Fulfilling the Promise 2017 part 1 • Attachment is the ongoing emotional bond the ... • Separation

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    F U L F I L L I N G T H E P R O M I S E , M A R C H 8 T H , 2 0 1 7 E L I Z A B E T H W A H L , M S S W C A P S W , I M H - E ®

    INFANT MENTAL HEALTH AND THE IMPORTANCE OF EARLY RELATIONSHIPS/INFANT MENTAL

    HEALTH ENDORSEMENT SYSTEM

    WI-AIMH is a statewide non-profit agency that promotes infant and early childhood mental health through:

    Public awareness

    Developing professional capacity

    Advocating for policies

    www.wiaimh.org

    WI Alliance for Infant Mental Health Vision

    “We aim for all Wisconsin infants and young children to reach their fullest potential

    through nurturing and consistent relationships within the context of family, community and

    culture.”

    OUR TOPICS FOR DISCUSSION

    • Early Childhood Social/Emotional Development

    • What IS IMH – Key Themes

    • Parallel Process

    • Reflective Practice

    • Secure Attachment

    • A Deeper Look at Behavior

    • Trauma/Toxic Stress

    • Resources – For More Info

    WHAT IS INFANT MENTAL HEALTH?

    The developing capacity of the child from birth to five to:

    • Experience, regulate and express emotions;

    • Form close and secure interpersonal relationships;

    • Explore the environment and learn

    … all in the context of family, community and culture Adapted from a working definition developed by Zero to Three: National Center for Infants, Toddlers and Families—Infant Mental Health Task Force

    “THERE IS NO SUCH THING AS A BABY, THERE IS A BABY AND SOMEONE…” D. W. WINNICOTT

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    The Developmental Continuum from Birth to 15 months: Social and Emotional Indicators*

    Age Range Attachment Trust/Security Self-Awareness/

    Identity

    Exploration Autonomy/Independence

    Infant (Birth to 15

    months)

    • Newborns recognize human language and prefer their own mother's voice

    • Prefer human faces

    • Early social interaction is a smile and mutual gazing

    • Crawls away but checks back visually; calls, and gestures to ensure adult contact

    • Stretches arms to be taken

    • Prefers familiar adults

    • Acts anxious around strangers

    • Uses a blanket or stuffed toy for security and reassurance

    • Goes from accidentally sucking own hands to carefully watching them

    • Tries to make things happen

    • Hits or kicks things to make a pleasing sight or sound continue

    • Talks to self when alone

    • Prefers to be held by familiar people

    • Imitates adult behaviors

    • Knows own name

    • Understands simple directions

    • Brings thumb or hand to mouth

    • Tracks mother’s voice

    • Observes own hands

    • Babbles using all types of sounds

    • Uses a few words mixed with babbling to form sentences

    • Tries to keep a knee ride going by bouncing to get the adult started again

    • Shows strong feelings (anger, anxiety, affection)

    *This list is a sampling of developmental indicators and is not intended to include all behaviors associated with early development. For infant, there is considerable overlap among areas of growth. The term “mother” is used to represent the primary attachment figure.

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    The Developmental Continuum from 12 months to 2 ½ years: Social and Emotional Indicators (cont’d)

    Age Range Attachment Trust/Security Self-Awareness/

    Identity

    Exploration Autonomy/Independence

    Toddler (12 mos. to 2 1/2 years)

    • Relates to others by exploring things with them

    • Pulls up, stands holding furniture, then walks alone

    • Goes through a phase of clinging to primary caregiver

    • Experiences periods of intense feelings when separating or reuniting with a parent

    • Sees others as a barrier to immediate gratification

    • Knows can make things happen but is not sure of responsibility for actions

    • Becomes bossy

    • Uses the words me, you, and I

    • Says "No" to adults

    • Explores everything

    • Is sensitive to others' judging behavior

    • Keeps looking for a toy that is hidden from view

    • Understands many more words than can say

    • Has wide mood swings (for example, from stubborn to cooperative)

    • Wants to do things by self

    Adapted with permission from J. Ronald Lally, Abbey Griffin, et al., Caring for Infants and Toddlers in Groups: Developmentally Appropriate Practice (Washington, DC: ZERO TO THREE/The National Center, 1995), pp. 78-79.

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    The Developmental Continuum from Age 2 ½ - 3 ½ : Social and Emotional Indicators (cont’d)

    Age Range Attachment Trust/Security

    Self-Awareness/ Identity

    Exploration Autonomy/Independence

    Preschool (2½ to 3½ years)

    • Is capable of dramatic play

    • Has better control over all aspects of self

    • Needs to practice

    • Needs adult coaching to get along well with others

    • Shows feelings with words and in symbolic play

    • Is more aware that others have feelings

    • Can plan ahead

    • Is capable of self- evaluation (for example, good, bad, pretty, ugly)

    • Tries to control self (for example, emotions and toileting)

    • Is learning to take turns in conversations

    • Knows a lot about communicating in the style of own culture

    • Can play well with others if the setting is right

    • Uses names of self and others

    • Can tell others about what happened that day

    • Has much larger vocabulary to express ideas

    • Shows concern for others

    • Classifies, labels, and sorts objects and experiences into groups

    Adapted with permission from J. Ronald Lally, Abbey Griffin, et al., Caring for Infants and Toddlers in Groups: Developmentally Appropriate Practice (Washington, DC: ZERO TO THREE/The National Center, 1995), pp. 78-79.

    LET’S WATCH SOCIAL EMOTIONAL DEVELOPMENT IN ACTION

    WHAT DO PROFESSIONALS IN THE FIELD OF IMH ACTUALLY DO?

    The field of IMH is multi-disciplinary and inclusive

    Professionals attend to the social and emotional needs and experiences of the infants and toddlers (Holding the Baby in Mind)

    AND Attend to the relationships surrounding the infants and toddlers (often parents and significant caregivers). Intervening at the relationship level & focus on what’s happening between the dyad.

    IMH IS NOT…

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    YET INFANTS AND YOUNG CHILDREN DO HAVE MENTAL HEALTH NEEDS

    SOME KEY THEMES IN INFANT MENTAL HEALTH

    Ghosts in the Nursery – Seminal work by Selma Fraiberg

    • Understanding attachment relationships • Understanding the family’s story • Parents own experiences of being

    parented • The past affects the present • Risk/protective factors (ghosts/angels) • Resilience • Rupture and Repair

    INVITATION TO REFLECT

    • Think of a special person (adult) from your childhood

    • How did they make you feel?

    • What did they do?

    SECURE ATTACHMENT - BOWLBY

    • Attachment is the ongoing emotional bond the child builds with a familiar adult through a nurturing relationship (Devereaux Center for Resilient Children).

    • Babies are hardwired to develop strong, emotional connections with primary caregivers

    • Healthy attachment to a safe, nurturing caregiver(s) creates a sense of safety in child’s world

    ATTACHMENT & THEMES OF SAFETY FOR YOUNG CHILDREN

    “The most important part of attachment is the quality of attachment formed, as it predicts later development.” (ZERO to THREE)

    Infants who develop a healthy emotional bond, or secure attachment with a primary caregiver in the early years are more likely to have positive relationships with peers, perform better in school and respond to adversity with resilience (ZERO to THREE)

    WHY SO CRITICAL?

    The ability to attach to a significant caregiver affords a child healthy social/emotional development and fosters:

     TRUST  CONFIDENCE  PERSISTENCE  COPING/ SELF-REGULATION skills to manage

    Stress and Distress

    (ZERO to THREE)

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    THE ADULTS – A SECURE BASE

    • Adults who serve to nurture and protect infants and young children become a “secure base” for the child, through sensitive, attuned responses and consistency.

    • A young child begins to learn the world is safe to explore. “Someone will be there to protect me and help me meet my needs.”

    TWO FUNDAMENTAL QUESTIONS PARENTS EXPERIENCE:

    THE PARALLEL PROCESS AND CONCEPT OF “HOLDING”

    BABY PARENT PROFESSIONAL SUPERVISOR

    HOLDING COMPLEXITIES

    REFLECTIVE PRACTICES THE WORK IS EMOTIONAL AND REQUIRES REFLECTION

    • We all experienced childhood

    • Working with infants, toddlers, young children and their families evokes a range of emotions, and even triggers, at times

    • Our own experiences may cloud how we view a child, family, situation or experience we are presented with

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    REFLECTIVE SUPERVISION/REFLECTIVE PRACTICES – CRITICAL COMPONENT

    • Reflective practice is a way of practicing in which