Newswise — Mental health. It’s a term we most often associate with adults and balancing high-stress jobs with an enjoyable lifestyle. But what exactly does “mental health” mean for infants and families? We talked to Marian E. Williams, PhD, director of the Stein Tikun Olam Infant-Family Mental Health Initiative at Children’s Hospital Los Angeles to learn more about this often “taboo” topic.
Infant mental health is defined as “the social and emotional development of a child from birth to 3 years”. How do you evaluate the progression of this development in such young children?
Since infants exist in the context of relationships with others, when we talk about “mental health” in an infant, we are considering how their relationships with adults help them to feel loved, protected, safe, and cared for—in fact, we now more often use the term “infant-family mental health” to highlight this focus on relationships.
Are there certain children/families that are more at risk for developing mental health issues?
Research on stressful events in childhood, such as the ACE (Adverse Childhood Events) Study by the CDC, has shown that experiencing events such as domestic violence, divorce, living with a family member who abuses drugs or has a mental illness during childhood can lead to long-term health challenges, including mental health. An infant living in a stressful home environment can exhibit signs of distress and the beginnings of mental health issues.
Children with developmental delays are also at a greater risk for mental health challenges, as are infants with medical conditions who experience pediatric medical traumatic stress due to repeated, painful medical procedures and extended hospitalization.
How do you assess mental health issues in infants and young children, especially those who are non-verbal?
Infant mental health specialists develop acute observational skills, because young children can’t tell us with words what they are feeling or what they need. By observing other infant cues, such as the tone of their cries, their eye gaze, and their physiological responses and facial expressions, we can recognize signs of stress and observe the infant’s ability to be soothed by others and to self-soothe. We also observe the interaction between the infant and his or her caregivers. The “dance” of interaction between caregiver and baby tells the story of their attachment relationship.
We look for signs such as: • Can the infant signal in clear ways what he or she needs? • Is the parent emotionally and physically available to recognize and respond to the infant’s cues? • Do the parent and child enjoy each other, interacting with joy and playfulness? These interactions can be observed in everyday activities such as feeding, dressing, changing diapers, holding, and playing.
After you diagnose a mental health issue, what sorts of interventions do you recommend?
When an infant or young child is exhibiting significant mental health or social-emotional challenges, early intervention is critical. The first step is assessment: we carefully evaluate the child’s mental health symptoms and level of distress, the relationship between the young child and his caregivers, the level of support available to the family, and the stressful experiences that the family may have encountered. This assessment then leads to a treatment plan that is developed by various child health experts and the family to focus on their areas of greatest need.
In some cases, intervention may be very brief, like supporting a family through their child’s difficult hospitalization or taking part in a “baby and me” group where parents learn about child development and how to make their child feel safe and protected. For children who have experienced prolonged traumatic events, such as exposure to domestic violence or placement in foster care, more intensive interventions like Child-Parent Psychotherapy are needed.
What research still needs to be completed to improve the mental health of these infants and children? Are there specific areas of focus that you think are the most important?
Research that investigates topics such as the impact of maternal depression on infant-parent relationships when the infant is critically ill, and improving mental health incomes for hospitalized infants as they transition home, is much needed in this field. Having the privilege of working at Children’s Hospital Los Angeles in an urban, underserved community, I feel passionate about adapting effective interventions to meet the needs of families with complex, and often overwhelming, challenges and broadening our scope of mental health.
RSS