Title: HANDLE WITH CARE: STRATEGIES FOR PROMOTING THE MENTAL HEALTH OF YOUNG CHILDREN
1HANDLE WITH CARE STRATEGIES FOR PROMOTING THE
MENTAL HEALTH OF YOUNG CHILDREN
- Nancy J. Cohen
- Hincks-Dellcrest Centre University of Toronto
- Supporting Childrens Social and Emotional
Health - Assessment Tools, Research and Practice
- University of British Columbia
- Vancouver, May 11, 2006
2COLLABORATORSBonnie PapeHeidi Kiefer
3WHAT IS MENTAL HEALTH PROMOTION?
- activities that seek to enhance mental health and
take into account the broad psychosocial factors
that affect mental health - for young children, activities to develop
age-appropriate and culturally relevant life
skills - in centre-based care, mental health promotion is
associated with good practices that foster
childrens social and emotional development,
build family and community connections, and
create a positive working climate for those in
the child care field
4WHY PROMOTING MENTAL HEALTH IN EARLY CHILDHOOD
PROGRAMS IS IMPORTANT
- more children are entering the childcare system
at younger ages and many are exposed to stresses - early disruptions in emotional development can
have long-term negative consequences on social
and emotional functioning and learning - social and emotional development are important to
ensure that when children enter school they are
ready to learn
5(No Transcript)
6BRITISH COLUMBIA Day Care Centres
- Cariboo Child Care Centre, Kamloops
- College of New Caledonia Demonstration Day Care
Centre, Prince George - Grandview Terrace Child Care Centre, Vancouver
- Langara Child Development Centre, Vancouver
- Plum Blossom, Vancouver
- Simon Fraser University Child Care Society,
Burnaby - University of British Columbia Child Care
Services, Vancouver - West Wood Players Ltd., Port Coquitlam
7AREAS EXPLORED IN INTERVIEWS WITH PRACTITIONERS
AND DIRECTORS (1)
- building trusting relationships between
practitioners and children - supporting individual characteristics and
self-esteem - fostering independence and problem solving skills
- encouraging understanding and expression of
emotions - respecting diversity and the rights of others
- helping children build positive peer
relationships - helping children deal with changes and transitions
8AREAS EXPLORED IN INTERVIEWS WITH PRACTITIONERS
AND DIRECTORS (2)
- centres policies and arrangements of the
physical setting underpinning mental health
promotion - ways that practitioners
- interact with parents
- support and respect a childs home language and
culture - receive support themselves in the work environment
9 Handle with Care Strategies for
Promoting the Mental Health of Young
Children in Community-Based Child Care
10WHY FOCUS ON ATTACHMENT SECURITY?
- When children are securely attached they can feel
free to explore the world, show curiosity and
benefit from learning experiences.
11ATTACHMENT
- Attachment is a biologically primed behavioral
system which operates under threatening
conditions and enables infants to seek safety
and comfort from distress through proximity to
their mothers.
12BEHAVIOURS THAT HELP CHILDREN ATTAIN SECURITY
- Infants
- crying
- clinging/grasping
- responding to comfort
- smiling
- reaching out
- sharing affect
- Toddlers and Preschoolers
- crying/tantrums
- following (crawling, walking)
- using language
- affective sharing
- smiling
- initiating interaction
- exploring from a secure base
13CAREGIVER BEHAVIOURS THAT FACILITATE SECURE
ATTACHMENT
- rapidly responding to a child who is frightened,
ill, or otherwise distressed by physically
comforting and talking - building trust in their availability and
consistency - providing predictable routines, responses, and
traditions - creating a safe environment for children to
explore, and gradually become more autonomous - taking an active interest in the children and
offering them encouragement that is supportive
and reciprocal rather than directive - showing positive feelings to children
14ESSENTIALS OF ATTACHMENT
- Attachment relationships provide the foundation
for social and emotional development - A secure relationship involves children feeling
that they are safe and important - Children typically have the strongest attachments
to their parents - However, children also form attachments to other
important people in their lives - For practitioners, building trust with children
usually involves building trust with their
families - It takes time for children to develop a secure
attachment - Attachments are informed by cultural, family and
individual beliefs and preferences
15- I give the children time to become comfortable
with me. I wont push myself on them. The first
time at the center I dont hug and snuggle
children right away. Its not appropriate because
I am a stranger to them. The second time I put a
toy between myself and the child as a way of
getting closer, but not too close. Maybe the
third time, I will share some physical affection
with the child.
16STAGES OF ATTACHMENT
- Preattachment
- Attachment in the making
- Clear-cut attachment
- Goal-corrected partnership
17SECURE ATTACHMENT PROVIDES A FOUNDATION FOR
CHILDREN TO
- regulate their emotions and behaviour
- have a sense of inner confidence and efficacy
- express curiosity and eagerness to explore
- enjoy more pleasure and harmony in relationships
- show greater competence in cognitive and language
development
18CHILDREN WITH SPECIAL NEEDS
Children with special needs develop attachment
relationships, but for some this happens later.
Attachment signals may be subtle so it is
important to be a good observer.
19INDIVIDUAL DIFFERENCES IN ATTACHMENT
- Secure
- Avoidant
- Resistant or ambivalent
- Disorganized
- Insecurely attached and disorganized children
often behave in ways that make them more
difficult to care for, which further exacerbates
their insecurity.
20- Insecure and disorganized behaviours occur some
of the time in most children. It is when the
behaviour becomes a repetitive and persistent
pattern that it is of concern.
21RESULTS OF STUDIES OF ATTACHMENT OF CHILDREN IN
CHILDCARE
- Childcare alone does not have a negative impact
on attachment security with mothers at any age. - There is not a simple or direct relationship
between childcare attendance and childrens
attachment security. - When childrens relationships with their mothers
are not secure, coupled with enrolment in low
quality care for extensive periods or in unstable
childcare arrangements, childrens mental health
suffers.
22- Attachment relationships of children to a
professional caregiver can be independent of
the childrens attachment to parents. - Characteristics of practitioners in
relationships with children that promote mental
health are the same as those of parents. - Structural features of child care and education
and training of practitioners also contribute to
attachment security.
23- Sometimes we are led to believe that if secure
attachment relationships are established early
that is enough to inoculate children against
stress. However, benefits actually come about
from persistence of secure attachment and
sensitive parent and practitioner care rather
than secure attachment specific to the first
year.
24COMPENSATORY EFFECTS OF CHILDCARE ON MENTAL
HEALTH (1)
- Depressed mothers who rely on childcare have more
positive interactions with their infants than do
depressed mothers who do not. - When maternal sensitive responsiveness and
affection are low but child care quality if high,
children are more likely to be securely attached
than when quality of care is low both at home and
in child care - Children who had an insecure relationship with
their mother, and who attended childcare early,
are less withdrawn than were insecure children
who remained at home.
25COMPENSATORY EFFECTS OF CHILDCARE ON MENTAL
HEALTH (2)
- Childcare quality had a positive effect on
externalizing behaviours for children from less
advantaged homes as well as a positive effects on
boys internalizing problems and sense of
effectiveness. - Children in enriched programs have fewer
behaviour problems than comparison groups who do
not have an enriched experience. - High quality childcare can serve a compensatory
function for children who are temperamentally
difficult in infancy.
26WHAT GETS IN THE WAY
- unfortunately, not all centres meet standards for
high quality - rate of child care practitioner turnover is high
which has an impact on childrens security - many individuals working in childcare settings
have minimal training - practitioners must feel secure in order to help
children feel the same - practitioner-parent relationships are important
but training often does not include how to work
with families
27SUGGESTIONS FOR HOW TO INVOLVE PARENTS (1)
- We do home visits, ideally before the start of
care. Two teachers visit in the evening or on the
weekend and stay for an hour. They leave the
child with a book/CD from the centre. It creates
a different relationship with the child and
parents because they are more at ease. We also
give parents a questionnaire to fill out about
the home visits to get feedback.
28SUGGESTIONS FOR HOW TO INVOLVE PARENTS (2)
- We have pamphlets available for parents to know
what kinds of things they might expect to see in
their child when starting at the centre. I always
acknowledge parents feeling about separation
from their child and provide materials and
support for the child to show feelings through
play. I keep a record of the childs behaviours
so I can talk about them with my supervisor and
the parents.
29WHEN TO WORRY Assessment Tool
- The best tool that you have at your disposal is
careful observation of children and mothers with
their children. - Discussion with a parent or co-worker or
consultant about your observations. - Parents also should be encouraged to make
observations of their children.
30WHEN TO WORRY What to look for (1)
- Do you see the child checking with the parent
or practitioner visually or verbally, or
physically, while playing? - Does the child show a reasonable mix of exploring
and checking back? - What does the parent do to stay in touch with the
exploring child? - What is the childs/preschoolers activity level?
31WHEN TO WORRY What to look for (2)
- What evidence do you see that supports the idea
that children are intensely interested in
learning about their immediate world? - What examples do you see where the children take
the initiative? - How do the toddler/preschooler and parent react
when the childs assertion of will runs contrary
to the parents wishes or intentions? - How do the parent and toddler/preschooler
negotiate conflicts over safety?
32INTERVIEW WITH PARENT
- How is your child different at age 1, or 2 (or 3
or 4 ) compared with a year ago? - How has your relationship changed during the past
year (months)? - What do you recall about your child during the
3-4 months immediately after learning to walk? To
talk? Has this changed your relationship? - Do you find it easier or harder (or perhaps some
of each) to parent a toddler compared to an
infant?
33WHAT TO LOOK FOR POSITIVES
- pleasure
- empathy, support
- accurate interpretations of the childs behaviour
or signals - respect of childs moods
- can parent see things from their childs
perspective?
34WHAT TO LOOK FOR NEGATIVES (1)
- intrusive, directive, or rough with child
- lack of empathy and support
- distortions in interpretations of the childs
behaviour - consistently nonresponsive
- minimizes or distorts the childs feelings or
mood - gives contradictory messages to child
- asks child for reassurance or attention
- sexualized behaviours in tone of voice or actions
35WHAT TO LOOK FOR NEGATIVE (2)
- disorientation using unusual voices that suggest
fear and tension - spacing out
- pulling child or otherwise invading the childs
personal space - mocking the child or hushing a crying child
- using an angry voice or being critical
- teasing the child or removing or withholding a
toy withdrawal
36QUESTIONS FOR REFLECTION AND DISCUSSION
- What did you see happening?
- What do you imagine it feels like for the child?
For the adult? - What did you see that makes you think this?
37 QUESTIONS FOR REFLECTION AND DISCUSSION
- If you were the child what might you want
adults to do? - What strong feelings did it stir in you?
- How do you manage these feelings?
- Does it help to discuss these feelings with
someone else?
38SUGGESTIONS FOR HOW TO INVOLVE PARENTS
- When parents use harsh discipline methods such
as yelling at home, it makes children more
stressed when they know theyve done something
wrong at the centre. For example, one child
dropped some paint and started crying
immediately, expecting to be yelled at. Im
meeting with the parents over time and handling
it carefully. - I work with parents and deal with their
anxieties and concerns about what goes on in the
classroom. It has an effect on the children and
reflects in their behaviour (e.g., more
assertive, better able to express their needs).
39Note
- It is important to remember that these patterns
need to be seen frequently and not just
occasionally. Mothers need not be perfect but
good enough.
40RESOURCES THAT CAN BE USED TO FURTHER FOSTER
ATTACHMENT SECURITY?
- A Simple Gift Infant Mental Health Promotion
Project - Canadian Child Care Federation tip sheets
- Zero-toThree resources
- Watch, Wait, and Wonder play follow the childs
lead