Download Script Infant Mental Health – What Is It and Why Is It Important?

Script
Infant Mental Health – What Is It and Why Is It Important?
Slide 1: Title Page
Welcome to the “First 3 Years Digital Learning Initiative”. This is a 10 part series
offered online for professionals who want to obtain continuing education specific to infant
mental health and early childhood development. The phrase “Infant Mental Health” can be
confusing and even harsh on the ears of the average person. Whether they know it or not,
child care providers are instrumental in providing a sound environment to create optimal
mental health for the infants in their care. In this case, “health” actually means well-being,
and in this training we will dive into the foundations of infant mental health and the
importance of identifying the infant mental health implications in the work you already do
with children. Using the encompassing and focused lens of infant mental health, child care
providers are able to see development as it relates to cognitive, social, and emotional
growth. Young children learn and develop within the context of relationships and so as we
move through this series, it is important to reflect on the power of nurturing, responsive,
and intentional interactions in your work with infants and toddlers.
Slide 2: This Program Was Made Possible by the Generous Support of:
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The Dallas Foundation
Harold Simmons Foundation
Horace C. Cabe Foundation
Houston Endowment
M.B. and Edna Zale Foundation
Slide 3: Who is the Texas Association for Infant Mental Health? (TAIMH)
The Texas Association for Infant Mental Health, also known as TAIMH, is the only nonprofit organization in Texas focused on the social and emotional development of infants,
toddlers, and their families.
We believe that infants and toddlers learn and develop through the context of relationships
and we are committed to spreading research and best practices around Infant Mental
Health to those working with infants, toddlers, and their families.
Slide 4: What does TAIMH do?
The work of TAIMH includes Education, Advocacy & Collaboration, Outreach, and Support
and Endorsement for Professionals.
For more information, visit: www.taimh.org
Slides 5: How to View This Presentation
The digital learning module you are about to view describes key areas of infant and toddler
mental health.
Although we use the word “caregiver” throughout the presentation, we recognize that the
terms caregiver, teacher, care provider, and early childhood educator may all be used to
describe those who work with infants and toddlers.
Finally, while our goal is to present current evidence that supports best practices in early
childhood care and education, we recognize that new information is constantly emerging.
A list of relevant websites and additional resources can be found at the end of each module.
Slide 6: Infant Mental Health: What is It and Why is It Important? (Title Page)
Slide 7: Learning Objectives
In this module, you will learn about the importance of infant mental health for young
children’s development. Upon completing this module, you will be able to:
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Define infant mental health.
Identify key contributors to the field of infant mental health.
List several barriers to recognition for the field of infant mental health.
Describe why implementing infant mental health into practice has been challenging.
Discuss the importance of early relationships for healthy brain development.
Understand the role of secure attachments and self-regulation for infant mental
health.
Identify a variety of infant stress signals.
Discuss why an understanding of infant mental health is vitally important for early
childhood caregivers.
Slide 8: What is Infant Mental Health?
As we begin this training, it is essential to start with a basic understanding of what Infant
Mental Health is in order to grasp why it is so important. Infant Mental Health is rooted in
the understanding that developmental outcomes emerge from infant characteristics,
caregiver-infant relationships, and the environmental contexts within which infant-parent
relationships take place.
Infant Mental Health can be defined as the developing capacity of a child from birth to age 3
to:
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experience, regulate and express emotions
form close and secure interpersonal relationships
explore the environment and learn
Infant Mental Health is synonymous with healthy social and emotional development
In our society, we often think of mental health in terms of mental illness. In this context,
infant mental health actually means health, not illness. We are talking about what it
takes for a very young child to develop in a healthy way. We will explore this in much more
detail throughout this presentation, but for now it is important for you to understand that
when we talk about infant mental health, we are talking about:
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the importance of relationships for the developing child
how nurturing, responsive, stable and consistent care is essential for a young child’s
mental health and forms the foundation for lifelong positive or negative mental
health
how the state of an adult’s emotional well-being profoundly affects the quality of the
infant-caregiver relationship and ultimately the development of the child.
Slide 9: Enduring Foundations of Infant Mental Health
Infant mental health has its foundation in several important researchers, including Erik
Erikson, Selma Fraiberg and T. Berry Brazelton.
Slide 10: Erik Erikson
One of the first psychologists to really explore and study what happens psychologically for
very young children was Erik Erikson. In his book, “Eight Ages of Man”, which was
published in 1950, he argued that infants from birth to around 18 months of age have the
task of developing trust or mistrust of those around them. He believed that children
develop a sense of trust when caregivers provide reliable care and affection. In contrast,
the lack of reliable care and affection can lead to mistrust.
He further argued that young children, ages 2 to 3 years old, are conflicted with autonomy
vs. shame and doubt. Erikson noted that for children to successfully develop feelings of
autonomy, they must experience a sense of personal control in the world and be able to
experience independence in their day to day lives. Failure to do so results in young
children feeling shame and doubt.
Slide 11: Selma Fraiberg
Selma Fraiberg is widely considered one of the founders of infant mental health and was
one of the first to publish research on the subject in her book, “The Magic Years:
Understanding and Handling the Problems of Early Childhood.” She and her colleagues at
the University of Michigan helped to create a model for infant mental health practice. In
many ways, this was a brand new way of working with families. In her model, parents and
infants were seen together, most frequently in their own homes, for early identification of
risk and treatment to lower the likelihood that the infant would develop a serious
developmental delay or relationship failure. Selma Fraiberg was also a founding member of
ZERO TO THREE -- one of the strongest early childhood policy and advocacy organizations
in the United States.
Slide 12: T. Berry Brazelton
T. Berry Brazelton was also influential in the emerging field of infant mental health. Dr.
Brazelton began his research with parents and infants in the early 1950s and focused on
individual differences among newborns and the development of attachment between
parent and infant over the first four months. He also focused on cross-cultural studies of
infant behavior and early parenting practices and the importance of early intervention for
at-risk infants and their parents. Many of his findings were published in 1969 in “Infants
and Mothers: Differences in Development.” Dr. Brazelton went on to develop the Neonatal
Behavioral Assessment Scale, which is used worldwide both clinically and in research. The
scale is used to examine the physical and neurological responses of newborns as well as
individual differences and emotional well-being. Today the Neonatal Behavioral
Assessment Scale is often used to help parents understand and relate to their new infants.
Dr. Brazelton is perhaps most well-known for his book, “Touchpoints” which has become a
national training program and popular approach to working with families with young
children.
Slide 13: Barriers to Recognition for Infant Mental Health
There are many reasons why infant mental health is a relatively new field of study in
psychology. And there are also a number of reasons why many people have not yet learned
about infant mental health. One important reason is a philosopher named John Locke, who
believed that humans are born “Tabula Rasa” or as blank slates. He argued that infants
were born with no mental content or abilities and that all of their knowledge comes from
experience or perception. We now know that infants are born with many, many abilities
and have their own unique temperaments as well.
Perhaps in part because of this very early thinking from Locke, some people believe that
infants cannot develop mental health problems because they are resilient and will “grow
out of it”. Recent advances in the study of brain development, however, have shown
profound physical effects of abuse and neglect. And we have learned that early trauma
memories are stored in the body and brain and can be activated later in life.
Slide 14: Current Barriers to Implementing Infant Mental Health into Practice
Even among professionals who work with infants and toddlers, there are a variety of
reasons why infant mental health is not commonly understood. For example,
opportunities for training and professional development are lacking. This can be attributed
to a lack of funding as well as to a general lack of awareness about the importance of the
first three years of life. There is also a gap between the onset of mental health problems
and the availability of appropriate services for families. This means that given an infant
who is showing signs of emotional difficulty, a family may have few support services
readily available to them.
Because of these two barriers, parents and caregivers often get very mixed messages about
how to care for infants and can become frustrated when they receive differing advice about
issues as basic as sleep and feeding practices. As infant mental health research becomes
more widely accepted and distributed, many of these messages will become more unified
and easier for parents to understand. Each professional working with parents can help to
increase awareness of infant mental health by emphasizing the importance of the early
years.
Slide 15: Infant Mental Health Services
Although there may be a significant gap between the onset of mental health problems and
access to appropriate services, once connected, infant mental health professionals and
practitioners offer a variety of services to support healthy development. According to
Weatherston, these include concrete assistance (such as providing food or medical care),
emotional support, developmental guidance, early relationship assessment and support,
infant-parent psychotherapy and advocacy. Traditional infant mental health service
requires that the practitioner work with the parent and child together to help model
interactions and to help strengthen the relationship between the parent and the child.
Slide 16: Why is Infant Mental Health Important?
The first three years of life provide the foundation for a developing child’s mental health
and social-emotional well-being. Thus, Infant Mental Health is important because it helps
us to understand why and how early experiences shape children’s views of themselves and
others.
Healthy social development refers to a child’s ability to establish positive relationships and
align with social norms and standards. In contrast, healthy emotional development refers
to the child’s ability to experience, express, and regulate a range of emotions – both
positive and negative – in appropriate ways. Together, healthy social and emotional
development reflects the young child’s growing capacity for self-control and selfregulation, as well as the child’s feelings of self-worth and self-confidence. All of these
skills help to support a child’s success both in school and in life.
Numerous studies show that children who do not develop healthy social-emotional skills in
the first three years of life are more likely to experience developmental delays, poor peer
interactions, and aggressive behavior. They may also have “fight or flight” reactions to
what others would consider to be low-stress situations. These children are also more likely
to develop insecure attachments with their caregivers, to experience later physical and
mental problems and to have poorer social outcomes.
Slide 17: Basic Concepts
One of the key concepts in infant mental health is the importance of early relationships.
Infants and toddlers learn in the context of their relationships with their caregivers. They
depend heavily on the adults in their lives to help them experience, regulate and express
emotions. Infants and toddlers thrive when they have close, secure and consistent
relationships with their caregivers. It is through these relationships that young children
learn what people expect of them and what they can expect of other people. Healthy
relationships facilitate healthy development.
Early development is the product of an infant’s unique characteristics. Infants and toddlers
have a drive to explore and master their environments. They are born with the ability to
actively participate in their own learning and development, which is an important aspect of
their mental health. It is also important to remember that infants and toddlers learn to
share and communicate their feelings with significant caregivers and other children within
the context of family, community and culture. These three contexts influence every aspect
of human development. They influence how infant mental health is understood and what
kinds of goals, expectations, and child-rearing practices adults have for young children.
Slide 18: The Work of Infancy
When we talk about infant mental health and social-emotional development, we are
referring to three primary tasks for the infant: brain development, self-regulation, and
attachment.
Slide 19: The Beginning of Healthy Brain Development
The first 3 years of life are critical years for brain development, building the foundation for
a lifetime of learning. During this time, it is critical for caregivers to provide the support
young children need to build healthy brains.
The infant brain grows best when the infant feels safe and secure in their world. You can
help infants to feel safe and secure by responding to their needs. When infants cry and
show signals of stress, they are asking you to attend to their needs.
I would like for you to consider the following scenario: an infant wakes up from their nap
and begins to cry. Their caregiver walks over to them, speaks softly to them and lifts the
infant from the crib. The caregiver continues to use a quiet voice while calming the infant.
After a minute or two, the infant calms and begins to smile at the caregiver, the infant
begins to make cooing noises which the caregiver repeats back to the infant.
Now, I would like to rewind that same scenario to the beginning, when the infant wakes up
from their nap. Only this time, nobody walks over, so the infant continues to cry. Still
nobody walks over, and the infant continues to cry but nobody walks over. The infant
becomes red in face and clenches their fists tight. You can actually see how stressed the
infant is.
Now, the difference between these two scenarios is critically important. In the first
scenario, the infant’s needs are being met, the infant is learning that the world is safe and
their needs will be met. The infant’s brain is teaching them about reliable patterns in their
care. In the second scenario, the infant is extremely stressed out and cortisol, a stress
hormone, is being released into the body. Over time, the stress hormone cortisol can be
very damaging to the brain and inhibit learning.
The previous example shows how important nurturing care is during the early years for
healthy brain development.
Slide 20: The Importance of Attachment
Attachment is the emotional bond between a young child and their primary caregiver or
group of caregivers. As a child care teacher, you are one of these primary caregivers, and
the attachment, or emotional bond that you have with the infants and toddlers in your care
is critical to their development and how they see themselves and their world.
Generally speaking there are two types of attachment relationships: secure and insecure.
Children who grow up with secure attachment relationships are used to having their needs
met on a regular basis. They interact with caregivers who anticipate their needs, provide
nurturing care, and offer guidance in new situations. All of these activities help children
learn social skills, manage their emotions, and cope with change.
Insecure attachment relationships reflect to situations in which the caregiver does not
respond appropriately to a child’s needs over an extended amount of time. Insecure
attachments can greatly stress a young child and lead to developmental delays. It also
interferes with a child’s ability to learn normal social skills and expectations. Children who
are abused and neglected will often have trouble forming attachment relationships with
their caregivers.
Every time you answer an infant’s cry or applaud a toddler’s art, you are strengthening the
attachment bond between yourself and the children in your care. This in turn strengthens
their self-confidence to explore their environment and try new things. Responsiveness
encourages healthy brain development.
Slide 21: Self-Regulation in Infants
Self-regulation in adults is the ability to have self-control while paying attention so we can
wait and notice what is happening then plan what to do or how to respond. We use our
thinking skills to consider what is happening, and calm our emotions so we can decide the
best action to take. You do this thousands of times a day. As caregivers, you must be able to
attend to the infants and children even if you are tired or hungry. You focus your attention
and energy on what must be done. Infants and young children must develop this skill over
time just as you did.
When you were a child, remember how hard it was to wait for a special event to happen.
The adults probably told you to calm down and wait because being excited wasn’t going to
make it come any faster. And you learned they were right. You may have chosen to do other
things until the special event was to take place. It took you many years to learn to do that.
Infants and young children need the support of nurturing caregivers to develop these skills.
They learn this fastest if caregivers respond quickly to their needs. Young children’s
emotions don’t get out of control if, when they begin to cry, someone comes and meets
their needs so they can calm down. They learn that they don’t have to lose control to get
what they need, just as you learned that being wildly excited for hours wasn’t going to
make the event happen sooner. And, you had more energy for the event once it did happen
just as the infants and young children will have more energy for learning.
Slide 22: Infant Stress Signals
Infants have many ways to show us they are stressed out. These are called stress signals.
Stress signals are an infant’s way of telling adults that they need your help. Examples of
stress signals include:
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They will squeeze their eyes tightly shut
They bring their hands to cover their ears or eyes
Their skin will become blotchy
They arch their backs upward
The will spread their fingers apart, with stiffened fingers
Their eyes or area around their eyes become red
They yawn, sneeze, or hiccup
Slide 23: Understanding Infant Mental Health Is Important for Caregivers
As you have seen, healthy brain development, attachment and self-regulation are all
dependent upon consistent, reliable care from caregivers in a young child’s life. As a child
care provider, you often have the opportunity to spend more waking hours with an infant
or toddler than their primary caregiver does. In this way, you share the responsibility for
promoting healthy development in the children you care for each day. You can help
promote healthy development by collaborating with and supporting families, reducing
family stress and providing important child development information. Your support of a
family and promotion of a child’s relationship with his or her parent could help to prevent
child abuse and neglect, maternal depression, attachment difficulties, and traumatic life
events. The work that you do matters! It is important to remember that by supporting
families, you are supporting the children you care for every day.
In addition to supporting families, understanding infant mental health enables you to fully
understand the impact of the work that you do every day. You may be an important
attachment figure for a child, and you are helping children form healthy neural connections
during critical periods of brain development. You also help children learn how to manage
their emotions and develop trust and empathy for others. By having an understanding of
infant mental health, you can form deeper and more intentional relationships with the
young children in your care. In addition, knowledge of infant mental health can help you to
identify infants and toddlers who may need more intensive services to support their
development.
As early childhood advocate Betty Ablon notes, as a child care provider, “You are
responsible for the next generation of Americans—for the people who will become
teachers, X-ray technicians, designers of the health care system that we will use when we
become older adults, produce buyers at the supermarket, airplane pilots, day care
providers, and the myriad other jobs that define how we live in America. Will this next
generation be caring, competent adults who respect and care about others and provide
meaningful services, or will they be needy, ruthless people, incapable of empathizing and
understanding another human being’s experiences and feelings? The children’s parents,
their extended family and you are the most important people in their lives. You have the
responsibility as well as the joy and pleasure of helping another human being to grow and
develop. You do this through being consistent and loving with the child; you also do this by
helping parents who sometimes need an ally and an advocate, someone who is interested
in their child and can help them with the many questions and problems that beset young
parents who are trying to raise their children in this difficult, complicated world. Consider
yourselves in the construction business: you are active participants in the building of
human beings.”
Slide 24: Video
As this presentation comes to end, please take a few minutes to watch this video summary
about why infant mental health and infant mental health services are so important.
Slide 25: Reflection
As you reflect on what you learned today, consider how you might respond to the following
two scenarios:
A colleague of yours is struggling to find reasons to work with the parents of the children in
her classroom. She tells you that she loves working with all the infants in her care, but that
she didn’t get into child care to deal with families. What might you say to her?
In your own words, write what infant mental health means to you. How can you use infant
mental health strategies in your classroom?
Slide 26: References
Slide 27: References
Slide 28: TAIMH Advisory Board
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Sarah Crockett, MSW
Deborah Diffily, PhD
Barbara Einsohn, M.S., IMH-E(IV)
Sadie Funk, M.S., IMH-E(IV)
Susan Meriwether, M.A., IMH-E(IV)
Patty Miller M.S., C.C.L.S., IMH-E(IV)
Credits:
 Cynthia A. Frosch, PhD
 Kristine Tolentino-Plata
 Heeseon Choe, M.Ed.
 Letitia Bledsoe
 Rafael Jimenez