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Topic: Infant and Early Childhood Mental Health Programs (Birth to 5)

Scientific Ratings in this topic:

1 - Well-Supported by Research Evidence

2 - Supported by Research Evidence

3 - Promising Research Evidence

4 - Evidence Fails to Demonstrate Effect

5 - Concerning Practice

NR - Not able to be Rated

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Definition for Infant and Early Childhood Mental Health Programs (Birth to 5):

Infant and Early Childhood Mental Health Programs (Birth to 5) are defined by the CEBC as those that address mental health issues and early attachment disruptions by intervening through parental/caretaker guidance, supportive counseling, and parent/infant dyadic psychotherapy in children from birth up to five years of age. Infant and early childhood mental health approaches support the child within the context of their relationship with their parents and other primary caretakers. Infant and early childhood mental health programs also help develop capacity in the child for expressing emotions, forming close and secure relationships, and mastering their environment. Infant and early childhood mental health programs can potentially interface across the child welfare service continuum, from working with parents and their infants/young children in prevention-based voluntary services to supporting structured visitation processes with the infant/young child and their parental/caretaker while attempting to reunify. Infant and early childhood mental health programs could also potentially play a key role in supporting the relationship between the care provider and the reunifying parent through a permanency teaming approach. Per the DC:0–5™ Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood Version 2.0:

    Diagnosing an infant/young child who is experiencing mental health problems must include developing an understanding and appreciation of the family’s cultural background and the parents’ socioeconomic conditions, national origin and history, immigration status, ethnic and racial identity, sexual orientation, religious and spiritual practices, and other sources of diversity (p. 9).
  • Target population: Children from birth up to five years of age
  • Services/types that fit: Typically outpatient services, either individual or family, that target the child directly, work with the parent and child together, or target the entire family
  • Delivered by: Mental health professionals or trained paraprofessionals
  • In order to be included: Program must specifically target mental health or attachment issues in children from birth up to five years of age
  • In order to be rated: There must be research evidence (as specified by the Scientific Rating Scale) that examines outcomes related to mental health or attachment in young children or their parents, such changes in symptom levels, behaviors, and/or functioning.

Programs in this Topic Area

The programs listed below have been reviewed by the CEBC and, if appropriate, been rated using the Scientific Rating Scale.

One Program with a Scientific Rating of 1 - Well-Supported by Research Evidence:

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One Program with a Scientific Rating of 2 - Supported by Research Evidence:

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Six Programs with a Scientific Rating of 3 - Promising Research Evidence:

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  • Child First
    [Child FIRST, Child FIRST (Child and Family Interagency Resource, Support, and Training)]
    Children prenatal to 5 years old and their parents/caregivers who are at risk of or have experienced child abuse, neglect, ...
  • Early Childhood Consultation Partnership®, The (ECCP®)
    Children birth to age five in early care and education settings and their caregiving adults (e.g., family caregivers and ...
  • Mellow Babies
    Disadvantaged families with mothers with children eighteen months old and younger; families can include teenage parents, parents with mental health ...
  • Promoting First Relationships (PFR)
    Caregivers of children birth to three years
  • Theraplay
    Children ages 0-18 who exhibit behavioral problems and their caregiver (biological, adoptive, or foster)
  • Watch, Wait, and Wonder (WWW) – non-responder
    Parents and their children who are experiencing relational and developmental difficulties

One Program with a Scientific Rating of NR - Not able to be Rated:

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Why was this topic chosen by the Advisory Committee?


This was written when the topic area was the Infant and Toddler Mental Health Programs (Birth to 3) which was prior to December 2021.

The Infant and Toddler Mental Health Programs (Birth to 3) topic area is relevant to child welfare 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; they make up one third of all admissions into the child welfare system. 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. In addition, scientific evidence shows that 75% of the brains wiring occurs by age 1, and 90% by age 5, and research indicates trauma from abuse and neglect adversely impacts proper neural development. All of this shows the importance of early intervention with this young child population. Child Welfare needs to integrate evidence-based strategies in the continuum of services they provide that maximize healthy relationships for the child ages 0-3 in order to minimize and mitigate harmful impacts on brain development and future negative behavior.

Howard Himes, Director
Napa County Health and Human Services
Napa, CA

Topic Expert

Laurel K. Leslie, PhD, Associate Professor of Medicine and Pediatrics
Tufts Medical Center, Floating Hospital for Children
Director, Aligning Researchers and Communities for Health (ARCH)
Tufts Clinical and Translational Science Institute
Boston, MA