Add to cart. Be the first to write a review About this product. About this product Product Information Infant and toddler mental health is a growing area of interest for psychiatrists, child psychologists, pediatricians, and educators. Expanding research in this area highlights the need for early identification and assessment of mental health problems and risk factors in infants and toddlers. In addition, public policy and recent legislation have offered new opportunities to provide services to infants and toddlers who are at risk or are already exhibiting delays or deviance in social and emotional functioning.
This handbook is the first of its kind to bring together the several new diagnostic and assessment approaches for working with infant and toddler mental health.
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Additional Product Features Dewey Edition. This is a much-needed volume that will advance both research and clinical work. It will be of great interest and value toinvestigators, practitioners, and students alike. Volkmar, Yale University, This comprehensive and useful handbook covers a neglected field, so it will be very welcome to child and educational psychologists.
Early identification is a common point of principle in our practice, and we can now be assisted in that challenge by this reference book. Show More Show Less. Add to Cart. The aims of this paper are 1 to describe the development of the screening measure, 2 to investigate the patterns of infant mental health problems identified by this measure, 3 to assess the validity and feasibility in existing public health settings. The study was conducted within the existing child health surveillance in 11 urban and suburban municipalities around the city of Copenhagen.
In Denmark all registered delivered childbirths are reported from midwives to the CHNs in the municipalities; and all families with newborn babies are offered a series of home visits free of charge by the same CHN. The CHN is a registered nurse with specific training in assessment of child health and development and communication with parents. The database comprises information on child health and development, parent—child relations and the family situation recorded from the birth of the child and onwards [ 13 — 15 ].
The measure was founded on theoretical and empirical knowledge on developmental psychopathology in young children, and created to fulfill the requirements to population based screening [ 4 ], be easy-to-use and well accepted by the parents and CHNs. Fundamentally, the measure should demonstrate sufficient validity and reliability, and be feasible in combination with intervention towards problems identified.
Building on the international literature of early developmental psychopathology [ 6 , 16 ] and findings from a recent study embedded in existing primary health care service settings in Denmark [ 8 , 14 ], we considered child age 9—10 months to be a window of opportunity regarding the CHNs screening of developmental problems as well as socio-emotional problems. The items of the measure were created after reviewing the literature on validated measures to assess infant mental health problems, e.
Basically, it was conditioned that the instrument could be easily applied in the procedures at home visits and perceived by the CHNs as appropriate and beneficial [ 4 ]. Among the scheduled home visits, the visit at child age 9—10 months was considered to be optimal regarding valid identification of mental health problems [ 8 , 12 , 14 , 16 ]. The items are answered with yes or no. A dichotomized response option was chosen to facilitate the daily use. This is in accordance with existing national health recommendations since the CHN is obliged to consider intervention when child problems of health or development are identified.
Handbook of Infant, Toddler, and Preschool Mental Health Assessment …
The pilot study was conducted from January to April It included a total of children who were assessed by 20 CHNs as part of the scheduled routines at home visits at child age 9—10 month. The practical procedure was planned in dialogue with the CHNs, with the priority not to change the routines of the CHNs.
Results of the analysis of the qualitative data above resulted in minor precisions and semantic adjustments of the measure and manual, now called the Copenhagen Infant Mental Health Screening, CIMHS. The study population in this part of the study was a total of infants who were consecutively enrolled for participation in the period from 1 th of March to 31 th of December These children were recruited from the same 11 municipalities as the pilot study and included for participation as part of the home visit scheduled at child age 9—10 months.
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Practical procedures at the home visit were unchanged compared to former practise at home visits at child age 8—10 months, apart from the assessment according to the CIMHS at the end of the visit. Infants born before week 36 were included while adjusting for the gestational age of the child. Excluded were infants having severe somatic and developmental disorders, and infants of parents who did not speak or understand Danish language.
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Overall, a total of 45 CHNs participated, with some replacements during the study period. Compliance of the CHNs was optimized during the study period by supervision ad hoc and two joint seminars. The MBR includes information on child and family factors recorded during pregnancy, birth and peri-natal period [ 25 ].
The variable was dichotomized in any neonatal complications vs. Finally, a variable of family structure was applied, parents living together at the time of the birth of the child vs.
At each visit, the CHN record information from parents together with the results of her examinations of the child and her evaluation of the relation between parent and child. Mother-child relationship recorded between child birth and child age six months, dichotomized in problems vs. Maternal mental health problems and mother-child relationship were assessed by CHNs at home visits at child age 1—4 weeks, 2—3 months and 4—6 months. These variables were recoded to be present, if the CHN had recorded problems at least at one visit.
Qualitative data from the pilot study were used to examine the face validity of the overall conceptualisation of mental health problems in the CIMHS. All comments in the data sources were analysed by the first stages of the Grounded Theory analyses. These analyses include an open coding, a categorisation of the comments and an interpretative reading [ 27 ].
Statistical analyses were carried out using the SAS version 9. Exploratory factor analysis EFA was applied for a tentative search of patterns initially supporting the theoretical construct of infant psychopathology [ 24 ]. A total of children were eligible for the study, of which civil registration number was missing for ten, leaving children to be included in the study. Overall, problems of eating were identified in A total of Analyses of differences among children born preterm vs. Differences among children with low birth weight vs. None of these items have loading in more than one cluster.
The remaining items did not fit the factor structure as the factor loadings were low. The new screening measure CIMHS builds on solid evidence on early developmental psychopathology and the potentials of mental health screening in early childhood [ 2 , 8 ]. The earliest possible valid identification of mental health problems, which is feasible within existing service settings, was a priori suggested to be at child age of 9—10 months [ 8 ].
In a general population sample of infants, the measure identified problems of feeding and eating, sleep, developmental and socio-emotional problems in 9—10 months olds with a frequency in line with findings from other general population samples at comparable ages [ 8 , 28 , 29 ]. These findings are in line with prevalence studies of older preschool children [ 28 — 31 ]. Moreover, the findings on differences in prevalence of CIMHS items of sleep regulation, feeding and eating, reduced level of activity, and impressive language development in infants born preterm, are in line with existing evidence on a higher risk of immature regulation and developmental delays in children born premature [ 32 , 33 ].
Similarly, CIMHS identified higher frequencies of eating problems manifested as vomiting without being ill, as well as problems of impressive language in infants born with low birth weight [ 33 , 34 ]. Exploratory factor analyses suggest five clusters of mental health items: 1 problems of language and communication, 2 problems of attention, 3 emotional problems, 4 problems of attachment and 5 problems of eating.
The clusters identified correspond to patterns of clinical problems seen in referred children, and mental health problems identified in general population studies of children aged 0—3 years [ 8 , 24 ]. Some items did not fit the factor structure e.
The following are considered to be major strengths of the CIMHS: 1 the measure builds on current knowledge on the developmental presentation of mental health problems, 2 an important stage of child development is targeted, 3 the whole spectrum of putative psychopathology is included, and 4 information from parents as well as assessments by health professionals are included. Moreover, 5 it is a considerable strength that the measure is developed within an existing service setting and 6 validated in a large general population sample within the same setting.
Some limitations need to be highlighted. First, there are obvious challenges of developing a new measure, which aims to cover the full range of infant mental health problems. We are fully aware of the pitfalls of this, and we have sought to integrate all main aspects of current conceptualizations of infant mental health, and have included as many items as feasible from existing validated measures.
Overall, we have taken into account, the importance of developmental variations and shifts in behaviour, skills and regulation in this young age [ 6 ].
Accordingly, the manual of the CIMHS repeatedly states, that the definition of particular deviations from a putative normative developmental course, only become problems when they occur either in excess or too infrequently [ 6 ]. It is a limitation of the study that we cannot report on concurrent validity against a gold standard, e. Moreover, the financial resources to perform in depth psychological and clinical assessments were neither available, nor within the scope of the present study.
Another limitation concerns the unknown feasibility and validity of CIMHS in children with severe physical illness or major developmental handicap, or children of parents who did not understand and speak Danish language, as these were not included in the present study. Taken together, the demonstrated content validity, discriminatory validity and feasibility of the newly developed measure, CIMHS, suggest promising potentials regarding infant mental health screening in existing service settings. The validity has to be further explored regarding construct validity, reliability, sensitivity, specificity and positive and negative predictive value.
Alice Carter is at University of Massachusetts, Boston. Compartilhe seus pensamentos com outros clientes. This book was a great find. As an educator and mother of special needs children this book is a valuable resource.