• The healthy social and emotional development of young children, and
• A field of practice that promotes social and emotional well being, prevents the development of mental health problems in at risk populations, and provides intervention to young children with mental health problems and their families (Adapted from Zero to Three)

Social and emotional skills begin to develop in infancy. An infant’s social smile charms his parents. His cries may indicate that he is hungry or uncomfortable. The cues an infant gives to his parents help him to get the care and attention that he needs. Infants’ social emotional development hinges on their interactions with parents or caregivers. Infants show a clear preference for their parents (or primary caregivers) and may be afraid of strangers. As they approach toddlerhood, infants begin to develop their own identity and may show defiant behavior. Toddlers and preschoolers begin to be more comfortable separating from their parents. They develop social relationships with their playmate or peers and are able to express emotions of happiness, sadness, anger, frustration, and empathy.

Sometimes social-emotional development in young children does not go as expected. Infants may not be able to give the cues their parents need, or parents may not be able to respond to those needs. When this happens, typical social-emotional development can be interrupted, creating social, emotional, or behavioral difficulties. For children and families affected by early childhood mental health problems, intervention is critical for optimal development.

What do mental health difficulties look like in young children?
Just like adults, young children can be anxious or depressed, or have trouble relating to others. And like adults, young children are affected by events in their life. They will react to traumatic events and grieve the loss of loved ones. Extremes in infants’ moods or reactions to life events may trigger emotional problems and maladaptive behaviors, especially if an infant is predisposed to emotion regulation problems or lacks a consistent person who responds to her physical and emotional needs.

Infants and toddlers who experience social emotional difficulties may have challenges becoming attached to their parents or primary care givers. They may not be able to regulate their alertness level or sleeping routines. Play and exploration may be hindered because of elevated fear and anxiety or because of sensitivities to sounds, lights, or touch. As children approach pre-school age, social-emotional problems are often exhibited by the child’s behavior, such as extreme hyperactivity or aggressiveness, difficulty in managing frustration, or a lack of interest in interacting with adults or peers.

Why is early childhood mental health intervention important?
Social and emotional development is a key component of early learning and school-readiness. (Shonkoff, Neurons to Neighborhoods ). When children have social/emotional difficulties, problems tend to spiral. Young children may be expelled from preschool, setting them up for later school failure. They may not be able to establish close relationship with family or friends, leading to antisocial behavior, violence, or severe depression. Research shows that early intervention can significantly improve social and emotional functioning and reduce later violence and antisocial behavior in school age children (Sprague and Walker).

What does early childhood mental health intervention look like?
A critical component of early childhood mental health intervention is that it happens within the context of the child’s family and other caregiving relationships, such as childcare or preschool settings. In addition, intensive care coordination is key to assuring that the services are addressing the child and family needs, as identified by the family.

• Parent-child interaction therapy, helping the parent learn to read and respond to the child’s cues
• Individual or group play therapy for the child, helping her learn to express or regulate his emotions through play
• Parent or group psychotherapy/education or family support groups, helping parents learn to understand their own childhood histories or mental state, and how that may impact their parenting
• Consultation by mental health specialists in early childhood settings, providing strategies to early childhood providers to address the social, emotional, and behavioral needs of individual children or the whole group

With attention and intervention, mental health and emotional development problems in young children can be recognized and successfully treated.