Children/Adolescents > Early Childhood Mental Health
Bullet What is Early Childhood Mental Health (ECMH)?
Bullet Periodic Updates on ECMH Initiatives
Bullet ECMH Consultation Project
Bullet Parent Child Interaction Therapy (PCIT)
Bullet Resources
Bullet Focus on Early Childhood Mental Health - Handouts
Bullet Strengthening Families Through Early Care and Education

What is Early Childhood Mental Health?

As attention to early childhood mental health has increased, some people question the use of the term “mental health” in connection with young children, given the stigma still associated with mental illness. Can infants, toddlers, and pre-schoolers even be mentally ill and, secondly, even if they can, why would we want to attach such a label to a child that might stick with him or her for a long time and negatively affect the way others respond to the child? Why call it early childhood mental health? To begin with, mental illness and mental health are not the same thing, even though they are often closely connected because, for example, agencies that treat mental illness often have the words “mental health” in their names. But one term focuses on a problem (illness), while the other focuses on something positive (health). When we talk about “early childhood mental health,” we are not primarily talking about bipolar disorder, major depression, or even oppositional defiant disorder or conduct disorder, even though it is possible that some of the young children served by early childhood mental health initiatives will develop those illnesses. Rather, we are referring to the positive results of intervening early before problems develop into something more serious. Simply put, early childhood mental health is the same as healthy social and emotional development in young children, encompassing things like learning to express and regulate emotions, forming close and secure personal relationships, and exploring and learning about their environment. So why don’t we call it “early childhood social and emotional development?” Besides that being quite a mouthful, the language of mental health is important not only for its educational value in combating stigma against mental health problems, but also for its implicit reminder that if we don’t do our job with prevention with young children, their problems may require more serious interventions later in life. We truly do want them to develop good “mental health” in the most positive sense of that term.

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Periodic Updates on Early Childhood Mental Health Initiatives in Pennsylvania

April 2012: Includes results of 2010-2011 evaluation of ECMH consultation project, progress on Parent-Child Interaction Therapy in Pennsylvania, and highlights of county work on ECMH initiatives.

March 2011: Includes information about Parent-Child Interaction Therapy expansion in Pennsylvania, 2011 National Children’s Mental Health Awareness Day, updates on various ECMH initiatives, and several new resources for ECMH practitioners. Please print and distribute freely.

April 2010: Includes information about the Early Childhood Mental Health Consultation Project, the Advisory Committee recommendations, and other initiatives; also features a rationale for investing in early childhood mental health. Please print and distribute as you like.

June 2009: Includes data from Early Childhood Mental Health Consultation Project, information about various workforce development efforts, and a tribute to the late Jane Knitzer. Feel free to print and distribute.

November 2008: Contains a report of the new Early Childhood Mental Health Advisory Committee, along with updates on initiatives in workforce development.

May 2008: Contains information about the December 2007 Infant-Toddler Mental Health Symposium and brief summaries of other ECMH-related initiatives. For a fuller report of the symposium, check the Briefing Report.

  • Briefing Report from Pennsylvania’s Infant-Toddler Mental Health Symposium, December 2007

These updates are designed to be printed and distributed to anyone who is interested.

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Pennsylvania’s Early Childhood Mental Health Consultation Project

The Office of Child Development and Early Learning and the Office of Mental Health and Substance Abuse Services are partnering to promote healthy social and emotional development in young children. The two offices have combined resources to establish an Early Childhood Mental Health Consultation Project to serve infants and toddlers birth to age three in early care and learning centers. Originally funded by grants and operating in three regions of the state, the Early Childhood Mental Health Consultation Project expanded statewide. There are Early Childhood Mental Health consultants in each of the six regional Keys that serve early learning programs in Pennsylvania. The consultants help staff at early care and learning centers by observing children and program practices, developing goals and strategies to enhance the practitioners’ capacity to encourage positive relationships, creating a learning environment that promotes positive behaviors, and addressing the needs of children who are experiencing behavioral challenges. As a resource to the Early Childhood Mental Health Consultants, a child psychiatrist is available for clinical consultation. In addition, collaboration between county children’s mental health systems and the consultants is encouraged when young children need to be referred to the mental health system.

We are Pennsylvania's Future" video from Pennsylvania’s Promise for Children shares from the children's perspective how investments in quality early education build a brighter future for Pennsylvania's families, businesses and communities.

Video about Early Childhood Mental Health Consultation, from the University of Pittsburgh's Office of Child Development

Research information from the Office of Child Development and Early Learning: OCDEL works with many partners to create opportunities for the commonwealth’s children. Parents, schools, child care, early intervention, Head Start, libraries, community organizations and other stakeholders have joined with the Office of Child Development and Early Learning to provide high quality early childhood programs and effective prevention strategies to mitigate challenges faced by families that affect school readiness and academic success.

Research Brief, February 2013; shows significant evidence suggesting that technical assistance is effective in helping facilities advance STAR levels and improve the quality of their programs.

Early Childhood Mental Health Consultation Reports

Resources on Early Childhood Mental Health Consultation

Evaluation Report Released on Early Childhood Mental Health Consultation

Evaluation of the Infant/Toddler Systems Building Initiative: Final Report for the Early Childhood Mental Health Consultation Program, June 2006-June 2008

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Parent Child Interaction Therapy (PCIT)

In 2010, the Department of Human Services received a two-year grant from The Heinz Endowments to assist with the goal of implementing Parent-Child Interaction Therapy in Pennsylvania and issued a Request for Applications to all licensed mental health agencies in the commonwealth. Eight providers from across the state received grant assistance to receive training in PCIT.  Parent-Child Interaction Therapy (PCIT) is an evidence-based mental health intervention that has been shown to decrease child behavior problems, improve the parent-child relationship, decrease parental stress while increasing their sense of control, and decrease the re-occurrence of or prevent child abuse. Implementing this intervention will help increase the capacity of Pennsylvania providers to serve very young children. PCIT has been demonstrated to have positive outcomes with many children and families and is listed in the National Registry of Evidence-based Programs and Practices.

University of Pittsburgh Receives Grant; PCIT to Expand in Pennsylvania

PCIT Across PAIn 2012, the University of Pittsburgh received a five-year grant for $3.3 million from the National Institute of Mental Health called “A Statewide Trial to Compare Three Training Models for Implementing an Evidence-Based Treatment (EBT).” The EBT that will be used in the statewide trial is Parent-Child Interaction Therapy (PCIT), comparing three training models for that treatment modality. The grant project is known as “PCIT Across PA: Healthier Kids Happier Families.”

The grant will help us understand what training methods are most effective for implementing an evidence-based treatment like PCIT. It will also help to build workforce capacity and significantly expand access to PCIT services in Pennsylvania for children ages 2½-7. Seventy-two additional licensed outpatient mental health providers will be chosen to participate in the grant project. The grant will cover the cost of training four clinicians from each agency and some site preparation costs. In addition to expanding PCIT across Pennsylvania, the grant provides an opportunity for the state to help inform PCIT International about the efficacy of various training models since currently the answer is not known to the question of which training method is most effective. By the end of the grant, the goal is for all 67 counties in Pennsylvania to have received training. To date (March 2015), 100 providers in 60 counties have received training and are able to offer PCIT to children and families.

For more information about the grant, contact Dr. Amy Herschell, principal investigator, University of Pittsburgh School of Medicine.

Map and list of PCIT providers in Pennsylvania. This document shows the growth in the number of counties and providers offering PCIT from 2011 to the present. Map is updated as of March 2, 2015.

More information about how PCIT is being implemented in Pennsylvania is in an expanded edition of the December 2012 edition of the PA CASSP Newsletter.

Policy Clarification for Parent-Child Interaction Therapy programs regarding the use of seclusion and restraint

The OMHSAS Bulletin, “The Use of Seclusion and Restraint in Mental Health Facilities and Programs” (02-01, issued 4/8/01), applies to a wide range of mental health facilities and programs, including psychiatric Outpatient clinics. The bulletin prohibits the use of seclusion, except in psychiatric hospitals, and identifies the rationale for use of manual restraint to be in response to an emergency safety situation, “only after appropriate less restrictive behavioral techniques have been tried…”

Parent-Child Interaction Therapy (PCIT), an evidence-based practice for young children (2.5-7 years) with severe behavioral challenges and their families, has procedures that may involve a parent picking up and moving a child, and also may involve the use of a room for the child that is separate from the therapy room, referred to as a time-out room, a time-out space, and a safe space.  Are these practices, understood within the context of PCIT as an integrated treatment for the above target population, compatible with the bulletin and with other bulletins related to the use of seclusion and restraint?

Policy Clarification

Guidelines for PCIT Time-Out Rooms used within Pennsylvania Outpatient Clinics (examples of acceptable and unacceptable practices)

Find out how PCIT works in real-life settings:  “Parent Training Can Improve Kids Behavior”

Parent-Child Interaction Therapy, overview webinar, April 28, 2015


Focus on Early Childhood Mental Health - Handouts

One of the resources the Early Childhood Mental Health Consultation Project is providing to Keystone STARS early care and learning facilities across the commonwealth is a series of brief reader-friendly discussions of various topics of concern to parents of young children and early learning practitioners, called "Focus on Early Childhood Mental Health." A new topic is explored each month and can be used in facility newsletters or as handouts for parents.

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Additional Resources on Early Childhood Mental Health

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Strengthening Families Through Early Care and Education

Pennsylvania is one of 17 state affiliates of the Strengthening Families National Network and is working to implement the Strengthening Families approach in early childhood programs.

Strengthening Families is a project of the Center for the Study of Social Policy and emphasizes five protective factors that not only reduce the incidence of child abuse and neglect but also encourage healthy social and emotional development. These protective factors are:

  • Parental resilience: the ability of parents to cope with challenges
  • Social connections: friends, family members, neighbors and other community members who provide emotional support and assistance to parents
  • Knowledge of parenting and child development: accurate information about child development and how to appropriately discipline young children
  • Concrete support in times of need:  financial, formal and informal supports
  • Children’s emotional and social competence: child’s ability to interact positively with others and communicate emotions effectively.

Early childhood programs can use an online self-assessment tool to help them begin to build the protective with families.

Factsheet from Strengthening Families Pennsylvania

Strengthening Families Pennsylvania website

Preventing Child Maltreatment and Promoting Well-Being: A Network for Action 2012 Resource Guide, developed to support service providers in their work with parents, caregivers, and their children to prevent child abuse and neglect and promote child and family well-being. Resources are in both English and Spanish.

Parent Leadership and the Five Protective Factors;  An Idea Book for Successful Program Integration, December 2012

Core Meanings of the Strengthening Families Protective Factors

Briefs on Five Protective Factors

What Makes Your Family Strong: Meet the Protective Factors!

How Strengthening Families Helps Programs Meet Head Start Performance Standards

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