb sticking up). Have the thumbs bow to each other while singing, "how are you today sir, very well I thank you. Run away (left hand hides behind back) Run away (right hand hides behind back), Continue song with "Pointer" (index finger), "Tall Man" (middle finger), "Ring Man" (4th finger) and "Pinky" (pinky finger). When get to "pinky" be sure and use a high squeaky voice! Then final verse is "Where is family, where is family. Here we are (bring out right hand with all fingers up and wiggling), Here we are (bring out left hand with all fingers wiggling). How are you today sir, very well I thank you (hands wave back and forth to each other), Run away (right Hands and fingers Baby/Tod dler and up Restaurants, Appointments, Travel/Traffic, Sporting Events, Shopping, Church Relationsh ip building, Memory, Hand activity, Brain break, Sequencin g, Mindfulne ss 69 hand goes behind back), run away (left hand goes behind back). Then a special surprise at the very end all the fingers come out for a tickle session. This hand activity/song is very good for dexterity and fine motor development. Counting How? Together practice counting by 2's, 3's, 5's and 10's, then practice counting to 100 clapping when reach each 10's place- Ex. "1,2,3,4,5,6,7,8,9,10 (clap), 11,12,13,14,15,16,17,18,19,20" (clap) and so forth. Variation: when counting to 100 whisper all the 20's, 40's, 60's, and 80's. Close eyes for every number with 8 in it etc. Variation For Church: write the numbers on paper None 4 and up Restaurants, Appointments, Travel/Traffic, Sporting Events, Shopping, Church Executive function, Memory, Sequencin g, Mindfulne ss, Problem Solving Alphabet Backwards Together try and say the alphabet backwards without looking at any helps. "Z,Y,X, W,V,U,T,S,R,Q,P,O,N,M,L,K,J,I,H,G,F, E,D,C,B,A" For church: write it backwards None 4 and up Restaurants, Appointments, Travel/Traffic, Sporting Events, Shopping, Church Executive function, Memory, Sequencin g, Mindfulne ss, Problem Solving. Language developm ent Alphabet STOP Choose one person to be "it". That person will determine when to shout "STOP" during the singing of the alphabet song. Whatever letter was being said when "STOP" was shouted is now the letter everyone in the group has to say one thing that starts with that letter (a category can be determined before play begins such as animals, cities etc) or everyone has to say one thing that starts with that letter that is in the room or can be seen from wherever you are. Play continues with a new 'it' person and song repeats from the beginning each time until each person in group has had a turn to shout "STOP". VARIATION: When 'it' person shouts "STOP" whatever letter is said