1. Infant Mental Health PSY 417

2. Infant Mental Health ► Risk verus Infant Mental Health

3. Risk Factors ► Biological or psychosocial hazards that increase the likelihood of a negative developmental outcome in a group of people. ► Known or suspected factors that may affect development.

4. Small Group Activity ► List as many risk factors as you can. Be as specific as possible.

5. Types of Risk: Tjossem (1976) ► Established: medical disorders of known etiology with well known expectancies for developmental outcomes. ► Biological: prenatal, perinatal, neonatal and early developmental effects that are considered biological insults to the CNS. ► Environmental: biologically sound infants with life experiences that have a high probability for delayed development.

6. Class Activity ► Take list from small groups and categorize them into the Tjossem types.

7. General Principles ► Can have more than one type of risk factor. ► Can have more than one risk factor within categories. ► The more risk factors, the more likely adverse developmental outcomes will occur. ► Early risk factors are less predictive than later risk factors. ► Biological factors associated with poorer developmental outcomes only when combined with environmental risk factors. ► Family/ecological variables most predictive for predicting developmental outcomes.

8. Resilience/Protective Factors ► Factors that protect or buffer children at risk. ► Also called mitigating factors.  Characteristics of children  Parental characteristics  Community factors

9. Small Group Activity ► Identify three examples of resilience/protective factors in each of the three categories.

10. Risk Models ► Single Risk Model: assumes that any one risk factor is sufficient to put a child at-risk for developmental delay.  Danger of over-identification or under-identification of children at-risk.  No single risk factor is predictive of developmental delay. ► Cumulative Risk Model: assumes that risk is not due to a single factor but the concurring of a variety of environmental and biological factors.

11. Increases in the Number of At-risk Children ► Advances in medical technology ► Increases in social problems ► Increases in multiple births

12. Infant Mental Health ► A broad-based, multidisciplinary, and international effort to enhance the social and emotional well-being of young children and which includes the efforts of clinicians, researchers, and policymakers (Zeahnah & Zeahnah, 2009).

13. Steering Committee on Infant Mental Health ► Zero to Three, 2001 ► “the young child’s capacity to experience, regulate, and express emotions, form close and secure relationships, and explore the environment and learn. All of these capacities will be best accomplished within the context of the caregiving environment that includes family, community, and cultural expectations for young children. Developing these capacities is synonymous with health social and emotional development.”

14. Clinical Practice of Infant Mental Health ► Strengths-based ► Relational framework ► Prevention orientation

15. Empirical Foundations of Infant Mental Health ► Early experiences matter  Critical periods ► Relatively short period of time in which learning can occur. ► Must have certain experiences in order for normal development to occur. ► Permanent and irreversible effect.  Sensitive Period: time that is optimal for certain capacities to emerge - especially responsive to environmental stimulation. ► Importance of context/relationships

16. Interventions ► Goals of infant mental health: to reduce or eliminate suffering, to prevent adverse outcomes and to promote healthy outcomes by enhancing social competence and resilience. ► Interventions must:  Enhance ability of caregivers to nurture young children  Ensure families receive needed services  Increase ability of nonfamilial caregivers to identify, address and prevent social-emotional problems in early childhood.

17. Preventative Interventions ► Aim to prevent the initial onset of a disorder, decrease causal factors and increase protective factors and/or decrease the severity or duration of a disorder. Treatment Indicated Intervention Selective Intervention Universal Interventions