|
What
is Early Childhood Mental Health?
As attention to early childhood mental health has increased,
some people question the use of the term “mental health”
in connection with young children, given the stigma still associated
with mental illness. Can infants, toddlers, and pre-schoolers
even be mentally ill and, secondly, even if they can, why would
we want to attach such a label to a child that might stick with
him or her for a long time and negatively affect the way others
respond to the child? Why call it early childhood mental health?
To begin with, mental illness and mental health are not the same
thing, even though they are often closely connected because, for
example, agencies that treat mental illness often have the words
“mental health” in their names. But one term focuses
on a problem (illness), while the other focuses on something positive
(health). When we talk about “early childhood mental health,”
we are not primarily talking about bipolar disorder, major depression,
or even oppositional defiant disorder or conduct disorder, even
though it is possible that some of the young children served by
early childhood mental health initiatives will develop those illnesses.
Rather, we are referring to the positive results of intervening
early before problems develop into something more serious. Simply
put, early childhood mental health is the same as healthy social
and emotional development in young children, encompassing things
like learning to express and regulate emotions, forming close
and secure personal relationships, and exploring and learning
about their environment (paraphrased from the definition
developed by Zero to Three’s Infant Mental Health Task Force
and used by Pennsylvania’s Infant-Toddler Mental Health
Project.) So why don’t we call it “early childhood
social and emotional development?” Besides that being quite
a mouthful, the language of mental health is important not only
for its educational value in combating stigma against mental health
problems, but also for its implicit reminder that if we don’t
do our job with prevention with young children, their problems
may require more serious interventions later in life. We truly
do want them to develop good “mental health” in the
most positive sense of that term.
Return to Top
Periodic Updates on Early Childhood Mental Health Initiatives in Pennsylvania
June 2009: Includes data from Early Childhood Mental Health Consultation Project, information about various workforce development efforts, and a tribute to the late Jane Knitzer. Feel free to print and distribute.
November 2008: Contains a report of the new Early Childhood Mental Health Advisory Committee, along with updates on initiatives in workforce development.
May 2008: Contains information about the December 2007 Infant-Toddler Mental Health Symposium and brief summaries of other ECMH-related initiatives. For a fuller report of the symposium, check the Briefing Report.
- Briefing
Report from Pennsylvania’s Infant-Toddler Mental Health
Symposium, December 2007
These updates are designed to be printed and distributed to anyone who is interested.
Return to Top
Early Childhood Mental Health Advisory
Committee Update
The advisory committee met again on June 2. Michele Myers-Cepicka, a member of the advisory committee and executive director of the Alliance for Infants and Toddlers in Pittsburgh, reported on her recent testimony before a Pennsylvania House of Representatives subcommittee on the importance of attention to the social and emotional development of young children. The remainder of the agenda focused primarily on preparing the recommendations that the advisory committee will present to Estelle Richman, secretary of the Department of Public Welfare, at the next meeting on September 1. Each of the three workgroups—prevention and intervention, professional workforce development, and communication and collaboration—is developing recommendations that if implemented will help to sustain and advance Pennsylvania's efforts to promote the social and emotional development of young children, birth through five years.
Return to Top
Pennsylvania’s Early Childhood
Mental Health Consultation Project
The Office
of Child Development and Early Learning and the Office of
Mental Health and Substance Abuse Services are partnering to promote
healthy social and emotional development in young children. The
two offices have combined resources to establish an Early Childhood
Mental Health Consultation Project to serve infants and toddlers
birth to age three in early care and learning centers. Originally
funded by grants and operating in three regions of the state,
the Early Childhood Mental Health Consultation Project has expanded
statewide during fiscal year 2007/08. There are Early Childhood
Mental Health consultants in each of the six
regional Keys that serve early learning programs in Pennsylvania.
The consultants help staff at early care and learning centers
by observing children and program practices, developing goals
and strategies to enhance the practitioners’ capacity to
encourage positive relationships, creating a learning environment
that promotes positive behaviors, and addressing the needs of
children who are experiencing behavioral challenges. As a resource
to the Early Childhood Mental Health Consultants, a child psychiatrist
is available for clinical consultation. In addition, collaboration
between county children’s mental health systems and the
consultants is encouraged when young children need to be referred
to the mental health system.
Resources on Early Childhood Mental Health Consultation
- Characteristics
of Effective Mental Health Consultation in Early Childhood Settings:
Multilevel Analysis of a National Survey, by B. Green, M. Everhart,
L. Gordon, and M. G. Gettman. Published in 2006 in Topics in Early
Childhood Special Education (Vol. 26, No. 3, pp. 142-152).
- Early
Childhood Mental Health Consultation, by E. Cohen and R. Kaufmann.
Volume 1 of 2005 series on Promotion of Mental Health and Prevention
of Mental Health and Behavioral Disorders, published by the Substance
Abuse and Mental Health Services Administration.
- Early
Childhood Mental Health Consultation: A Developing Profession,
by M. Allen, E. Brennan, B. Green, K. Hepburn & R. Kaufmann.
Published in the Winter 2008 edition of Focal Point, a publication
of the Research and Training Center in Family Support and Children’s
Mental Health, Portland State University.
- Early
Childhood Mental Health Consultation: An Evaluation Tool Kit,
by K. Hepburn, et al. Published in 2007 by the National Technical
Assistance Center at Georgetown University, and the Research and
Training Center in Family Support and Children’s Mental
Health at Portland State University.
Evaluation Report Released on Early Childhood Mental Health Consultation
Since 2006, Early Childhood Mental Health Consultants, located in the six regions of the Pennsylvania Key, have helped staff at early care and learning facilities address the needs of young children who are experiencing emotional and behavioral challenges. The University of Pittsburgh Office of Child Development recently released their evaluation report of the first two years of the Early Childhood Mental Health Consultation Project. Here are few of the findings:
- Over the course of the two-year pilot, the seven-member team served 226 children and 133 early learning programs.
- ECMH consultants referred 58% of their cases to other support services, most frequently to early intervention, but also to STARS technical assistance, children's mental health agencies, and other supports (pediatricians, etc.).
- The program received high praise from early care and education practitioners; on-site assistance was viewed as the most valued and helpful aspect of the program.
- Stakeholders felt that the project made valuable contributions to the state's early childhood mental health system: increased awareness of children's mental health issues; increased knowledge of services, supports and child development; and increased access to educational materials, referrals, support services, training and collaboration.
- There is still much work to be done: families need information, education and support, and practitioners and administrators need more resources, training and networking opportunities.
- The evaluators recommend that the project develop a detailed plan to identify goals, core program activities and program outcomes.
Finally, the ECMH consultants made several specific suggestions:
- Consultation services to young children through age 5 years,
- Additional training for early care and education staff on mental health and family issues,
- Expanded education for legislators on the importance of social emotional development in young children,
- Directed outreach and marketing of the project to families especially in rural counties,
- A continuing education system and professional development opportunities for early care and education staff focusing on social emotional development, and
- Support for ECMH staff that includes regularly scheduled reflective supervision, and expansion of consultants’ role to include systems building.
The Department of Public Welfare recently issued a news release about the evaluation report which includes a link to the full report.
Return to Top
Focus on Early Childhood Mental Health - Handouts
One of the resources the Early Childhood Mental Health Consultation Project is providing to Keystone STARS early care and learning facilities across the commonwealth is a series of brief reader-friendly discussions of various topics of concern to parents of young children and early learning practitioners, called "Focus on Early Childhood Mental Health." A new topic is explored each month and can be used in facility newsletters or as handouts for parents.
Return to Top
Additional Resources on Early Childhood Mental Health
- Building
Blocks to a Healthy Future. This resource from SAMHSA for
parents, caregivers, and teachers of children aged three to six
provides lots of great tips, materials, and ideas for spending
time with their children and learning together.
- Child, Family and Community Core Competencies: Competencies
for Infant-Toddler and Early Childhood Mental Health Professionals,
by M. Hansen, C. Anderson, S. Peters, M. Lindblad-Goldberg &
D. Marsh. Published in 1999 by the former PA CASSP Training and
Technical Assistance Institute. Contact hsb5@psu.edu
for a copy.
- Helping
Young Children Succeed: Strategies to Promote Early Childhood
Social and Emotional Development, by J. Choen, N. Onunaku,
S. Clothier & J. Poppe. Published in 2005 by the National
Conference of State Legislators and Zero to Three.
- Improving
maternal and infant mental health: Focus on maternal depression,
by N. Onunaku. Published in 2005 by Zero to Three: National Center
for Infants, Toddlers and Families.
- Program-Wide
Positive Behavior Support: Supporting Young Children’s
Social-Emotional Development and Addressing Challenging Behavior,
by L. Fox, S. Jack & L. Broyles. Published in 2005 by the
University of South Florida’s Mental Health Institute.
- Promising
Practices in Early Childhood Mental Health, by J. Simpson,
P. Jivanjee, N. Koroloff & M. Garcia. Volume III in the 2001
Series on Promising Practices in Children’s Mental Health,
published by the Substance Abuse and Mental Health Services Administration.
- Putting
It Together: Providing Mental Health Services in Early Intervention,
by S. Burns, V. Stagg, and B. Brennermon. Published in 1999 as
a CASSP Monograph.
- Reducing
maternal depression and its impact on children: Toward a responsive
early childhood policy framework, by J. Knitzer, S. Theberge,
S. & K. Johnson. Published in 2008 by the National Center
for Children in Poverty at Columbia University.
- Screening for Social Emotional Concerns: Consideration in the Selection of Instruments. J. Henderson and P. Strain, January 2009. This "Roadmap to Effective Intervention Practices," published by the Technical Assistance Center on Social Emotional Intervention for Young Children, provides an overview of various screening instruments and helps administrators and teachers decide which ones are best for their programs.
- The
Social and Emotional Development of Young Children, March
2008 edition of the PA?CASSP?Newsletter, published by the Office
of Mental Health and Substance Abuse Services, Bureau of Children’s
Behavioral Health Services.
- What
Is Infant Mental Health?
Return to Top
Action Plan Released for Fetal Alcohol Spectrum Disorders
During Fetal Alcohol Spectrum Disorders Awareness Week in September, the Department of Health released The Pennsylvania Fetal Alcohol Spectrum Disorders Action Plan 2008. Secretary of Health Dr. Calvin Johnson noted that the action plan “is intended to provide a plan of action to address the very serious issue of birth defects caused by prenatal alcohol exposure. With a prevalence rate estimated at 1 in 100 live births for a spectrum of disorders which are 100 preventable, it is vital for the commonwealth to take steps toward prevention and intervention of FASD.”
The plan was developed by a state task force that included parents, advocates, physicians, researchers, service providers, nurses and government policy makers. It lists goals and objectives in five major areas:
- Awareness: Increase awareness of FASD and its symptoms.
- Data: Collect, interpret, and disseminate information on FASD.
- Education: Increase the knowledge of FASD within the professional community and the general population.
- Funding: Ensure adequate funding for prevention as well as services for diagnosis and intervention for children, adults and families affected by FASD.
- System: Align and improve systems of care by making FASD a statewide priority.
According to the National Organization on Fetal Alcohol Syndrome, alcohol use during pregnancy is the leading preventable cause of mental retardation and birth defects in the United States, and affects about 40,000 babies each year—more than spina bifida, Downs Syndrome and muscular dystrophy combined. Effects of FASD include growth deficits, mental retardation, physical defects, behavior problems, attention and memory problems, difficulties with motor skills and poor judgment. Additional descriptions and diagnostic labels for children and adolescents with FASD include oppositional defiant disorder, obsessive compulsive disorder, depression, conduct disorder, attention deficit hyperactivity disorder, attachment disorder, sleep disorders, extreme aggressiveness, extreme impulsivity and learning disability. The Centers for Disease Control asserts that there is no cure for FASD, but if children are identified early and receive appropriate services, they can be helped.
For additional information about FASD and two Pennsylvania family stories, check out the June 2006 edition of the PA CASSP Newsletter, “Focus on Fetal Alcohol Spectrum Disorder.”
Return to Top
|
