Addressing mental health needs of infants and young children

Work with infants and young children is a subspecialty of child psychiatry. Special areas of expertise and clinical skills are required for work in this area and even traditional areas of clinical skills--evaluating mental and developmental competency, collaborations with other professionals, synthesizing information for parents--have an added valence when applied to work with very young children. Furthermore, in the last three decades, there has been a remarkable increase in knowledge about the first years of life. Most recently, understanding about early brain development and the complex interactions among biology, environment, and experience in shaping early development has highlighted the critical nature of psychological interventions in the first years of life. Providing mental health services for very young children requires a multidisciplinary approach, and the field has evolved simultaneously in the disciplines of child psychiatry, pediatrics, psychology, social work, neurology, early childhood education, and nursing. With that range of theoretic and professional background, the resulting evaluative approaches and services are also quite diverse. The agenda for the next decade of work is to bring together these multiple viewpoints around critical areas for the development of the field, including improved diagnostic nosology, a better understanding of the number of young children needing services, pathways for accessing those services, and more explicit descriptions of the important features of a mental health intervention for very young children and their families.