Archive for category: Child Development

Social Determinants of Health

Social Determinants of Health

Children are at an even higher risk from environmental factors (social determinants of health) because they are completely reliant on others.

Experiencing challenges with one or two social determinants will not necessarily have an influence on family and child health, however, as the number of determinants negatively impacting a family increases, the risks also increase.

When discussing early childhood mental health, it is important to remember to look holistically at children and their families. It is easy to develop a limited perspective of a family based on the context in which we meet them. Please see the list of the social determinants of health below. The list provides some examples of factors that may have a positive or negative influence on a family and child.

Social Determinants of Health

Income and Social Status


  • Access to affordable food
  • Access to transportation
  • Access to services


Social Support Networks


  • Presence of extended family
  • Influence of peers
  • Support from other families in the community


Education and Literacy, i.e., health literacy


  • Availability of literacy-friendly health resources and information
  • Computer proficiency


Employment/Working Conditions


  • Availability of work for one or both parents in the community
  • Safe working conditions
  • Availability of child care for working parents


Social Environments


  • Availability of free or affordable resources and community events for families
  • Safe environment in which children can play
  • Safe home environment

Social Determinants of Health

Physical Environments


  • Geographical location or isolation
  • Access to safe environments for community gatherings during the winter
  • Space within home, e.g., overcrowding
  • Living space, e.g., a house, apartment, or a shelter


Personal Health Practices and Coping Skills


  • Resilience and coping skills
  • Understanding of health information

Social Determinants of Health: Healthy Child Development

Healthy Child Development


  • Understanding of child development
  • Availability of referral and assessment services
  • Clear, literacy-friendly information about child development and parenting


Biology and Genetic Endowment


  • Illness or disability in child or family

Social Determinants of Health

Health Services


  • Availability of family doctors in the community
  • Access to emergency service

Social Determinants of Health

Gender


  • Roles and expectations


Culture


  • Cultural norms and expectations about child rearing

Stress and Trauma

Stress and Trauma

Stress refers to the biological and emotional responses to situations that are new, unexpected, or a threat to a person’s well-being.

Stress is not always a bad thing. In fact, stress is experienced every day and this can be healthy as it teaches individuals how to adapt, cope, problem solve, regulate emotions, and seek support when needed.

Young children (including infants) can experience stress and trauma. In fact, both stress and trauma can have immediate effects during childhood and can cause lifelong impacts.


What is Stress?

Stress refers to the biological and emotional responses to situations that are new, unexpected, or a threat to a person’s well-being.

Stress is not always a bad thing. In fact, stress is experienced every day and this can be healthy as it teaches individuals how to adapt, cope, problem solve, regulate emotions, and seek support when needed.

However, some stress is toxic. Toxic stress is stress that is frequent, serious, or prolonged. In cases of toxic stress, the child has little to no adequate adult support in the situation, e.g, chronic belittling of child by parent or ongoing child sexual abuse. Toxic stress is the most damaging.


What is Trauma?

Trauma is defined as a young child’s experience of events that harm, or threaten to harm, him or others physically or emotionally. This threat can be real or perceived.

Can young children experience stress and trauma?

Yes, young children (including infants) can experience stress and trauma. In fact, both stress and trauma can have immediate effects during childhood and can cause lifelong impacts.

Do young children experience stress and trauma the same way an adult does?

A child’s body undergoes the same response to trauma as an adult’s does. However, there are some differences. Young children experience stress reactions more often and more intensely than adults, and they do not have the ability to self-regulate or to process the stress. They rely on adults to help them during and after the stressful event.

Young children who experience chronic stress can develop sensitized stress responses, where their stress response system is triggered into action by non-stressful events. This can have a large impact on the child’s future physical and mental health, including chronic states of hyper-alertness, fatigue, damage to the brain and organs, and chronic illnesses.

Brain Development

Brain Development

The early years (0-6 years) are a critical period for brain development. There is rapid growth and development of the brain during early childhood. In fact, by four years of age, a child’s brain is already 90% of the size of an adult’s brain and the brain has mapped out the way it will communicate with its different parts of the body.

Early childhood is a critical time for brain development. This is also a time when the brain is the most vulnerable.

My Curious Brain

My Curious Brain sparks children’s curiosity about how the brain works. This book provides parents, teachers, and caregivers with tools to support brain health for children.

The different parts of the brain are represented by the instinctual dinosaur, the emotional monkey, and the wise owl. The story offers children and adults a fun and interesting way to gain a greater understanding of how the brain develops, how it processes emotions, and how to deal with those emotions.



The brain: a sum of its parts

Although the brain is a complex system of interconnected parts, the functions of these parts can generally be identified by their location in the brain. Different areas of the brain are responsible for different functions. However, all of these areas interact together to allow the brain to work as a whole system.

How does the brain communicate between different areas?

Communication within the brain is called neurotransmission. Neurotransmission takes place using neurons (nerve cells) and neural networks (connections between neurons). Neurons communicate with each other through electrical stimulation that passes from one neuron to another. There are over 100 billion neurons in the brain. Many of these are already formed by the time a baby is born, although some are added after birth. However, although many neurons already exist at birth, they are not connected in any meaningful way that allows for “communication”.

What are neural networks?

Neurons that are stimulated together form connections and these connections develop into networks of interconnected neurons. These networks are developed and reinforced in a “use-dependent” fashion. The repeated stimulation of neural networks through similar experiences reinforces or strengthens them. When neural connections are not reinforced, they “die” off or “fade away”. This process takes place in early childhood and the networks that are strengthened are based on the sorts of repeated experiences the child has (e.g., if a child has frequent positive interactions, his brain will become ‘wired’ to perceive, interpret, and respond to positive interactions).

Consistent caregiving is one of the key forms of repetitive experiences available for very young children. Stimulation through repetitive experiences, such as, listening to their mother’s heartbeat, rocking, caregiving routines, and hearing soothing sounds, all build neural networks.

How does the brain develop?

The brain develops in a sequential and hierarchical fashion, starting from the lower regions and working its way up. Repetitive, consistent, and loving experiences in the early years build the brain.

Both the structure and the function of the brain can be impacted positively and negatively in early childhood.

If the brain does not develop properly in early childhood, can it still be fixed later on?

The answer to this is no and yes.

Brain structures that are underdeveloped in childhood, or with structures that have been impacted by stress-related chemicals, will probably not develop as they would have if they had not been impacted.

However, neural systems have plasticity and can be changed. This can be a lengthy process and some systems are easier to change than others. Change is easiest at an early age but is possible later in life as well.

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Breastfeeding

Breastfeeding

Certain medications, as well as alcohol and most illicit drugs, can be passed to the baby through breast milk. If a woman is taking medication, she should discuss her intake with her healthcare professional.

It is safest to not use drugs and alcohol in pregnancy and when breastfeeding.

Certain medications, as well as alcohol and most illicit drugs, can be passed to the baby through breast milk. If a woman is taking medication, she should discuss her intake with her healthcare professional.

It is safest to not use drugs and alcohol in pregnancy and when breastfeeding.

Alcohol can be passed to the baby through breast milk. The baby’s system is not mature enough to process alcohol in the same way as the mother’s. When there is alcohol in the mother’s milk, it can change how the baby breastfeeds, his sleeping patterns, and behaviour. It is healthiest for baby when the mother does not drink before breastfeeding. If she would like to use alcohol, it is recommended that she breastfeeds before drinking alcohol and waits until the alcohol has left her body before she breastfeeds again. It may take up to two hours for one standard drink to leave the mother’s system and longer if she has more drinks.



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Early Childhood Mental Health

Early Childhood Mental Health

Early childhood mental health refers to the ability of children to experience, control, and express their emotions; form close and secure relationships; and learn while exploring their environment. These abilities are fostered and grow within the context of a positive caregiving environment. Children’s communities also play a large role in their mental health.

The impact of poor mental health on a person’s life is intensified when the problems begin in early childhood. In fact, many childhood mental health issues persist into adolescence and adulthood.

What is early childhood mental health?

Early childhood mental health refers to the ability of children to experience, control, and express their emotions; form close and secure relationships; and learn while exploring their environment. These abilities are fostered and grow within the context of a positive caregiving environment. Children’s communities also play a large role in their mental health.

Why is it Important?

Research is showing that our mental and physical health is interconnected in so many ways that we cannot talk about one without considering the other. Young children need to develop skills that will help them be mentally and physically healthy throughout their lives. Developing these skills can help to prevent chronic physical illnesses and behavioural, learning, and mental health problems later in life. These skills will also help children adapt to transitions and stress in their lives, including school.

We can all help children develop the skills that they need for healthy development in early childhood. These skills include:
  • Forming secure attachments with their caregivers
  • Developing a sense of curiosity
  • Exploring their environment
  • Making sense of and being able to control their emotions
  • Controlling their impulses
  • Understanding other people’s emotions, facial expression and body language
  • Developing social skills
  • Learning to communicate with others
  • Feeling safe in their homes
  • Coping with changes and new environments
  • Understanding and accepting differences among people
  • Developing resilience (skills to cope with change and stress)
Early Childhood Mental Health Concerns
Child Development
15%

of children and youth in BC have a diagnosable mental illness. In Saskatchewan, we do not collect statistics on early intervention.

The impact of poor mental health on a child’s, youth’s and adult’s life is heightened when the problems begin in early childhood. In fact, many childhood mental health issues persist into adolescence and adulthood.

The following list of diagnosable clinical disorders that has been compiled using the DC:0-3R, Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition (2005). It is important to note that some clinicians choose to use the DSM-IV-TR Casebook and Treatment Guide for Child Mental Health (2009). The DC:0-3R is unique in that it views the child within his or her relationships and caregiving environment.

Clinical Disorders:
  • Post-traumatic Stress Disorder (Traumatic Stress Disorder)
  • Deprivation or Maltreatment Disorder
  • Disorders of Affect
  • Prolonged Bereavement/Grief Reaction
  • Anxiety Disorders
  • Depression
  • Mixed Disorder of Emotional Expressiveness
  • Adjustment Disorder
  • Regulation Disorders of Sensory Processing
  • Hypersensitive
  • Hyposensitive/Under-responsive
  • Sensory Stimulation-Seeking/Impulsive
  • Sleep Behaviour Disorder
  • Feeding Behaviour Disorder
  • Disorders of Relating and Communicating

Early Indicators

Mental health disorders in young children may be hard to detect as children may be unable to explain their emotional distress with words. More frequently, physical complaints and social behaviours are indicators that there may be a problem. The following behaviours in infants and young children that warrant concern and further intervention (Cohen, Onunaku, Clothier & Poppe, 2005) are:

Infants and Toddlers (birth to age 3)

  • Chronic feeding and 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 and withdrawal behavior
  • Flat affect

Preschoolers (age 3 to 5)

  • Compulsive activities (e.g., head banging)
  • Wild, despairing tantrums
  • Little interest in social interaction; withdrawn
  • Repeated aggressive or impulsive behaviours
  • Difficulty playing with others
  • Little or no communication
  • Loss of earlier developmental achievements

Universal Assessment and Early Intervention

Universal assessment of all children and early intervention when problems are identified are the most effective ways to address early childhood mental health concerns.

Resilience

Resilience is the ability to cope with and recover from stressful situations, changes, or problems. Being resilient does not mean that a child will not feel stress, distress, sadness, and other emotions. It means that the child will use skills that he has developed in past situations to cope better with his current situation. It also means that the child will learn from the current situation and grow. Resiliency skills are always developing and changing.

The language of resilience is I CAN, I AM, I HAVE. For example, for a two year old this might translate to: I AM loveable, I AM safe, I CAN get comfort and support, I CAN tell mommy I am sad, I HAVE people who love me, and I HAVE a safe haven.

Why is resilience important?

Life is not stress free. It is guaranteed that each of us will experience stress, transitions, change, and problems throughout our life. When we are young, one of our caregivers’ roles is to help us cope with and protect us from the negative effects of stress and harm. It is in this protected environment that we are best able to learn how to cope with stress on our own.

What do protective and risk factors mean?

There are many factors during childhood that affect a child’s resiliency skills.  An example of a protective factor is the development of a secure attachment with a caregiver. A risk factor is having no one to support you during a difficult time.


  • Provide unconditional love.
  • Provide a stable, safe, and consistent environment.
  • Express love safely, both physically and verbally.
  • Enforce rules in a calm, kind way, starting with children aged two or three.
  • Do not belittle, harm, or reject a child when you discipline.
  • Learn about early childhood development
  • Model behaviour that communicates confidence, self-esteem, courage and optimism.
  • Praise children for accomplishments, being specific about what you are praising and why.
  • Encourage safe exploration and independence.
  • Acknowledge and label young children’s feelings.
  • Encourage children to recognize and express their own feelings and to recognize some feelings in others.
  • Give children comfort and encouragement in stressful situations.
  • Use holding, rocking, and a soothing voice to calm children.
  • Encourage children to learn self-soothing techniques.
  • Encourage children to use problem-solving skills and decision-making skills.
  • Help children begin to accept responsibility for their own behaviour and to understand consequences.
  • Allow children to develop close, safe relationships with other adults and children in their community.
  • Encourage and model flexibility.
  • Accept children and families into already established communities.
  • Show respect for and foster positive attitudes towards members of both genders within a community
  • Promote safe, equal access to recreation and other services in your geographical communities.
  • Encourage children and families to get involved with activities outside of the family.
  • Befriend and act as a safe mentor to young people in your community.
  • Praise children and make them feel valuable.
  • Offer all parents skill and confidence building information and programs.
  • Provide opportunities for daily physical activity for children of any age.
  • Support media that show healthy images and messages about children and families.
  • Provide information to communities and families about stress and trauma in young children.
  • Increase understanding in the community about attachment. Teach community members about caregiver behaviours that contribute to secure attachment relationships.
  • Provide practical support to families within the community.
  • Decrease violence in communities.

Many of the above suggestions apply to service providers in their practices. In addition, service providers can can:

  • Provide a non-judgmental space for service users.
  • Encourage families to reach out for social support.
  • Encourage children to build on their strengths.
  • Advocate for changes that will create equal opportunities for your clients, e.g., adequate supports and social assistance rates.
  • Advocate for early childhood mental health to become part of strategic plans in mental health organizations.
  • Advocate for funding and staffing resources to be allocated specifically towards infant and early childhood mental health.
  • Advocate for system change in education, early childhood education, and mental health in recognizing the value of early childhood mental health.
  • Advocate for policy and system change that will create equal access to information, medical, and social services for all caregivers.
  • Advocate for the creation of quality daycare that promotes infant mental health.
  • Advocate for free and affordable access to recreational services.
  • Advocate for universal maternal depression screening and support.
  • Advocate for information and support for families in which parents have mental illnesses.
  • Receive training to work with children who have been traumatized.
  • Invest in the space and equipment that will be most appropriate for use with young children.



The Saskatchewan Early Childhood Mental Health Provincial Network provides an opportunity for professionals interested and/or working in the area of early childhood mental health to network, share information about current services, collaborate, and keep up-to-date with current research.

Early Childhood Mental Health Sign Up

Please fill out the form below so we can gather information on Saskatchewan programs, services, and educational opportunities in the area of early childhood mental health.



For more information about the Saskatchewan Early Childhood Mental Health Provincial Network call 306-651-4300 or email [email protected]

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The Saskatchewan Prevention Institute hosts this network and provides opportunities for communication through the website, professional development opportunities, and information brochures.



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Attachment

Attachment

Attachment is a biologically based (innate) connection children develop towards their parent or caregiver on whom they rely to help them feel safe, cared for, and protected.

Attachment is important. Early attachment experiences have an impact on a child’s later social, emotional, behavior, and cognitive development by influencing: brain development, development of self-regulation, how the child responds to experiences, development of resiliency skills, and expectations and behaviour in relationships throughout life.

What is attachment?

Attachment is a biologically based (innate) connection children develop towards their parent or caregiver on whom they rely to help them feel safe, cared for, and protected.


When does attachment develop?

The process of attachment begins at birth. Some people believe it starts before birth. By six months, children who become distressed have begun to form expectations of how their parents will respond. By the end of their first year, children have a clear attachment to one or more of the people who provide regular care. Children can form attachments later in life.

Who do children become attached to?

Children become attached to people who take care of them regularly. This can extend towards people outside of the immediate family, such as daycare providers.


Why is attachment important?

Early attachment experiences have an impact on a child’s later social, emotional, and cognitive development by influencing:


  • brain development
  • development of self-regulation
  • how the child responds to experiences
  • development of resiliency skills
  • expectations and behaviour in relationships throughout life

How do children try to get their attachment needs met?

Beginning in the first year of life, children naturally show they need care and protection through attachment behaviours, including crying, clinging, following, trying to be physically close, focusing their attention on the caregiver, cooing, and smiling.


What are children’s attachment needs?

Parents need to be physically and emotionally available to help their children feel safe, cared for, and protected. Parents also need help regulating their own feelings, physical states, and behaviours.

What is Secure Attachment?

Secure attachment is the ideal form of attachment. Secure attachment can happen when a child is able to rely on his caregiver(s) for comfort and protection.

Caregivers of children with secure attachment:


  • respond warmly, sensitively, and consistently to the child’s needs

A securely attached child:


  • trusts that her caregiver(s) will be there for her when needed
  • feels confident to explore and play
  • seeks comfort from her caregiver(s) if distressed
  • is easily comforted by her caregiver(s)

Why is secure attachment optimal?

Secure attachment is a protective factor that contributes to resilience and psychological health through neural development, emotion regulation, and feelings of competence and self-efficacy. Secure attachment is related to fewer behaviour problems, higher social competence and competence in general (e.g., problem-solving), as well as more empathy and better boundaries. Early secure attachment provides children with the ability to deal well with, or recover from, difficult experiences later in life.

What happens when a child does not develop a secure attachment?

A child cannot develop a secure attachment if he cannot rely on the parent to meet his attachment needs.


An insecurely attached child:


  • is anxious about whether her parents will be available to provide care and protection when needed
  • learns ways of behaving that keep his caregiver(s) close and available in case of real danger, but may not serve him well in other relationships

What are the risk factors for a child who is insecurely attached?

Children with an insecure attachment are at risk of developing behaviour problems and potentially, mental health problems. They are more likely to have problems such as:


  • poor social skills
  • low self-esteem
  • anxiety
  • impulsive behaviour
  • angry and aggressive behaviour
  • withdrawing when upset
  • giving up easily

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