Early childhood mental health is a subject area that has grown tremendously with the explosion of neuro-biological research over the past few decades. It is a classic example of timeless principles of development being enhanced and scientifically validated by new research. The combination of what we have always known, with what we now know from new research in this area, creates an opportunity for small interventions at just the right moments to have profound, life-long impacts on the lives of children and families.
Young babies learn the most about emotions and how to navigate them when they experience a wide range of feelings. Feeling alternately happy, sad, scared, and safe are all good for children; as long as the feelings cycle through and the children ultimately feel that they can manage a difficult experience they will add to their capacity for resiliency. However, too much of any one of those emotions prevents that very healthy loop from forming. Neurobiology sheds light on how the biology of the primitive nervous system in the body interfaces with the eventually more sophisticated nervous system of an adult. The immature brain of the young child relies heavily on the more primitive system responses to navigate stressful experiences. Young babies are born knowing that they are dependent on adults and cannot survive alone in the world, an innate survival reflex in the nervous system. Newborns who cry desperately when they are hungry are actually hard-wired to do that – it has worked for 200,000 years to keep the species alive. Any parent, who has warmed a bottle in the middle of the night while listening to the baby scream as if she is abandoned in the Serengeti, knows that while these reflexes are not always modulated to fit reality they are most certainly effective. When adults experience anxiety in the pit of their stomachs, or feel a tightening in their throats when faced with something difficult, those are simply holdovers from an earlier time in their lives when highly emotional reactions and physical sensations were inextricably linked.
When a baby or young child has a scary experience, like being in a fender bender, having a strange dog jump up and knock him over, or losing sight of a parent while playing at the park, he will accurately interpret it as a threat to his safety and respond accordingly. A child’s ability to sense danger is not only informed by his own interpretation of an experience, but also by how he senses that those around him are responding. In an instant, the central nervous system takes in all of this information and produces a reaction designed to trigger a response in the people around him. Thinking back to that screaming, hungry baby in the middle of night it is easy to see how early this stress response mechanism is in place long, long before a child has any language to articulate reasoned thought about the event. Even as language does develop, one need look no further ahead than toddler age to see how quickly that same primal response can be accessed when faced with a displeasing or stressful situation. Temperament tends to determine whether that response takes the form of fight, flight, or hiding, but the mechanism remains the same. When this primal brain is triggered, it is almost impossible to connect it to higher brain function where logic, language and thought would help determine whether the situation actually warrants the dramatic response. Most children eventually go through this process, but we know now that experiences in those earliest months and years can inhibit the brain’s ability to regulate the response of the central nervous system. Scientists tell us the brain takes nearly 28 years to fully form, and throughout those years of development there are repeated chances to either recover and experience resiliency after times of stress, or to get stuck.
Early intervention in mental health for young children focuses on realizing that potential and integrating the primal, visceral emotional response (whatever it might be) with the higher thinking necessary to remember even in the midst of it that you are loved, safe, cared for, and capable. We know now that prolonged or chronic exposure to cortisol, the hormone that is secreted when a stress response is triggered, inhibits healthy development of the nervous system. Parents, teachers, and therapists work to understand the situation that has locked the child into dysfunction, then help the child manage the reaction. This is done by adding language to the experience, moving it from the brain stem into the upper, thinking brain, and giving the child more control over her behavior. When experiences are explained and verbalized, both acknowledging the genuine feelings behind the reaction and normalizing the experience, a better balance can be reached. This builds neural pathways to be called upon the next time stress is experienced, laying a better foundation for the future.
This offering from a parent would contribute to that reframing and retraining:
“When the big dog jumped up to lick you and you fell down, that man pushed the dog away so you could stand up. I came and held you and when you were done crying we decided to go tell that dog to sit down so he couldn’t scare you anymore! Then we drove home and you got your shovel out and we dug in the garden for a while.”
It is that “and then we dug in the garden” that allows the distress to be put to rest, brings the story back to normalcy, and closes the loop. Parents and teachers, of course, cannot always have the clarity of vision or the tools at their fingertips to see when an experience is going to “get stuck” and block emotional growth for a child; one child living the story above might brush it off and never think of it again, while another will become more and more frightened whenever he sees a dog. This is why we are so fortunate to have more and more people specializing in the field of early childhood mental health.
Early intervention is not limited to the “classically traumatic” issues (such as loss of a loved one, exposure to parental depression, or a serious family illness), but embraces a very expansive view of the sorts of stress can affect the future development of a child. There are many situations where the little boost that comes from trained eyes at the right juncture is just enough to see a child or family through a challenging time, and re-set the trajectory of a child’s healthy emotional development. An example of this involved a preschool boy whose teachers had been tracking his weak core strength since his days of delayed crawling and sitting up in the Baby House. His affable, easy-going temperament dovetailed all too easily with this physical delay to produce an inclination to hang back and not seek out much social stimulation, and also manifested in a very quiet speaking voice due to a lack of diaphragm strength. Despite liking him, the other children didn’t respond to him because they never heard or saw him say anything with any gusto. We saw him developing a sense of himself as a child other kids don’t listen to and whose contributions are ignored, and saw that it was a critical moment to address this misunderstanding. His parents agreed to sign him up for play therapy in addition to the physical therapy he was already receiving, and the play therapist helped him correct this misalignment. We know that without it, he could well have struggled for the rest of his life with feelings that nothing he had to say would be heard or valued. It is a nice example of the way that successful collaboration of a family, skilled teachers, and knowledgeable physical and mental health consultants moved a child through a time that in the future he will barely remember. There will not be scars to deal with in his twenties because this problem was nipped in the bud, and was over and done with so long ago.
Whether a family utilizes the expertise of a mental health professional for years or just a short while, the goal is always to provide whatever is necessary for the child to believe that he or she is a good person who deserves a happy life and has gifts to share with others. We know the child will carry the fruits of that intervention with him or her for their whole lives.