By Abha Ranjan Khanna
Infant and Early Childhood Mental Health (IECMH) is “the developing capacity of the child from birth to five years old to form close and secure adult and peer relationships; experience, manage and express a full range of emotions; and explore the environment and learn-all in the context of family, community, and culture.”
Emotional health of infants and young children is an essential ingredient for a happy and healthy future for all children. During the early childhood years (0-5 years), there are many ways to promote emotional health, to prevent emotional disturbances, and to treat mental health problems before they become severe later in life.
Early experiences matter a lot.
More than one million new neural connections develop every second in the first years of a baby’s life. Relationships and experiences that babies have right from birth, literally shape the architecture of their brain, creating a foundation on which all future development and learning unfolds.
Parents and caregivers who engage with their infants and toddlers in responsive, consistent, nurturing ways promote strong emotional health — also referred to as infant and early childhood mental health.
As babies mature, their emotional health supports growth and wellbeing in other essential areas including physical development and health, cognitive skills, language and literacy, social skills and even their approach to learning and readiness for school. When emotional health is compromised, development across these other areas is impacted leaving children vulnerable and susceptible to poor health, poor educational performance, compromised learning and immature adaptive skills.
Behaviours That Warrant Concern – Infants and Toddlers (birth to three years old):
• Chronic eating or sleeping difficulties
• Inconsolable “fussiness” or irritability
• Incessant crying with little ability to be consoled
• Extremely upset when left with another adult
• Inability to adapt to new situations
• Easily startled or alarmed by routine events
• Inability to establish relationships with other children or adults
• Excessive hitting, biting, and pushing of other children or very withdrawn behaviour
• Flat affect (shows little to no emotion at all)
Pre-schoolers (three to five years old):
• Engages in compulsive activities (e.g., play enacted in a specific order, hand washing, repeating words silently)
• Throws wild, despairing tantrums
• Withdrawn; shows little interest in social interaction
• Displays repeated aggressive or impulsive behaviour
• Difficulty playing with others
• Little or no communication; lack of language
• Loss of earlier developmental achievements
• Anxious and fearful in most situations
Why Is IECMH Important? While positive early childhood experiences promote strong emotional health, negative experiences can adversely impact brain development, with serious lifelong consequences. When an infant or young child’s emotional health deteriorates, they can, and do, experience mental health problems.
Approximately 9.5-14.2 per cent of children birth to five years old experience emotional, relational, or behavioural disturbance. Young children who live in families dealing with parental loss, substance abuse, mental illness, or exposure to trauma are at high risk of developing IECMH disorders.
If untreated, IECMH disorders can have detrimental effects on every aspect of a child’s development i.e., physical, cognitive, communication, sensory, emotional, social, and motor skills and the child’s ability to succeed in life.
However, when mental health concerns are identified early, there are services that can redirect the course and place children who are at risk on a path for healthy development.
An early childhood mental health consultation system would involve a consultant with mental health expertise such as a child psychologist or child psychiatrist working collaboratively with programs such as preschools and day care centres, their staff, and families to improve their ability to identify and prevent mental health issues among children in their care. This is of critical importance for our children today.
(The writer is an occupational therapist.)