How to Get the Best Help for Your Infant or Young Child
Talking about mental health may be difficult for parents and caregivers. You may want to think about your child ‘s developmental and mental health issues just as you do their physical health issues. For a sick child, you would make an appointment with your child ‘s pediatrician and talk about your concerns. Your doctor is the place to start with a social/emotional or mental health concern. Share your worries and describe what is happening at home or at school. Your pediatrician can help you decide if you need more help. In some cases, your doctor can assure you that some of your concerns are normal issues for your child ‘s developmental age and phase. In other cases, your pediatrician might ask you to get a further evaluation or refer you to a qualified child mental health professional.
If your pediatrician is not able to help, you can seek a consultation through a local child mental health provider, community agency, early intervention program, or Connecticut residents can call 211 or the Child Development Infoline at 1-800 505-7000. A Consultant from Help Me Grow at 211 will help you get the right referral for your child. Programs available to help you in Connecticut include: Birth to Three Early Intervention that can provide a developmental evaluation or preschool special education through your local school district, a community referral or a way for you to follow your child ‘s development using Ages and Stages (see below section on Developmental Screening). Remember it is very important for the young child to have his/her developmental or mental health concerns found early, so that he/she can get the right services or intervention. To learn more about the infant/early childhood programs available in Connecticut and nationally, click on the section called, “Infant/Early Childhood Mental Health Services and Resources.”
Problems at Child Care or Pre-School
If your child is having problems in child care or pre-school, if a teacher has concerns, you will want to work with your child’s teacher to find an answer. Often there are mental health consultants who can work with you and your child’s teacher to provide guidance for how to respond to your child or how to change the classroom environment to meet your child’s needs. In Connecticut, the Early Childhood Consultation Partnership provides consultants to child care programs and to Foster Parents for mental health concerns. You may ask for help to get an evaluation to see whether your child can get special education services (for ages 3-5 years). If your child is age birth to three there are services available through Part C of the Individuals with Disabilities Act (early intervention).
A child can get special education and related services if they have a significant delay in one or more areas of development, such as learning, speaking or playing. Special education and related services are required by federal and state law. Early childhood special education as defined by the federal law known as the Individuals with Disabilities Education Act (IDEA Part B) is for 3-, 4- and 5-year-old children with disabilities who need special education. In Connecticut, special education and related services are available to eligible children by age 3 and are provided by local and regional school districts. Connecticut residents can call the Child Development Infoline at 1-800-505-7000 to find out about services in each town or to find the nearest local school district. Connecticut Parents and caregivers may also visit the Connecticut State Department of Education’s website, to learn more about access to Early Childhood programs.
To get information about mental health in schools for an older child (age 6-18), please read the section of this website, called, “Mental Health in Schools.”
Evaluation and Screening
An assessment or screening is the way a practitioner may start a conversation with a parent or caregiver about his/her young child’s social and emotional and physical development. The screening will ask parents and caregivers questions about their young child and his/her physical, social and emotional milestones. The practitioner may ask questions about the child’s learning and care-giving places as well as give the parent/caregiver the chance to share their concerns about their child’s needs. It is important that the evaluation or screening for your infant or toddler be done in your home or a place where you are comfortable.
A Birth to Three Evaluation, as well as evaluations from other home visiting programs will take place at your home. Other settings where the evaluation can be conducted for children older than three are: your pediatrician’s office, at a mental health provider’s office, through an early care or educational institution, through a family resource and support center, or through a community mental health center. A parent/caregiver will want to be with their child during the assessment. Some children will not do well on any type of assessment if they are not comfortable with the place that it is given. Also, it is important for parents/caregivers to understand that they can get a second opinion about their child’s assessment results if they do not agree. The section called Infant/Early Childhood Mental Health Services and Resources, has a list of Connecticut and national organizations/programs that can help a parent/caregiver with the screening/assessment process.
The National Early Childhood Technical Assistance Center (NECTAC) has a list of screening tools used by different states and organizations in a document called, Developmental Screening and Assessment Instruments, with an Emphasis on Social and Emotional Development for Young Children Ages Birth through Five.
Please see the main section of the www.kidsmentalhealthinfo.com website called, “How to get the Best Help” and “What Questions do I Ask” section. These sections will help a parent/caregiver understand more about the screening process and have access to a list of questions to take to a provider in a first meeting with him/her.
Once a screening or assessment is done, the right service plan can be developed for the child and family. It is important to understand the different treatment choices, which can include consultation in your home or child care, parent/child psychotherapy, play therapy or medication in very special cases. You will want to talk about the options with a health care professional who has experience treating your child’s developmental and mental health issues. For children ages 0-6, parents and caregivers almost always participate in their child’s treatment in some way. For very young children, parents and children often participate in “dyadic” treatment which is when the parent and child take part together in treatment such as parent/child psychotherapy. As your child grows older and does more on his/her own, you may be less involved in your child’s treatment.
Types of Treatment
Each infant or young child’s treatment plan will be different depending upon his/her diagnosis and needs. The following are some of the types of treatment available for infants and young children with developmental delays or behavioral problems.
Early Intervention: Early intervention services are for children ages birth to three who have a disability or developmental delay (IDEA, Part C). Depending on your child’s needs, his or her early intervention services may include:
- family training, counseling, and home visits;
- special instruction;
- speech-language pathology services (sometimes referred to as speech therapy);
- audiology services (hearing impairment services);
- occupational therapy;
- physical therapy;
- psychological services; medical services (only for diagnostic or evaluation purposes);
- health services needed to enable your child to benefit from the other services;
- social work services;
- assistive technology devices and services;
- nutrition services; and
- service coordination services.
To learn more about Early Intervention services, please visit the National Dissemination Center for Children with Disabilities website. For Connecticut residents please go to www.birth23.org
Psychosocial therapies: Infant Mental Health Specialists can help parents try and understand what their babies and toddlers might be thinking or trying to communicate. There are limited therapies available for young children. Please see a selection of key treatments below and please also see the section entitled, “Infant/Early Childhood Mental Health Services and Resources.”
Parent-Child Dyadic Therapies:
Child-Parent Psychotherapy (CPP): CPP is an intervention for children aged birth through age 5 who have experienced at least one traumatic and, as a result, are experiencing behavior, attachment, and/or mental health problems, including post-traumatic stress disorder (PTSD). The main goal of CPP is to support and strengthen the relationship between a child and his or her parent (or caregiver) as a way to restore the child’s sense of safety and attachment, and improve the child’s cognitive, behavioral, and social functioning. To learn more about this intervention, click here.
Parent Child Interaction Therapy (PCIT): PCIT is a parent-child treatment program that helps parents of children aged 2-7 years old with behavioral problems (aggression, non-compliance, defiance, and temper tantrums). PCIT focuses on promoting positive parent-child relationships and interactions while teaching parents effective child management skills. PCIT has been adapted as an intervention for many different types of families (child welfare population, at-risk families, adoptive families, foster families, and other languages including Spanish and Chinese). To learn more about PCIT and to find a PCIT therapist in your area, click here to be linked to the PCIT Training Center.
Child FIRST (Child and Family Interagency Resource, Support and Training): This home-based program focuses on prevention and early identification of at risk children and their families. Child FIRST was developed by Dr. Darcy Lowell, a developmental pediatrician, and is an innovative evidence-based model which effectively decreases emotional and behavioral problems, developmental and learning problems, and abuse and neglect among very vulnerable young children (prenatal through age six years) and families.
Birth to Three: The Birth to Three System helps families to meet the developmental and health-related needs of infants and toddlers who have delays or disabilities. Parents and caregivers can call the Child Development Infoline and ask for an evaluation for their child, or download a Referral Form on the Birth to Three website.
Minding the Baby: MTB is an intensive home visiting program for first-time young mothers and their families living in New Haven, Connecticut. This program brings together a home visiting team including a pediatric nurse practitioner and a licensed clinical social worker to promote positive health, mental health, life course, and attachment outcomes in babies, mothers, and their families by helping mothers understand or wonder about what their baby is thinking.
Nurturing Families Network: This program is a no-cost, voluntary program that provides information, guidance and assistance to first-time parents. Available through some 33 community agencies and birthing hospitals throughout Connecticut, the network offers home visiting services, access to parents support groups and community assistance.
Emergency Mobile Psychiatric Services (EMPS): Services for children and adolescents that gives immediate, mobile assessment and intervention to individuals in an active state of crisis and can occur in a variety of settings including the member’s home, school, local emergency department, or community setting. Because this service is mobile and available to all Connecticut residents, it can be a helpful alternative to bringing your child to an Emergency Department in a time of crisis. To access EMPS services across Connecticut, call 2-1-1.