Infant and Toddler Mental Health (0-3)

What is Infant and Toddler Mental Health (0-3) as it relates to Child Welfare?

Infants and Toddlers make up one third of all admissions into the child welfare system and, once they are in care, young children remain longer and are more likely to be abused and neglected. New advances in neurophysiologic research indicate that trauma from physical and sexual abuse and neglect dramatically and adversely affects the structure and development of the brain. The research also indicates that many of the negative impacts to the brain’s neural structure are potentially reversible. The need for timely interventions to help rewire the brain and eliminate potential future behavioral and learning problems for foster children is critical for the Child Welfare system. One potential intervention is Infant and Toddler Mental Health which offers ways of conceptualizing early attachment disruptions and intervening through parental/caretaker guidance, supportive counseling, and parent/infant dyadic psychotherapy. Infant and toddler mental health approaches support the child within the context of his/her relationship with parents and other primary caretakers. Infant and toddler mental health also helps develop capacity in the child for expressing emotions, forming close and secure relationships, and mastering their environment. Infant and toddler mental health can potentially interface across the Child Welfare service continuum, from working with parents and their infants/toddlers in prevention-based voluntary services to supporting structured visitation processes with the infant/toddler and their mother while attempting to reunify. Infant and toddler mental health could also potentially play a key role in supporting the relationship between the care provider and the reunifying parent through a permanency teaming approach.

Why Infant and Toddler Mental Health (0-3) was chosen by the Advisory Committee? Infant and Toddler Mental Health was selected by the Advisory Committee because infants and toddlers represent the fastest growing age group of children being removed from their homes as a result of abuse or neglect and placed in foster care in the United States. Nationally, approximately 50,000 infants under 12 months (NCANDS) enter foster care every year. These children are the most vulnerable for many reasons, including their small stature, dependency on adults, and compromised ability to communicate and protect themselves. For instance, according to National Data (NCANDS) for 2007, children younger than 1 year accounted for 42.2 % of all child fatalities, while children younger than 4 years accounted for more than three quarters of all child fatalities. Combine the disturbing child fatality data with scientific evidence through neuro-brain imaging that 75% of the brains wiring occurs by age 1, and 90% by age 5 (New Directions Institute for Infant Brain Development) as well as research that indicates trauma from abuse adversely impacts proper neural development and the gauntlet has been thrown to Child Welfare. Child Welfare must integrate evidence-based strategies at key strategic points in the continuum of services that maximize healthy relationships for the 0-3 child in order to minimize and mitigate harmful impacts on brain development and future negative behavior. Child Welfare must change the negative trajectory that foster children often face from failed reunifications, failed attachments, and increased problems of emotional disturbance which can lead to multiple disruptions in placements and eventually involvement with drugs, prostitution, and the criminal justice system.

Howard Himes, MSW
Deputy Director
Fresno County Dept. of Children and Family Services