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Mental Health

Ask the Expert: Defining Infant Mental Health

“The physical, mental and emotional health of the very young child provides the foundation for all further development.”

—Jane Knitzer, National Center for Children in Poverty, Columbia School of Public Health, 1998

Christopher Watson is the coordinator of the Minnesota Infant Mental Health Project and two other early childhood projects funded by the Minnesota Departments of Health, Human Services, and Education, as well as the Co-Director of the Center for Early Education and Development (CEED) at the University of Minnesota.

Infants can’t develop without attention from adults. Simple interactions such as holding a child when she is crying, rubbing her back, and talking to her in a calm voice help her grow emotionally and socially. Without this kind of touch, babies literally starve for attention.

Studies have shown that without consistent nurturing care, an infant’s development will come to a halt— babies have been known to develop digestive problems and stop eating, and as the baby grows older he or she will begin repeating self-soothing behaviors like rocking.

“Because human infants are vulnerable and remain so for a long time, they rely incredibly on adults to protect and nurture them,” said Christopher Watson, coordinator of the Center for Early Education and Development at the University of Minnesota. “That’s why the concept of infant mental health is so important.”

Infant and toddler mental health essentially means that infants and toddlers need to develop good relationships with their parents so that they trust that their needs will be met.

The reason for the recent emphasis on infant and toddler mental health is simple: families are under more stress than ever before and children have more non-nurturing stimulation around them, such as TV and video games.

“Traditionally, we’ve put skill-building ahead of parent-child interactions,” Watson said. “But parents are really the most important part of a child’s life. If parents recognize how important they are to their children, it is so empowering for them.”

All children need interaction and support to develop in a healthy way. However, Watson and others in his field believe that children with disabilities are at a higher risk for mental health issues. For example, a child with a communication barrier or a physical disability may have a harder time making friends, and may be less self-confident.

Parents and teachers who are trained to support children appropriately may be able to help them deal with new situations, feel more confident, and handle conflicts better.

“Our premise is that a child’s first job is to play and explore in a safe way,” Watson said. “Physical and emotional safety comes from adults. Parents need to know how important it is that a child has trust in other people, and that creates a basis for all other learning. Don’t rush ahead to teach your child to read without dealing with the basics of providing responsive caregiving, which sets the stage for later success in school, work, and interpersonal relationships.”

Note: Children can develop mental health disorders in spite of responsive caregiving. Many parents with children with mental health needs have had excellent parent-child interactions.

The Center for Early Education and Development

CEED at the University of Minnesota provides information regarding young children (birth to age 8), including children with special needs, in the areas of education, child care, and child development.

CEED has developed several on-line classes for people interested in topics such as “Bridging Education and Mental Health” and “Relationship-based Teaching with Young Children.”

Nurturing, Belonging Lead Children with Disabilities Toward Independence

By Susan Shogren Smith and Patricia Bill, PACER Center

The community, friends, and family sometimes see a child’s disability rather than his or her many abilities. Attitudes of others affect how children view themselves, how they interact with others, and, ultimately, their expectations for success. It is important for parents to understand how general perceptions about disability affect their child so they can avoid or correct situations that may be negative.

Regardless of their specific needs, children with disabilities usually benefit when others treat them as much like typical children as possible. All children need nurturing and a feeling of belonging. Knowing how to provide them for your child with a disability will go a long way toward helping him or her become a well-adjusted, successful adult.


Most children enjoy affection, such as hugs and hearing “I love you,” from family and friends. The desire for trustworthy relationships begins in infancy. Dependable nurturing fuels a child’s self-confidence and leads to independence and autonomy.

It is easy to be affectionate with a child who responds appreciatively. Some children with disabilities, however, do not have the physical ability to return smiles, embraces, or compliments. Others, with mental or emotional disabilities, may seem to discourage interaction. Despite behaviors resulting from their disabilities, the children need nurturing.

Frequent, positive communication is one way to nurture. When families and friends are patient and encouraging, they motivate the child to try to communicate. Enjoyable exchanges help children develop social skills and create mutually satisfying relationships with others. On the other hand, children sense others’ frustration when attempts to communicate are not immediately successful. The result: they quit trying.

Nurturing some children with disabilities takes time, a precious commodity for their families. Often, however, it is simple activities, such as reading a short story, singing a song, chatting in the kitchen, or taking a brief walk, that involve a child and satisfy a need for nurturing.


When parents and others learn that a child has a disability, each person reacts differently. If the reaction is disappointment or dismay, it must be must overcome to support the child and one another.

When family members and friends work together to help the child, they create an environment that tells the child he or she is loved, valued, and included. Inclusion (or belonging) is the safe foundation from which children eventually launch their independence.

Friends and relatives may inadvertently exclude children with disabilities by treating them differently than they do the other children in the family. Most children notice if an aunt has a pat on the shoulder for the child in a wheelchair but hugs for the others. If grandparents take some siblings, but not others, on an outing, those who stay home feel left out.

Inclusion or belonging usually results when others are accustomed to a child with disabilities. Frequent contact and interaction with the child improves comfort levels and communication for both parties. For example, becoming familiar with a child’s speech pattern may help friends and relatives better understand the communication efforts of a child with speech and language difficulties. Children with behavior challenges may relax and respond more positively toward people with whom they feel familiar and accepted.

Helping a child with a disability become part of the family circle, or the wider community, may seem to be a daunting task for parents. Nurturing and providing a sense of belonging, however, are simple and effective first steps toward the goal. Furthermore, there is a bonus: successful results last a lifetime.

Parents Help Promote Good Emotional Health in Young Children

From the moment they are born, babies are social, emotional beings. Every coo and cry is an attempt to express needs and feelings and communicate with the world around them. By responding with unconditional love and consistency, parents can help their babies and young children develop healthy social and emotional patterns that will serve them well throughout life.

That’s not always easy to do—especially when your infant is wailing through the night or your toddler is having a tantrum in the grocery store. Yet through every interaction you have with your child throughout the day, you have the opportunity to support your child’s social and emotional development. You are helping your child build trust in others and the ability to form meaningful relationships, says Christopher Watson, Co-Director of the Infant and Early Childhood Mental Health Certificate Program at the University of Minnesota.

“Children need adult emotional partners to help them interpret what they’re feeling and manage their emotions,” Watson explains. “For example, a toddler who is suddenly afraid of something will look to Mom or Dad to see if they should be scared. They need an adult to help them know what’s okay, what’s not, and how to respond to the world.”

Watson offers these tips on how you can promote social and emotional health in your young children, with or without disabilities.

Provide Unconditional Love

Children need to know that they are loved even if they misbehave, make mistakes, or experience failures.

Provide Appropriate Discipline

Children need to explore and experiment, and they also need to know where the limits of acceptable behavior are. When rules are broken, criticize the behavior, not your child. Be firm but kind. Help your child understand why the behavior was not okay and what he or she can do instead.

Foster Self-Esteem

Children develop feelings of self worth when they are praised, encouraged, respected, reassured, and treated fairly.

Encourage Play

Play helps children learn how to relate to others, handle challenges, gain a sense of belonging, and learn social skills.

Express Feelings Appropriately

Children learn from imitation. They will learn to express their own feelings and develop empathy by watching how you deal with emotions.

Provide a Safe Home

Stability, consistency, and predictability help a child feel safe. Protect your child from violence in the home— including violence on TV.

Interpret the World and Develop Emotional Literacy

Children begin to understand other people by learning about their own feelings first. Build emotional vocabulary through your day-to-day actions together. For example, if your son has fears about monsters under the bed, reading books about scary things may give him a safe way to explore that feeling, gain perspective, and understand that everyone has fears.

Name and Affirm Your Child’s Emotional Experiences

Your child will learn to trust emotions and relationships if you name and affirm what your child is feeling and provide assurances that you can help your child deal with them. For example, if your daughter is upset because you limit before meal treats, saying, “Yes, I see you are angry because I won’t let you have a cookie before dinner,” helps her identify the feeling she is having, affirms the feeling, and demonstrates that you understand (even though she still can’t have a cookie). “The goal,” Watson says, “is to create an environment where a child feels held emotionally.”

Set Children Up for Success

Anticipate when your child is prone to emotional outbursts and avoid those times when scheduling activities. For example, if your son is demanding and whiny when he’s tired, wait until after his nap before you take him grocery shopping. “If you know a child won’t like something, think about what they do like and mix a reward with the activity,” Watson suggests.

Be Calm

When your child is agitated, upset, or out of control, “your only job is to bring them down from that state,” Watson says. How? “Be present. Keep a calm tone of voice and repeat simple, comforting words, such as ‘It’s okay. I’m here,’ ” he says. “Don’t add extra demands on the child. In fact, take away demands. If necessary, remove your child from the environment,” he adds, noting that large stores and fluorescent lighting can be overstimulating to young children. Another approach is to try distracting the child. Finally, “if your child is getting physically distraught, you may want to hold him or her closely to provide a calming sense of safety. Adults play a crucial role in providing support to children as they learn to regulate their feelings,” Watson says.

All children—with and without disabilities—need a secure base in order to develop into emotionally healthy adults. That foundation is built moment by moment, in the daily interactions between you and your child. By helping your child understand and express his or her emotions, you’re promoting social and emotional health that will allow your child to face life’s challenges in the best way possible.

When Should You Seek Help?

Did you know that infants and preschoolers can become depressed, suffer from traumatic events, or have a tendency to develop mental health problems? It can happen to any child— regardless of age, race, ethnicity, religion, or family situation, says Christopher Watson, Co-Director of the Infant and Early Childhood Mental Health Certificate Program at the University of Minnesota.

Symptoms of mental health issues vary but may be suspected if a young child regularly:

  • Lacks emotion
  • Rejects affection
  • Is unable to calm himself or herself
  • Is extremely fearful
  • Acts withdrawn
  • Is often inconsolable
  • Acts violent, defiant, or aggressive
  • Has significant sleeping or feeding problems
  • Is extremely clingy, sad, or out of control

All children go through challenging phases, but that doesn’t mean they have mental health issues, he adds. When a child’s behavior repeatedly seems too extreme, intense, or unusual, however, it may be a sign that something is amiss.

Remember, no one knows your child better than you. If you are concerned about your child’s mental health, call your pediatrician or county public health office and request a social/emotional screening. An infant or toddler with a diagnosed physical or mental condition that’s likely to result in developmental delay may qualify for early intervention services even if the delay isn’t apparent at the time. Early intervention can help turn problems around before they become more severe or long lasting.