C3.6 Early Childhood Mental Health

Introduction

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A young child’s emotional well-being and mental health are significantly tied to the functioning of their caregivers and their living environments. This makes early childhood mental health a key consideration in prevention and child welfare practice. Just as having healthy attachments to a consistent nurturing caregiver(s) is critical to overall child development, it is also critical to promoting social-emotional development in young children and supporting early childhood mental health.  

Children can display characteristics of significant mental health challenges at a very young age. Children under age five (5) may display signs of anxiety, attention deficit/hyperactivity, depression, post-traumatic stress, or neurodevelopmental disabilities such as autism spectrum disorders. Experiencing traumatic events, lack of stability in caregivers, or exposure to toxic stress can increase the likelihood of a young child developing mental health concerns or further exacerbating symptoms of mental health disorders. It is often more difficult to diagnose mental health disorders in young children because they are still in a period of rapid brain development and learning how to get along with others, follow the rules, and practice socially acceptable behaviors. Often, the terms “social-emotional development” and “early childhood mental health” are used interchangeably. Social development includes the ability to have meaningful relationships with both adults and other children. Emotional development is a child’s ability to express, recognize, and manage their own emotions (often referred to as self-regulation), as well as respond appropriately to others’ emotions. These two areas of development relate closely to one another and often are referred to collectively as “social-emotional development.” Both social and emotional development are foundational to early childhood mental health. Early identification of potential mental health concerns and provision of services can drastically improve outcomes for young children.

Practice Guidance


  • It is never too early to screen and assess for mental health concerns in young children.  
  • In addition to healthy attachments, supporting social-emotional development and self-regulation can promote mental health in young children. Early childhood providers such as high-quality early care and education, early intervention, and home visiting programs can provide support and services in this area.  
  • Early care and education providers specifically focus on helping young children with social-emotional development, which supports early childhood mental health. Early Head Start and Head Start provide support and training to staff to work with young children and their families on development in the following areas:
    • Relationships with adults;
    • Relationships with children;
    • Emotional functioning; and
    • Sense of belonging and identity.
  • Social-emotional development is one of the domains of development for which the Kentucky Early Intervention System (KEIS) provides assessment and services.  
  • Mental health concerns in early childhood must be addressed within the context of the child’s family and/or other caregiving relationships.

Procedure

​The SSW: 

  1. May utilize the Social-Emotional Development Tip Sheet to identify concerns with social-emotional development, and behavioral or mental health for young children at any point during service provision to the child or family;
  2. Completes standardized screening and assessment for any child entering out-of-home care (OOHC) as described in SOP 4.26.3;
  3. Refers the child and family for further assessment or services as indicated by the standardized screener, the Social-Emotional Development Tip Sheet, or concerns of early childhood providers or caregivers;
  4. Refers children under the age of three (3) to KEIS as described in SOP C3.2;
  5. Refers children over the age of three (3) for assessment through Early Periodic Screening Diagnosis and Treatment (EPSDT) services (please see SOP 4.26.5​) or utilizes the child’s pediatrician for guidance; and  
  6. Refers the child to services to address social-emotional development or mental health concerns if a child under the age of five (5) is suspended or expelled from an early care and education setting due to behaviors or disruption from an OOHC placement due to behaviors.  




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Revisions