A Guide to Infant & Early Childhood Mental Health
Welcome to A Guide to Infant and Early Childhood Mental Health, originally published in 2006 as A Guide to Early Childhood Mental Health. This revised and updated version reflects recent advances in the multidisciplinary field of Infant and Early Childhood Mental Health (IECMH) and will focus on infants and young children, beginning prenatally and extending to six years of age. In keeping with IECMH principles, we also focus on the relationships between children, their parents, caregivers and the professionals who work with them. In this guide we emphasize the promotion of young children’s heathy mental health during these critical early years of brain development and the prevention of mental health difficulties. This guide is written for the multidisciplinary practitioners who work with infants, toddlers and preschoolers, and their caregivers and families. This includes providers of early care and education in settings such as Head Start, childcare, early childhood education, medical settings, early childhood special education and intervention, home visiting programs, and early childhood family education. We hope that parents also find this guide to be a practical resource.
This guide presents information on:
1. the importance of healthy social and emotional development (infant and early childhood mental health) as the foundation of lifelong mental health, social interaction and learning;
2. the influences on the development of healthy mental health, including relationships, brain development and environmental influences;
3. the most common concerns and disorders of early childhood; and
4. strategies and resources to facilitate parents’ and caregivers’ effective response to the children in their care to promote their mental health.
There are 11 chapters in this guide. Chapters 1 through 5 present a framework for understanding young children’s development and behavior as viewed through four lenses: the developmental lens, the attachment lens, the stress and trauma lens and the culture lens.
Chapters 6 through 11 explore more specific topics including regulation; partnering with children’s parents and caregivers; addressing common concerns, such as sleep, gender identity, and toileting; identifying when to be concerned, referral for assessment and intervention, and promoting children’s resilience.
A reference list follows each chapter and the bibliography is included at the end of the Guide.
Strategies are integrated throughout the guide. For example, there is a section on tantrums in Chapter 8, Common Concerns. Tantrums are also mentioned in Chapter 2, The Developmental Lens, and Chapter 4, The Stress and Trauma Lens, as they all are interrelated.
When words are italicized and bolded, they are defined in the glossary at the end of the guide. The appendices include handouts which readers are welcome to photocopy and distribute as well as informational sheets on common early childhood mental health diagnoses.
Following are definitions of terms we frequently use throughout the guide:
+ The term parent refers to the adults with the primary legal, parental and/or caregiving responsibilities of a child. This could include a mother, father, non-binary parent, foster parent, kinship (family member caring for a child) step- or adoptive parent and a non-custodial parent.
+ The term caregiver generally refers to all of the adults invested in the development and care of a child, other than the child’s parents.
+ The term practitioner refers to anyone working with infants, young children and their families regardless of discipline. This may overlap with caregiver.
+ Infant will refer to children from birth through seventeen months; toddler refers to a child eighteen months to thirty-six months of age; and preschooler is a child from three through five years of age (thirty-six to seventy-two months). We will use child when the material applies to the age range of infant to preschool.
+ When we refer to a child, parent or caregiver, we will use the pronouns they or their, unless we feel that designating the gender is important to understanding the text. This is done intentionally to avoid implying gender bias where we intend none and in acknowledgment that gender is on a spectrum, which includes many gender identities that may be male, female, non-binary, transgender, all, none or a combination of these.
+ In this manual, the terms behavior problem or challenging behavior are interpreted as behaviors that challenge adults. Differentiating between a child’s challenging behavior and behaviors that challenge adults is a critical distinction for a couple of reasons:
– Challenging behavior is a subjective term. For example, we adults can have a broad range of how high an activity level we can tolerate in children.
– Gender, culture (the child’s and our own), age, context and other factors influence our expectations of what we consider to be ‘appropriate’ behavior in children.
– Behavior that is identified as ‘challenging’ or ‘a problem’ in a classroom setting may be considered acceptable at home and vice versa.
+ Behavior is a form of communication for young children. Children want to do well and when they act in ways that challenge adults, they are letting us know that they need adult help to regulate or do things differently. As adults it is our job to figure out what they need.
Finally, most of this guide was written during the significant events of 2020-22, including the Covid-19 pandemic and its economic fallout, the racial unrest following the murder of George Floyd, and the divisive politics in our country. While we do not address these things directly, we want to acknowledge the increased stress experienced by families, caregivers and young children during this time and hope this guide will be a useful resource.