U.S. Department of

Health and Human Services

ACF/ACYF/HSB

Washington, DC 20201

OFFICIAL BUSINESS

Penalty for private use $300

Dear Reader:

Even before the tragic events of September 11, 2001 the Head Start Bureau had set its sights on strengthening our Infant and Child

Mental Health training, research, technical assistance, policy and practice. This is reflected in this issue of the Head Start Bulletin that

we are proud to present to you. In addition, we are pleased to announce two mental health initiatives that we feel will contribute

greatly to meeting the mental health needs of and challenges faced by our Head Start children, families, and staff. 

In order to build on the momentum and knowledge generated from the October 2000 Head Start Forum on Infant Mental Health

(see page 46), the Early Head Start National Resource Center (EHS NRC) has been commissioned to engage in crucial follow-up

knowledge development/dissemination, policy development, and practice development activities. The Center on the Social and

Emotional Foundations of Early Learning is a new project jointly funded by the Head Start and Child Care Bureaus (see page 52).

Among the tasks of the new national Center will be the identification of evidence-based practices for promoting social and emotional

development and preventing challenging behaviors, the development of training and technical assistance material on evidenced-based

practices, and the support of evidenced-based practices at the local level. The Center and the EHS NRC will work closely together.

We are very excited about the work that has occurred to date with respect to mental health in Head Start. We are equally excited

about the anticipated contributions of our new initiatives. We hope you will find this issue of the Bulletin a useful resource for meeting the mental health needs of the children in your life.

George L. Askew, M.D., F.A.A.P.

Chief, Health and Disabilities Branch, Head Start Bureau

Medical Advisor to the Commissioner of ACYF

Daily Separations and Reunions ■ Stress and the Developing Brain ■ The Effects of Violence ■ New—Parent/Teacher Pull-out
a Head Start Bulletin a

HeadStart

ENHANCING HEAD START COMMUNICATION

Child Mental Health

A Welcome to Windy Hill

Daily Separations and Reunions

Stress and the Developing Brain

The Effects of Violence on Mental Health

New!

Issue Pull-out in English & Spanish: 

Helping Children and Adults Cope 

with Trauma in the Community

Cómo Ayudar a los Niños y a los Adultos 

a Enfrentar Sucesos Traumatizantes 

en la Comunidad

bulletin

2002 ISSUE NO. 73

U.S. Department of Health and Human Services 

■ Administration for Children and Families 

■ Administration on Children, Youth and Families

www.acf.dhhs.gov/programs/hsb
The Head Start Bulletin is published six times a year by the Head Start Bureau,

Administration on Children, Youth and Families, Department of Health and 

Human Services.

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Tommy Thompson, Secretary

ADMINISTRATION FOR CHILDREN AND FAMILIES

Wade F. Horn, Assistant Secretary

OFFICE OF PUBLIC AFFAIRS

John C. Allen, Director

ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES

Joan E. Ohl, Commissioner

HEAD START BUREAU

Windy M. Hill, Associate Commissioner

The Bulletin is a service of the Head Start Bureau’s Training and Technical Assistance

Branch. Its purpose is to enhance communication among the Head Start Bureau, Head Start

programs, and interested national, regional, and state organizations and agencies.

HEAD START BUREAU

JoAn Knight Herren, Chief, T/TA Branch

Beverly Gould, Guest Editor

Jeff Fredericks, Managing Editor 

Carmen Bovell-Chester, Division of Program Management 

Head Start Bulletin

The Head Start Bulletin is prepared under Contract No. 105-96-2010 with PaL-Tech, Inc.

Deborah Kremer, Co-Editor

Judy David, Co-Editor

Marith Schuhart, Production Assistant

Head Start Bulletin

Child Mental Health

Issue No. 73
Head Start Bulletin 1

FEATURES

3 Promoting Mental Health

5 A Welcome to Windy Hill

6 The Infant Mental Health Approach

10 Relationship as Curriculum

13 Daily Separations and Reunions 

16 Stress and the Developing Brain

19 The Psychological Work of Pregnancy

22 Buffering the Effects of Maternal Depression

24 Challenging Behaviors in the Classroom

29 The Effects of Violence on Mental Health 

34 Reflective Supervision

RESOURCES

31 PULL-OUT: Helping Children & Adults

Cope with Trauma in the Community

32 PULL-OUT: Cómo Ayudar a los Niños y a 

los Adultos a Enfrentar Sucesos 

Traumatizantes en la Comunidad

51 Resources

52 Webliography

ARTICLES

26 Strategies of Behavior Management for

Special Needs Children

27 The COMPASS Program: Addressing Aggression 

in the Classroom

37 Early Childhood Behavioral Specialist: An Interview

39 Home-Based Early Head Start “Kitchen Therapy”

42 Working with Native American Fathers

44 Mental Health in the Migrant Head Start Community

46 The Infant Mental Health Forum

48 Guiding Principles

50 The Head Start Mental Health Research Consortium

52 The Center for the Social and Emotional 

Foundations of Early Learning

page 3:

Promoting 

Mental Health

2002 Issue No. 73

HeadStart

bulletin

Cover photo by Eyewire

page 13: Daily

Separations and

Reunions

page 16: Stress

and the Developing

Brain

page 24: Challenging

Behaviors in the

Classroom
Children’s school experience is more positive and

productive when they have a sense of personal

well-being and are grounded in stable, caring

relationships in their early lives. by Beverly Gould

2 2002
T

HE NOTION OF PROMOTING social-emotional development and mental health is not new to Head Start.

In his 1979 critique of the Head Start Program,

Edward Zigler, one of its founders stated, “We

should have never allowed the intelligence (IQ) score to

become the ultimate indicator of compensatory education’s

success or future...The goal of Head Start is the production 

of socially competent human beings.”

The development of social competence and school readiness is of paramount concern to our society. Social and economic changes in the country are posing challenges to parents as

they attempt to balance spending quality time with their children with making a living and protecting them from environmental risks affecting their health and development. 

As a national laboratory, Head Start has always been a

leader in the field of early childhood, recognizing the needs of

low-income young children and acknowledging the impediments

that need to be addressed to help them learn and grow.

Children’s school experience is more positive and productive

when they have a sense of personal well-being and when they

Mental

PROMOTING MENTAL HEALTH

Health

online...For more information on Head Start, visit our site at <www2.acf.dhhs.gov/programs/hsb/>.

Child

PHOTOS LEFT TO RIGHT: Photography by Eyewire, Linda Goldman, Indiantown MHS, and HSNRC Photo Archive

Head Start Bulletin 3
4 2002

are grounded in stable, caring relationships in their early lives.

Unhappy, fearful, or angry children are preoccupied with their

struggles and their pain. This makes them unable to give their

full attention and engagement to learning experiences. 

Mental health needs exist on a continuum. Services to

address those needs can range from activities and interventions

designed to help children develop self-confidence; to interventions for children dealing with socio-economic disadvantages

and social disorganization, abuse, and family disruptions; to

diagnosed disabilities and health challenges. The relatively new

field of infant mental health brings a multi-disciplinary perspective that enhances our understanding of infant competency,

the parent/infant relationship, child development, and risk and

protective factors that affect development, assessment, prevention, and intervention. This perspective seeks to enhance a family’s strengths while addressing those circumstances that can

threaten it. 

The impacts of poverty, substance abuse, violence, physical

and sexual abuse, and teen pregnancy are undeniable. Early

Head Start and Head Start can help facilitate the unfolding of

healthy self-esteem and internal regulation. They can teach

how to tolerate, experience, and modulate deeply felt emotions—skills that lead to social competence and the capacity to

participate in a learning environment. 

Some key social skills are respecting the rights of others,

relating to peers without being too submissive or too overbearing,

being willing to give and receive support, and treating others the

way one would like to be treated. Recent early childhood

research, such as From Neurons to Neighborhoods and the

Surgeon General’s Report on Children’s Mental Health, has

demonstrated that developing social skills are seriously affected

by the infant or young child’s early experiences and the quality of

early relationships. What Early Head Start and Head Start staff

members do in a variety of settings and with a variety of populations can have a monumental effect on families and on society.

We know that the chances of favorable outcomes, particularly

when working with extremely vulnerable, emotionally damaged

populations, are increased when we create nurturing, responsive

environments and well-informed, well-planned interventions

based on current knowledge and outcomes-based research. 

As Head Start continues to encourage increased knowledge

and advanced credentials within its programs, staff must also

bring an increased sensitivity, awareness, sophistication, and skill

level in addressing creatively the mental health needs of our children and families. The emotional needs of children and families

dealing with serious life issues require a new level of emotional

commitment and strength from the staff who works with them.

Staff members who work with families dealing with challenging

situations need to identify and reinforce their strengths, celebrate

their successes, and build on the positive relationships and experiences that Head Start provides. This, in turn, demands that

administrators and program supervisors provide adequate training, supervision, and emotional support for staff facing the challenge of remaining emotionally present in the face of tremendous

stress, emotional pain, and challenging behaviors. 

The articles in this issue of the Head Start Bulletin describe

some of the most current interventions and issues affecting pregnant women, father involvement, and children birth to five, as

well as some innovative program models. The Head Start Bureau

and its collaborative partners are committed to reinforcing the

message that mental health does not just refer to interactions

between patients and therapists but to the quality of relationships

in our centers and the confidence we feel in successfully creating

happiness in our lives. The ways that we use curriculum to support emotional connections, the honest acknowledgement of

strengths and challenges, and how we support and encourage

staff all reflect Head Start’s mandate to create atmospheres of

social competence and mental health. We invite you to consider

how your program might be able to incorporate some of the successes described here to improve the lives of your children and

families. In this Bulletin, we also introduce you to Windy Hill,

the Associate Commissioner for the Head Start Bureau. Windy

has been involved with Head Start for many years, as a child in

the program and as a parent, and she is a strong advocate for all

that is best for Head Start children, families, and staff. ■

Beverly Gould was a 2000-2001 Head Start Fellow. 

T: 202-554-0484; E: priyadarsa@aol.com.

PROMOTING MENTAL HEALTH
Head Start Bulletin 5

WINDY M. HILL WAS NAMED THE ASSOCIATE COMMISSIONER for the Head Start Bureau on January 7, 2002. She

brings a lifetime of involvement and commitment to the principles of the Head Start Program. As a child, she

was enrolled in Head Start in Bastrop, Texas. Her child was also enrolled in the program. She has served as a

parent representative on the center's policy council and later was part of the community group that developed

and received a Head Start grant. Prior to joining the Head Start Bureau, since 1993, Associate Commissioner

Hill served as Executive Director of Cen-Tex Family

Services, Inc. which administers nine Head Start centers in 

a four-county region of central Texas.

At the Region 12 Migrant and Seasonal Head 

Start Annual Conference held in March 2002, Associate

Commissioner Hill affirmed the initiatives affecting Head

Start that include fatherhood, positive youth development,

literacy, faith-based, and the rural initiatives. She explained,

“We see these initiatives as tools to deliver better outcomes

for Head Start children and their families.”

Associate Commissioner Hill described the President’s

early childhood initiative at the NHSA conference in

Phoenix in April 2002, “The President’s Good Start, Grow Smart initiative will help states and local communities strengthen early learning for young children to make sure that they have the skills they need to start school

ready to learn—to ensure that No Child Is Left Behind. To strengthen Head Start’s school readiness efforts, the

Administration will support the development of appropriate standards of learning in early literacy, language,

and numeracy skills.” She explained that “Good Start, Grow Smart is about making sure that programs have

the support, guidance, and leadership that ensures quality Head Start environments; healthy, successful children;

and empowered parents.”

Associate Commissioner Hill is very committed to the Head Start vision. “I have experienced Head Start

from different vantage points and seen how it has benefited my life and the life of my daughter. These experiences have taught me the value of Head Start and the importance of putting children first.” Welcome Associate

Commissioner Windy Hill.

A WELCOME TO

ASSOCIATE COMMISSIONER WINDY HILL

online...For more information on Head Start, visit our site at <www2.acf.dhhs.gov/programs/hsb/>.Photography by ACF
6 2002

When the Infant Mental Health (IMH) Specialist walks

into the playroom, she sees Karina and her mother Karen. Sixmonth-old Karina sits in her infant seat on the table and

Karen sits in a chair. They both face the door. Karen reads a

magazine as Karina gazes at the side of her face. The IMH

Specialist softly says, “Karina, is Karen the prettiest mommy

you’ve ever seen?” Karen looks up and smiles at the IMH

Specialist. The IMH Specialist then says, “Did you see how

lovingly Karina was looking at you?” Karen laughs and tickles

Karina’s belly, saying, “You’re such a silly baby!” Karina and

her mother exchange sounds and giggles as the IMH Specialist

looks on.

The home visitors happily chat over the complimentary

breakfast that the agency provides for their meeting every

Friday morning. They are also getting ready for their meeting

with the Mental Health Consultant (MHC). Every Friday the

MHC meets with the home visitors as a group and then holds a

reflective supervision session with the home visitor supervisor.

The supervisor, in turn, conducts individual supervision sessions

with the home visitors. Everyone looks forward to Fridays

because they feel appreciated, taken care of, and important.

THESE SCENARIOS ARE TYPICAL of any infant/toddler program

that provides mental health services. Mental health services for

pregnant women, infants and toddlers, and their families can

take many forms, depending on the program and the families

(e.g., consulting with staff, consulting with children and families, providing direct mental health services, etc.). Regardless of

how mental health services are delivered, the understanding of

mental health is the same: prevention first, promotion always,

and intervention when necessary. 

Before making recommendations and decisions to guide the

mental health services in a program, the first step is to understand

infant mental health. This article will illustrate the infant mental

health approach by providing a historical and philosophical context, identifying infant mental health guiding principles, and outlining examples of infant mental health program features.

Infants and Mental Health

THE TERM “INFANT MENTAL HEALTH” conjures up odd

images for many—even for those people who have

worked for years in early childhood settings. Some have never

considered the words “infant” and “mental health” together.

Some think of the negative and stigmatizing meanings of

“mental health” and are surprised that infants can have mental health problems. Unfortunately, some view mental health

as a human quality or a field of work that is concerned with

deficits in people. 

Infant mental health affirms that mental health is a positive aspect of human development (although we address problems when they arise) and the field of mental health is both

proactive and reactive—hence the prevention, promotion, and

intervention approaches noted earlier.

From their first moments, infants are busy building an

emotional and social life. Infants’ emotional development

forms basic notions about the self and the world.

Development in all other areas—cognition, communication,

and motor skills—is organized by the emotional development

of the child. Most importantly, the infant’s development

begins and continues within the context of an emotional relationship. As Donald Winnicott (1987), famed pediatrician

turned child analyst stated, there is no such thing as an infant

THE INFANT MENTAL HEALTH APPROACH

From their first moments, infants are busy building an emotional and 

social life. by GAMBI WHITE-TENNANT AND GERARD COSTA

There is no such thing

as an infant alone

Photography by Eyewire
Head Start Bulletin 7

alone. We must always consider the infant/caregiver relationship. Emotional life is fundamentally a relational life. We must

always view infants in the context of their earliest attachment

relationships. This relational focus is relevant throughout

early childhood—and throughout life.

Infant Mental Health as a Field

THE PROCESS WHEREBY INFANTS AND PARENTS attach or have

difficulty attaching to each other, and the factors that influence

this dynamic and vulnerable process constitute the field of

infant mental health. It is an interdisciplinary field that studies

the optimal emotional, social, physical, communicative, and

motor development of infants within the context of their earliest primary relationships. 

Selma Fraiberg (1987), Social Worker and Child Analyst at

the University of Michigan at Ann Arbor, is credited as the

founder of infant mental health as a distinct field of intervention. She founded the Child Development Project at Ann Arbor

which created influential ways of understanding and treating

problems in the infant/parent relationship—most notably the

notion that all work must be dyadic, meaning that the dyad, or

pair, to always consider is that of the infant and parent. This

gave rise to unique methods of intervention, particularly

infant/parent psychotherapy and home-based services (sometimes called “kitchen-based” therapy, see article on page 39).

This emphasis on the relationship, rather than on the child or

parent alone, forever changed the methods used in understanding and helping infants and their families. 

While students and professionals who study and work with

infants and their families come from many different fields, there

are certain principles that guide this work for everyone.

Guiding Principles

1 The human infant comes into the world with remarkable capacities for human relatedness—with

Attachment Promoting Behaviors (APBs)—that help

invite, inform, and regulate relationships with the caregiver.

From the earliest moments, infants require consistency, stability,

predictability, availability, and attuned love. 

2 The period of life from birth to three is a sensitive

period of development for the formation of character

or personality. The greatest period of brain development, the brain “growth spurt”, occurs from the last trimester

of pregnancy through the first 18 months of life. During this

period, nutritional, physical, social, and emotional satisfactions

and failures will be “biologized,” meaning that actual changes

occur in the physical and chemical structures in the brain. 

3 Pregnancy and childbirth are powerful conscious and

unconscious reminders in the parent of childhood

issues that can help or hinder the parent in responding to, caring for, and loving the infant. In every birth, the infant

can serve as a powerful transference object for the parent—

meaning that thoughts, feelings, and beliefs about other figures

and events in the parent’s past can become associated and confused with the infant. Pregnancy, birth, and the first two years of

maternal care require the availability of psychological resources,

emotional support, and parent/infant psychotherapy. Parenting is

a relationship, not a skill, and the belief that parenting can be

“taught” as we do other skills is not clearly supported.

4 Those of us who work with infants and their parents also have our own emotional histories that

influence how we work with families—especially

those families where infants are not adequately cared for or

are hurt. We are not immune from the same psychological

forces that influence the parent/child relationship. Infant mental health requires that these feelings be addressed. Delivery

systems and child protective agencies must provide protected

time for intensive and rigorous staff training and ongoing regular supervision. 

5 The nature of the infant/parent relationship is best

understood within the setting of the family home

because the context of family events (eating, sleeping, relating, nurturing) as well as the alternate ways parents

communicate to us (through pictures, objects and toys, family

stories and memories) are rooted in the family home.
8 2002

THE INFANT MENTAL HEALTH APPROACH

6 The infant/parent relationship emerges within a

unique set of cultural and economic factors that provides a historical and practical context to the family

and to the intervention. Infant care, expression of affection, use

of health care, and relationships with mental health professionals are strongly influenced by these factors.

As we consider ways to integrate principles of infant mental health into Early Head Start and Head Start programs, we

should consider the following points—

• Understanding infant mental health and working with a

relationship-based approach are skills that are not exclusive to mental health professionals. These skills belong to

all of us who work with infants and their families.

Teachers, pediatricians, speech therapists, occupational

therapists, bus drivers, nutritional staff, and all others

within the Head Start family can learn ways to implement IMH practices. 

• There are many strategies of intervention, including

building an alliance with families and providing services

and systems advocacy; developmental/parental guidance;

supportive counseling; and more specialized services of

infant/parent assessment and dyadic psychotherapy. 

Integrating IMH practices into Early Head Start and

Head Start programs does not mean that everyone must 

now become a psychotherapist. Those who wish to develop

these specialized mental health skills can participate in the

growing number of graduate and post-graduate programs

being developed throughout the United States. It does, 

however, mean that awareness of infant mental health and 

the importance of working in a relationship-based way with

families must be supported through training, supervision, 

and consultation to ensure that the guiding principles are

achievable.

To incorporate these principles, programs should consider

several strategies to become more infant mental health centered.

Infant Mental Health Program Features

THE FOLLOWING FEATURES for an infant mental health program

are typically implemented by using the program’s internal

capacity to provide mental health consultation or through collaboration with external consultants from local agencies. Any

combination of employee or consultant services can be used.

The design depends on the strengths and needs of the children,

families, and staff, as well as on the program’s human and 

fiscal resources. 

When staff identifies children needing mental health

assessment or services, a mental health professional can provide direct consultation to the children and families. This 

can be accomplished through playgroups that may include 

parents. These groups assist children in the initial learning 

of social skills, such as the capacity to wait, take turns, read

the cues of adults and peers, and accept support from others.

Groups with parents and their young children allow time for

parents to enjoy their children and learn to play with them 

in sensitive and attuned ways. Staff is able to observe the

interaction between the caregiver and child, assess the need 

for intervention, and model emotional presence and ways 

of handling emotionally challenging behaviors. This consulonline...For more information on Head Start, visit our site at

Photography by HSIPC Photo Archive

<www2.acf.dhhs.gov/programs/hsb/>.

Gum Springs Head

Start Children’s

Center
Head Start Bulletin 9

tant would communicate and maintain documentation with

the appropriate staff and parents as well as maintain communication with teachers and parents to support the outcomes of

the intervention.

Another option is to provide direct consultation services

to the program staff. This can take the form of regular reflective supervision with the staff members who have direct contact with children and families, or supervision of the supervisors, strengthening their ability to provide support and technical expertise to their staff. Within this context, challenging

classroom interactions or difficult family situations can be discussed in depth. In this model, the primary focus is on providing training to staff rather than clinical services to the children

and families. 

Staff members who are trained to conduct developmental

screenings and psychological assessments and to create developmental plans also provide valuable consultative services in

Early Head Start and Head Start programs. Through the use of

insights gained through formal and informal assessments, staff

and parents can develop a deeper understanding of their child’s

behavior and needs. 

Collaborations with local agencies, clinics, hospitals, and

universities providing services to the Early Head Start and Head

Start population can be formed or expanded. Students being

trained as professionals within the variety of disciplines that

make up infant and preschool mental health can be a valuable

source of providing counseling services and playgroups as well

as formal assessments.

As you design or make improvements to your IMH program keep the following in mind—

• The design must fit the strengths and needs of the children and families.

• The program’s resources must be able to support the

design or outside resources should be cultivated.

• Contracted services are only as good as the contract’s

content.

• Communication is vitally important to the success of the

program. Paraprofessionals and professionals involved

must have a piece of the family picture.

These are exciting times for families and those of us who

work with them. Programs that invest in knowledge and skill

development will yield priceless dividends for both families and

staff. Our goal is to regard every infant and family with respect,

consideration, and empathy to better support their loving and

attuned relationships. ■

REFERENCES

Brazelton, T.B. 1992. Touchpoints: The essential reference.

Reading, MA: Addison-Wesley/Lawrence. 

Costa, G. 1996. Guiding principles in infant mental health and

their implications. Keynote Address. New Jersey

Association for Infant Mental Health.

Fraiberg, S. 1987. The clinical dimensions of baby games. In

Selected writings of Selma Fraiberg, ed. L. Fraiberg.

Columbus: Ohio State University Press.

Stern, D. & N. Bruschweiler-Stern. 1998. The birth of a

mother. New York: Basic Books.

Winnicott, D. 1987. Babies and their mothers. New York:

Addison-Wesley Publishing Co.

Gambi White-Tennant is an Infant Toddler Specialist at 

NYU Steinhardt School of Education, Head Start Quality

Improvement Center. T: 212-998- 5550; E: gambi.

whitetennant@nyu.edu. Gerard Costa is the Director for 

the Institute for Training in Infant & Preschool Mental

Health, Youth Consultation Service. T: 973-483-2532; E:

gcosta@ycs.org.

Integrating infant mental

health practices into 

programs does not mean

that everyone must now

become a psychotherapist.
10 2002

AT THE ZERO TO THREE NATIONAL TRAINING INSTITUTE in

Washington, D.C. in December 2000, Dr. Gil Foley suggested

that we are engaged in a vast social experiment—the venue and

style of child rearing are being dramatically altered. For the first

time, large numbers of children are being cared for by non-family members who have a professional rather than personal

investment in them. Millions of babies are now in child care,

some for 50 hours a week or more. How do we as early childhood professionals provide care for young children that meets

their most basic human needs?

Regardless of the setting, the experts agree that the 

primary need of infants and toddlers is emotional connection.

Relationships are the key and emotional development is the critical domain. As Dr. Foley said, “Child care must be organized to

protect, sustain, and support emotional development.

What is most at risk for children in care outside the

home is the development of the capacity for relationships

and endeavoring sense of inner security and spark of self

that are spawned in relationships.” 

This view is also expressed in the current report, From

Neurons to Neighborhoods. In the executive summary, we learn

that research has “generated a much deeper appreciation of the

emotional role of early relationships as a source of either support and adaptation or risk and dysfunction. Complex emotions

have powerful capabilities for the development of the essential

social skills during the earliest years of life.” Given the essential

nature of deep emotional relatedness, how are we to capture

these most profound and formative human experiences of infancy and toddlerhood in the context of a curriculum?

What does curriculum mean? According to the Head Start

Program Performance Standards, curriculum is a written plan

that indicates goals for children’s development and learning, the

experiences through which they will achieve these goals, how

staff and parents will help them achieve these goals, and the

materials that are needed to support these goals. 

The needs of babies in group care are the same as those of

babies at home—a safe, secure, and predictable environment;

routines that are dictated by their own unique patterns and

rhythms; and the presence of a primary caregiver who loves

them. This caregiver needs to be attuned to the baby and able

to recognize the baby’s signals and respond appropriately. These

are aspects of a good home environment that group care should

replicate. As Dr. Foley put it, “The environment itself should be

as home-like as possible. It should be designed to be nurturing

and informal, in support of the experiences and interactions

between children, caregivers, and families.”

A misconception about the use of a written curriculum for

infant/toddler care is that it will lead to the notion that quality

care should be based on a school model rather than a home

model. There is a certain pressure to define quality care as skills

based and focused on cognitive development. Existing curricula

look at infant/toddler development in separate domains (cognitive, gross motor, fine motor, language, and social-emotional)

RELATIONSHIP AS CURRICULUM

“Child care must be understood as a profound influence on the lives of

children, not as a service to parents like ATM machines.” Dr. Gil Foley, Ed.D.

by LINDA LLOYD-JONES

Young children’s

primary need is

emotional connection

Photography by Indiantown MHS
Head Start Bulletin 11

and set goals and objectives for babies in each of these domains.

But, a rigid, fragmented perspective to infant/toddler curricula is

not in the spirit of the Performance Standards. The standards

clearly indicate that social and emotional development is to be

encouraged by—

• enhancing each child’s individual strengths; 

• providing a setting that allows for building trust;

• fostering independence; 

• having realistic expectations; 

• encouraging respect for

feelings and for the rights of

others; 

• supporting and respecting a

child’s home language and

culture; and 

• planning routines and transitions so that they occur in a

timely, predictable, and

unrushed manner, according

to each child’s needs. (See

Performance Standard

1304.21 [A] [3].) 

These mandates enumerated in the Performance Standards

cannot truly be accomplished in any other way but within the

context of a relationship attuned to the individual child.

Babies in group care live there. They live with caregivers

and other babies and children while their parents are temporarily away. When looking at what constitutes quality care for

infants and toddlers, think of it in terms of quality of life.

What are the minute-by-minute, day-to-day experiences of

babies in care and how does this stack up against a “good natural home environment?” One feature that distinguishes home

from school is that the home does not have a rigid set of activities. Even though home has basic routines and predictability, in

between the necessary daily activities that families engage in

are long leisurely periods when people do the activities that

reflect their priorities within the protective shelter of love.

The strong and secure attachment that infants and toddlers

need to share with their primary caregivers is described as a

secure home base by noted child psychoanalyst, Margaret

Mahler (1975). From this home base, infants and toddlers can

venture out to explore their environments, engage with others,

experiment, and problem solve. This secure home base, where

children can relate to and connect with their primary caregiver

as they need, has to be the central focus of any curriculum. It is

through and in the context of relationships that infants and toddlers learn how to be in the world.

According to research

described by Dr. Ronald Lally

(1997), an Early Head Start collaborator in the Program for

Infants and Caregivers, infants and

toddlers develop their sense of

who they are from the adults who

care for them. They learn from

their caregivers what to fear, 

what behaviors are appropriate,

and how their communications 

are received and acted upon. 

They learn how successful they 

are at getting their needs met by

others, what emotions and intensity levels of emotions 

to safely display, and how interesting others find them. 

None of these can be taught with a narrow focus on the

behavioral aspects of curriculum, but are learned through

awareness in relationships. 

Children everywhere are becoming themselves and experiencing their feelings in increasingly complex ways during infancy and toddlerhood. Identity formations occur and it is the

relationship with babies rather than the activities planned for

them that profoundly affects the child’s sense of self and emotional development. Beneficial environments, high quality toys

and equipment, and a variety of developmentally appropriate

activities are, of course, desirable in infant and toddler care.

But, the only indispensable aspect of quality care is the relationship between babies and their caregivers. All the activities

and materials in the world will not make up for the lack of

bonded, loving relationships.

Children develop

their sense of self

from their caregivers

Photography by Eyewire
12 2002

So what should be done to ensure quality of care? One idea

is to expand the focus on curriculum for babies to include a

curriculum for grown-ups. Dr. Lally has provided curricula for

training staff that focus on helping caregivers develop attachments with babies. This program emphasizes watching, asking,

and adapting as the steps to follow when interacting with

infants and toddlers. 

A curriculum will set goals and objectives for adults who

care for babies. For example, one goal may be that caregivers

will learn and demonstrate skills that promote children’s curiosity. The effects will be seen in the happy, well-adjusted, and active

children who feel free to explore their environment. Helping

caregivers learn to engage in authentic, deep, loving relationships

with infants and toddlers is something that must be done for the

long-term benefit of social and emotional competence.

We need to turn caregivers’ attention away from planning what babies will do all day in care and onto what their

babies are actually doing all day. Noted infant specialist Jeree

Pawl (1998) offers this wise advice, “Don’t just do something, stand there and pay attention.” We should watch and

observe our babies much more closely. What are they doing?

How are they playing? What are they trying to achieve? Ask

them who they are, what they need, how they can be helped.

Then listen and watch for the answer and let that guide what

we choose to do with our babies. In this way the baby will

truly direct his or her care. The baby will lead.

This is hard work for caregivers. To truly attend to and

“be there” emotionally for babies is not a skill, but a way of

being. Engaging in loving, responsive relationships with each

individual baby while at the same time fully supporting the

family/child relationship is a tall order. It requires that caregivers have a depth and breadth of knowledge about infant

and toddler development; a high degree of self-awareness; a

wellspring of emotional resources; and intense dedication to

the well-being of other people’s children. As a society we do

not yet sufficiently value the people who take on this responsibility, nor do we give them the support they need. This is an

area where Head Start and Early Head Start can take the lead

as a national laboratory for best practice.

Alison Clarke-Steward (1993) stated that one of the primary goals for child care is to facilitate a happy childhood. When

we focus fully on training and supporting caregivers to love

their babies and be responsive to their needs, this will allow for

the optimal expression of each infant’s needs and abilities in a

curriculum. Babies in the hearts and hands of such caregivers

have a real chance for a happy childhood and the development

of social and emotional competence. Loving, responsive, and

well-trained caregivers will know how to meet their babies’

needs because they will listen to what their babies are telling

them and respond from the heart. ■

REFERENCES

Clarke-Stewart, A. 1993. Daycare: Rev. Ed. Cambridge:

Harvard University Press.

Foley, G. 2000. Child care from a trandisciplinary perspective:

A relationship centered approach. Presentation at the Zero

to Three National Training Institute, Washington, D.C.,

December 1-3, 2000.

Lally, J.R. 1997. Curriculum and lesson planning: A responsive

approach. Unpublished manuscript. Sausalito, CA: WestEd.

Mahler, M., F. Pine & A. Bergman. 1975. The psychological

birth of the human infant: Symbiosis and individualization.

New York: Basic Books.

Pawl, J. & M. St. John. 1998. How you are is as important as

what you do. Washington, D.C.: ZERO TO THREE/

National Center for Clinical Infant Programs.

Shonkoff, J. & D. Phillips, eds. 2000. From neurons to neighborhoods. Washington, D.C.: National Academy Press. 

Linda Lloyd-Jones is an Early Head Start Teacher, Teen Aide

High School, LYFE-Early Head Start. T: 718-935-9836; E:

JLloyd8475@aol.com.

“Don’t just do something,

stand there and pay

attention.” Jeree Pawl

RELATIONSHIP AS CURRICULUM
Head Start Bulletin 13

FROM BIRTH, POSITIVE GIVE AND TAKE in relationships fosters

social and emotional well-being and resilience. Secure relationships are particularly important for a very young child’s language development, problem solving, social interaction, and

emotional regulation. The patterns of interpersonal exchanges

during the early years have significance for the developing

brain, including the development of

a young child’s sense of self, as well

as what the child thinks, remembers,

and feels. Researchers have found

that although brains are impressive

in their continuing ability to change

and adapt throughout the life cycle,

early relationships are significant in

influencing future development. 

Relationships described as

“secure attachments” involve identifying and enhancing positive emotional states such as joy and elation

and identifying and supporting

painful emotional states such as fear, sadness, and anger. Hellos

and goodbyes—times when young children’s emotions are often

heightened—provide golden opportunities to build and enhance

relationships. It is important to take into account the reality

that parents and professionals often experience intense emotions

themselves and are influenced by their past experience with

comings and goings from loved ones. 

In Early Head Start and Head Start center-based programs,

reunions and separations happen simultaneously. Every morning,

young children separate from their parent and reunite with their

teacher. Every evening, young children separate from their

teacher and reunite with their parent. Since the mental health of

young children depends on the emotional well-being of the

adults who care for them, providing support for the adults is

equally as important as providing support for the children. 

The pattern of give and take that occurs among

young children and their parents and teachers shapes

how children feel about themselves. Both infants and

adults contribute to the quality of the relationship.

Some patterns lead to a child’s sense of safety and well-being.

For example, an adult who generally responds to the specific

emotions and non-verbal requests of an infant by remaining

emotionally present and focused while not being intrusive helps

a child to feel noticed and valued. As infants grow older, their

contributions evolve from non-verbal signals to a mixture of

non-verbal and verbal signals as the

adults’ verbal responses become

more detailed. 

Misunderstandings are inevitable

in the course of the normal give and

take between young children and

adults. The key component in secure

relationships is the ability to repair a

misunderstanding. For example,

when a mother realizes that her ninemonth-old is fussy because he wants

her to look at the light on the ceiling,

not at the toy on the shelf, she will

be rewarded by a delighted smile and

squeal as she redirects her attention to the light, smiles, and

begins to talk about it with him. 

How children express emotion during hellos and goodbyes

evolves with age and with their length of time in a program. A

newly enrolled three-month-old baby rarely says goodbye in a

pronounced way; however, she might withdraw or take time to

observe another baby rather than engage with a toy or person.

This apparent lack of response may be difficult for some parents to understand. Loud protests are taken as a more common

sign of connection. 

Older infants (six to nine months of age), toddlers, and

preschoolers might say goodbye with cries of protest when they

begin a new program or they might walk in with a smile and a

wave goodbye. Each response merits the teacher’s and parent’s

acknowledgement and affirmation. 

DAILY SEPARATIONS AND REUNIONS

Daily separations and reunions are part of the fabric of relationships. In

center-based programs, they provide opportunities to develop a young

child’s skill at making positive transitions. by LIBBY ZIMMERMAN

Emotions are

often heightened

during hellos and

goodbyes

Photography by Eyewire
14 2002

DAILY SEPARATIONS AND REUNIONS

Separations and reunions are stressful for the adult, especially at the beginning of a relationship. Acknowledging the

adult’s emotions, whatever they might be, mitigates the stress.

Supervisors and peers can provide this for the teacher and the

teacher can support the parent, as can other parents. A parent’s feelings might range from sadness and fear about separating to relief and elation about having time away. 

Saying goodbye to a crying or withdrawn child might

make a parent sad. Finding and talking to another parent in

the hall who is also feeling sad or finding it hard to say goodbye can be comforting. At other times the educational coordinator or site manager might be the right person to chat with

for a few moments. 

Staff members generally report that by the end of the first

month in a center-based program, even young infants look to

the teacher for comfort and stimulation and indicate preferences through calling to, looking at, and wriggling with

delight towards specific staff. Teachers are rewarded by these

interactions and by their ability to comfort a crying child.

However, some children who are temperamentally slow to

warm up may not demonstrate delight for a long period of

time. They also may be quick to cry when they are getting to

know a new person. Supervisors and peers can support the

teachers through this process by acknowledging their feelings

of frustration or anxiety.

Over time, young children begin to express joy in reunions

with their teacher. How staff and parents interact can support

the well-being of the adults as well as the child. When ninemonth-old Leah leans out of her mother’s arms with a broad

smile on her face and eagerly goes to the teacher in the morning, her mother smiles warmly and says, “Oh, you are happy to

see Sarah.” Many mothers appreciate the pleasure their children

experience in their expanding social world. However, some parents might feel concerned or anxious about whether their baby

still loves them. 

The teacher can have a pivotal role in reassuring the parent

that the baby has room for more than one significant relationship and keeps each person “straight” in his or her own mind.

The teacher can point out how the baby might wriggle or crawl

towards the parent when he arrives, or help a parent understand that an older child might need time to reconnect through

playing or reading a book before going home.

Infants, toddlers, and young children may cry when they

separate from their parent. At times the separation from the

parent may not be done in an optimal way and even exacerbate

the child’s distress. Here is an example of how a teacher in

Early Head Start responded to the distress of a young child in a

way that built her relationship with the toddler and her parent

and affirmed the child’s relationship to both adults.

Darlene, two years of age, bundled up in a snowsuit, hat,

and scarf, arrives crying at the gate to the infant/toddler room

in the arms of her mother. The mother, in a rush that morning, hands Darlene to a teacher standing at the other side of

the gate. The mother dashes off after quickly saying goodbye. 

Supporting emotionally meaningful separations 

and reunions

• Provide parents with access to staff after saying goodbye to

their children. If a baby was crying when the parent left, the

parent might be comforted by talking to the teacher or the

director and hearing how the baby is doing. 

• Spending time in the morning observing the classroom can

give the parent a concrete image of other babies in the arms

of caregivers singing and talking and reminding the babies

that “mama or dada will be back later.”

• Create a welcoming environment for parents so that they can

enter the room, help children get settled, connect with a

teacher, and hang out at the end of day. These moments

allow the staff and parents to interact and share their

feelings and knowledge of the child.

• Arrange for and invite parents to regular (monthly)

parent/staff meetings to talk about their children and hear

how other parents and children are doing. 

• Provide regular, reflective supervision so staff can discuss

their emotions and responses to children and parents.

TIPS FOR PROGRAMS
Head Start Bulletin 15

The teacher says, “Goodbye, see

you later.” The teacher brings the

child to a cozy corner with large

animals. Darlene stays in the

teacher’s arms and sobs. The

teacher talks to her gently saying,

“It’s okay, mommy will be back

after work.” The teacher’s first

overture to take off Darlene’s hat

and scarf are met with louder sobbing. The teacher holds Darlene

and continues holding her, reassuring her that it is okay to feel sad

and angry and reminding her that

her favorite giraffe is waiting to play. Within a minute,

Darlene’s sobs begin to subside and she lets the teacher take

off her hat, scarf, and snowsuit. Within the next minute, she is

calm and explores a giraffe sitting next to the teacher.

With preschool children, we might begin to wish they

would not cry or cling. We may see the tears as a failure rather

than as an opportunity for connection. Parents and program

staff struggle with fears that it may be “bad for the child” if we

respond immediately to a crying child, especially a boy. In fact,

boys, as well as girls, need to know that they can express their

feelings, be comforted by caregivers, and develop their own

coping mechanisms.

Whatever a child’s emotional state might be, the quality

of interaction between all the participants influences a child’s

sense of well-being when saying goodbye to a parent and hello

to a teacher.

Susi, a little over three years of age, arrives walking and

holding her father’s hand. Susi and her father enter the room

and the father greets the teachers. He kneels down and helps

Susi take off her snowsuit, hat, and

scarf, talking to her about what he is

doing. A teacher comes over and

talks to them and asks how Susi’s

morning was and the father describes

what they ate. Susi stays close to her

father as he hangs up her clothes and

puts some things in her cubby. Susi

observes what the teachers and other

children are doing and smiles when a

teacher invites her to come and sit

and read a book with her and several

other children. The father walks over

with her and stays while she settles 

in and then says goodbye. Susi waves goodbye to her father

and the teacher says, “Bye Dad, we will see you later.” The

father leaves and Susi sits close to the teacher, focusing on the

pictures in the book. In a minute or two, Susi gets up and

walks over to the housekeeping corner and begins “cooking”

with a friend.

Although many parents and staff know that even young

infants are aware of comings and goings, at times it still might

be tempting to leave without saying goodbye—generally at a

moment when the child is engaged in play or snuggling in the

teacher’s arms. The understandable goal is to prevent a child’s

protests and tears. However, the hidden cost is a missed opportunity for the child to develop the skills necessary for making

positive transitions. Over time, adults’ comforting helps children learn to comfort themselves. ■

Libby Zimmerman is a Senior Early Childhood Associate at Early

Head Start National Resource Center @ ZERO TO THREE, E:

Lzimmerman@acf.hhs.gov.

With preschool children, we might begin to wish they

would not cry or cling and we might see the tears as a 

failure rather than as an opportunity for connection.

Children learn

to comfort

themselves

Photography by Eyewire
16 2002

RECENT RESEARCH AND TECHNOLOGICAL ADVANCES have changed

our understanding of the developing brain. With this new

information, parents and educators have the opportunity to

provide children with interactions and settings that will allow

them to reach their greatest potential. We now have a greater

appreciation for the fact that the early years are a very fertile

period in the child’s life. We need to make conscious choices

about how we treat children so that impact can be positive.

Research has demonstrated that there is an interaction

between one’s genetic endowment (nature) and the environment (nurture). Structural, hormonal, and chemical influences

that are present during pregnancy affect the growth

and development of the fetus. As early as three weeks

after conception, a baby’s brain cells begin to form

(Berg 1994). These nerve cells then migrate to sections

of the brain that will eventually control the reflexes,

voluntary body movement, perception, language and thought.

These structural changes—the cellular linkages being made—

are unique to each individual infant. The linkages form as a

result of the infant’s experiences, both in the womb and once

they are born. 

Medical science continues to demonstrate the far-reaching

harmful effects of stress. Stress is defined as an emotional reaction that elevates cognitive and physiological activity levels. It

places demands upon the system for physical or cognitive productivity. When those demands are activated over a period of

time, it progresses to a series of changes leading to exhaustion. 

The degree of stress experienced by a woman while she is

pregnant can have a negative affect on the fetus (Gunnar &

Barr 1998). When maternal hormones, such as corticosterone

and tryptophan, become overstimulated due to her own stressful conditions, there is a harmful chemical effect on the fetus’

brain development.

The adult “fight or flight” response to stress is not an

option for an infant or young child. Exposure to intense anger,

loud screaming, or physical violence creates fear within the

child that floods the brain with stress hormones. Being left

alone and crying when hungry or wet are also conditions that

create fear and stress in a young child. Various types of unpredictable, traumatic, chaotic, or neglectful environments physically change the brain by over-activating the neural pathways.

As a result, there may be an increase in the child’s muscle 

tone, profound sleep difficulties, an increased startle response,

and significant anxiety. These responses, in turn, can lead to 

a permanent state of high alert, a tendency to misperceive the

intentions and behavior of others, and the tendency to react

with aggression. 

Conscious memories of the first years of life are lost but

the emotional part of the brain, referred to as the limbic system,

and the body remember (Karr-Morse & Wiley 1997). An

STRESS AND THE DEVELOPING BRAIN

Some people believe that babies and young children are not affected 

by events that take place when they are very young, but what we do 

in the first three years has a tremendous impact on children’s future

development. by BEVERLY GOULD

Playful give and take

with a caregiver

stimulates development

Photography by Eyewire
Head Start Bulletin 17

infant’s first sense of what the world is like is recorded in the

body. Without intervention, young children who have experienced high levels of stress will be at serious risk for emotional,

behavioral, and learning difficulties. 

Early Learning 

NEUROSCIENTIST DR. JAMES LEDOUX (1993) agrees that

events early in life, experienced

with strong emotions, can and

do remain an influence throughout our lives. He suggests that

what we feel is processed before

what we think. Feelings experienced precognitively and preverbally continue to play out in

later life even though the individual may have no conscious

memory of the association. A

significant trauma that takes

place often or intensely enough

can rob a child of the ability to learn normally by pulling

away brain circuitry meant for other tasks. 

An area of the brain, referred to as the amygdala, is central

in understanding how stress affects learning. The amygdala governs attention, memory, planning, and behavior—all skills necessary for the child to be able to take in and process information. Difficulties in attention often include distractibility and

impulsivity, which impair problem solving. In social situations,

children who are overly active, impulsive, and unable to focus

tend to have trouble reading others’ social cues and responding

appropriately to others in the environment. 

Role of Relationships 

RESEARCH LINKS THE EXTERNAL ENVIRONMENTAL influences

on brain development with the quality of stimulation and

degree to which the caregiver is attuned to the needs of the

infant. Social interaction with an empathetic and attuned caregiver plays the major role in the growth and regulation of the

child’s nervous system and in helping the child develop the

strength needed to become socially competent and able to learn.

The consistent experience of empathy that takes place with an

emotionally available caregiver gradually builds the child’s

capacity to empathize with others. 

Relationships that a child experiences provide the foundations for approaches to learning, which, hopefully, will be

enthusiastic, curious, and persistent. Stanley Greenspan (1997),

a noted child psychiatrist, explains

that the capacity to feel a full

range of emotions—learned

through relationships—allows children to organize events and ideas

before they have the words to

express them. Children learn how

to think by creating ideas based on

their experiences and how it feels

to engage in those experiences. For

example, young children become

more focused and interactive

through being able to enjoy the

excitement of reciprocal play. The playful and creative give and

take with an emotionally present, verbal adult motivates the

development of language and encourages the child toward discriminating, generalizing, categorizing, and organizing her

experiences. This is the basis for the ability to think first concretely and then abstractly. 

The Abecedarian Project at the University of Alabama

(Campbell & Ramey 1994) found that when at-risk young

children were exposed to a stimulating environment, appropriate toys, playmates, and good nutrition, they developed less

mental retardation than the control group. Early intervention

in infancy, when the neurological circuits for learning are

being formed, resulted in higher IQs in comparison to the control group. The conclusion was that early enrollment in a high

quality, enriched day care setting is paramount to the children’s significant and long-lasting improvements.

Emotions from

early experiences

play out in life

Photography by Eyewire

online...For more information on Head Start, visit our site at

<www2.acf.dhhs.gov/programs/hsb/>.
18 2002

How Head Start Can Help

HEAD START IS IN A UNIQUE POSITION to assist in healthy

brain development. 

• Through services to pregnant women, expectant mothers

can be helped to receive pre-natal care, get adequate

nutrition, and be educated about the dangerous effects

that drugs and alcohol have on the developing fetus.

During pregnancy, families can be helped to identify areas

of stress and provided with the necessary emotional support and assistance. 

• Parents need to be educated about the child’s need for

appropriate stimulation. As caregivers learn to read the

child’s cues, undue stress can be avoided. Parents need to

understand the importance of talking and reading to the

child, holding a child during feedings, making eye contact,

singing, and playing games that provide novelty and fun. 

• Parents also need to be supported in maintaining their

own mental health. Untreated depression and anxiety

interferes with the parent/child bond and interrupts a

parent’s ability to be fully aware of the child’s needs. 

• Abuse, neglect, and family violence must be prevented.

The population at large needs to be aware of the devastating impact these things have on growing children. 

In addition to the developmental assessments required by

the Head Start Program Performance Standards, an assessment

of the interaction between the caregiver and the child can identify relationship issues that might need mental health intervention. The ability of caring and well-informed Head Start staff to

recognize problems early can prevent difficulties that would be

much more difficult to remedy later. 

Classroom teachers and home visitors play a crucial role in

optimizing healthy brain development. Infant researcher Ron

Lally (1995) points out the key role the infant/toddler caregiver

plays in the development of the child’s sense of identity. Through

imitation and absorption of the environment, children form their

sense of who they are in the world. Helen Raikes (1993) cited the

importance that a relationship between a child and a high quality

teacher plays in “modulating attention, creating interest, building

trust, and assuring predictability for the infants.” This is especially true when the child is given the time needed with one teacher,

as opposed to multiple interactions from a variety of caregivers.

The time spent building this attachment allows the teacher to

fine-tune her interactions based on her intimate knowledge of the

individual child and his needs and responses. Both parents and

children can be supported in Head Start to minimize stressful situations that impede healthy development. ■

REFERENCES

Berg, B. 1994. Child neurology: A clinical manual. Philadelphia:

J.B. Lippincott Company.

Campbell, F.A. & C.T. Ramey. 1994. Effects of early intervention on intellectual and academic achievement: A follow-up

study of children from low-income families. Child

Development 65: 684-698. 

Gunnar, M.R. & R.G. Barr. 1998. Stress, early brain development,

and behavior. Infants and Young Children 11(1): 1-14.

Greenspan, S. & B. Benderly. 1997. The growth of the mind:

And the endangered origins of intelligence. Boulder, CO:

Perseus Books Group.

Karr-Morse, R. & M. Wiley. 1997. Ghosts from the nursery.

New York: The Atlantic Monthly Press.

Lally, J.R. 1995. The impact of child care policies and practices

on infant/toddler identity formation. Young Children

51(1): 58-67. 

LeDoux, J. 1993. Emotional memory systems in the brain.

Behavioral Brain Research 58.

Raikes, H. 1993. Relationship duration in infant care: time with

high ability teacher and infant-teacher attachment. Early

Childhood Research Quarterly 8: 309-325.

Beverly Gould was a 2000-2001 Head Start Fellow. T: 202-554-

0484; E: priyadarsa@aol.com.

An intense trauma can 

rob a child of the ability 

to learn normally. 

STRESS AND THE DEVELOPING BRAIN
Head Start Bulletin 19

THE HEAD START PROGRAM Performance Standards mandate that family and health care providers offer services for

pregnant women that address both physical and mental health

needs. Head Start is in a position to provide invaluable support

to expectant and new mothers. This article will explore some of

the emotional needs of mothers and discuss areas for fruitful

exploration and intervention to help in that process. 

Pregnancy ushers in a tremendous physical and psychological transformation. Besides the bodily changes, there are

disruptions in basic physiological processes that affect sleep,

appetite, and digestion. Hormonal surges can affect mood and

the ability to think and to remember. There are also intensely

ambivalent emotions and fantasies about the process of labor

and delivery.

A woman also experiences changes in her sense of self. She

has to expand her sense of who she is to incorporate her child

as a part of herself, yet also as a separate being. The appearance

of a child will change her intimate relationships, such as with

extended family members, as well as her role in society. 

Mental Work and Reworking

IN LOOKING AT THE PERIOD SURROUNDING a woman’s giving

birth, Daniel Stern (1995) described this as a time when she

must engage in the greatest amount of “mental work and

reworking” in her life. He says that this is especially true for

the birth of the first child since no amount of babysitting or

exposure to siblings can prepare a woman for the intense

empathic connection needed to mother successfully a child.

There is no other activity in a woman’s life that will require

her full emotional presence and involvement as much as raising

a child. Stern identifies four concerns that preoccupy the expectant mother. 

First, the expectant mother is afraid of not being able to

maintain the baby’s life. She has fears for her own and the new

baby’s survival. Once the child is born, she wonders if she will

be able to provide the care that will allow the infant to

grow, progress, and thrive. She is very vulnerable to

the criticism and judgment of others. Society expects

the birth of a new baby to be a happy time. For many

women, even those who are in the most supportive circumstances, it is conflictual and stressful. 

Second, the expectant mother wonders if she will really be

able to feel love for her baby. Will she feel the bond that society

says she is supposed to feel? Will that bond allow her to develop the special sensitivity that will allow her to read and respond

to her baby’s needs? 

The next concern is the expectant mother’s ability to create

and maintain an adequate support network for herself. There

are no societal structures that function in place of the extended

family. As a result, there is greater stress on the father, if he is

present, to provide the emotional support so that the mother

will be able to devote herself to the child. Stern sees inherent

dangers for a mother who has a limited support network and

THE PSYCHOLOGICAL WORK OF PREGNANCY

There is no other activity in a woman’s life that will require her full

emotional presence and involvement as much as raising a child. This is

especially true for the birth of the first child. by BEVERLY GOULD

✓ Form support groups for pregnant women to share fears

and expectations and educate them about pregnancy,

childbirth, and child development;

✓ Form activity groups like knitting or craft groups as a

vehicle for support and discussion;

✓ Pair young mothers with older, more experienced

mothers as mentors;

✓ Form support groups for fathers;

✓ Form mother/baby and father/baby groups to

encourage responsive interactions and reciprocal play;

✓ Use videotapes as a tool in teaching how to respond to

an infant’s cues;

✓ Provide anticipatory guidance showing new parents

what to expect at each phase of development;

✓ Explore in-depth the themes described in this article with

both parents, whether or not they are together.

PUTTING THIS TO WORK IN YOUR CENTER

Steps that programs can take to promote the mental health

of new mothers and fathers—
20 2002

THE PSYCHOLOGICAL WORK OF PREGNANCY

therefore, limited sources for feedback, information, and emotional support. She may be seen as an inadequate mother by the

father or the extended family; the father may compete with the

baby for her attention; or the father may compete with her to

be the “better” parent. 

A new mother may fear emotional as well as physical abandonment. In the past, a supportive network of women who surrounded the mother and baby, keeping males outside of the protective circle, used to be something that all women could rely

upon. Besides her baby, the new mother’s major involvement

would have been with these maternal figures. 

A new mother also reflects on her relationship to her own

mother. This allows her to remember the intricacies of this first

important relationship, and to form either positive or negative

models of parenting to guide her own behavior. 

The fourth concern deals with a woman’s need to rework

her sense of identity from “daughter to mother, companion to

parent.” A preoccupation with the memories and emotions connected to the long line of women throughout the family history

causes a woman to reconsider her beliefs and her choices. Stern

says that this is how the intergenerational transmission of family values and behaviors occurs. 

Babies cannot wait. During their waking hours, the mother

must be able to set aside her own preoccupations and concerns so

that she can be attuned to her child’s needs. The work of Selma

Fraiberg (1980) and other infant researchers tells us that an

infant stirs up many intense, raw emotions that reflect the mother’s unresolved conflicts with her own mother and father.

Reviving Old Patterns

THESE “GHOSTS” FROM THE MOTHER’S PAST can have an

enormous impact on her entire pregnancy experience and on

her ability to connect to her child. Simply having mixed feelings

about being a mother can raise significant conflict and guilt for

women who are not comfortable accepting emotions typically

seen as negative. For example, a woman may expect her child

to be active and controlling, as her own mother always

described her and this would influence the way she perceives the

needs and behaviors of her child. The key for a healthy relationship between mother and child is for the mother to be consciously aware of the issues between her and her mother, thereby avoiding displaced anger or feelings of abandonment or loss.

This will help her not to be preoccupied with winning or avoiding power struggles as they arise with her young child.

For those women who have had significant difficulties

growing up or have been the victims of trauma or abuse, it is

important to help them identify the good qualities of their

mother among the difficult memories of their early lives. The

demands of being in the mothering role can be a terrifying

experience for women unable to resolve a deep-seated belief in

their own “badness” or fear of “turning into their mother.”

Attempting to relate to a helpless, crying, demanding, and

dependent infant can trigger old patterns of behavior from the

mother’s childhood where she was perceived negatively because

of her own mother’s unmet needs and psychological difficulties.

Without awareness of her past and the feelings associated with

the trauma or abuse, she may in fact treat her child the way she

was treated rather than in a more healthy, protective, and nurturing fashion.

Family Dynamics

A NEW BABY ALSO CHANGES THE DYNAMICS between the couple

and within the nuclear family. The father experiences a significant

change in role and identity. In today’s western culture, a father’s

role is more than financial; men are expected to take on increasSix-month-old 

James Mathews Jr. 

Photography by EHS NRC
Head Start Bulletin 21

ing amounts of responsibility for the child’s emotional and physical care. A man may feel ambivalence about the changes in his

partner. He may also feel abandoned and excluded as the woman

turns her attention to her pregnancy and new baby. On the mother’s part, it may not be easy to share caretaking with the father

since it has traditionally been the domain of women. Without

awareness, issues of power and control may arise. As the partners

move from being a couple to a family, all decisions will need to

consider the needs and the role of the child.

Emotional Stress and the Infant

CURRENT RESEARCH, particularly the work of Megan Gunnar

(1998), demonstrates the negative effects that emotional stress

has on the developing fetus. Those who provide services to

pregnant women and their families need to help expectant

parents talk openly and fully about positive and negative feelings associated with pregnancy and their role as parents,

including fears about the pain of childbirth. They need to

explore how the new child will affect their relationship with

extended family and discuss boundary issues that may arise if

a family member is perceived as too helpful, too distant, or

too critical. Important discussions can occur about the values

that each parent holds, such as around discipline or religious

matters. Older siblings also need to be prepared for the new

baby and helped to deal with the anxious and jealous feelings

before and after the birth. 

Women need to be educated about maternal depression

and its consequences for the development of their child.

Support groups for pregnant women, a doula (a labor and

post-childbirth support person), non-medical childbirth coaching, mother/baby groups, and father/baby groups can be useful in providing the needed support and in assessing potential

difficulties. Pairing more experienced mothers with new,

young mothers who can mentor and be positive role models

may also be useful. 

Teaching parents about the stages of development allows

them to anticipate the joys and challenges that they will face

as their child grows. In those situations where the mother’s

emotional difficulties require more than community support,

or a child’s temperamental or constitutional factors lead to a

difficult fit between parent and child, referrals to early 

intervention or qualified infant mental health practitioners can

be necessary.

Helping our Head Start families become emotionally prepared during pregnancy can go a long way in preventing

emotional difficulties after the baby is born. We know that

times of change can bring great opportunities. The birth of a

new baby should be a joyful time. For many of our families

who have severe external stressors, such as financial difficulties, young or unwanted pregnancies, traumatic abuse, or

substance abuse histories, this is a time when our active intervention can open up unseen possibilities and provide much

needed insight and support. ■

REFERENCES

Fraiberg, S. 1980. Clinical interventions in infant mental health:

The first year of life. New York: Basic Books.

Gunnar, M.R. & R.G. Barr. 1998. Stress, early brain development, and behavior. Infants and Young Children

11 (1).

Stern, D. 1995. The motherhood constellation. New York:

Basic Books. 

Beverly Gould was a Head Start Fellow (2000-2001). T: 202-

554-0484; E: priyadarsa@aol.com.

Head Start Program Performance

Standard 1304.40c iii

Early Head Start grantee and delegate 

agencies must assist pregnant women to access

comprehensive prenatal and postpartum care,

through referrals, immediately after enrollment 

in the program. This care must include mental 

health interventions and follow-up, including

substance abuse prevention and treatment services,

as needed.
22 2002

FORTUNATELY, SOME CHILDREN escape the negative effects of

maternal depression. In a review of several decades of research,

Shonkoff and Phillips (2000) emphasize that many depressed

women do raise children who demonstrate no social or behavioral difficulties. Some studies suggest ways to prevent or protect damaging processes from occurring in young children’s

lives. Early Head Start and Head Start programs are in a position to benefit from this research and intervene to support

young children and their parents who might be experiencing

depression. Their intervention efforts can be guided by research

findings related to the complexity of maternal depression, the

effects of maternal depression on young children, and the

importance of prevention and early intervention.

The Complexity of Maternal Depression

DEPRESSED MOTHERS TYPICALLY have difficulty providing optimal levels of stimulation for their babies. Mothers who suffer

from untreated depression engage in two distinctive interaction styles with their infants (Field 2000). One style is characterized by the caregiver’s withdrawal from the infant’s cries or

smiles, minimal display of facial expression, and difficulty

expressing emotion or even talking to the infant. The other

style is characterized by the caregiver’s irritability, expressions

of anger, and demands for a reaction from the child. It is

unclear as to why mothers with depression display these differing interaction profiles; one, withdrawn, the other, intrusive. But, it is clear that each style is painful for the adult. One

mother described the feeling of “moving through water” to

reach her crying infant. 

Effects on Young Children

RESEARCH SUGGESTS THAT EACH MOTHER/CHILD interaction style

has different effects on the infant or young child (Field 2000).

Infants of withdrawn mothers display low activity levels, inattentiveness to people, activities, and objects, and low

expressiveness in response to the facial expressions of

adults. In contrast, infants of intrusive mothers display higher activity levels, a mix of positive and negative facial expressions, and high attentiveness and

expressiveness in response to the facial expressions of adults.

Preschoolage children of withdrawn mothers appear less

socially responsive, less able to regulate their own behavior

and impulses, and more inhibited. They also show internalizing behaviors, such as liking to be alone. In contrast,

preschoolers of intrusive mothers are more responsive, more

able to regulate their behaviors, and less inhibited.

Furthermore, they are likely to show externalizing behaviors,

such as getting in fights and teasing others.

The Importance of Prevention and Early Intervention

EVEN THOUGH MATERNAL DEPRESSION may have negative developmental outcomes for children from a wide range of life circumstances and family environments, certain factors serve to

minimize, or buffer, the effects of maternal depression on

young children. For instance, research by Hossain and colleagues (1995) shows that involved, supportive, and emotionally healthy fathers and child care providers cushion children

from negative effects of maternal depression. 

In addition, when maternal depression occurs in a family

experiencing marital harmony, mothers are better able to sustain positive and healthy interactions with their children. In

turn, the children are more likely to display sound social-emotional behaviors. Recent studies also suggest that depressed

mothers who use excessive verbal stimulation with their infants

may actually facilitate better cognitive and language development. Understimulation may be worse than overstimulation

during infancy. Furthermore, since the effects of maternal

depression begin as early as pregnancy and appear to be long

lasting, findings emphasize the importance of early

intervention. 

Implications for Programs

ONE OF THE PRIMARY GOALS of Early Head Start is to enhance

BUFFERING THE EFFECTS 

OF MATERNAL DEPRESSION*

Did you know approximately one in ten women with young children

experience depression? Rates often reach two times this level for mothers

living in poverty. Depression is likely to touch someone in our lives as 

well in as the lives of the families we serve. by TISHA BENNETT
Head Start Bulletin 23

infants’ and toddlers’ overall social, emotional, physical, cognitive, and linguistic development. Therefore, it is vital that Early

Head Start as well as other Head Start programs promote the

physical and mental health of mothers. Programs are in a

unique position to support the mental health of pregnant

women and mothers, but must be sensitive to the barriers

depressed parents experience in receiving services. 

Depression makes it difficult to mobilize and focus energy. Many parents experience shame and fear that professionals

might see them as incapable of parenting. However, given that

parents love their children, the birth of a child can provide the

impetus to seek services to provide a better life for the new

son or daughter. In addition to benefiting from the direct support and therapy offered them, depressed parents are reassured knowing that their infants and toddlers are receiving

nurturance and support within center-based or family child

care programs.

By looking for brief moments of positive interaction and

reflecting on them with a parent, program staff help build the

parent’s confidence. Low self-esteem often accompanies depression and the home visitor and center-based teacher can provide

positive images and reinforcement. For example, a home visitor

could support a depressed mother with a more demanding interaction style by noting when the mother takes turns vocalizing

with her baby and admiring the interactions when they occur.

Or, a teacher working with a depressed mother with more withdrawn interactions could highlight when the parent smiles or

talks in a lively way with the child.

Providing staff with access to mental health consultation

can support timely and effective referral to mental health services. Regular, consistent mental health consultation services

are key for supporting staff and families and can help distinguish the parent’s or staff member’s normal emotional ups and

downs of life from clinical depression. A skilled mental health

consultant can help staff find ways to connect with a depressed

parent as well as support them through the parent’s potential

resistance to getting help. Furthermore, the mental health consultant acknowledges that staff and parents approach the issue

of depression, or mental health, from their own beliefs, values,

and family history with mental health services. 

* The research discussed within this article is specific to

mothers with depression. However, the mental health of the primary and other significant caregivers is important for the wellbeing of infants and young children. ■

REFERENCES

Field, T. M. 2000. Infants of depressed mothers. In Stress, coping, and depression, eds. S. L. Johnson, A. M. Hayes, T. M.

Field, N. Schneiderman, & P. M. McGabe. Mahwah, NJ:

Lawrence Erlbaum Associates.

Hossain, Z., T. Field, J. Pickens, & J. Gonzalez. 1995. Infants of

“depressed” mothers interact better with their nondepressed

fathers. Infant Mental Health Journal 15: 348-357. 

Shonkoff, J. P. & D.A. Phillips, eds. 2000. From neurons to

neighborhoods. Washington, DC: National Academy Press.

Tisha Bennett is a Senior Early Childhood Associate at Early

Head Start National Resource Center @ ZERO TO THREE. T:

214-767-8868; E: tbe@acf.hhs.gov.

Questions that programs could ask themselves

• What is the understanding of program staff around issues

related to maternal depression?

• What is the understanding of program staff about the

mental health of primary and other significant caregivers

for the well-being of infants and young children?

• How does the Family Partnership Agreement include issues

related to mental health?

• Do the mental health consultants train program staff to

recognize symptoms of depression in mothers or other

primary caregivers of young children?

• Do mental health consultants suggest strategies to program

staff that correspond with the mother/child interaction

profile?

ADDRESSING MATERNAL DEPRESSION
24 2002

MY MOTHER STARTED A CHILD CARE CENTER when my little

brother was four years old and I was seven. She taught for 20

years and by the time I began studying formal child development ten years later, I had spent time with hundreds of children

ranging in age from three to six. Yet with all my mother’s skill,

she found that some children were not in the textbooks: children who had internal rages, who attacked, who destroyed, or

who had vulnerabilities that rendered them out of control.

Research indicates that the number, nature, and severity of

disruptive behavior problems are increasing. By three years of

age, children are capable of inflicting great bodily harm on others. I have met a number of families whose children have been

expelled from child care homes and centers before their third

birthdays. In my work with Head Start and Early Head Start, I

have consulted with a number of programs that have been overwhelmed by having as many as three of these children in a

classroom of eight. We must ask ourselves several questions.

First, what can cause well meaning programs to reject a child

still in diapers? Second, what caused the child’s problem in the

first place? Third, what can and should Head Start programs do

to resolve these problems? 

Signals for Help

THESE CHILDREN are easy to spot in a classroom, at home, or

in public. They bite, hit, destroy, and erupt like volcanoes on a

regular basis. Unlike many young children who may do these

things occasionally or even during a fairly intense stage that

may last a few weeks or months, these children feel overwhelmingly difficult to those dealing with them. They are unpredictable, difficult to channel into other activities, and almost

impossible to calm down once they act up. Usually they show

no remorse or guilt, and discipline strategies such as time-outs

are often ineffective. The child that sent me scurrying from my

mother’s child care center into mental health training walked

around saying that he could kill. He stabbed another three-yearold in the neck with a pencil. Two-year-old Danny at my own

therapeutic preschool reportedly tore his crib sheets

into shreds at six months old and was a perpetual biting machine who called himself, “Me Bad Teeth. ”

Four-year-old Henry dismantled everything from doorknobs to

cubbies at his day care center. Sent to mental health clinics, children like these may receive diagnoses of Attentiondeficit/Hyperactivity Disorder (ADHD) or Oppositional Deviant

Disorder (ODD).

What are the Origins of these Behaviors?

THERE IS NO SIMPLE ANSWER, and people in the field must be

like detectives, realizing that the story is different for every child. 

The origin may have a biological base, with brain make-up

being the root of the difficulty. Babies may come into the world

with a regulatory disorder. These atypical physiological, sensory,

attention-related, motor, or affective processes can seriously

affect a child’s behavior. Chemical addictions that pass through

a placenta to a fetus may affect some babies. Chronic mental illness inherited from parents and extended family members may

start to show up at young ages.

The relationship between parent and child is critical.

Attachment problems, temperament/personality conflicts

between parent and child, maltreatment, developmentally inappropriate discipline, and inconsistent and insensitive parenting

all call for attention and intervention within the relationship. 

Life events can determine out-of-control behavior. Juggling

between multiple caregivers, crowded, unresponsive child care

arrangements, and exposure to traumatic events all take their

toll with some children. Our society is particularly difficult for

children with its frightening violence, premature sexuality, exposure to over-stimulating, inappropriate media, substance abuse

epidemics, and overwhelmed, fragmented families.

Helping to Regulate the Uncontrolled Child 

HEAD START’S POLICY IS TO WORK WITH the neediest of the

needy, to pioneer new strategies for challenges faced by young

children and program staff, and to embrace parents and community partners in the work. Head Start institutes and builds

training for teachers, caregivers, and family advocates to sucCHALLENGING BEHAVIORS IN THE CLASSROOM

What kind of challenging behavior can cause well-meaning programs to

reject a child still in diapers? by ALICE EBERHARDT-WRIGHT
Head Start Bulletin 25

ceed rather than give up. The central focus is always what it

will take to help that child be successful.

Information contained in the Head Start Program

Performance Standards, Zero to Three publications, and training

guides are good general resources. Parents and community partners (Part C and Part B, mental health consultants, pediatricians,

and social service agencies) are critical, and the national and

regional Head Start training and technical assistance contractors

are on board to help find solutions. All of us are gaining more

expertise at surfing the Internet. 

Besides these formal resources, I suggest the following

practical advice.

1.Find someone to provide one-on-one shadowing. I tell

volunteers, trainees, or assigned staff to velcro themselves to that child and learn to predict and prevent disruptive behavior. If one child is about to hurl a block at

another, the assigned adult should firmly but gently help

the child place it down with appropriate words such as,

“Blocks can hurt. This one belongs right here.” If more

than one person provides the support, assign people in a

predictable, consistent way so that the child can build

relationships and experience stability.

2.Help staff and parents be creative, first understanding the

probable reason for the child’s out-of-control behavior and

then planning appropriate intervention. Example: Henry

used to dismantled everything because his psychotic father

threatened to tear the children apart limb by limb if they

got off the couch or out of bed. Intervention included getting the father into treatment and on medication and finding a toolkit for Henry to use to dismantle appropriate

items to his heart’s content.

3.Provide staff with consistent mental health consultation,

instructive and experiential training, and weekly supervision when they are handling difficult situations. A wonderful child psychiatrist met with my staff for several

hours weekly on a regular basis to understand behavior, to

plan, and to evaluate effectiveness. If a number of primary

caregivers, especially parents, are involved with a child,

the communication and planning needs to include all of

them. The more the child experiences loving, firm, and

consistent care, the more effective the intervention will be.

4.Provide a combination of behavioral controls and reasonable consequences; well-trained, consistent staff; facilities that offer quiet spaces and comfort; activities that

permit out-of-control children to work through difficult

feelings; and a psychiatric recommendation for medication reserved only for older preschool children who

require more than tight structure. 

Regular communication and planning with parents and

other primary caregivers are generally the formula that leads to

success. With everything in place, I have seen very challenging

children transform themselves into socially successful children

who are ready to learn over the course of a year.

As early childhood educators, we are remarkably creative

and innovative. If we allow ourselves to really feel and understand, we may receive the gift of effective intervention with the

tools of our trade. ■

Alice Eberhardt-Wright is an Infant/Family Specialist in Region

VII. T: 785-478-4085; E: AliceEW@aol.com.

Learn to predict 

and prevent

disruptive behavior

Photography by HSNRC Photo Archive
26 2002

Seals, and Diana Makombe, Head Start

Disability Specialist, have provided oneon-one training for the classroom teachers who are serving children with special

needs. This training has enabled the staff

to appropriately meet the needs of all the

children. Staff has noted that the children without disabilities provide invaluable assistance to the children with special needs. The stories below demonstrate the benefits and value of inclusion.

GREG, a three-year-old who attends

the Easter Seals program, was diagnosed

with autism shortly after enrollment.

Greg did not have any expressive language and had a great deal of difficulty

with his receptive language skills. He

was not toilet trained and engaged in

many repetitive behaviors. Easter Seals

worked with the local education agency

to develop an Individualized Education

Program (IEP) as required by the Head

Start Program Performance Standards.

Greg’s IEP focused on increasing his language, self-help, and socialization skills

and decreasing his inappropriate behaviors. Staff worked closely with the

school district in planning individualized

lessons for Greg and in assessing his

progress.

Like many other children at Easter

Seals, Greg now attends a special needs

preschool program operated by the public

schools for two and a half hours per day.

The remainder of the day, he is in the

Easter Seals Head Start Program. 

Greg has made wonderful progress

as a result of this cooperative partnership. He is using single words to greet

and request. Easter Seals Head Start

provides an inclusive setting that has

helped him increase his socialization

skills with his peers. He is beginning to

play with the other children. He actively

participates in group activities and his

repetitive behaviors have decreased. He

has also been successful in improving

his self-help skills, particularly toileting.

EROS is another success story. Eros,

who has Down Syndrome, is a bilingual, three-year-old child attending

Easter Seals and the public schools. In

addition to his developmental disabilities, Eros displayed aggressive behaviors

such as hitting, scratching, and pulling

the other children in the classroom. 

He often tried to leave the

classroom.

Easter Seals worked 

closely with the local school

district to develop goals and

objectives to manage these

behaviors. Eros responded to 

a fixed schedule with set 

routines and clear expectations. Redirection to deal with

his aggressive behaviors has

proven successful. 

The teachers also educated the other children about

Eros’ disability and taught them ways

to deal with his inappropriate behaviors, such as using redirection. His

peers are important to him and he

responds to their comments. Eros is

learning English and has mastered his

daily routine. He is playing very well

with the other children in the classroom and the negative behaviors have

significantly decreased.

Easter Seals, North Georgia is

thrilled to be a Head Start grantee and is

leveraging its expertise in early childhood

disabilities services to benefit all children

and families enrolled in our program. ■

Katy Beh Neas is Assistant Vice 

President at Easter Seals Head Start

Program. T: 202-347-3066, 

E: kneas@easter-sealsdc.org.

STRATEGIES OF BEHAVIOR

MANAGEMENT FOR SPECIAL NEEDS CHILDREN

BY KATY BEH NEAS

Teachers use positive behavior management strategies to serve

children with special needs

EASTER SEALS NORTH GEORGIA, a Head Start grantee, is succeeding in implementing

positive behavior management strategies for enrolled children, including children

with special needs. Approximately ten percent of the enrolled children have special

needs, ranging from mental health and behavior management issues to speech 

delays and physical impairments. 

Donna Davidson, President of Easter 

Photography by Indiantown MHS
Head Start Bulletin 27

delay gratification. But some children

continue to exhibit high rates of physical aggression as they enter elementary

school. They are at increased risk for a

range of negative developmental outcomes, including peer rejection, serious

conduct problems, delinquency, and

eventual criminality (Coie & Dodge

1997; Loeber, 1997).

Head Start centers in the rural eastern Maine counties of Penobscot and

Piscataquis are working to find the best

ways to manage aggressive behavior in

the classroom. For the past twenty years,

the Psychological Services Center (PSC)

at the University of Maine has held a

contract with Penquis Community

Action Program (Penquis CAP) Head

Start to provide mental health consultation services.

The PSC is a training clinic affiliated with the doctoral training program in

clinical psychology at the University of

Maine. Penquis CAP, a private, nonprofit, community health and social service

agency, coordinates the efforts of more

than 26 local Head Start classrooms in

eastern Maine. 

The PSC provides biannual visits 

to each center to assess the overall 

center environment (e.g., safety, daily 

activities, facilitation of developmental

skills, staff/children interaction). At 

the request of center staff, observations

of specific children exhibiting difficulties (e.g., noncompliance, separation

anxiety, aggression, etc.) are conducted.

Treatment recommendations are 

provided, including staff-initiated procedures (e.g., teaching peer interaction

skills to students, changing discipline

strategies) and/or referral for further

services. 

Over the years, we have been frustrated and concerned by the steady

stream of referrals involving aggression

and poor peer interaction skills. Of the

177 children referred between fall 1991

and spring 1999, 40% exhibited difficulties involving aggression. Rather than

address each case individually, we decided that a systemic form of intervention

might be more beneficial. 

Intervention in Curriculum

WE BEGAN DEVELOPING the Curriculum

on the Management and Promotion of

Appropriate Social Skills (COMPASS) program, a social-cognitive skills training

curriculum. First, we piloted

some of the COMPASS procedures by training a Head

Start teacher to provide brief

verbal instructions to the

most aggressive children in

one classroom. In a quiet,

isolated location, the teacher

engaged the child in conversation aimed at teaching

three concepts based on the

work of Zahavi and Asher

(1978)—(1) aggression hurts

other people and makes them unhappy;

(2) aggression does not solve problems

and only brings about the resentment of

the other child; and (3) positive ways to

solve conflicts are sharing, taking turns,

and playing. The effects of this intervention were measured through behavioral

observations and teacher ratings of

behavior (completed by the assistant

teacher who did not know which children received the training). 

After treatment, the children were

observed to display significantly higher

levels of positive behavior (e.g., complying with teacher directives and playing

appropriately with other children) and

significantly lower levels of negative

behavior (e.g., noncompliance and temper tantrums). Aggression decreased to

levels comparable to that of their nonTHE COMPASS PROGRAM:

ADDRESSING AGGRESSION IN THE CLASSROOM

BY ERIKA M . CARPENTER AND DOUGLAS W. NANGLE

AGGRESSION IN THE CLASSROOM IS A MAJOR CONCERN FOR HEAD START TEACHERS

and is a primary problematic behavior reported by all preschool teachers. Up until

about four years of age, physically aggressive behaviors, such as hitting and pushing

may be evident. In the course of development, they usually give way to verbal aggression as children make gains in language, empathy, perspective taking, and the ability to

During “free play,” children model the newly learned 

social skill with puppets

Photography by Penqis CAP
28 2002

aggressive peers. These changes in

behavior were maintained at a 1-month

follow-up observation period. Teacher

ratings revealed that social behavior also

improved and persisted one month later.

Program Components

ENCOURAGED BY THE SUCCESS of the pilot

study, the 12-session COMPASS program

was fully developed and is currently

being evaluated in four classrooms.

Researchers at the University of Maine

worked closely with Head Start program

staff to ensure that the curriculum was

manageable and appropriate for use in

their classrooms. 

COMPASS consists of four major

components—instructions, modeling,

rehearsal, and evaluation/feedback.

During “circle time,” the children 

are instructed on one of eight individual

social skills by puppets, who model the

skill for the children. During “free

play,” all of the children rotate through

a rehearsal station, where they re-enact

the scene with the puppets and then

practice the newly learned skill in a

related activity planned by the teacher.

A teacher is at the rehearsal station to

provide feedback to the children and to

ensure that the skill is rehearsed correctly. For example, for the skill “sharing,” the puppets engage in a tug-ofwar over a puzzle piece that is resolved

by sharing. The puppets model how to

share the puzzle pieces. At the rehearsal

station, two to three children reenact

the scene of the puppets sharing the

puzzle pieces. The teacher provides cues

to the children, if necessary. Finally, the

children put a puzzle together with the

teacher coaching and praising them in

the art of sharing. We plan to revise 

the COMPASS program curriculum based

on the results of our evaluation and

teacher feedback. 

Next Steps

A PARENT COMPONENT is being developed

to teach parents about the social skills

being taught in the classroom and the

best methods for reinforcing these skills

in the home environment. The parent

component is a critical addition to

COMPASS because children are best

served by consistency across the school

and home environments.

It is our hope that COMPASS will

function as an intervention and a prevention: intervention for those children

exhibiting aggressive behavior and 

prevention for others. Research shows

that half of all aggressive children in

middle childhood were aggressive

preschoolers, whereas the other half

first displayed aggressive behavior in

elementary school.

Moreover, the social skills taught

by COMPASS will aid children who are

behaviorally withdrawn or neglected

by their peers. The COMPASS program

was designed as a general social skills

curriculum to teach all Head Start

children how to navigate effectively

their social worlds.

REFERENCES

Coie, J.D. & K.A. Dodge. 1997.

Aggression and antisocial behavior.

In Handbook of child psychology,

vol. 3. Social, emotional, and personality development, ed. N.

Eisenberg, series ed. W. Damon.

New York: Wiley.

Loeber, R. 1990. Development and risk

factors of juvenile antisocial behavior and delinquency. Clinical

Psychology Review 10: 1-41.

Zahavi, S. & S.R. Asher. 1978. The

effect of verbal instructions on

preschool children’s aggressive

behavior. Journal of School

Psychology 16: 146-153.

Erika M. Carpenter is a doctoral candidate at the University of Maine. E:

Erika_Carpenter@umit.maine.edu.

Douglas W. Nangle is a faculty member

at the University of Maine. E:

Douglas_Nangle@umit.maine.edu.

It is our hope that

COMPASS will function as

intervention for those 

children who exhibit

aggressive behavior and 

as prevention for others.

THE COMPASS PROGRAM
Head Start Bulletin 29

WORKING TOGETHER IN HEAD START, we have the power and

the obligation to heal the violence in our community—if not

for ourselves, then for our children. Witnessing violence and

exposure to it can hurt all of us, especially our children, who

are the most vulnerable. 

Family Violence

FAMILY VIOLENCE OR ABUSE, whether physical, emotional, or verbal, is the most direct form of violence that children experience. 

It usually has the most profound and lasting effect on their development. Children who witness parental violence are seriously

affected because of their proximity, the directness of the experience, and the importance of the primary caregiving context.

Children who are victims may be scarred for life with irreparable

damage to their healthy self-identity and capacity for establishing

trusting relationships. Very young children are the most vulnerable targets of violence in the home. More abuse and more fatal

abuse occur to children in the first year of life than in any other

1-year period in their development. The risk of family violence is

increased substantially when other risk factors such as emotionally abusive relationships, substance abuse, or stressors associated

with poverty, are present in their lives.

Community Violence

CHILDREN ARE OFTEN INDIRECTLY EXPOSED to violence in their

communities. They may witness violent acts such as robberies,

assaults, or shootings. Although infants are unable to process

events outside of their immediate environment, they are tuned

into the emotional responses of their caregivers. The very young

child is primarily affected by the primary caretaker’s response to

the violence if it compromises the caregiver’s ability to provide

emotional consistency and protection to the child. 

Older toddlers and preschoolers who have been witnesses

to community violence are usually more aware of what

has occurred and have a deeper understanding of what

they have seen. They may show emotional distress as a

result of witnessing the violence, as well as being

affected by their caregiver’s response. 

Media Violence

MEDIA VIOLENCE IS ANOTHER FORM of indirect exposure. Some

research has shown a relationship between children’s aggressive

behavior and viewing violent programming. Young viewers may

experience desensitization or increased acceptance of violence as

normal. They may evidence a “mean world syndrome,” which

is described as fearfulness that the everyday world is as dangerous as the television world (Murray 1997).

Although media violence has been found to affect children’s

behaviors, it is also important to take into account the amount

of exposure to violent programming the child has had, the

child’s stage of development, and the way in which the media

violence interacts with other family variables before determining

the full impact on the child. 

THE EFFECTS OF VIOLENCE ON MENTAL HEALTH

Sometimes it seems that violence is accepted as just a fact of life in our

communities. We see it reported on the daily news and glamorized in the

media. Somehow we have learned to take it in stride. It seems the more

violence that exists in our society, the higher our threshold for acceptance.

by TERRA BONDS

Our children

are the most

vulnerable to

violence

Photography by Eyewire
30 2002

Behavioral Effects on the Child

CERTAIN BEHAVIORAL CHANGES (see sidebar) may be observed in

children who have witnessed or been victims of violence

(although some of the behaviors may also be in response to

other “normal” developmental issues). If the child is exhibiting any of these behaviors in a sudden, intense, unrelenting

fashion, gather as much information as possible about the

child and his circumstances to determine the source of the

behaviors and the best course of action. Your program’s

screening and ongoing assessments of children are important

sources of information.

Head Start Policies

SUGGESTIONS FOR HEAD START PROGRAMS AND STAFF to develop

policies and procedures related to violence include—

• Establishing procedures that will ensure the safety of

children, parents, and staff who are faced with violent

situations in the home, at the Head Start center, or out

in the community (i.e., during home visits).

• Developing a referral policy that includes the services of

a mental health consultant who helps the staff assess

and identify services for the child and family. 

• Exploring community resources that provide services for

children and families who have been witnesses or victims of violence. 

• Collaborating with agencies that provide services or

training to families and staff related to violence awareness, prevention, and intervention.

Many Head Start programs around the country already

have structures in place to address children’s and families’ needs

for mental health services related to violence. In cooperation

with local and national agencies, Head Start staff and parents

can plan and use appropriate strategies to address the violence

that interferes with our children’s optimal development. General

suggestions for addressing violence include therapeutic interventions provided by mental health agencies and communication

strategies for caregivers (see sidebar page 33).

September 11th, 2001

WHILE WE DEAL WITH OUR OWN EMOTIONS about the tragedy

of September 11th, we must be aware of the impression these

events have had on the emotional development of the very

youngest people in our country. Parents and educators, who are

responsible for the health and well-being of children, must do

everything possible to protect, reassure and restore a sense of

security for our children.

Although young children’s objective awareness of what

has happened is very limited, they respond to the fear, pain,

and tension of adults. Children will know if familiar adults

are upset. Therefore, it is important that adults be aware of

their own emotions and deal with them appropriately. Adults

can discuss their feelings with children, but nevertheless, must

model emotional strength and coping strategies. Caregivers

✘ Crying frequently or constantly

✘ Wanting to be held constantly or stiffening when held

✘ Exhibiting aggressive behavior (i.e., hitting, biting, or

kicking)

✘ Sleeping irregularities (i.e., trouble falling asleep or

staying asleep, nightmares)

✘ Stuttering

✘ Showing changes in developmental functioning (i.e.,

toileting practices)

✘ Expressing fear or worry about being safe

✘ Withdrawing from social interaction

✘ Eating irregularities

✘ Exhibiting psychosomatic symptoms (i.e., headaches,

stomachaches)

✘ Having lowered self-esteem

✘ Having difficulty in paying attention

✘ Being depressed 

COMMON BEHAVIOR CHANGES

According to Honig (1993), children who have

experienced violence may show its effects in any of 

the following ways—

THE EFFECTS OF VIOLENCE ON MENTAL HEALTH

Continued on page 33
31 Head Start Bulletin 31 Head Start Bulletin 31

HELPING CHILDREN & ADULTS COPE WITH 

TRAUMA IN THE COMMUNITY

A HEAD START BULLETIN PULL- OUT

■ Pay attention to your own feelings and concerns. Take care of yourself.

■ Be aware that your moods and feelings will affect those around you. 

■ Allow staff members time to talk and to express their feelings and concerns.

■ Provide guidance for families and staff members on how to help children deal with

anxiety related to trauma and crisis. Call in consultants or experts if necessary.

■ Be aware that distress related to traumatic events may not show up immediately among

adults or children. 

■ Help families and staff sort out their feelings. Do not be judgmental. Keep in mind that

there will be a wide range of reactions and experiences to any crisis.

■ Encourage parents to monitor their children’s television viewing, especially the news and

shows with violent content, including cartoons. 

■ Reassure children that they and their families are safe. Provide extra comfort and contact

frequently.

■ Maintain the typical, daily schedule of activities. This consistency will help children feel

more secure and in control.

■ Be honest and open about traumatic events if the children are talking about them but

carefully consider each child’s developmental level when giving information.

■ Acknowledge the children’s questions, even if you can only say, “I don’t know the answer.”

■ Do not tolerate prejudiced comments or behavior. Deal with them openly and

immediately.

■ Create a climate of respect, tolerance, and acceptance of diversity in your setting. 

■ Accentuate the positive. Point out the good around you (e.g., the rescue workers).

■ Pay attention to physical complaints, especially if they last more than one week or are

severe. See a health care professional.

■ Monitor particularly vulnerable children.

RESOURCES 

Although some of these resources were developed in response to the events of September 11th, they also

provide general advice about dealing with crisis and trauma in a community.

www.acf.dhhs.gov/sept11/public.htm

“Helping Children Handle Anxiety Related to September 11 Events”

“Coping with Disaster: Suggestions for Helping Children with

Cognitive Disabilities” (Accessible in Spanish, Chinese, Vietnamese)

www.counseling.org/tragedy/tragedy.htm

“Helping Children Cope with Trauma”

www.naeyc.org/coping_with_disaster.htm

“Helping Children Cope with Disaster”

www.nasponline.org/NEAT/crisis_0911.html

“Coping with a National Tragedy”

www.ed.gov/inits/september11/index.html

“Helping Children Understand the Terrorist Attacks”

www.apa.org/psychnet/coverage.html

“Help with Trauma”

www.nimh.nih.gov/publicat/violence.cfm

“Helping Children and Adolescents Cope with Violence and

Disasters”

Adapted from http://www.acf.dhhs.gov/sept11/public.htm

Head Start Bulletin 31
32 2002

CÓMO AYUDAR A LOS NIÑOS Y A LOS ADULTOS A ENFRENTAR

SUCESOS TRAUMATIZANTES EN LA COMUNIDAD

HOJA DESPRENDIBLE DEL BOLETIN DE HEAD START DIRIGIDA A LOS PADRES Y EL PERSONAL

■ Preste atención a sus propios sentimientos e inquietudes. Cuídese.

■ Esté consciente de que su estado de ánimo y sentimientos afectarán a aquellos que le rodean.

■ Permita que el personal tenga tiempo para hablar y expresar sus sentimientos e inquietudes.

■ Oriente al las families y al personal sobre cómo ayudar a los niños a manejar la ansiedad que

pueda derivarse de experiencias de trauma y crisis. Pida la colaboración de consultores o

expertos si es necesario.

■ Esté consciente de que la angustia suscitada por estos acontecimientos traumatizantes puede no

hacerse evidente de inmediato en los adultos o los niños.

■ Ayude a las familias a aclarar sus sentimientos. No juzgue sentenciosamente. Tenga presente

que de cualauler crisis surgirán distintos tipos de reacciones y experiencias.

■ Incentive a los padres a que controlen lo que ven sus hijos en televisión, particularmente las

noticias y los programas de contenido violento, incluso los dibujos animados.

■ Tranquilice a los niños, explicándoles que ellos y sus familias están a salvo. Bríndeles con mayor

frecuencia el consuelo y el contacto que necesitan.

■ Mantenga el típico horario diario de actividades. Esta constancia ayudará a que los niños se

sientan mas seguros y en control.

■ Sea honesto y abierto acerca del desastre ocurrido y los sucesos actuales si ve que los niños

conversan al respecto, pero tome cuidadosamente en consideración el nivel de desarrollo de

cada niño cuando comparta información.

■ Responda a las preguntas de los niños, aún cuando sólo pueda decir: “no sé la respuesta.”

■ No tolere conductas o comentarios prejuiciosos. Aborde el tema de inmediato y abiertamente.

■ Cree un clima de respeto, tolerancia, y aceptación de la diversidad en su ambiente.

■ Recalque lo positivo. Haga notar lo bueno que hay a su alrededor (por ejemplo, los

trabajadores de rescate).

■ Preste atención a las dolencias físicas, en especial si duran mas de una semana o son severas.

Vea a un profesional de la salud.

■ Vigile a los ninos que son particularmente vulnerables.

RECURSOS

Aunque algunos de estos recursos se desarrollaron como respuesta a los sucesos del 11 de septiembre, también

proporcionan consejos generales sobre como manejar las crisis y los sucesos traumatizantes en la comunidad.

Adaptado de http://www.acf.dhhs.gov/sept11/public.htm

www.acf.dhhs.gov/sept11/public.htm

www.counseling.org/tragedy/tragedy.htm

www.naeyc.org/coping_with_disaster.htm

www.nasponline.org/NEAT/crisis_0911.html

www.ed.gov/inits/september11/index.html

www.apa.org/psychnet/coverage.html

www.nimh.nih.gov/publicat/violence.cfm
Head Start Bulletin 33

must be careful to maintain close, loving, nurturing interactions with the child. They must also take care of their own

mental wellness.

The recommendations on the pull-out (see page 31) can

assist parents and caregivers with children (and other adults

too) who were not directly affected by the World Trade Center

or Pentagon bombings. Children who have lost loved ones in

either of these tragic events may need to receive more intensive mental health assessment and services.

Childhood is associated with innocence, hope, and

promise for the future. Children have the ability to stimulate

protective urges in adults who are motivated to shelter them

from the danger and damage that violence triggers. Let us all

work together to help protect our children by providing them

with the emotional support and positive experiences they need

to thrive. 

REFERENCES

Honig, A.S. 1993. Mental health for babies: What do theory

and research teach us? Young Children.

Murray, T. 1997. Media violence and youth. In Children in a

violent society, ed. J. Osofsky. New York: Guildford

Publications.

Terra Bonds was a 2000-2001 Head Start Fellow, 

E: terrab_4@hotmail.com.

SOLUTIONS FOR ADDRESSING VIOLENCE

The mental health services will assist children in coping with

violence in their community or in their homes. Suggestions to help

children include—

• Provide age-appropriate therapeutic services.

In a safe environment, children who have been witnesses or

victims can process their emotions and the events. Not all

children develop overt symptoms associated with trauma. The

specific kind of intervention needed depends on the form, level,

and duration of exposure that the child has had. Interventions

should begin as closely as possible to the traumatic event to

decrease the long-term impact of the trauma.

• Provide emotional support.

This support should come from non-offending family

members, caretakers, and teachers.

• Encourage children to communicate.

They need to talk about what happened and have their

experience validated by a parent (non-offending adult),

teacher, or mental health consultant. Younger children may

express themselves primarily in their play or drawings.

• Limit television viewing.

The media can be a powerful tool for education, but only if it

is used with close adult supervision. What children see

becomes part of their inner world. Spend time talking or

reading to the child.

• Protect the child from exposure to violence.

Whenever possible, eliminate physical confrontations or

arguing in the presence of the child. 

• Give the child positive experiences and emotional

support.

For example, console when the child is upset, or give a hug

for reassurance.

Childhood is

associated with hope

and promise

Photography by Eyewire

Continued from page 30, The Effects of Violence on Mental Health
Mary, a new Head Start teacher, is having difficulty with Sarah

again. Every time the class sits down for a family style meal,

Sarah refuses to behave. If Mary can even get Sarah to sit in a

chair, she begins to throw food and kick other children under

the table. She typically becomes violent when Mary tries to

quiet her. Sarah’s behavioral difficulties are consuming the

majority of Mary’s time and energy, and increasingly Mary has

less of herself to devote to the other kids in the classroom.

Lately, Sarah’s behavior has become even more unmanageable,

and other children in the class are beginning to act out as well. 

Mary knows she cannot handle this problem alone. She

has met with Sarah’s mother, Susan, who shrugs off the behavior. Susan claims there is nothing she can do, she has other

children to worry about, and she cannot enforce the behavioral management plans at home that Mary has tried to put in

place in the classroom. 

Mary is hesitant to tell her supervisor, Carlos, that she is

having problems with her new job, but she decides to speak to

him. When she approaches Carlos, he tells her he is too busy

with more urgent problems. Mary begins to feel helpless and

alone. Eventually, the children begin to control things and

Mary loses confidence in her ability to be successful

in her new role. What more can she do?

THIS SCENARIO IS FAMILIAR to anyone working with young

children. Mary is presented with a problem that becomes

unmanageable. She has tried everything she knows to solve it

and has even asked for help, but no one seems willing to work

with her. Mary may begin to feel like a failure at her job when

actually, everyone involved has failed. 

How could this situation have been handled differently?

How can supervisors ensure that their coworkers and peers do

not feel alone? The answer may lie in creating a workplace

environment where reflective supervision is integrated into the

overall framework of the agency. 

Learning—in the Context of Relationships

THE MOST POWERFUL ENVIRONMENT for learning takes place

in the context of relationships—people learn and are most apt

to be influenced when interacting with other people. Leaders

in the field, including J. Bertacchi and T. Norman-Murch

(1999), emphasize that reflective supervision promotes learning in the context of the relationships and interactions in

which it occurs. It takes into account the process of learning

as well as the content that is learned. The collaborative

process between supervisor and teacher becomes as important

as what was actually discussed since the communication and

problem-solving techniques used in the dialogue are part of

what is learned. Often, when we see certain behaviors modeled in relationships, we tend to mimic these behaviors in later

situations—at times intentionally, such as when the behavior

seemed particularly effective, and at times subconsciously,

such as when we have only been exposed to one way of handling a situation. 

Reflective supervision entails the supervisor taking on the

roles of teacher and coach. The learner in the example above

would be Mary. If reflective supervision had been the guiding

principle, in addition to talking about the issue at hand—in

this case, behavior management—the supervisor would have

modeled behaviors that the teacher, Mary, could then use in

34 2002

REFLECTIVE SUPERVISION

Utilizing reflective supervision in your Head Start program and setting a

good foundation for best practices. by Jackie Pflieger

✓ Safety and Trust

✓ Mutuality of Shared 

Goals

✓ Commitment to 

Evolving Growth and 

Change

✓ Commitment to 

Reflecting on the Work

✓ Respect for and Getting 

to Know Staff

✓ Sensitivity to Context 

of the Work 

Environment

✓ Open Communication

✓ Standards and Ideals 

for Staff to Strive 

Toward

8 CHARACTERISTICS THAT DEFINE 

RELATIONSHIP-BASED WORK 

The following concepts should appear in daily 

routines to reinforce positive child development 

(adapted from Bertacchi 1996):
the classroom when working with the children or with colleagues or parents. By working collaboratively to reflect on

the situation at hand, Mary’s supervisor would have been able

to teach her best practices.

A Collaborative Dialogue

REFLECTIVE SUPERVISION IS ESSENTIALLY a collaborative

process that requires open-ended communication, and is most

effective within a trusting relationship. Supervisors should

encourage staff to express themselves and freely share their perspective on challenges and possible solutions. Clear and comfortable communication will make it easier for the supervisor to

accurately assess problems and the level of assistance needed by

the teacher. By engaging the teacher in a two-way conversation

about the problem, and genuinely listening to her perspective

and ideas, the supervisor is also modeling effective techniques

for solving frustrating dilemmas. In effect, the supervisor takes

on the role of coach as he supports the teacher in her professional growth and in the resolution of her specific problem.

Building on Strengths

REFLECTIVE SUPERVISION IS ALSO a strengths-based approach.

The supervisor should concentrate on the teacher’s positive

qualities and work in collaboration with the teacher to solve

the problem. The focus on Mary’s strengths and appropriate

actions taken will allow both Mary and her supervisor Carlos

to assess accurately the problem and find the best solution.

This focus also reinforces Mary’s positive steps and so increases her confidence in her ability to handle her job.

By using many of the characteristics that model effective

relationship-based work (see side bar), Carlos could have set

the tone for a meaningful and instructive interaction. In

essence, his reaction of not sitting down and listening to Mary

was modeling only one thing—that her problems were not

important. Allowing Mary to express her concerns in an openended conversation may have let her effectively talk out the

problem. By reflecting on the situation and working through

the problem together, Carlos would have also shown a willingness to invest his time and expertise in the development of his

staff—the front-line people whose skills determine the quality

of the services provided by the Head Start program. 

By ignoring Mary’s request for help, Carlos lost an important opportunity to create a “teachable moment” in which he

could model behaviors that Mary could then follow when

working with children and families. In listening to her frustrations and concerns, he would have objectively been able to

assess the situation, and then ask Mary for the type of feedback that would be most beneficial to her. For example, he

could have offered to send Mary to in-depth training on

behavioral difficulties in young children. He could also have

offered to bring in an outside consultant to assess Sarah’s

behavior and help Mary develop a more effective behavior

management plan. He may have been able to ask targeted

questions that would have helped Mary come up with the

solution on her own, allowing Mary to build her confidence

and giving her a useful technique that she could then use in

speaking with Susan’s mother. Or maybe listening to Mary

was all that Carlos needed to do in this case. Reflective supervision would have allowed the best solution to surface. 

The Carryover Effect—Parallel Processes

THE RELATIONSHIPS WE MODEL in the workplace carry over into

the interactions we have with families. In the case of Mary and

her supervisor, Carlos, his lack of interest in Mary’s difficulties

with Sarah might have carried over into the way that Mary handled Sarah in the classroom. Mary may have written off Sarah’s

Head Start Bulletin 35

The supervisor should 

concentrate on the positive

qualities and work with

the teacher to maximize

those strengths.
36 2002

behavioral difficulties as unimportant—as Carlos did when

Mary approached him—and allowed the behavior 

to continue. Susan, Sarah’s mother, may have come to Mary

down the road with problems she was having at home with her

daughter. Mary may have acted similarly to the way Carlos had

treated her, such as telling Susan that she could not help her

because she has too many things to handle just in her classroom. 

Mary would probably not have been aware of the connection between her interaction with Susan and her earlier interaction with her supervisor, yet that earlier interaction set the tone

and modeled the way—even if inappropriately—to handle a difficult situation. Improving inter-staff relations and processes is

crucial to the outcome of the services we provide, since the relationships within the agency often parallel those that staff members experience with families.

Overcoming Barriers to Reflective Supervision

TO CREATE A “WIN-WIN” SITUATION for all people involved, all

levels of the organization must work together to create an

environment for shared learning. Obstacles may be encountered when first trying to implement reflective supervision. For

example, it is sometimes difficult for staff to get past the traditional views of and attributes associated with supervisors,

such as being authoritarian figures who are only there to

judge teachers’ competency. A teacher may feel that her supervisor does not understand her problems and is too far

“removed” from the classroom. Over time, the two-way conversations and sense of collaborative decision-making that are

a central part of reflective supervision help create an environment where teachers do not feel isolated and supervisors are

no longer “removed” from the daily interactions and challenges of the classroom. With time and practice, these supervisor stereotypes can be broken down, and ideally, the teacher

will feel at ease discussing her problems.

In developing an environment for shared learning, it is

important to stress common beliefs, such as Head Start’s family-centered approach to services where the family’s well-being

is put at the center of all problems and concerns. Although the

supervisor and teacher have different job roles, and at times

different perspectives, both are working toward a common

goal—improving the lives of children and families. The commitment that staff members feel toward their jobs can be a persuasive reason to put differences or discomfort aside. This is

important motivation for encouraging teachers to overcome

obstacles in the classroom. 

The way we interact with each other within our Head

Start programs can have serious implications for our work

with children and families. All members of the agency have an

important responsibility to children and their families that

begins with the recognition of the power of a seemingly simple

interaction. Supervisors and teachers have critical roles. They

are both responsible for modeling best practices—for their colleagues, the parents, and ultimately, the children. ■

REFERENCES

Bertacchi, J. 1996. Relationship-based organizations. Zero to

Three 17(2): 1-7.

Bertacchi, J. & T. Norman-Murch. 1999. Implementing reflective supervision in non-clinical settings: Challenges to practice. Zero to Three 20(1): 18-23.

Jackie Pflieger was a Project Assistant with the National Head

Start T/TA Resource Center.

Both supervisors and

teachers have the critical

role and responsibility of

modeling best practices

for their programs.

REFLECTIVE SUPERVISION
Head Start Bulletin 37

Question: Why did your program choose to develop the

Early Childhood Behavioral

Specialist position? 

Answer: Teachers in our Head

Start classrooms have been

encountering children’s behaviors that are becoming more difficult and

at times even violent. We have children

with severe temper tantrums, children

with rage, and children that bite others.

Early childhood educators have not been

receiving the training and resources they

need to address these behaviors.

Head Start values each child as an

individual and the development of selfesteem in the early years is what Head

Start philosophy is about. Promoting the

mental health of a child is a challenge for

any teacher, however skilled, and we

needed to support the staff members who

deal with these children and families. 

Question: What do you see as

the reasons for the increase in

unmanageable behaviors?

Answer: Children experience violence in the media, on the street,

and at home. Some children

deal with this as well as parental substance abuse, incarceration of a parent,

and other situations. Children exposed to

these situations are more likely to display

violence and atypical behavior.

Question: Can you describe

how you developed this

model?

Answer: Our program addressed

the increase in children’s

behavioral concerns in a

unique way. We studied the referrals

made to the disabilities and mental

health areas of the program for the past

two years. Sixty percent of all referrals

were behavior related. We employed a

Licensed Clinical Social Worker (LCSW)

and a Mental Health Assistant to support children, families, and staff, but this

model only addressed about ten percent

of the referrals because of the intensity

of the intervention needed by the children. The timelines from referral to

intervention were also a problem.

Sometimes the parents were not brought

into the center to discuss their children’s

difficulties. In addition, the mental

health staff (LCSW and assistant) had no

formal early childhood education and

therefore, were only performing triage

and giving community referrals. This

model did not seem to be meeting the

needs of the classroom staff. The staff

informed us, through surveys and interviews with a consultant, that they needed

someone who would respond rapidly,

directly model how to intervene, help

them develop behavior plans, and locate

resources. They also wanted someone

with experience in a preschool setting.

Question: How were you able

to fund these positions in

your Head Start programs?

Answer: The changes took place

when the new performance

standards were introduced. We

decided that we needed to reorganize the

program and change some of the management positions to accommodate the

mental health needs. We developed a

position entitled Early Childhood

Behavioral Specialist (ECBS). The ECBS

was not trained in mental health, but had

a very strong early childhood education

background. A Mental Health

Consultant was brought in to do intensive training. The ECBS (there were two

hired for a program of 387 children) also

attended training on the “Second Step”

conflict resolution/anti-violence curriculum, as well as other training on children’s behavioral issues.

Question: What exactly does

the Early Childhood

Behavioral Specialist do? 

Answer: In the ECBS model, they

are the first to respond to referrals. They are reachable during

working hours or after hours for behavioral emergencies. They perform triage

over the phone and personally go to the

classroom or send another person. 

Specialists meet with staff and families to develop behavior plans. They refer

families and children to mental health

professionals in the community who are

EARLY CHILDHOOD BEHAVIORAL SPECIALIST

AN INTERVIEW

BY BEVERLY GOULD

An interview with Paula Tripp,

Anita Hoag, and Jeannie Liwanag

EOC Head Start of San Luis

Obispo, California
38 2002

able to work with them while they are in

our program and after they move on.

The specialists also maintain a database

to provide handouts to parents and staff

about specific behavior concerns. 

Question: Why did you choose

to hire teachers to fill the

ECBS role?

Answer: We needed someone

with a strong early childhood

background. Teachers know

child development so well that they can

distinguish between age-appropriate

behavior and behaviors that should

cause concern. Teachers can identify

with the frustrations of other teachers

and there is an easy rapport. Teachers

are able to model appropriate guidance

in the classroom, review environments,

and support the teachers’ group management skills. They can identify needs

and plan training for the staff in behavioral issues. They can go into a classroom for consecutive days to help bring

the classroom under control.

Question: What

specialized

training does

the Behavioral Specialist

have? 

Answer: Our

ECBSs have

many years

experience as classroom

teachers and a knowledge

base in both mental health

and education. They have learned about

theories and interventions through extensive workshops and ongoing collaboration with our mental health personnel,

who are available for regular consultation. It is important for them to have a

grounding in the behavioral sciences and

comfort with the social, emotional, cognitive, academic, language, sensory,

motor, and physical domains. For example, it is helpful to know about brain

development and how certain brainrelated difficulties affect a child’s behavior and learning potential. This allows

the teacher to plan strategies that aim for

that child’s strengths. 

Question: Can you describe a

case to to illustrate how the

ECBS would operate?

Answer: One child recently

came to our center with no

background information and

fairly soon, began to curse, hit, and

bite. We observed that he had poor

social skills, was easily over stimulated,

had poor impulse control, and became

aggressive when his demands were not

met. We learned that his mother had

had substance abuse problems throughout her pregnancy and was currently

incarcerated. First, this boy was referred

for play therapy and seen on-site twice

a week. The therapist, teacher, and his

grandparents developed a plan of action

for him. An instructional aide was

assigned to shadow him to support his

developing self-control and determined

that the interventions were working. 

Question: What have been

some of the other positive

effects of this model?

Answer: This model just ended

its third year and the number

of referrals drastically

decreased. Specialists provide instant

help and intervene before negative

behavior escalates. The instructional

aides in the classroom also provide support. They do not function as playmates, but are close by to help when

necessary, which frees the teacher to

interact with all of the children and

helps them avoid feeling burned out.

The classroom staff members feel that

specialists have been the greatest addition to the program in years. ■

Beverly Gould was a 2000-2001 Head

Start Fellow, T: 202-554-0484; E:

priyadarsa@aol.com.

Save the Children

Early Head Start

Center 

Atlanta, GA

EARLY CHILDHOOD BEHAVIORAL SPECIALIST

Photography by EHS NRC
Head Start Bulletin 39

manner, is hesitant to join in play with

her sister, does not reach for her mother

when she hurts herself in play, and cries

inconsolably whenever Janice attempts to

leave. Lanita is also extremely sad,

lethargic, and unable to focus on even

small tasks. Lanita’s boyfriend supports

her and her children, but she does not

seem interested in maintaining this relationship. She does not find joy in anything she does nor does she have anticipation for the future. In her discussions

with Lanita, Janice has learned that

Lanita’s grandmother, who raised her,

died two years ago and that Lanita has

an older child who was placed in foster

care at birth.

When families such as Lanita’s are

referred to Early Head Start programs,

the programs are often at a loss as to

how to address their psychological needs.

Although Early Head Start is not a mental health program, it has an established

goal of promoting the development of the

whole child, including the child’s emotional development. For infants and toddlers, the major strategy for addressing

their emotional needs is enhancing the

parent/child relationship. In fact, the

development of the young child across

domains is exceedingly difficult to achieve

without the support and well-being of the

parent, even if the child participates in the

highest quality intervention. 

Infant mental health services are

designed to enhance the emotional wellbeing of young children through their

relationships with their caregivers. Selma

Fraiberg (1980), a pioneer in the infant

mental health field, referred to these services as “kitchen therapy,” an allusion to

the home setting in which she felt these

services were best provided. 

Providing infant mental health services in the context of the home has several advantages—

• Intervention that is conducted on

the family’s turf allows for increased

comfort, openness, and trust on the

part of the family.

• Observation of parent/child behavior is possible in familiar surroundings and where the larger family system is present (e.g., grandmothers).

• Services can be more flexible in terms

of time, space, and focus of work.

• Intervention can incorporate the

family’s resources and address the

family’s needs in a concrete

manner.

• Intervention can capitalize on natural

parent/child interactions in

the home, such as feeding,

bathing, grooming, and

putting the child to bed.

Home Visitors’ Role

Alicia Leiberman (1999),

an expert in the field of

infant mental health, has

stated that you do not have to be a therapist to be therapeutic. In other words,

there are specific services that can be

delivered by EHS staff with appropriate

training. Staff members should be consistently supervised. They should discuss

families and what needs to be accomplished in the home visits. They should

have access to regular mental health consultation to learn more about particular

mental health issues and specific strategies to employ with families. Finally, if

possible, programs should develop collaborations with local mental health services where parents can obtain treatments for any mental health difficulties. 

With an overarching goal of enhancing the parent/child relationship, infant

mental health services should focus on

meeting the psychological needs of the

parent, supporting the parent to attend

HOME-BASED EARLY HEAD START 

“KITCHEN THERAPY” 

BY BRENDA JONES HARDEN

Two-year-old Montez Brown with his mother and Home Visitor

LANITA’S COMMITMENT TO HER TWO DAUGHTERS IS READILY APPARENT TO JANICE,

an Early Head Start (EHS) home visitor, but Janice has also noted several issues. The

older daughter has the expressive language skills of a much younger child. She tends to

be very oppositional and ignores her mother’s directives or attempts to engage her.

Lanita’s younger daughter has a very sad 

Photography by EHS National Resource Center
40 2002

HOME-BASED EARLY HEAD START “KITCHEN THERAPY”

to the child’s cues, enhancing parent/

child interaction, and fostering the

child’s sense of security within the parenting relationship. The following are

strategies to meet these objectives in the

context of EHS home-visiting programs.

Psychological Needs of the Parent

Jeree Pawl (1998), who has spoken and

written on the provision of infant mental

health services, coined a “platinum”

rule: Do unto others as you would have

others do unto others, meaning home

visitors should nurture parents in the

manner that parents should nurture children. Parents should have the opportunity for an emotionally corrective experience with the home visitor, in which they

receive unconditional acceptance

throughout the duration of their relationship with the program. Home visitors must provide consistent and

empathic care to families, even when

parents display “resistance”—such as not

being home for appointed visits or

expressing anger at the home visitor. In

addition, home visitors can do initial

screenings regarding the psychological

health of the parent. Many programs

screen parents for depression using a

questionnaire. Parents who report clinical symptoms can be referred for individual psychotherapeutic intervention.

Attending to the Child’s Cues

Pre-verbal children have to rely on the

insight of their caregivers regarding their

needs. They need adults who understand

the message behind their cries, facial

expressions, and body movements.

Home visitors can help parents pick up

these cues by talking about the child’s

need for the parents, pointing out specific child behaviors and potential reasons

for the behaviors, and mimicking the

child’s voice and asking for certain

parental responses. Parents can be

coached to understand their infants’ temperaments and preferences, and to anticipate their moods and needs. Emphasis

should be placed on parental responsiveness during times of distress. For example, when an infant is most vulnerable

(e.g. hungry, tired, frustrated, fearful),

parents can be coached to remember the

behaviors their infants display and the

strategies that are effective in consoling

them. Coaching the parent during the

home visit to use the consoling strategies

at the time these behaviors are displayed

can be beneficial.

Fostering Parent/Child Interaction

Building a relationship is best carried out

in the context of “in-vivo” parent/child

interaction. Home visitors can engage

parents and infants in play interactions

to provide them with positive joint experiences without pressure. They can use

the toys and materials that are in the

home to increase the likelihood that

mothers will repeat these activities when

the home visitor is not there. Similarly,

capitalizing on the routine interactions

between the mother and her baby (e.g.,

grooming, feeding, putting to bed)

allows the caregiver to work on relationship issues with the infant during frequent or daily activities. Finally, coaching the parent to use playful, fun types of

interaction can enhance the parent/child

relationship.

Enhancing Child’s Sense of Security

Developing an attachment to a primary

caregiver is the major social-emotional

milestone of the infancy period. Scholars

have emphasized that security of attachment during the infancy period leads to

later positive outcomes across all

domains of child development. Thus,

when home visitors work toward establishing secure attachments between parents and children during infancy, they

are potentially supporting the child’s

long-term development. Home visitors

can accomplish this in several ways,

including 1) promoting parents’ constant

expression of love and care for their

infant; 2) coaching parents to be consistent, gentle, and developmentally appropriate in their provision of structure and

discipline; 3) encouraging parents to be

a secure base for their infants when they

are distressed; 4) helping parents think

through how to handle separations from

their infants appropriately; 5) facilitating parents’ feeling of joy when they are

with their infants; and 6) meeting the

child’s needs as responsively as possible.

Other Services 

Deborah Weatherston (1995), who

directs one of the few long-standing
Head Start Bulletin 41

infant mental health training programs

in the country, has delineated a set of

comprehensive infant mental health services that should be provided to families

at environmental risk. In addition to the

relationship-focused therapeutic intervention that should occur at each home

visit, she suggests including the following

intervention modalities—

• Developmental Guidance

Educating the parent about developmental milestones and appropriate

expectations for their children is a

major component of the services

that Early Head Start programs provide. This guidance should be provided in the course of the momentto-moment interactions that the parents have with their children. It is

less effective to lecture to the parent.

• Emotional Support for the Parent

Because the role of Early Head Start

home visitors is not to provide mental health services to parents, it is

essential that programs have a mental health consultant on staff who

can offer such services or have a

cooperative agreement with a local

mental health provider. In rural

areas, where it may be difficult to

access a mental health provider, it

may be appropriate to arrange mental health supervision by telephone or

Internet for the most qualified person

on staff to provide such services. As

discussed in the previous section,

home visitors themselves can augment this type of mental health intervention by directly providing emotional support to the parent as well.

• Concrete Services for the Family

Families at environmental risk are

beset by many stressors that come

from not having adequate resources,

such as food, housing, money, and

transportation. For parents to focus

on psychological issues, they must

have their basic needs for survival

met. Home visitors must address

these issues with parents through

joint problem solving as well as direct

referrals. This work can be linked to

the goals of infant mental health

intervention by promoting parental

self-esteem when parents overcome

one of these barriers, and addressing

how the parents’ stress affects the

child’s psychological well-being.

In sum, infant mental health intervention can facilitate the accomplishment

of the overarching goal of Early Head

Start—to promote optimal child development. Many scholars and clinicians advocate for the provision of preventive infant

mental health services in the context of

the home. Early Head Start home visitors

have a unique opportunity to support

child and family development through

this modality. By receiving infant mental

health services in the home, families like

Lanita and her children can move toward

the sense of psychological well-being that

is essential for their capacity to progress

toward other developmental goals. ■

SELECTED REFERENCES

Fraiberg, S. 1980. Clinical studies in

infant mental health: The first year

of life. New York: Basic Books.

Leiberman, A. & C. Zeanah. 1999.

Contributions of attachment theory

to infant-parent psychotherapy and

other interventions with infants and

young children. In Handbook of

Attachment, eds. J. Cassidy & P.

Shaver, 555-574. New York:

Guilford Publications.

Pawl, J. & M. St. John. 1998. How you

are is as important as what you do.

Washington, D.C.: ZERO TO

THREE/ National Center for

Clinical Infant Programs.

Weatherston, D. 1995. She does love me,

doesn’t she? Zero to Three 15(4): 

6-10.

Brenda Jones Harden was a 2000-2001

Society for Research in Child

Development Fellow, CORE, Office of

Planning, Research and Evaluation, ACF,

DHHS. She currently serves as Assistant

Professor at the University of Maryland

Institute for Child Study. T: 301-405-

2580; E: bj34@umail.umd.edu. 

Guidance should be

provided through the

moment to moment

interactions between

parents and children.
42 2002

mental health needs of families through

a new Fatherhood Project.

The Red Cliff Band of Lake

Superior Chippewa live on the Red Cliff

Reservation in northwest Wisconsin on

the shores of Lake Superior. Young families must overcome problems with

unemployment, financial difficulties,

alcohol and substance abuse, lack of

education and job skills training.

Unemployment on the reservation is

40%, and 33% of those families who

work are employed in jobs that pay

well below the Federal poverty level.

Twenty-six percent of births at Red

Cliff are to teenage mothers. Young

fathers are often not present in the

home and are not actively involved in

rearing their children. They also 

struggle with cultural heritage and role

model issues. 

Although it is a small reservation,

the tribe has a Head Start program, an

Early Head Start program, a health clinic, a youth services program, and a

community center. These programs

serve 95 children and their families on

the Red Cliff Reservation. The Red Cliff

Early Childhood Center (ECC) serves

all 75 children through Early Head

Start, Head Start, or Child Care. All

age-eligible children on the reservation

and all tribal families within ten miles

of the reservation may apply to one of

the programs at the Early Childhood

Center. The Center provides comprehensive services to pregnant women 

and children birth to five through

strong collaborations and community

partnerships.

Traditionally, the mother and her

family are responsible for child rearing

among the Red Cliff Chippewas.

Through programs like Head Start and

Early Head Start however, families 

recognize the need to involve fathers

more meaningfully in the lives of their

children. Unfortunately, there are few

role models because fathers have not

been involved in child rearing for many

generations. 

Young fathers, who are often struggling with issues of survival, have not

had an easy transition to active involvement in raising their children. They

often feel guilty for not being involved

in their children’s lives, but have little

access to opportunities to improve

involvement. Given this history, the Red

Cliff Early Head Start applied for

funds for a Fatherhood Initiative to

help meet the needs of the fathers

on the reservation.

Dee Gokee-Rindal, the Red

Cliff Early Childhood Center

Director, has worked for several

years to develop mental health services to meet the needs of the families at Red Cliff. The goals for serving families at Red Cliff Early

Childhood Center include increasing social competence of children;

enhancing a child’s social, emotional,

cognitive, and physical development;

supporting parents as primary nurturers

of their children; and providing continuity of care for children and families.

The program has established partnerships with the Red Cliff Community

Health Center and the Bayfield County

Birth to Three Program to provide support services to families. In addition,

the program has been working with a

mental health consultant for the last

two years. 

Dawn Nixon is completing her

work in a doctoral program and provides services as the Early Head

Start/Head Start mental health professional to families 10-15 hours per week.

She provides therapeutic intervention

on-site for children and meets with families on-site or in their home, depending

WORKING WITH

NATIVE AMERICAN FATHERS 

BY CECELIA GODFREY

MANY OF THE PROGRAMS IN THE AMERICAN INDIAN/ALASKA NATIVE PROGRAM Branch

are implementing mental health services for children and families. The services range

from mental health professionals on staff to partnerships with local health departments and mental health agencies. The Red Cliff Band of Lake Superior Chippewa

Early Head Start is attempting to meet the

Through Head Start and

Early Head Start, families

recognize the need to

involve fathers more

meaningfully in the lives

of their children.
Head Start Bulletin 43

on their preference. Dawn has worked

with the program to try to identify

additional support for families.

Red Cliff was recently awarded a

Fatherhood Demonstration Grant. The

grant will utilize the Touchpoints program developed by Dr. T. Berry

Brazelton (1992) to strengthen the parenting of young parents, with a focus

on young fathers. The goal of this grant

is to work with young fathers to

increase their involvement in the lives of

their young children. Although both

Dee and Dawn are working on this project, they are currently in the process of

hiring a father to coordinate the grant.

Specific components of the grant will

consist of—

• Prenatal education that will 

include fathers;

• Newborn assessment;

• Home health care visits;

• Postnatal support groups for mothers and fathers;

• Home health visits through Indian

Health Services.

The Red Cliff vision of Touchpoints includes a community-wide

approach. Staff from the Health Center

and other community agencies will be

trained along with the Early Childhood

Center staff. Five staff members and

community services providers attended

training at the Brazelton Institute in

January 2001 and returned to the program to train other staff. The goal of

the program is to create a new tradition

where men become equal partners in

raising their children—blending

Chippewa traditions with the

Touchpoints program.

Touchpoints will be a programwide initiative, working with families in

both center-based and home-based 

settings. The work of the Touchpoints

trainers will increase staff and family

knowledge of child development, help

young parents understand the behaviors

and cues of babies from their first day

home through their infancy, and work

with pregnant mothers and their partners to build a working relationship

that will carry them through the Head

Start years.

The goal of the Red Cliff Early

Childhood Center is to work with families in a respectful manner at all times,

understanding culture and heritage and

integrating the values of the culture into

their work with families. The fatherhood grant is one of many initiatives the

program will utilize to support families

in their community. ■

REFERENCES

Brazelton, T.B. 1992. Touchpoints: The

essential reference. Reading, MA:

Addison-Wesley/Lawrence. 

Cecelia Godfrey is a Senior Early

Childhood Associate at the American

Indians Alaska Natives Program Branch.

T: 202-401-5140; E:

cgodfrey@acf.hhs.gov.

The goal of the program is to create a tradition

where men become equal partners in raising

children—blending Chippewa traditions with

the Touchpoints program.

online...For more information on Head Start, visit our site at <www2.acf.dhhs.gov/programs/hsb/>.
44 2002

migrant farm worker families, you must

understand them in context. Migrant

farm workers travel thousands of miles to

plant, harvest, and weed crops. Parents

work long hours in the fields and are

often forced to leave young children in

child care or in the care of older siblings

for eight to twelve hours a day. The pay is

poor and in spite of the critical service

these skilled laborers bring to communities, migrant farm workers are not always

accepted, or, in some communities, even

tolerated. They and their children are subjected to racism and classism typical for

people that come to an area for a limited

time. Sometimes migrant families have to

sleep in their cars because no housing is

available. When available, it is often substandard. In some instances, banks will

not cash their paychecks, and grocery

stores have been known not to sell to

them. Yet many times each year, migrant

farm workers pack up their families to

begin the journey over again.

Despite the grueling lifestyle, migrant

farm worker families have incredible

strengths. They are very family-oriented.

The majority of migrant families are twoparent families with close, supportive,

extended family members. This dependence on and belief in the strength of family extends to the larger “community family.” Many migrant communities have

informal support networks which help

protect families from the stress associated

with their lifestyle.

Migrant children and families are

resilient. In the face of numerous transitions between places and caretakers, most

migrant children develop healthy and

appropriate attachments to their caregivers. Also, despite their marginalization

in the community, parents still seek out

services offered by Migrant Head Start

programs. Most importantly, migrant parents hope to provide better lives for their

children. Hope and resiliency sustain

migrant families as they leave their homes

to return to areas far away to harvest

crops. The trusting relationships that

many migrant families have with the

Migrant Head Start programs nationwide

have added to the network that supports

families’ and children’s mental health.

To gain a better understanding of

how Migrant Head Start programs

respond to the mental health needs of

migrant farm workers and their families,

we interviewed several programs that provide exemplary mental health services.

The programs discussed their challenges

and successes serving migrant families and

described a complex system of mental

health services based on promotion, prevention, and intervention. 

Addressing mental health issues in

migrant families is complicated by cultural differences, lack of trust, and language

barriers. Migrant families are typically not

forthcoming with their problems. Often

families believe that health concerns

should be dealt with within the family,

not through formal health care systems.

Many families also have strong religious

and cultural beliefs that affect their

response to mental health concerns. There

is a belief among some people of Latin

descent that physical and mental health

issues arise in children as a punishment

for past sins of the parents. Many parents

choose to use home remedies and spiritual

healing techniques when addressing physical or mental health concerns.

Trust issues arise from a long history

of conflict with government agencies

regarding immigration and naturalization,

even though most migrant farm workers

have legal status in this country. Some

migrant parents choose not to use formal

systems of care because of fear of government action against them, such as being

deported or losing benefits. 

The vast majority of migrant farm

workers speak Spanish. Of the many

MENTAL HEALTH IN THE MIGRANT 

HEAD START COMMUNITY

BY DONALD WYATT AND JENNIFER BOSS

WHEN WE THINK OF MENTAL HEALTH WE MIGHT ENVISION SOMEONE lying on a couch undergoing intense psychological therapy to uncover the evil demons that lie within. Thankfully,

a more useful understanding of mental health is developing. This process is most evident

in Head Start programs serving migrant and seasonal farm workers.

To discuss the mental health needs of

Migrant parents hope to provide better lives for

their children

Photography by Indiantown MHS
Head Start Bulletin 45

agencies that provide mental health services to families, most are not equipped

to handle the needs of migrant families.

Often, there are no Spanish-speaking

mental health professionals or no one

familiar with migrant families’ culture or

needs, especially if intensive intervention

is required.

The Migrant Head Start program is

in the unique position to become a “hub”

of services because of its level of trust and

sensitivity to culture and language.

Families often take advantage of community services because of the link that

Migrant Head Start programs provide. 

Most Migrant Head Start programs

approach mental health needs through

promotion, prevention, and intervention.

They support mental health promotion

by training staff and parents and working

with community partners. One program

instituted the concept of “wellness” by

developing a wellness committee consisting of parents and staff who advise the

program on mental health and wellness

issues. Some programs include mental

health professionals on the Health

Services Advisory Committee to serve as

links to the community for mental health

issues. Most migrant programs address

the unique needs of the migrant families

by ensuring that information is shared

and trainings are conducted in the language of the families, and that the cultural needs of the families are incorporated

into all services.

Migrant Head Start programs address

prevention of mental health complications

in strategic and creative ways. Staff are

trained to observe children and administer

developmental screenings in the children’s

home language, as required by the Head

Start Program Performance Standards.

Many programs maintain primary caregivers who are responsible for a small

group of children. Some programs attempt

to provide continuity of care, where a

caregiver stays with the same group of

children until the age of three. Despite

complications related to shortened programs and family mobility, these efforts

are made because of the importance of

supporting the social-emotional needs of

infants and toddlers by creating a trusting

and secure environment. 

Several programs stress the importance of including all staff in trainings,

even bus drivers who are often the first

point of contact for parents and children.

Parent support groups provide opportunities to share their struggles, questions, and

successes. Many Migrant programs hire

former Head Start or migrant parents to

ensure a bilingual, bicultural staff.

As designated by the Program

Performance Standards, Migrant Head

Start programs must have access to a mental health professional to observe the children for the purpose of intervention and

to make recommendations for further testing or treatment. This person often provides the training for staff and parents, as

well as services for the whole family. A

number of programs describe the challenges to hiring bilingual, bicultural mental health specialists, especially in rural

areas of the country. All of the programs

interviewed stressed the critical importance

of being able to communicate with families and understand the culture. 

Addressing the emotional needs of

migrant farm workers is challenging. One

of the answers to the challenge lies in the

spirit of Migrant Head Start and the desire

of each program to optimize service delivery to children and families. Each agency

faces similar challenges when working

with the mental health needs of migrant

families. Programs cannot face these challenges alone and must continue to be creative and pull in community partners, such

as community clinics, churches, and other

local agencies, whenever possible. 

Migrant Head Start programs hold

the honorable position of trusted partner

to many migrant families. Respect for

culture, language, community collaboration, cooperation, and the continual

reassessment and improvement of the service approach hold the greatest promise

for addressing the mental health needs of

migrant farm worker families. ■

We would like to thank the Migrant

Head Start grantees that gave their time

to speak with us for this article. The

information they provided was both

valuable and informative.

Donald Wyatt is a Program Specialist for

the Migrant and Seasonal Head Start

Programs Branch. T: 202-205-8900; E:

DWyatt@acf.hhs.gov. Jennifer Boss is a

Senior Early Childhood Associate at EHS

National Resource Center.
46 2002

continuum needed to support children of

all ages—beginning with promotion and

prevention and including intervention.

Teachers and parents in the Head Start

community—and in early care and education settings—report that they struggle to

understand and address the mental health

needs of very young children and their

families, and that they lack the knowledge, skills, and resources within the

community to assess and serve children. 

Hearing these concerns, the

Department of Health and Human

Services—under the leadership of the

Head Start Bureau and the

Commissioner’s Office of Research and

Evaluation (CORE), both of the

Administration of Children, Youth and

Families—held an Infant Mental Health

Forum on October 23-24, 2000. The

Forum was attended by more than 140

people representing parents; Early Head

Start and Migrant Head Start directors,

program staff, and home visitors; early

educators; training and technical assistance providers; researchers; pediatricians; psychiatrists; psychologists; social

workers; Federal partners; and private

foundation representatives. The purposes

of the Forum were to (1) develop a common understanding of the term “infant

mental health”; (2) focus on the role that

Early Head Start and Migrant Head

Start programs—in collaboration with

their community child care and early

education partners—play in promoting

the social and emotional development of

infants and their families; and (3) identify action steps as part of a comprehensive initiative to address infant mental

health using Head Start as a leader for

the field. (For more details on the meeting and on suggested action steps, see the

full report from which this article is

excerpted, A Commitment to Supporting

the Mental Health of Our Youngest

Children: Report of the Infant Mental

Health Forum, to be available on the

Head Start Web page in the future.)

Defining Infant Mental Health

Charles Zeanah, M.D., a keynote speaker at the Infant Mental Health Forum,

defined infant mental health as emotional and social competence in young children who are developing appropriately

according to biology, social relationships,

and culture. This definition emphasizes

the multiple contexts in which infants

operate as well as the change inherent in

infant development. Normal paths of

development within various domains

serve as reference points to assess infant

competence. Factors that increase the

risk of suffering, developmental

deviance, or maladaptation create threats

to mental health. Discussion at the meeting focused on the context for mental

health, including age-appropriate developmental sequence; parental factors;

relationships between young children

and parents; and factors in the broader

family context and environment that

affect child development. 

Zeanah also addressed the reluctance that many people feel toward

using the term “infant mental health”

because “infant” is associated with

innocence and beginnings, but “mental

health” with maladjustment and major

mental illness. He argued that the term

brings attention to the real suffering and

needs of infants and brings to the table

a wider array of disciplines and experts

to address collectively the problems that

families are facing.

Role of Early Head Start and the

Child Care Community 

The mental health provisions included

in the Head Start Program Performance

THE INFANT MENTAL 

HEALTH FORUM

BY DEBORAH RODERICK STARK , RACHEL CHAZAN - COHEN , AND JUDITH JERALD

Head Start is a leader in infant mental health

SUPPORTING THE SOCIAL AND EMOTIONAL WELL-BEING OF CHILDREN IS A goal shared by

staff of both the preschool Head Start and the Early Head Start programs. In recent

years, the country has paid increased attention to the mental health of children.

However, most discussions have focused on the schoolage population and issues surrounding treatment rather than the full Photography by Eyewire
Head Start Bulletin 47

Standards guided discussion to address

promotion, preventive intervention, and

treatment. Promoting the mental health

of infants is central to everything high

quality early care and education programs do. These programs continuously

build and nurture relationships which

support the social and emotional development of infants and their primary

caregivers. Teachers interact with

infants during feeding and diapering,

for example, as well as engage parents

in the care of their child. Early experiences with caring adults play an important role in preparing children to

explore and learn and set the stage for

all future development. 

Factors such as maternal depression,

domestic violence, poverty, homelessness,

and a lack of supports for the family

pose challenges to mental health promotion among some Head Start families.

These challenges are even more difficult

when a child has biological problems

such as prematurity, low birth weight, a

disability, or a regulatory disorder. The

strong relationships programs develop

with families enable them to have a

unique vantage point to observe problems or the emergence of problems, and

to have the trust and respect of families

in order to provide or coordinate the

help they may need. Thus, program staff

need to understand the factors that influence infant mental health and how their

work with families can best support

mental health and emotional development. Programs will also need to have

relationships with other providers in the

community who are able to offer more

intensive and specialized services.

Early care and education alone cannot provide the range of services needed

to support emotional development of

infants and their families. Similarly, a

small dose of mental health services cannot be the all-healing remedy for those

infants and their families who are most

challenged. A continuum of services and

supports are needed to meet the individual needs of infants and their families

over an extended period of time. These

services should be provided by those in

the community most qualified to offer

the particular services and support.

At the Forum, four Early Head Start

programs with promising mental health

practices presented their models. Three

of the programs have social work professionals on staff to serve families, and the

fourth uses external consultation in collaboration with a local mental health

clinic. Themes that emerged from their

presentations were the need to support

frontline staff with reflective supervision

(see article, Reflective Supervision, on

page 34) and the need to establish working relationships with a variety of community network agencies.

Participants at the Forum recognized

the challenges of moving forward to

address the emotional health of infants

and their families, but believe the research

and experiences in the field necessitate the

development of a more purposeful

approach to infant mental health.

Action Steps for Consideration

Forum participants worked in discussion

sessions to identify action steps necessary

to fully address infant mental health.

Their suggestions (the specifics of which

are included in the full report) fall within

two broad categories: action steps that

are specific to Head Start, and action

steps that relate to the broader early care

and education field. While many participants commented that some of the Head

Start specific steps should begin immediately—especially given the role of Head

Start as a national laboratory—they recognized that infant mental health transcends Head Start. Efforts should be

undertaken to build the capacity

throughout the child care and early education field and related health, mental

health, and social service professions to

increase understanding of early emotional health and appropriate responses.

Only then will the nation be able to support the emotional health of all infants

and their families. Suggested action steps

address the areas of program guidance,

public awareness, public policy, professional development, reflective supervision, cross-disciplinary collaboration,

financing, research and evaluation,

demonstration, and a national agenda on

infant mental health. (For more information on action steps, see page 48 of the

article, Guiding Principles.)

First Steps

Already, the Administration on Children,

Continued on page 53
GUIDING PRINCIPLES

BY DEBORAH RODERICK STARK , 

RACHEL CHAZAN - COHEN , AND JUDITH HERALD

PARTICIPANTS AT THE INFANT

MENTAL HEALTH FORUM, held in

October 2000 (see article on page

46), recognized that a comprehensive

approach to the emotional health of

infants and their families must be

guided by a set of principles that

influence policy, programming,

service delivery, materials

development and dissemination,

training, technical assistance,

research, and funding. Like the priniciples that undergird the

Early Head Start program, the principles outlined below convey

respect for the individual, appreciation of strengths, and the

need for continuous, stable, and accessible relationships and

supports. The guiding principles define the ways in which the

systems—early care and education, early intervention, health,

and higher education—can work individually and collectively to

create an environment that honors the relationships necessary

for promoting the emotional health of infants and their families. 

All pregnant mothers and their partners and new parents

need to have relationships that support their emotional wellbeing and prepare them for the joys and challenges of

parenthood. All infants need to have stable, loving relationships

with their parents and other primary caregivers for their cues to

be understood and addressed in ways that support and nurture

their emotional development. For the infant and for the adults

who care for them, these relationships need to be—

Individualized: Attention must be given to individual needs.

Responsive caregiving that acknowledges and addresses the

infant’s needs and behavioral temperament will convey the

respect and security essential for early emotional development. It

is equally important to recognize the individual needs of

parents; attending to the parents’ issues (e.g., maternal

depression, substance use) can enable parents to more

comfortably engage in a beneficial relationship with their infant. 

Strengths-based: Early relationships must emphasize the

strengths and resources of each participant. Everyone has

strengths, even the newborn. Helping parents understand their

own strengths and the strengths of their infant builds their

confidence and supports parent and infant interactions. This is

not to obscure the fact that many families have significant needs.

Rather, by building on strengths, trusting relationships can be

built that will make addressing families’ needs more successful.

Continuous and stable: For infants, continuous and stable

caregiving builds confidence that their needs will be met. It is

important for infants who are cared for out of the home to have

a long-term relationship with a primary caregiver. For parents,

knowing that there are consistent people they can turn to—the

child’s caregiver, a home visitor, extended family—is equally

important. There is no silver bullet for promoting emotional

development or addressing mental health needs, and emotional

wellness will not be realized overnight. The more complex the

needs of the family and infant are, the more intense and

extensive the services should be. Early care and education

programs can promote emotional development through best

practices that focus on relationships. But, it is unrealistic to

expect that these programs can provide the more intensive

services infants and families with complex needs must have. A

well-coordinated continuum of community-based services and

supports are needed to provide the family with the targeted

support they need at any particular point in time.

Accessible: Relationships need to be accessible and

responsive to when and how the infant and parent need

attention and support. Parents must understand the rhythm of

the infant, being mindful of the cues the infant sends. Parents

and caregivers also need to be participants in supportive

relationships. The availability of family and program staff and

administration to the parent and caregiver, helps to meet the

individual needs of the adults, making them better able to

engage in responsive interactions with the infant.

These early relationships, which provide the foundation for

future social, emotional, and cognitive development, must be

supported by systems that are—

Child focused and family centered: The services,

training, policy, funding, and research of systems must support

the well-being of the infant and active involvement by family

members to achieve optimal infant development. A true family48 2002 Photography by Eyewire
centered system includes family members as equal partners with

caregivers and administrators in a cohesive, responsive,

respectful, and interdependent team focused on meeting the

child’s and family’s needs to support emotional health.

Culturally responsive: Systems need to recognize the

importance of understanding the values, beliefs, and practices

of diverse cultures. Systems should integrate diversity into the

policies, practices, and products of the organization so that the

ultimate interactions with individual children and their families

can be mindful of and honor their culture.

Community-based: Community-based systems offer targeted

services and supports that reflect the particular needs, strengths,

resources, and cultures of the community. Staff members from

the community further enrich the appropriateness of interactions

that support infants and their families.

Comprehensive, coordinated, and integrated: In

addition to being based in the community, systems need to offer

comprehensive services and supports to infants and their

families that reflect the continuum of care needed—from

promotion to prevention and treatment. No one agency can

fulfill all the needs of families and infants. It is critically

important that across the community, systems are coordinated

so that the broad range of factors, needs, and contexts are

addressed. This ensures that resources and opportunities—

including training opportunities—are shared.

Committed to continuous improvement and reflective

supervision: At every level, systems must be committed to

creating an environment that values and practices continuous

improvement. Reflective supervision is a very important piece of

this safe, nurturing environment. Staff can regularly reflect on

their experiences and gain new knowledge and perspectives

that will help them better approach their work with infants and

families. Fortunately, the early care and education field is

increasingly recognizing the value of reflective supervision both

for the emotional support it brings to the staff and for the

enhancement of services and supports to the family. Many are

hopeful that with appropriate information and training, more

programs will include this component in their program. Research

that helps programs measure the effectiveness of their

interventions is another important piece of continuous

improvement. Knowing what works for whom and how and why

can be a critical guide for ensuring that resources are expended

in ways that are most effective and efficient.

ACTION STEPS

Across Head Start and the broader early child care and

education field, several themes emerge in the action steps

outlined by the Forum participants. These include—

Program guidance: Inform early care and education

programs and related providers in the community about the

principles of infant mental health and the appropriate roles they

can play in supporting emotional wellness.

Public awareness: Increase public awareness about infant

mental health to reduce the stigma associated with it and help

the general public understand the importance of relationships in

overall infant development and well-being.

Public policy: Promote public policy that acknowledges 

the importance of early social and emotional development and

provides direction and adequate funding to build collaborative

systems in communities to support infants and families.

Professional development: Develop evidence-based

curriculum and training resources and opportunities that are

culturally appropriate and enhance the knowledge and skills of

all those working with infants and families.

Reflective supervision: Build the capacity for reflective

supervision in early care and education settings to enhance the

quality of interactions caregivers are able to offer.

Cross-disciplinary collaboration: Stimulate and formalize

cross-disciplinary collaboration—sharing resources, joint

training, coordinated planning and service delivery—that will

build systems of care in communities to provide the continuum

of supports and services needed to focus on emotional health

promotion, prevention, and treatment.

Financing: Identify and secure financing to cover the continuum

of mental health services needed by infants and their families. 

Research and evaluation: Support ongoing evaluation to

ensure that practice is informed by research and to measure the

Continued on page 53

Head Start Bulletin 49
50 2002

by Head Start. These researchers, Federal

staff and Head Start partners, as well as

other researchers conducting similar

research, comprise the Head Start

Mental Health Research Consortium

(HSMHRC). The goals of the HSMHRC

are to—

• identify the current range of mental

health related services; 

• determine the types, rates, and severity of mental health problems; and 

• assess the impact of home-based and

classroom-based skills training interventions on children’s mental health

problems or overall social and emotional functioning. 

The five projects are—

1. Cross-Cultural Analysis of the Early

Screening Project. Institute On

Violence and Destructive Behavior,

College of Education, University of

Oregon. (Principal Investigator: Hill

Walker)

2. UNC-Head Start Partnership on

Mental Health Interventions. Frank

Porter Graham Child Development

Center, The University of North

Carolina at Chapel Hill. (Principal

Investigator: Donna Bryant)

3. Systematic Early Detection and SelfDetermination Approach for Mental

Health Intervention in Head Start.

Special Education/At-Risk Program.

College of Education, University of

New Mexico with partners at the

University of California, Los

Angeles. (Principal Investigator:

Loretta Serna)

4. Early Identification and Prevention

of Conduct Disorder in Head Start

Children. Peabody College,

Vanderbilt University with partners

at Pennsylvania State University

(Principal Investigator: Ann Kaiser).

5. The Emotional Health of LowIncome Children Over Time:

Influences of Neighborhood, Family,

Head Start, and Early School

Experiences. Teachers College,

Columbia University with partners

at Harvard University. (Principal

Investigator: Jeanne Brooks-Gunn)

These projects are in the fourth year

of their 5-year research grants. A few

preliminary findings are presented below.

(The variability in percentages reported

for each of these areas is the result of

different settings, samples of children,

and assessment measures across the different sites that comprise the HSMHC.)

Rates of problems

• Approximately 10% to 34% of

children are described by their

parents and teachers as experiencing problems with anxiety, depression, fears, sleep, and withdrawal.

• Approximately 8% to 52% of

children are described by their

parents and teachers as exhibiting

aggressive and destructive behavior. 

• Approximately 10% of Head Start

children are reported by their teachers as being aggressive every day.

This percentage is similar to what is

seen for preschoolers in other child

care settings.

• Almost 50% of parents report that

their children have less than average

social skills.

• Head Start children exhibiting problems with anxiety, depression, fears,

and withdrawal symptoms are also

more likely to be reported as having

low social skills. 

• As Head Start children become

older, they are more likely to be able

to control their impulses, but the

ability to control their impulses is

harder when the children are in

groups with peers. 

• A classroom-based, culturally adapted prevention program focusing on

THE HEAD START MENTAL HEALTH

RESEARCH CONSORTIUM

BY RHONDA C . BOYD AND MICHAEL LOPEZ

A classroom- and culturally-based program focusing on skill

building improved interaction.

IN 1997, FIVE RESEARCH GRANTS WERE FUNDED through a collaboration between

the Administration on Children, Youth and Families and the National Institute of

Mental Health, as the core component of a research initiative designed to develop and

study new approaches for preventing, identifying, and treating the mental health concerns of young children served Photography by Indiantown MHS

Continued on page 53
Head Start Bulletin 51

ARTICLES/REPORTS

DEC (DIVISION OF EARLY CHILDHOOD)

RECOMMENDED PRACTICES IN EARLY

INTERVENTION/EARLY CHILDHOOD

SPECIAL EDUCATION

Sandall, McLean, Smith (Eds.) (2000)

Order at www.sopriswest.com or call

(800) 547-6747 ($20.00).

LESSONS FROM THE FIELD: HEAD START

MENTAL HEALTH STRATEGIES TO MEET

CHANGING NEEDS (EXECUTIVE

SUMMARY)

Order at <cpmcnet.Columbia.edu/dept/

nccp/lessons.html>.

VIDEOS/TOOLKITS

MENTAL HEALTH IN HEAD START: 

IT’S EVERYBODY’S BUSINESS

(English and Spanish) Order by fax at:

(703) 683-5769, or by E-mail at

www.headstartinfo.org/cgi- (www.hskidstmsc.org/cgi-bin/Introduction.cfm#Order).

MENTAL HEALTH TOOL KIT: MENTAL

HEALTH RESOURCES FOR TRAINING AND

TECHNICAL ASSISTANCE 

Order at <www.headstartinfo.org/

infocenter/mentalhealth/mh_tkbok.htm>.

THE POWER OF QUESTIONS: BUILDING

QUALITY RELATIONSHIPS WITH INFANTS

AND FAMILIES 

Rebecca Parlakian (2001) 

Order at www.zerotothree.org/

bkstr_support.html ($7.50).

1. RESEARCH ON THE RISK FACTORS FOR

EARLY SCHOOL PROBLEMS AND 

2. SELECTED FEDERAL POLICIES

AFFECTING CHILDREN’S SOCIAL AND

EMOTIONAL DEVELOPMENT AND THEIR

READINESS FOR SCHOOL 

National Institute of Mental Health 

(301) 443-4513 or order at

<www.nimh.nih.gov/childhp/

goodstart.cfm>.

THE YEC MONOGRAPH SERIES:

PRACTICAL IDEAS FOR ADDRESSING

CHALLENGING BEHAVIORS

Order at www.sopriswest.com or (800)

547-6747 ($12.00).

1 FROM NEURONS TO NEIGHBORHOODS: THE SCIENCE OF EARLY 

CHILDHOOD DEVELOPMENT

Jack P. Shonkoff & Deborah A. Phillips, Editors (2000)

From Neurons to Neighborhoods is a report of the work of the Committee on

Integrating the Science of Early Childhood Development of the National Research

Council and the Institute of Medicine. It is a comprehensive and up-to-date

reference work available for the early childhood field. The findings, conclusions,

and recommendations are supported by almost 80 pages of references. This

publication can be printed off the Internet or order at

www.nap.edu/catalog/9824.html ($39.95).

2 HANDBOOK OF INFANT MENTAL HEALTH, SECOND EDITION

by Charles H. Zeanah Jr,. Editor

This volume offers a sweeping analysis of the developmental, clinical, and social

aspects of mental health from birth to age three. This second edition reflects

changes in the field in the past decade, and contains new chapters on the

psychology of pregnancy, neurobiology of fetal and infant development, and

examination of mental status in infancy. Order at 

www.therapeuticresources.com/cgi-bin/shopper.cgi?67-23text.html ($75.95).

3 REPORT OF THE SURGEON GENERAL’S CONFERENCE ON CHILDREN’S 

MENTAL HEALTH: A NATIONAL ACTION AGENDA

This Report represents collaboration among three major Federal Departments: the

Department of Health and Human Services, the Department of Education, and the

Department of Justice. It introduces a blueprint for addressing children’s mental

health needs in the United States. To access the report, visit

<phs.os.dhhs.gov/CMH/childreport.htm>.

RESOURCES TOP PICKS

The following resources are 

highly recommended
52 2002

1 www.childrensdefense.org

THE CHILDREN’S DEFENSE FUND. Includes pages on 

mental health.

www.nimh.nih.gov

THE NATIONAL INSTITUTE OF MENTAL HEALTH. Links

(www.mentalhealth.org) to the Substance Abuse and Mental

Health Services Administration’s Knowledge Exchange

Network, which provides information about mental health.

www.aboutourkids.com

THE NEW YORK UNIVERSITY CHILD STUDY CENTER. Useful

for parents, teachers, and professionals. 

www.actagainstviolence.com

ADULTS AND CHILDREN TOGETHER AGAINST VIOLENCE.

Focuses on adults who raise, care for, and teach children

from birth to eight years old.

www.bazelon.org/

THE JUDGE DAVID L. BAZELON CENTER FOR MENTAL

HEALTH LAW. Links to news and legal analyses with a focus

on children’s issues. 

www.mentalhealth.org/cmhs

THE CENTER FOR MENTAL HEALTH SERVICES. Created to

assist adults and children with serious emotional disorders. 

www.ffcmh.org

THE FEDERATION OF FAMILIES FOR CHILDREN’S MENTAL

HEALTH. Offers information on government policy and

research as well as links to informational resources for

parents. Hosts a Spanish language version.

www.calib.com/nccanch

THE NATIONAL CLEARINGHOUSE ON CHILD ABUSE AND

NEGLECT INFORMATION. 

WEBLIOGRAPHY

The following Web sites about mental health are recommended as 

further resources for teachers, parents, and administrators

2

4

3

7

8

5

6

THE UNIVERSITY OF ILLINOIS IS PARTNERING with the University of Colorado at Denver, the University of

Connecticut, the University of South Florida, Education Development Corporation, Tennessee Voices for Children, and

several national professional organizations to create a Center for the Social and Emotional Foundations of Early

Learning. The goals and activities of this consortium are designed to strengthen the capacity of Child Care and Head

Start to improve the social and emotional outcomes of young children. As evidenced through a variety of recent publications, there is a direct link between social and emotional development and children's successful transition to school.

While there are data on practices that are effective in facilitating the social and emotional development of children, this

information has not been consistently translated into information that is useful to consumers. The lack of user-friendly

information, combined with the growing number of children with challenging behaviors and mental health needs in

Child Care and Head Start programs, highlights the need for systematic training efforts related to social and emotional

development. The consortium is committed to addressing these issues through: a) a focus on promoting the social and

emotional development of children as a means of preventing challenging behaviors, b) a comprehensive, culturally sensitive approach that is inclusive of and responsive to the needs of programs, families, other professionals, and communities, c) the dissemination of evidence-based practices, d) the ongoing identification of training needs and preferred delivery formats of local programs and T/TA providers, and e) collaboration with existing T/TA providers for the purpose of

ensuring the implementation and sustainability of practices at the local level. The Center is jointly funded by the Head

Start and Child Care Bureaus. For more information, contact Dr. Mary Louise Hemmeter, Project Director. T: 217-330-0260; E:

mlhemm@uiuc.edu. The Center’s Website is <www.ed.uiuc.edu/sped/grants/centerec.html>.

CENTER FOR THE SOCIAL AND EMOTIONAL FOUNDATIONS 

OF EARLY LEARNING
Head Start Bulletin 53

long-term community impacts of increased focus on infant

mental health.

Demonstration: Conduct demonstration efforts to help the

early care and education community gather new knowledge

and test models and assumptions, ultimately providing more

targeted and effective services to infants and their families.

A national agenda on infant mental health: Build a

universal commitment to address infant mental health to transcend

the scope and responsibility of Head Start. To offer the continuum

of services that will support emotional development, it is

imperative that the broader caregiving community and related

providers (e.g., social work, psychology, psychiatry, nursing,

pediatrics, obstetrics, family health) come together. For more

Youth and Families is moving forward on suggestions from the

Forum. To build on its lessons, the Early Head Start National

Resource Center (EHS NRC) will engage in a number of followup activities critical to maintaining a sustained focus on this

important issue. Activities will include consensus building, training, and dissemination. Within CORE, efforts are underway to

encourage relevant research. For example, infant mental health

was added as a priority for the Head Start University Partners

Grants. Additionally, the Child Care Bureau convened a

National Leadership Forum with child care, health, and mental

health professionals on March 6, 2001. Importantly, all three

units—the Head Start Bureau, the Child Care Bureau, and

CORE—have agreed to work together on implementation of all

aspects of follow-up to the Infant Mental Health Forum, recognizing that together their efforts will be more effective and reach

across the early child care and education field. ■

Deborah Roderick Stark is Principle with Stark Consulting. T:

301-889-0430; E: DRS889@aol.com. Rachel Chazan-Cohen is a

Social Research Analyst for CORE. Office of Planning, Research

and Evaluation, ACF. T: 202-205-8810; E: rccohen@acf.hhs.gov.

Judith Jerald is the Coordinator of Early Head Start in the Head

Start Bureau. T: 202-205-8074; E: jjerald@acf.hhs.gov.

Continued from page 47, Infant Mental Health Forum

Continued from page 49, Guiding Principles

information on this national agenda, contact Lynette Kimes of

the EHS National Resource Center at l.kimes@zerotothree.org. ■

Deborah Roderick Stark is Principle with Stark Consulting. T:

301-889-0430; E: DRS889@aol.com. Rachel Chazan-Cohen is a

Social Research Analyst for CORE, Office of Planning, Research

and Evaluation, ACF. T: 202-205-8810; E: rccohen@acf.hhs.gov.

Judith Jerald is the Coordinator of Early Head Start in the Head

Start Bureau. T: 202-205-8074; E: jjerald@acf.hhs.gov.

skill building for all children in selected Head Start classrooms showed some benefit for attentional skills, social

interaction, and adaptive behavior of children. 

Future Directions

An important element of this collaborative mental health

research consortium is that for several crucial child, parent, and

classroom characteristics or domains, similar information was

collected across two or more projects. This approach will allow

important cross-site comparisons. The HSMHRC is in the

process of gathering the cross-site information to report major

findings on the mental health of more than 2,400 Head Start

children across different geographic regions, populations, and

program approaches. 

The major aims of the cross-site effort are to investigate

risk and protective factors related to mental health problems;

exposure to violence; classroom quality and teacher characteristics; parental depression; mental health needs of Head Start

children; and accurately screening mental health problems. 

These cross-site aims are consistent with the initial goals of

the HSMHRC, but also address some of the pertinent issues

facing a broader range of Head Start children, families, and

staff across the country. ■

Rhonda C. Boyd was a Society for Research in Child Development

Fellow, CORE. T: 215-590-3945; E: rboyd@mail.med.upenn.edu.

Michael Lopez is Lead Senior Social Science Research Analyst,

CORE. T: 202-205-8212; E: milopez@acf.hhs.gov.

Continued from page 50, Research Consortium