How Everything Fits Together, or Can: The Early Childhood Comprehensive System

This handy, dandy visual portrays  the collaboration and partnerships the comprise on overall comprehensive system to ensure that children are healthy and ready to learn in early childhood.

Early Childhood Comprehensive Systems grants help states and communities to build and integrate early childhood service systems that better meet the needs of children and families. Since 2003, 49 States, the District of Columbia, Guam, the Republic of Palau and the commonwealths of Puerto Rico and the Mariana Islands have participated in the program. 

b.hrsa.gov/programs/earlychildhood/comprehensivesystems/

Here is our Washington State Plan.

On Middle School Is Too Late: Developmental and social risk factors show up in early childhood

More on the importance of early identification of mental and behavioral health problems comes from a study cited in on an article on the Washington Post website. -gw

• Over 70 percent of students diagnosed with mental illness and behavioral health problems by middle school exhibited warning signs by second grade. 

• Almost 25 percent exhibited red flags during pre-kindergarten years, including developmental and health issues, adverse social factors and exposure to trauma. 

• Twenty-five percent of the children studied had documented traumatic experiences in their records. 

Yet it is not until middle school that mental and behavioral health problems are identified, according to educational records of children referred to the Center for Children’s Advocacy, a Connecticut nonprofit that provides legal support for abused and neglected children.

http://www.washingtonpost.com/blogs/answer-sheet/wp/2013/09/19/study-impact-of-unaddressed-mental-health-issues-on-students-is-severe/

On Back to Basics: Infant mental health defined

OK, what's infant mental health again? Here is  the definition of infant mental health developed by ZERO TO THREE’s Infant Mental Health Task Force.

"Infant mental health" is defined as the healthy social and emotional development of a child from birth to 3 years; and a growing field of research and practice devoted to the: 

Promotion of healthy social and emotional development;
Prevention of mental health problems; and
Treatment of the mental health problems of very young children in the context of their families.

http://www.zerotothree.org/child-development/early-childhood-mental-health/

Zero To Three's Early Childhood Mental Health page is a great place to start finding resources for both parents and professionals. -gw

On the Infant Toddler Temperment Tool: Handy tool for understanding adult and child similarities and differences

The Infant Toddler Temperament Tool (IT3) was developed for the Center for Early Childhood Mental Health Consultation, an Innovation and Support Project funded by the Office of Head Start. The Infant Toddler Temperament Tool includes a short online survey that allows parents and caregivers of infants and toddlers to recognize and explore their own temperament traits and those of a child for which they provide care. The IT3 generates results which support parents and caregivers in understanding how adult and child similarities and differences in temperament traits may affect “goodness of fit.” Along with these results, the IT3 generates simple best practice tips adults can use to foster the unique temperament of each child within their care.

Infant Toddler Temperament Tool (IT3)

Handy tool. -gw

To use the IT³ click here:

For Infants
(birth up to 18 months)
For Toddlers
(18 months up to 36 months)

On an Unhealthy Diet's Impact On Externalizing and Internalizing Problems of Your Children: Study results

Here are the results of a study looking at impact of diet on early childhood mental health. -gw

Higher intakes of unhealthy foods during pregnancy predicted externalizing problems among children, independently of other potential confounding factors and childhood diet. Children with a high level of unhealthy diet postnatally had higher levels of both internalizing and externalizing problems. Moreover, children with a low level of postnatal healthy diet also had higher levels of both internalizing and externalizing problems.

Maternal and Early Postnatal Nutrition and Mental Health of Offspring by Age 5 Years: A Prospective Cohort Study

On Looking At the Numbers for Early Childhood Mental Health Consultation: Oklahoma in 2012 as an example

It seems helpful to see how other states handle the task of early childhood mental health consultation. It's helpful to look at their numbers. How many centers are served? How many referrals? How many hours of service are provided per referral -- that sort of thing. For example, the average time devoted to each referral in Oklahoma during 2012 was 11.11 hours. That seems quite substantial, enough time that actual behavioral change can occur and be supported -- a reduction in the challenging behavior of the child by changing the behavior of the caregivers and altering the environment. -gw

http://www.ok.gov/health2/documents/MHC%20FY12.pdf

On Another Way To Put It: Transdisciplinary infant-family and early childhood mental health practitioner

I love generic terms. How is this for one?  Transdisciplinary infant-family and early childhood mental health practitioner. Is that you? -gw

They are a group of highly skilled practitioners from multiple health and human service, developmental, and educational disciplines, including early intervention, nursing, occupational therapy, physical therapy, speech and language pathology, special education, human development, audiology, social work, and pediatrics. They provide direct services to pregnant women, infants, toddlers and preschoolers and their families. These practitioners have the most frequent contact with infants and very young children and their families and are the most likely individuals to provide promotion and preventive mental health interventions.

http://cacenter-ecmh.org/professional-development/categories/transdisciplinary-mental-health-practitioner-tmhp-and-mental-health-specialist-mhs/

And check this out, the California Training Guidelines and Personnel Competencies for Infant-Family and Early Childhood Mental Health, Revised. It defines the universe of competencies assumed necessary to do the work. -gw

MATRICES AND GUIDELINES FOR THE TRANSDISCIPLINARY INFANT-FAMILY AND EARLY CHILDHOOD MENTAL HEALTH PRACTITIONER

On the Three Surprises for DSM-5 Users: If you work with kids

Do you like surprises? Some people do, some don't. -gw

The first of several surprises: DSM-5 includes only Axis I Disorders. Axes II, III, IV and V are eliminated and replaced by a developmental conceptualization and organization throughout the manual. ...

Another surprise, and most controversial, is the new diagnostic name, Autism Spectrum Disorder (ASD). ...

A third surprise, Disruptive Mood Dysregulation Disorder (DMDD), a new Depressive Disorder, describes children up to age 18 years with “persistent irritability and extreme behavioral dyscontrol”.

http://cacenter-ecmh.org/dsm-5-a-concise-review-of-the-changes-with-a-special-focus-on-young-children/

On the Long-Lasting Effects of PCIT: Cited in CHADD publication

Outcomes of parent child interaction therapy: mothers; reports of maintenance three to six years after treatment.

Parens maintain skills 3 to 6 years after PCIT treatment? That's long lasting -- and duly noted by National Resource Center on AD/HD, a program of CHADD. -gw

On Project Launch: Helping children soar

Welcome to the Project LAUNCH Web site. Project LAUNCH, a grant program of the federal Substance Abuse and Mental Health Services Administration (SAMHSA), seeks to promote the wellness of young children birth to age eight. Project LAUNCH focuses on improving the systems that serve young children with the goal of helping all children reach physical, social, emotional, behavioral, and cognitive milestones. This Web site is a resource for Project LAUNCH grantees and others interested in learning about how to promote young child wellness.

http://projectlaunch.promoteprevent.org/

Washington State was included in this initiative for 2008. The evidence-based programs that were funded were: Parents as Teachers, Strengthening Multi-Ethnic Families and Communities Program, Incredible Years, Positive Behavior Supports (Iowa Model), and Early Childhood Mental Health Consultation. The existence of the Peninsulas Early Childhood Mental Health Consultation group is the result of a conference that was funded by the last program mentioned, I  believe. You can check out the origins of our group in a 2008 initiative described in this blog post. -gw

For children to thrive in school and beyond, it is essential to invest in the physical and emotional health of young children. Project LAUNCH, a grant program of the federal Substance Abuse and Mental Health Services Administration (SAMHSA), seeks to do just that by promoting the wellness of young children birth to age eight. Using a public health approach, Project LAUNCH focuses on improving the systems that serve young children and address their physical, emotional, social, cognitive and behavioral growth.

 http://ncssle.airprojects.org/events/early-childhood-prevention-project-launch

On Improving Mental Health Care of Young Children In California: Grounded in evidence-based practices

This from WestEd, the "research, development, and service agency [that] works with education and other communities to promote excellence, achieve equity, and improve learning for children, youth, and adults," whose roots "go back to 1966, when Congress funded regional laboratories across the country to find practical ways to improve the education of our nation’s children."

This article examines how the California Center for Infant-Family and Early Childhood Mental Health has developed evidence-based practices that focus on assessing the state of the infant-parent relationship and working with the family in culturally and socially sensitive ways to strengthen it.

http://www.wested.org/resources/early-childhood-mental-health-raising-awareness-taking-action/

View Online / PDF Free

On $1.25 Million for Early Childhood Mental Health Consultation: In Massachusetts

Massachusetts is investing $1.25 million in grant funds for the Early Childhood Mental Health Consultation Services Program. 

Jointly supported by the Department of Early Education and Care (EEC) and the Department of Mental Health (DMH), the program provides “social and emotional development supports for early education programs serving young children,” according to an EEC press release from earlier this summer. 

The plan is to boost educators’ “core competencies, skills and abilities to assess children’s social and emotional progress and to respond to children in behavioral distress,” the press release explains. Doing so can help children and families overcome behavioral challenges and also reduce unnecessary suspensions and expulsions in early education and care settings.

http://eyeonearlyeducation.com/2013/08/15/improving-early-childhood-mental-health/

What can Washington State learn from Massachusetts' example? - gw

On Planting the Seeds of the Future: Annual KAEYC conference is schedule for February 2014

The Kitsap Association for the Education of Young Child is holding is annual "Planting the Seeds of the Future" Conference on Saturday, February 22, 2014 from 8 a.m. to 3 p.m. at Olympic College in Bremerton. For over 20 years this conference has supported numerous early childhood educators in meeting the needs of young children. For further information you can contact KAEYC at P.O. Box 5214, Bremerton WA 98312, or via email to hlanoue@ oc.ctc.edu. -gw

On Ideas for Child-Parent Activities: Help for parents from Zero-to-Three

Slide source: Sherri Hill, Babies, brains and relationships

Parent-Child Activities that Promote Thinking Skills

• Create an obstacle course. Lay out boxes to crawl through, stools to step over, pillows to jump on top of, low tables to slither under. Describe what your child is doing as he goes through the course. This helps him understand these concepts.

School Readiness: Birth to Three 

There are so many resources available through Zero-to-Three. Do you subscribe to the Baby to Big Kid E-newsletter?

An e-newsletter that showcases how children learn and grow each month from birth to 3 years. From Baby to Big Kid translates the science of early childhood and offers strategies parents can tailor to their unique family situation and to the needs of their child.

 http://www.zerotothree.org/child-development/from-baby-to-big-kid/

On Avoiding the Classroom-to-Prison Pipeline: Ending the kick-out mentality

Slide: Cognitive Behavior Therapy Plus conference

A former CPS caseworker expresses regret for families that were disrupted through her actions 30 years ago, when children were removed permanently in the absence of services to teach parenting skills. -gw

As a culture, are we just too punitive to get our vengeful eyes off the offender and onto collateral casualties, like the kids? By removing defective moms as though they didn’t matter, social services endorses the kick-out mentality. The mom is bad, thus disposable. Labeling people “bad” and putting them aside is too simple. It ignores all the connections, the attachments, the context. 

As such, automatically removing children from troubled homes is an early-childhood version of the kick-out mentality that leads to the classroom-to-prison pipeline. It demeans how critically important relationships are to kids — all kids, of all ages. Family members are not spare parts.

Why ‘Bad’ Moms Still Should Parent Their Kids

Looking Beyond the Silo of Our Discipline: A story of a mother's faith restored

Slide source: Sherry Hill, Babies, Brains and Relationships

Another great story to demonstrate the importance of not being stuck in the "silo" of  the discipline we were trained in. Barbara Kalmanson PhD is speaking to me here. -gw

...mental health providers are often under informed about the impact of sensory processing, motor development, or communication systems on the social and emotional development of the child. Here’s an example from the mental health consultation room. A young mother brings her toddler son for consultation. She is concerned he is on the Autism Spectrum. During the play assessment, the child shows interest in a toy drum. Mom and therapist join his play, each sitting to one side of him. The child bangs on the drum. The therapist captures his interest by holding her hand in the air and exaggerating a look on her face that signals high affect anticipation. With the therapist’s support, Mom tries the same gesture and facial expression, but the child only looks in the therapist’s direction. Mom’s facial expression sinks into depression. The therapist, informed by sensory processing differences, as well as psychological processes, sees Mom’s face and checks on her perception. Mom thinks the child prefers the therapist to his own mother. The therapist empathizes with her worry but also conjectures that it might have to do with his visual – motor systems. What if he prefers to look to the right? She has Mom switch places with her on the floor, and low and behold, the child only looks toward the mother. The mother’s faith in her capacity to engage her child is restored and the treatment can proceed by noticing the individual difference needs of her son, and how the parents can build engagement and intimacy in the relationship.

Implementation of principles of infant mental health across disciplines

On Seeking Pleasure/Avoiding Pain or Designed for Connectedness: Theories about human nature

Which story about our "human nature" do you prefer? Are we in this world out of self-interest, or are we designed for connectedness and relatedness? -gw

Overview of Attachment Impact of Chronic Relational/Ambient Trauma

On Understanding Violence in America: Quotable quotes from an infant mental health specialist

Keep your eye peeled and you'll discover so much in the news about infant mental health. -gw

"It's sort of like the best kept secret of why I think America is so violent,” she says. “It's because we really don't take good care of our children at a policy, national level."
    

"So, if we can first admit as a society that infants and toddlers are adversely effected by their experiences,” she says, “and sort of not protect ourselves from the pain of that, then we can begin to look at public policy, funding and training that can alter the course."

University of Michigan researcher and infant mental health specialist Julie Ribaudo

On Murder Rates Are Down For Youth: Is it chance or programs that have been shown to work?

Those of us in the field of early childhood typically see the work as so hopeful because effective early intervention can stave off disaster. A young child becomes a teenager and then an adult in what seems like the blink of an eye. Murder rates are down for youth. To what can we attribute the success? Chance? Or programs that have been shown to work?

The CDC, other researchers and partners over time have evaluated different approaches to reducing risk for violence. These types of approaches do reduce risk for violence,” she said. “There is no one reason a young person gets involved with violence. There is no one prevention approach that solves this problem.” 

Programs that have been shown to work give youngster better communication skills, encourage parents to be more involved in what their children are doing, and discourage violence in general. Not all programs do work, Ferdon noted. “What we have seen is there is a lot of variablility in these programs,” she said. 

She said the Center for the Study and Prevention of Violence at the University of Colorado outlines some, which include intensive family counseling such as parent-child interaction therapy; multisystemic therapy aimed at homes, schools and neighborhoods; and cognitive-behavioral group therapy.

http://www.nbcnews.com/health/youth-murder-rates-30-year-low-cdc-reports-6C10604586

The Incredible Years and violence prevention

On Holding a Potential Therapist Accountable: Ask questions in advance

One way to ensure therapist accountability is to ask questions up-front, in the same way you might ask a plumber if he is bonded and certified before having him do work on your house. Yes, therapists are required to be licensed in Washington State. But are they qualified to provide a particular therapy, especially one that meets the criteria for being evidence-based? Do they follow protocol, if it is a manualized therapy? 

A lot of the posts on this blog reference Parent Child Interaction Therapy, well-suited for doing dyadic work with parent and young child. What should a caseworker or parent ask a potential PCIT therapist? This comprehensive monograph by the Child Welfare Information Gateway on "Parent-Child Interaction Therapy  With At-Risk Families" outlines those questions.

• How will the parent be involved in this process? 

• What is the nature of your PCIT training? When were you trained? By whom? How long was the training? Do you have access to follow-up consultation? What resource materials on PCIT are you familiar with? Are you clinically supervised by (or do you participate in a peer supervision group with) others who are PCIT trained? 

• Why do you feel that PCIT is the appropriate treatment model for this child? Would the child benefit from other treatment methods after they complete PCIT (i.e., group or individual therapy)? 

• What techniques will you use to help the child manage his or her emotions and related behaviors? 

• Do you use a standard assessment process to gather baseline information on the functioning of the child and family and to monitor their progress in treatment over time? 

• Do you have access to the appropriate equipment for PCIT (one-way mirror, ear bug, video equipment)? If not, how do you plan to structure the sessions to ensure that the PCIT techniques are used according to the model? 

• Is there any potential for harm associated with treatment?

https://www.childwelfare.gov/pubs/f_interactbulletin/f_interactbulletin.pdf

On Keeping Up With Insights, Trends, Programs, Practices and Information: An idea for a new website

Perhaps you received an invitation to participate in a survey to inform The Washington Strengthening Families Collective as to whether to proceed with an intriguing online endeavor. -gw

Survey on Mapping Family Strengths in Washington State - Project Overview. Organizations, groups, families, and individuals all over the state are committed and engaged--both formally and informally--in The Strengthening Families Approach and the Protective Factor Framework. The Washington Strengthening Families Collective (formerly Strengthening Families Washington) recognizes that there is a significant amount information and activity related to strengthening families and building protective factors in a range of sectors throughout the state. 

Mining Insights and Opportunities. We believe that valuable insights and opportunities can be mined by collecting information across sectors on work that is applying the Strengthening Families Approach. Insights and opportunities gained from the collective information can help stimulate collaboration and innovation, increase collective impact, inform funding and thereby accelerate the presence of protective factors in our state. 

Simplifying and Making Meaning. We are embarking on creating a dynamic, searchable, simple and useful online tool through which insights, trends, programs, practices, and information aligned to the Strengthening Families Approach (including strategies to build Protective Factors) can be accessed. Once people have access to this collective perspective, we envision providing forums for discussion and collaboration.

On the Provider Experience: The mystery and glory of seldom-opened file drawers

Some file drawers in my office hardly ever get opened. I even forget what's in them. Today, avoiding required paperwork, I cracked open one and saw file folders neatly labeled  in pencil, alphabetized from A to Z, with some keywords and pat phrases of my discipline (whatever it is). Perusing the folders I experienced one discovery after another. "Wow! There is that file on hiring attachment-ready staff I got at that conference in 2002!" -- etc., etc.  Below are the folder titles just through the A's, B's and C's. Don't you just love lists! -gw

Adult attachment
Abuse and brain development
Adult child-relationship
Adverse childhood experiences
Antecedent, behavior, consequences
Aggression continuum
Ambivalent child/preoccupied parent
Antisocial personality
Arousal curve
Assertiveness training
Attachment-ready

Bedtime
Biting
Body language
Brain and trauma
Bullying

Caregiving in groups
Challenging behaviors
Child development
Child-parent psychotherapy
Child/parent/provider
Children's books
Circle of security
Classroom observation
Cognitive behavior therapy
Conflict cycle
Cross-cultural consideration
Cultural competence
Culture of poverty

On Every Domain of Development Is Our Concern: The benefits of cross-disciplinary information

Every domain of development is our concern. Relying too heavily on information from one area underestimates the value of another. We all need each others’ expertise in our work. The more attentive we become in working together, the smarter we are in our own work.

When you watch a baby and parent interact, the lens of your own discipline colors what you see, and how you interpret your observations. If you are a mental health provider, you may be wondering about maternal depression or attachment disorder. If you are an OT or a PT you may be noticing the atonic neck reflex or the infant’s response to vestibular stimulation. If you are a Speech/ language pathologist, you may focus on the absence of vocalizing or the lack of social referencing. Cross disciplinary information allows us to see how one area of development is influencing another and protects us from misinterpreting a symptom as a cause of the problem. 

 http://kidsattuned.com/an-introduction-to-the-interdisciplinary-approach-to-infant-mental-health-section-2/

Barbara Kalmanson's comments on KidsAttuned bring up for me how unique our consultation group is. We have, and continue to have, the kind of diversity of disciplines represented at our meetings she describes as beneficial to getting at the truth of development. -gw

On What Effect Size Tells Us: PCIT has twice the effect of stimulant medication on disruptive behavior

Parent Child Interaction Therapy has twice the effect size of stimulant medication over disruptive behavior, as Dr John-Paul Abner coneys in this recent PCIT conference video clip.-gw

Effect size is a simple way of quantifying the difference between two groups that has many advantages over the use of tests of statistical significance alone. Effect size emphasises the size of the difference

It's the Effect Size, Stupid: What effect size is and why it is important

Dr Abner's explanation of effect size

On the Screening of Infants By Pediatricians For Toxic Stress: Recommended

Source: Using the DC-0 to 3 conference with Donna Westin

An awareness of the impact of  adverse childhood experiences (ACEs) in early childhood continues to grow. -gw

An infant’s early visits to the pediatrician now might consist of screening for “toxic stress” symptoms, according to recommendations being created by the American Academy of Pediatrics (AAP).

With growing awareness in the field of infant mental health, based on the deepening body of scientific evidence, experts agree that monitoring babies for healthy brain development will lead to better longer-term outcomes.

AAP's recommendations are similar to previous warnings to shield children from second hand cigarette smoke or too much video screen time. This time, AAP is looking at how stress can impact a baby’s development.

http://www.scpr.org/blogs/education/2013/06/06/13920/pediatricians-urged-to-screen-infants-and-toddlers/

On How Are We Doing: I-ECMH in Washington State

 

If we ask the questions above, posed in Nurturing Change: State Strategies for Improving Infant and Early Childhood Mental Health, how is the State of Washington doing in the area of infant and early childhood mental health services (I-ECMH)?

On CARE, Child-Adult Relationship Enhancement: A trauma-informed modification of PCIT

Child-Adult Relationship Enhancement (CARE) is a trauma-informed modification of specific PCIT skills for general usage by non-clinical adults who interact with traumatized children and their caregivers within various milieu settings. CARE has been adapted during the 2006 NCTSN project year by the National Center on Family Homelessness and the Trauma Center at Justice Resource Institute for use in homeless serving systems.

Child Adult Relationship Enhancement - Homelessness Resource

I learned about CARE through Joshua Masse's presentation at the 2013 Washington State PCIT Conference. -gw

PCIT = Parent Child Interaction Therapy

TF-CBT = Trauma Focused-Cognitive Behavior Therapy

On Parents Who Are Supported and Valued By Society: They give rise to mentally healthy children

When parents are supported and valued by society, they are able to be fully present with their children, in turn helping to grow healthy brains. Children who grow up in an attuned caregiving environment are flexible, resilient, and empathic. In contrast, when children experience toxic stress, or stress in the absence of a safe, secure caregiving relationship, the parts of their brains responsible for emotional regulation do not develop normally. What results are symptoms that are then labeled "mental illness."

http://www.boston.com/lifestyle/health/childinmind/2013/05/to_cdc_on_childrens_mental_hea_2.html

So often mental illness has its basis in early childhood experiences. The opposite is also true -- mental health has its basis in early childhood experiences. -gw

On the 3rd Regional Washington State Parent-Child Interaction Conference: Complete pics and video

3rd Regional Washington State Parent-Child Interaction Conference

Above is the link to the collection of all sets of photos and videos from the 3rd Regional Washington State Parent-Child Interaction Conference held early last month in Des Moines, Washington. There is so much to draw from here, so much that speaks to the central focus of this blog. -gw

Arriving at aLandmark

13 photos | Edit

Fancy place tohave a training

31 photos | Edit

1st Day Photos - PCIT...

156 photos | Edit

Welcome andintroductionof...

2 photos, 2 videos | Edit

KeynoteSpeaker: PCITfor...

38 photos, 32 videos | Edit

Supporting PCIT Fidelity...

41 photos, 6 videos | Edit

Round tableworkshop...

37 photos, 13 videos | Edit

Be Direct!

23 photos, 4 videos | Edit

PCIT in theLummiNation:...

15 photos, 1 video | Edit

Block ByBlock:...

5 videos | Edit

2nd Day Photos - PCIT...

219 photos | Edit

GreatExpectations:.. .

20 photos, 48 videos | Edit

From Lab toLiving Room:...

46 photos, 28 videos | Edit

"I Like How You Are...

12 photos, 12 videos | Edit

CoachingTechniques: How to...

13 photos, 4 videos | Edit

Lunch & break

9 photos | Edit

Coding andCoaching

24 photos, 12 videos | Edit

PCIT andAutism:Lessons...

58 photos, 29 videos | Edit

DPICS IVExtravaganza

19 photos, 19 videos | Edit

Ask the Experts

10 photos, 26 videos | Edit