Policy Engagement Strategies for Early Childhood Mental Health Professionals

The Massachusetts Multi-City Young Children’s System of Care Project was a federally funded program to provide integrated early childhood mental health (ECMH) services in primary care for families of very young children (birth-six years old) with Serious Emotional Disturbances across three cities in Massachusetts, U.S.A. This study describes lessons learned from the implementation of this program and makes recommendations for best practices to improve the delivery and efficacy of ECMH services in primary care settings. Staff and leadership (n = 35) from 11 agencies (primary care practices, community service agencies, and local health departments) that co-implemented this program participated in focus groups and semi-structured key informant interviews. Thematic analysis was used to characterize specific facilitators and barriers to successfully implementing system-wide programming for ECMH. Four main themes were identified: (1) Strong multilevel working relationships are critical for integration, (2) Capacity-building activities can be leveraged to improve implementation, (3) Financial challenges are a primary barrier to building efficacious systems of care, and (4) Flexibility and resourcefulness can help overcome logistical challenges in integration. Implementation lessons learned may serve as guidance for other states and institutions in the U.S. seeking to improve the integration of ECMH services into primary care. They may also provide strategies to adapt and scale these interventions to improve the mental health and well-being of young children and their families.

Literature suggests that well-being and health status differ by generational status among Asian American individuals. To compare young children's well-being and health behaviors and their parents' parenting practices among families of second-generation Asian American, third- or later-generation Asian American, and third- or later-generation non-Hispanic White children in the US. For this survey study, secondary data analysis was conducted from September 2, 2023, to June 19, 2024, using data from the 2018 to 2022 National Survey of Children's Health participants aged 6 months to 5 years. Parents completed a survey about their positive parenting practices and their child's psychological well-being and health behaviors via mail or online. Multivariable logistic and linear regression analyses were conducted to compare psychological well-being and health behaviors by study groups and positive parenting practices, adjusting for sociodemographic variables. Positive parenting practices (ie, reading, storytelling or singing, and family meals), psychological well-being (ie, flourishing, social-emotional development, and self-regulation), and health behaviors. The analysis included 42 846 participants (5456 in 2018, 5140 in 2019, 7494 in 2020, 12 817 in 2021, and 11 939 in 2022; 46.6% female and 53.4% male). Participants were categorized into 3 groups: 2881 (6.7%) were second-generation Asian American children aged 0 to 5 years, 570 (1.3%) third- or later-generation Asian American children aged 0 to 5 years, and 39 395 (92.0%) third- or later-generation non-Hispanic White children aged 0 to 5 years. Compared with White children, Asian American children were less likely to flourish (odds ratio [OR], 0.57 [95% CI, 0.52-0.63] for second-generation Asian American; OR, 0.82 [95% CI, 0.65-1.03] for third- or later-generation Asian American), have regular bedtimes (OR, 0.80 [95% CI, 0.69-0.92] for second-generation Asian American; OR, 0.66 [95% CI, 0.49-0.88] for third- or later-generation Asian American), and have moderate screen time (OR, 0.92 [95% CI, 0.84-1.00] for second-generation Asian American; OR, 0.82 [95% CI, 0.69-0.97] for third- or later-generation Asian American). Results for regular reading and storytelling or singing were the lowest among second-generation Asian American children (1430 [49.6%] for reading and 1629 [56.5%] for storytelling or singing), followed by the third- or later-generation Asian American children (376 [66.0%] for reading and 412 [72.3%] for storytelling or singing) and than White children (28 628 [72.7%] for reading and 30 375 [77.1%] for storytelling or singing) (P < .001). Results for family meals were similar between second-generation (2356 [81.8%]) and third- or later-generation (467 [81.9%]) Asian American children; however, both were significantly lower than for White children (33 928 [86.1%]) (P < .001). All 3 positive parenting practices were positively associated with children's psychological well-being and health behaviors. This survey study of young children found lower likelihoods of flourishing, regular bedtimes, and moderate screen time among Asian American children compared with non-Hispanic White children in the US. Reading and storytelling or singing parenting practices, which were associated with children's well-being and health behaviors, were particularly less frequent among parents of second-generation Asian American children than those of third- or later-generation Asian American children. Promotion of these practices among Asian immigrant parents may help improve the psychological well-being and health behaviors of their young Asian American children.

This paper delineates a preventive approach to early childhood mental health by preparing the workforce to provide relational, sensitive care to young children ages 0–5. One of the most prevalent issues in early childhood is behavioral challenges and the inability of young children to regulate themselves. This leads to an expulsion rate in early childhood (3–4 times higher than K-12 expulsion rate) and future mental health issues. The Early Childhood Social-Emotional and Behavior Regulation Intervention Specialist (EC-SEBRIS) graduate level certificate program was created to strengthen early care and education providers with the knowledge and practice of how to support emotion and behavior regulation in young children in their groups. Evaluation data provide evidence that early care and education professionals increased in their perception of self-efficacy and in their sensitivity of care and skills to support behavioral health in young children. Results indicated that the children in their care showed less challenging behaviors and increased social competencies. This manuscript highlights the importance of prevention and the dire need to provide young children with high-quality, appropriate care to support their mental health.

Infant and early childhood mental health practices can be supported by policies and professional standards of care that foster the healthy development of young children. Policies that support infants and toddlers include those that strengthen their families to provide a family environment that promotes mental wellness. Policy issues for infants, toddlers, and young children have come to the forefront of thinking as children need a "voice" to advocate for their support and care. This article (a) highlights several important policy areas that support the social-emotional development of very young children and (b) gives examples of current policy accomplishments and challenges. The article offers a policy agenda to promote the mental health of infants and young children and suggests ways that psychologists can engage with policymakers to promote policies that foster infant mental health, including contributing to the knowledge base that informs policy decisions, educating the public and policymakers about early childhood development and mental wellness, forming community partnerships to identify and address infant mental health risks, and participating in the development of policy recommendations that improve access to evidence-based practices in infant mental health.

Young children are especially susceptible to exposure to trauma. Rates of abuse and neglect among this population are staggering. This article presents a review of relevant literature, including research findings specific to early childhood vulnerability to trauma, symptoms associated with traumatic events, diagnostic validity of early childhood trauma, and treatments for young children. In the past, misconceptions about the mental health of young children have hindered accurate diagnosis and treatment of trauma-related mental illness. Due to the prevalence of trauma exposure in early childhood, counselors are encouraged to become familiar with ways that clients and families are impacted and methods for treatment. Implications for future research also are presented.Keywords: early childhood, trauma, treatment, mental health, mental illnessChildren from birth to age 5 are at a particularly high risk for exposure to potentially traumatic events due to their dependence on parents and caregivers (Lieberman & Van Horn, 2009; National Child Traumatic Stress Network, 2010). Traumatic events are incidents that involve the threat of bodily injury, death or harm to the physical integrity of self or others and often lead to feelings of terror or helplessness (National Library of Medicine, 2013). The American Psychological Association (APA) Presidential Task Force on Posttraumatic Stress Disorder (PTSD) and Trauma in Children and Adolescents (2008) indicated that traumatic events include suicides and other deaths or losses, domestic or sexual violence, community violence, medical trauma, vehicle accidents, war experiences, and natural and manmade disasters. With more than half of young children experiencing a severe stressor, they are especially susceptible to accidents, physical trauma, abuse and neglect, as well as exposure to domestic or community violence (National Child Traumatic Stress Network, 2010).Over 20 years ago, Straus & Gelles (1990) estimated that three million couples per year engage in severe in-home violence toward each other in the presence of young children. The Administration on Children, Youth, and Families (2003) reported that in 2001, 85% of abuse fatalities occurred among children younger than 6 years of age, and half of all child victims of maltreatment are younger than 7. More recently, the Child Welfare Information Gateway (2014) indicated that 88% of child abuse and neglect fatalities occurred among children 7 years of age and younger. Often, there is an overlap between domestic violence and child physical and sexual abuse (Osofsky, 2003). In addition to domestic violence, young children also are vulnerable to community violence.A study conducted by Shahinfar, Fox, and Leavitt (2000) suggested that the majority of young children enrolled in Head Start experienced violence in their communities. Young children also are exposed to traumatic Stressors such as accidental bums or falls resulting in hospitalization or death (Grossman, 2000). It is common for children to experience more than one traumatic event (APA Presidential Task Force on PTSD and Trauma in Children and Adolescents, 2008).Young children birth to age 5 are especially vulnerable to adverse effects of trauma due to rapid developmental growth, dependence on caregivers and limited coping skills. However, despite decades of statistical data, counselors generally have limited knowledge of the impact of traumatic events on younger children in comparison to older children and adolescents (De Young, Kenardy, & Cobham, 2011). Reasons for this disparity in knowledge include a historical resistance to the notion that early childhood mental health is important and concerns about diagnosing young children with mental disorders.Research in early childhood mental health has developed rapidly over the past 20 years. Practitioners and researchers who work with this population continue to contribute to the understanding of trauma and early childhood mental health. …

Many Australian Defence Force (ADF) and Veteran families are affected by the stressors of Defence family life, including frequent and prolonged parental deployments, and frequent relocations. To address a gap in information about Defence and Veteran (hereafter Defence) parents' knowledge, confidence and resources to support their young children's well-being and build their resilience. This study used a mixed methods design to explore Defence parent's perceptions of their young children's (aged 2-8 years) social and emotional well-being and understanding of their children's responses to unique stressors as well as their confidence in providing support. Data from 41 parents were available. Overall, parents reported positive well-being evaluation of their children. However, just over a third of parents also reported that their children rarely cope well on two indicators combined (adapting to new situations and sharing negative emotions with others). Significantly, more than half of the parents (61%) were only partially confident in their ability to assist their children to cope with unique stressors in military families. Qualitative data provided further insights into children's struggle with relocations and parental absence and the challenges parents face in supporting them. Parents reported having limited access to effective age- and culturally appropriate resources to support their young children. In a first-of-its kind study, we found that Australian Defence parents reported their young children were coping on most of the key well-being indicators. However, awareness of currently available supports for children remains a barrier as well as access to contextualised, age- and culturally appropriate resources are lacking. There is a need for access to free, quality, online, research-based Australian resources to support young children from Defence families, especially for those living in regional and rural locations and are less likely to have access to mental health and other specialist supports.

Early Childhood Services in OECD Countries

Public interest and public policy attention on the importance of cognitive and social development of young children has increased in recent years, at least in part, because scholars and researchers have found that experiences early in life have critical developmental consequences. Although scholars have generated a great deal of data on young children, relatively little is known about spatial variation in the well-being of young children. This study uses 12 indicators of child well-being to construct a comprehensive composite index of child well-being for children age 0 to 5 in each state in the United States. Examination of the 12 indicators of well-being for young children shows a high level of variation across states. The modest positive correlations among the four domains in the index suggest that they are measuring different elements of well-being. The composite index reveals that the well-being of young children follows a familiar spatial pattern, namely the well-being of young children in states located in the Deep South and the Southwest is relatively poor and the well-being of children in New England and the upper Midwest is relatively good. However, there are a several exceptions to this pattern which underscores the importance of examining the wellbeing of young children separately for all children. This study adds to a growing literature that uses an index of well-being to examine different groups of children.

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

Background This review evaluated the existing literature exploring the effects of arts-inclusive programs (AIPs) on the mental health and wellbeing of young children. AIPs include activities, programs, or interventions containing creative arts. Methods Literature searches were conducted across three databases (SCOPUS, psycINFO, and ERIC). The search was restricted to studies reporting outcomes of children 0–6 years. Results Nine studies were included in the review (3,671 participants). Three key themes were identified: music-related (n = 4); artmaking (n = 3); and storytelling/drama (n = 2). All included studies reported positive outcomes on children’s wellbeing following engagement in AIPs. Discussion This review found emerging evidence demonstrating positive impacts of arts engagement on the wellbeing of children aged 0–6. However, most studies were low quality and used varying outcome measures. The review is one of the first to highlight the lack of high-quality studies on the relationship between AIPs and wellbeing in young children.

The rapid spread of COVID-19 has triggered a worldwide epidemic emergency which is an international concern that poses a number of challenges to the physical and mental health of humans across the globe. Like businesses and universities, schools around the world have been closed and children must remain at home during this pandemic. However, social isolation could have a negative impact on young children's wellbeing if it is not addressed adequately. Social epidemiology research shows that the comorbidity of physical illnesses and mental disorders is higher especially in the absence of positive social relationships. Psychological studies show that social isolation could trigger several complications including emotional disturbance, sleep disorders, depressive syndromes, anxiety and stress. However, little is known about the psychological impact of social isolation during COVID-19 on young children's mental health and there are still no specific guidelines regarding effective psychological strategies that could support children's wellbeing. Drawing on existing research on social isolation, this review aims to synthesise previous literature to explore the negative impact of social isolation in young children and offer a comprehensive set of evidence-informed recommendations for parents and professionals to safeguard the mental health of young children currently on lockdown across the globe. Keywords: social isolation-COVID-19-children's wellbeing-children's mental health-socioemotional well-being.

Policy Recommendations to Promote Integrated Mental Health Care for Children and Youth.

This study examined the extent to which parental confirmation and affection mediate the associations among family communication patterns (i.e., conversation and conformity) and young adult children's mental well-being (i.e., self-esteem, perceived stress, and mental health). Participants included 567 young adult children from both first-marriage and postdivorce families. Results supported most of the hypothesized relationships among family conversation and conformity orientations, parental confirmation and affection, and young adult children's mental health and well-being. No significant differences emerged in the associations among mothers' and fathers' communication behaviors and children's well-being. Finally, hierarchical regression analyses revealed that parental confirmation and affection partially mediates the effects of conversation orientations, and fully mediates the effects of conformity orientations, on young adult children's self-esteem and perceived stress. For mental health symptoms, however, parental confirmation fully mediated the effects of conversation and conformity orientations.

Playing games using gadgets in early childhood is now a common thing. Children mostly spend their time playing gadgets alone rather than playing with their friends. This has an impact on their mental development, especially their social and emotional development. Unfortunately, it has not become a concern for the parents. They assume that playing gadget would not affect their children’s mental development at all. Therefore, this study aims to find out how is the teacher's perception of playing gadgets for early childhood mental health, especially in their social and emotional aspects. This was a qualitative study, in the form of a case study. Data were obtained through interviews and focused group discussions by 7 kindergarten teachers from 4 different classes. The study result reveals that all the teachers had the same perceptive that gadget has both positive and negative effects on early childhood's mental health. The positive impact of the gadget for early childhood's mental health is the contains of the games can stimulate the creativity and imagination for the children. Besides, the games in the gadget should be educative so they can learn in a fun way. The positive emotion of children when learning using gadgets will also maintain their mental health. The negative impact of the gadget for early childhood's mental health is if there they become addicted to the gadget so they spend more time playing gadget and refuse to interact with other people. As an effect, they will face difficulty in communicate with other people, get angry easily, hard to concentrate, unruly, which such things may cause deterioration in their mental health. Finally, teachers and parents as a significant person for the children must control the children while playing gadgets and give the rules and boundaries for the children to maintain their children's mental health.

This study investigates the impact of the COVID‐19 pandemic on young children's mental health and their engagement in mental health services in the midwestern United States. Previous research investigating the impact of COVID‐19 on young children's mental health service utilization has rarely included children under 5 years. Therefore, this study examined how the COVID‐19 pandemic and the caregiver‐child relationship impacted children's mental health symptoms. It also investigated the impact of COVID‐19 and the child's symptom presentation on caregivers’ engagement and attendance in mental health treatment. Data were collected with children 0 to 5 years old (n = 486) from January 2017 to April 2022 using archival records from a community mental health organization. Participants were primarily low‐income (81.9%) and White (81.3%). Results found that the caregiver‐child relationship impacted children's mental health symptoms before and during the COVID‐19 pandemic. Both caregivers and children were rated as more engaged after the pandemic began if the child experienced externalizing symptoms. Children attended fewer therapy sessions after the pandemic started, and those with externalizing symptoms received more overall services than those without.