2018/19 Infant Mental Health · implementing infant mental health into program design and delivery and how to overcome some of the existing barriers. Learning Objectives : 1. To become

2018/19 Infant Mental Health Community Training Institute

www.IMHPromotion.ca

- Session 1 - Introduction to Infant and Early Childhood Mental Health

Thurs Jan 11,

2018

2 – 4 pm

This introductory session will provide an overview of early development with aunique focus on early mental health and the factors that can both support orhinder development. Theoretical models that can be used to understandbehaviors and influencing factors will be explored and considered within thecontext of community programs the work with families and young children. The session will conclude with a discussion about the challenges faced whenimplementing infant mental health into program design and delivery and how to overcome some of the existing barriers. Learning Objectives :

1. To become familiar with the meaning of infant mental health. 2. To understand normal infant and toddler development with a focus on

mental health. 3. To understand theoretical models of child development 4. To understand the influence of risk and protective factors on a young

child’s development. 5. To become familiar with what promotes or impairs the development of

positive early mental health. 6. To understand the challenges that may be experienced when

implementing infant mental health into community programs.

Presenter: Dr. Chaya Kulkarni (BAA, M.Ed, Ed. D)

Chaya Kulkarni is Director of Infant Mental Health Promotion (IMHP) at The Hospital forSick Children. Infant Mental Health Promotion is a national organization focused onpromoting and influencing practice, policy and knowledge in areas related to infantmental health. In her role with IMHP Chaya is currently leading advocacy and traininginitiatives in areas such as child welfare including family courts, and community basedprograms supporting families in their neighborhoods. Chaya also lectures frequently atprofessional development events. Prior to joining IMHP Chaya held positions as VicePresident of Parent and Professional Education at Invest in Kids and as a Senior

Policy Advisor at the Legislative Assembly of Ontario. Chaya has also sat on the Prime MinistersCommittee for the Award of Excellence and currently sits a number of committees within the health and social services sectors including: the Children’s Programming Advisory Committee for TVO, HealthNexus - Healthy Baby Healthy Brain project, FRP Canada Advisory Committee, Metro Toronto FamilyServices Consortium, Self-Regulation Working Group (SickKids), SickKids Continuing Professional Development Committee, and the Board of Directors for Family Day one of the largest not for profitproviders of child care in the GTA. She is also the co-author of a book, Your Guide to Nurturing Parent Child Relationships.


Session 1

Introduction to Infant and Early Childhood Mental Health ‐ Chaya Kulkarni 1

Chaya Kulkarni, M.Ed, Ed.D

Director, Infant Mental Health Promotion

The Hospital for Sick Children

“…early childhood presents an incomparable window of opportunity to make a difference in a child’s life.” (https://www.unicef.org/earlychildhood/)

“Mental health in childhood means reaching developmental and emotional milestones, and learning healthy social skills and how to cope when there are problems.” (https://www.cdc.gov/childrensmentalhealth/index)

“The early child period is considered to be the most important developmental phase throughout the lifespan.” (http://www.who.int/social_determinants/themes/earlychilddevelopment/en/ )


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Increasing enrollment by month

• Coast to coast

• Multi-disciplinary

• French and English

1450 Trainings Completed by Region

ON

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PEI

NWT

US & Intn'l


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• Provide a level understanding of what is known about infant and early mental health – what are the facts – no more debate required;

• Provide an introduction into the science of infant and early mental health;

• Provide an overview of what have we learned and documented about infant and early mental health in communities across the country.

In your agency or community, is the promotion of infant and early mental health a strategic priority?

Yes

No

I don’t know…


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1. You will hear things today that may cause you to reflect on some of your own experiences as a parent or as a child. Remember, science and our understanding of early mental health has come a long way so don’t be hard on yourself. Talk to someone if any of this is overwhelming.

2. This is a sales pitch. I have the following products that I will do my best to sell you.

o The knowledge that infant mental health exits

o An understanding and acceptance that you are an influencer on many levels

o Knowledge about infant mental health is empowering

Creating a Context for Understanding Infant & Early Mental Health – Perhaps more important than

dinasours?


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• Infancy is a period of profound development in the brain unmatched by any other period with over 1 million neural connections made every second –an incredible opportunity (Centre on the Developing Child, 2017)

• Early experiences (both positive and negative) have a decisive effect on how the brain is wired. Practitioners who understand even the most basic brain science of brain development are better equipped to meet the needs of this young group of children.

• When young children focus on getting their basic needs met, these connections in the brain mature, while other circuits may be lost if unused/activated.

• The greatest opportunity to influence developmental outcomes is in the first three years of life.

• Relationships drive development: For a young child, a supportive relationship is as important as good nutrition – the absence of either can negatively impact development.

• When young children experience adversity and don’t have a reliable and protective caregiver, their physical and mental wellbeing can be derailed.

• Maltreatment is harmful at any age, but the inherent vulnerability of infancy causes an amplification of maltreatment’s harmful impact.


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Mental disorders do occur among infants and rates are comparable to those of older children. The concept of mental disorders in infancy is largely invisible, its not recognized in those systems and policies that provide support to this age group, nor in the preservice training of many within those system.

(Lyons – Ruth, Manly, Klitzing, Tamminen, Emde, Fitzgerald, Paul, Keren, Berg, Foley, Watanabe, 2017)

• Infancy (birth to 3 years) represents a “time of particularly rapid brain and behavioral development…. Atypical developmental trajectories can be identified in the first six months” (Lyons – Ruth, Manly, Klitzing, Tamminen, Emde, Fitzgerald, Paul, Keren, Berg, Foley, Watanabe, 2017).

• “features of symptoms and disorders in infancy are somewhat different from those in the later years.”

• “During infancy stressors on caregivers have particularly immediate consequences for the infant’s developing stress response systems and overall development.”

• There is a “misconception that infants are too young to need treatment or that they will grow of their symptoms.”

(Lyons – Ruth, Manly, Klitzing, Tamminen, Emde, Fitzgerald, Paul, Keren, Berg, Foley, Watanabe, 2017)


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Early identification, intervention and prevention are more effective than

fixing things later in life…

(Centre on the Developing Child, 2017)

There are some mental health disorders that can be avoided if early mental health is better supported.

a) Don’t know

b) Disagree

c) Somewhat agree

d) Agree


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Estimated population affected

Dr. Charlotte Waddell, 2017

Disorder Prevalence (%) Age (y) Ontario Canada

Anxiety Disorders 3.8 4‐17 80,200 204,800

ADHD 2.5 4‐17 52,800 134,800

Substance Misuse 2.4 11‐17 26,000 65,100

Conduct Disorder 2.1 4‐17 44,300 113,200

Major Depression 1.6 4‐17 33,800 86,200


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(Cohen, Oser & Quigley, 2012, pg. 1)

Form close and secure adult and peer

relationships

Experience, manage and express a full

range of emotions

Explore the environment and learn – all in the context of family, community, and

culture

Infant and early childhood mental health, sometimes referred to as social and emotional development, is the developing capacity of the child from birth to five years

of age to:

• Refers to the promotion of optimal development and well-being in infants (0-3 years) and their families, the prevention of difficulties and intervention when infants are at-risk or have identified problems.


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Secure Attachment

Capacity for Self-

RegulationResilience Optimal Brain

Development

Positive early mental health increases the likelihood of:• Positive physical and mental health outcomes

• Overall success

DEVELOPMENT

1. Gross Motor

2. Fine Motor

4. Cognitive

3. Language

and Communi-

cation

5. Self-Help

6. Emotional

7. Social


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ASQ-3™ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth TwomblyCopyright © 2010 Paul H. Brookes Publishing Co. All rights reserved. www.agesand stages.com

BEHAVIOURAL AREAS

DEFINITION

Self-RegulationAbility/ willingness to calm, settle, or adjust to physiological or environmental conditions

ComplianceAbility/ willingness to conform to the direction of others and follow rules

CommunicationVerbal/ nonverbal signals that indicate feelings, affect, internal states

Adaptive Ability/ success in coping with physiological needs

Autonomy Ability/ willingness to establish independence

Affect Ability/ willingness to demonstrate feelings and empathy for others

Interaction with People

Ability/ willingness to respond or initiate social responses with caregivers, adults, peers

Mary Rella, BA (Hon.), Dip,CSManager of Clinical ServicesYorktown Child and Family Centre


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Practitioners in the field of infant mental health (IMH) come from diverse educational backgrounds

IMH Professional Background/

Education

Medicine

Nursing

Social Work

Speech Language Therapy

Early Childhood Education

Occupational Therapy

Physio-therapy

Psychology

• Far too often we hear that when a concern is raised a referral made, it is followed by lengthy wait times.

• Often the wait is not for intervention but further assessment.


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• Far too often we hear that when a concern is raised a referral made, it is followed by lengthy wait times.

• Often the wait is not for intervention but further assessment.

• Because a child’s brain continues to be wired while waiting for the “village” to recognize and respond in a way that reflects the needs of the child and science.

• Wait times leave parents and caregivers feeling helpless.

• All of us are too familiar with what many experts describe as the crisis in youth mental health.

An estimated 1.2 million children and youth in Canada are affected by mental illness—yet, less than 20 per cent will receive appropriate treatment. https://www.mentalhealthcommission.ca/English/focus-areas/children-and-youth

• If we want to change the story, change the narrative about our youth, we have to embrace the science that is showing us in so many ways that the support that will give them every opportunity to succeed later in life, begins early in life.


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• Infant mental health is complex not well known as critical to later outcomes

• Goes against the images we have of babies

• Requires an expertise that is rare in Canada

• Competes against the mental health needs of other populations such as youth who are much more able to speak out

• Many think there’s not much to know about babies – so simple – feed and clothe them

LIFE ALTERING


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0-5 years is a critical and rapid period of development

1,000,000 new neural connections form every second in the first few years of life

Neural connections in the early years provide a foundation for the connections that form later in life

Blueprint for the formation of these connections largely depends on the caregiving environment

(Centre on the Developing Child, 2017)

When young children experience adversity in the absence of a protective caregiver, physical and mental wellbeing may derail

Maltreatment is harmful at any age, but the inherent vulnerability of infancy causes an amplification of maltreatment’s harmful impact

Relationships drive development during this early period


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Studies suggest that:

– Preconception stressful life events (PSLEs) can lead to an increased risk for very low birth weight as well as poor health at 9 and 24 months of age (Cheng, Park, Wisk, Mandell Wakeel, Litzelman, Chatterjee and Witt, 2016)

– Women exposed to PSLE are 38% more likely to have a very low birth weight baby compared to those who are not explosed (Cheng, Park, Wisk, Mandell Wakeel, Litzelman, Chatterjee and Witt, 2014)

– The accumulation of PSLEs was associated with very low infant birth rate (Cheng, Park, Wisk, Mandell, Wakeel, Litzelman, Chatterjee and Witt, 2014)

What does this mean for policies and programs?

From the moment of conception, an infant’s physical development and mental health are influenced

Mom’s maternal emotional state can impact the in utero

physiology and impact the baby across his/her

lifespan (Kinsella, Monk, 2009)

We know that environmental factors such as maternal stress

during pregnancy can effect later

emotional, behavioural and

cognitive outcomes(Glover, 2011)

In a systematic review by Gavin

(2005) it was found that 13% of women

experience depression during

pregnancy

Such studies are concluding that the

prenatal environment

including exposure to maternal stress can have an effect that is sustained

across the lifespan(Kinsella, Monk, 2009)


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• They show emotions

• They respond to comfort

• They react differently to people or voices they are familiar with

Center on the Developing Child (2013). Early Childhood Mental Health (InBrief). Retrieved from www.developingchild.harvard.edu.

• The earliest and most significant relationship through the lifespan

• It is the foundation for regulation and resilience

• Absence of a secure attachment can negatively impact outcomes


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• The earliest relationship in a child’s life

• Develops early in infancy, but is most clearly evident at 7-9 months through proximity seeking and stranger anxiety (Bowlby, 1969)

• External regulation system akin to a thermostat

Proximity seeking behaviour triggered by infant’s distress

Caregiver responsiveness and sensitivity brings about feelings of comfort and safety

Secure base for exploration (Bowlby, 1969)

Attachment and bonding are terms that are often used interchangeably, but there are distinct differences (Hughes, 2010)

Attachment Bonding Scientific term to describe infant’s relationship

with the parent or primary caregiver (felt‐sense of safety)

Degree of security “determined” through parents’ responsiveness and sensitivity

Developmental process over the first two years of life

Initiated by child

Parents’ & primary caregivers’ surge of love and tenderness felt towards the infant

Ongoing relationship that is emotionally meaningful and creates desire to maintain mutual contact

Can develop well before birth of infant (i.e., at conception)

Initiated by caregiver


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• Attachment is the template for all future relationships and core beliefs

• Sensitive parenting invites children to good quality relationships

Infants will form an attachment to any

caregivers, good or bad –not just those who are

consistently responsive and loving.

Bruce D. Perry (2004). Maltreated Children: Experience, Brain Development, and the Next Generation. New York: W.W. Norton.


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• Regulation begins to develop immediately but requires support

• In the newborn, regulation is unstable and is not a predictor of regulation capacity later (Kopp, 1982; Porges, 1996 as referenced in Halligan et al 2013)

• Physical systems are not well regulated in early infancy and will take time

• Requires the prefrontal cortex

• Influenced by the brain – requires the child to apply cognitive functions to problem solving and emotions

• When the child is dysregulated, the prefrontal cortex shuts down

An infant’s early experiences, including emotional ones, will be wired into the

architecture of their brain. This includes good and bad experiences.

National Scientific Council on the Developing Child (2004). Children’s Emotional Development Is Built into the Architecture of Their Brains: Working Paper No. 2. Retrieved from www.developingchild.harvard.edu.


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Resilience is:

a) Something children are born with

b) An internal capacity that cannot be changed

c) Develops over time

d) Determined by a child’s temperament with easy going children being the most resilient.


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National Scientific Council on the Developing Child (2012). Supportive Relationships and Active Skill‐Building Strengthen the Foundations of Resilience: Working Paper No. 13. Retrieved from www.developingchild.harvard.edu.

When they experience early adversity it can be difficult for them to recover without a secure attachment.

Resilience develops over time. Infants are born with the capacity to develop resilience.


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Early experiences matter. The experiences a child

has before starting school will influence their

development and success once in school.


How has vulnerability changed from 2004 to 2015?

Adapted from https://edi.offordcentre.com/wp/wp-content/uploads/2017/09/EDI-in-Ontario_revised.pdf, 2017

+3.2% +1.4% +2.0% -2.0% -1.9% Increased vulnerability in physical health and wellbeing,

social competence, and emotional maturity

Improved outcomes in language and cognition, and communication and general knowledge


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We can recognize poor mental health during

infancy.

In a perfect world we would respond immediately.

National Scientific Council on the Developing Child (2012). Establishing a Level Foundation for Life: Mental Health Begins in Early Childhood: Working Paper No. 6. Retrieved from www.developingchild.harvard.edu.

Jack Shonkoff, Centre on the Developing Child https://www.youtube.com/watch?v=L41k2p‐YRCs June 2015

RISK FOR MENTAL HEALTH

PROBLEMS

Social emotional challenges

Difficulty controlling emotions


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How would you describe the understanding of those in your agency about the importance of infant and early mental health? (a reminder answers are anonymous and no one, not even IMHP staff, can connect answers with specific participants).

a) Non existent – no understanding

b) A little bit familiar

c) Somewhat familiar

d) Very familiar


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Bruce D. Perry (2004). Maltreated Children: Experience, Brain Development, and the Next Generation. New York: W.W. Norton.

Many infants and toddlers who experience neglect and/or abuse are not getting the help they need to address their mental health needs.

There is common belief that young children may outgrow early mental health problems, but longitudinal studies show that this is not the case (Breslau et al., 2014).

Clinton, J., Kays-Burden, A., Carter, C., Bhasin, K., Cairney, J., Carrey, N., Janus, M., Kulkarni, C., & Williams, R. (2014). Supporting Ontario’s youngest minds: Investing in the mental health of children under 6. Ontario Centre of Excellence for Child and Youth Mental Health. Retrieved from http://www.excellenceforchildandyouth.ca/sites/default/files/policy_early_years.pdf.

In fact, the long term social and economic impact of mental health problems among infants and young children is significant, making infant and early childhood mental health an issue of critical importance for government and communities.


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Center on the Developing Child (2007). The Impact of Early Adversity on Child Development (InBrief). Retrieved fromwww.developingchild.harvard.edu.

When we recognize and respond earlyto mental health concerns with the appropriate supports and services it is easier and more likely we will positively influence development.

Poor mental health can be detected before children enter the formal school

system.



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Early adversity does not build

strength it increases the likelihood of poor

outcomes in all aspects of life – physical health, mental health, school

success

Early adversity can have a damaging

effect on short and long term outcomes

When we don’t understand a child’s

context including their relational history and

their lived experiences, our ability to respond to

their needs in a meaningful way is

significantly compromised.


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Behaviour that needs to be “fixed”?

Child that needs to be “fixed”?

Development that is not what you expected?

Families that need to be “fixed”

Hope or hopelessness?

Questions

All of the above?


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Early adversity can significantly influence physical and mental health outcomes much later in life.

a) Disagree

b) Somewhat agree

c) Agree

d) Don’t know

Largest investigation

ever conducted to assess the relationship of early adversity

and adult health

Source: Adverse Childhood Experiences (ACE) Study.Information available at http://www.cdc.gov/ace/index.htm


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• Of 17,000 respondents, two-thirds had at least one adverse childhood event.

• One in six people had 4 or more ACEs.• People with 4 or more ACEs were twice as likely to be

smokers and 7 times as likely to be alcoholics.

Early Adversity Is Linked to the 10 Leading Causes of Death & Disability

1. Heart disease2. Cancer3. Chronic lower respiratory diseases4. Stroke5. Unintentional injuries6. Alzheimer's disease7. Diabetes8. Kidney disease9. Influenza and pneumonia10. Suicide Source: Anda, R. (2008). The health and social impact of

growing up with alcohol abuse and related Adverse Childhood Experiences: The human and economic costs of the status quo.


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CHILDHOOD • Developmental

Delays

• Expulsion

ADOLESCEN

CE • Obesity

• Mental Health

• Suicide

• Teen pregnancy/STDs

• Drugs & Alcohol

• Violence

• Delinquency

ADULTHOOD •Drug Abuse

•Psychiatric Problems

•Alcohol

•Crime

•Heart disease

•Cancer

•Chronic lower respiratory diseases

•Stroke

•Unintentional injuries

•Alzheimer's disease

•Diabetes

•Kidney disease

•Influenza and pneumonia

Source: Adverse Childhood Experiences (ACE) Study.Information available at http://www.cdc.gov/ace/index.htm

Sometimes adults say, “They’re too young to understand.” However young children are affected by traumatic events, and prolonged and frequent

stress. While they may not understand what is happening, the impact on the development of their brain can alter their life outcomes.

Age does not protect a child from trauma and the impact it can have on developmental outcomes.

The National Child Traumatic Stress Network, Early Childhood Trauma (http;//nctsn.org/nccts/nav.do?pid=typearly1, August 2010.


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(Lieberman, 2014)

Structural Effects: Larger lateral ventricles; smaller

intracranial volume (De Bellis, Keshavan, et al., 1999)

Chemical effects:Dysregulation of stress

hormones (De Bellis, Chrousos, et al., 1994; Hart, Gunnar, &

Cicchetti, 1996; Kroupina et al., 1997; Tarullo & Gunnar, 2006)

Neuropsychological Effects:

Higher neurological sensitivity to angry visual and auditory stimuli

(Pollak, Cicchetti, Klorman, & Brumaghim, 1997; Shackman, Shackman, & Pollak, 2007)

Chromosomal Effects: Telomere erosion; shorter

telomere length (O’Donovan et al., 2011; Shalev et al., 2012)


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It is not what you do

It is not what you know

It is in fact, what you do with what you know that can make the difference for a young child

• Essential but not enough• WAIT TIMES ARE EXCESSIVE

• In each community a lead is needed to create a “gap” plan

• We call this a Developmental Support Plan

Make a referral!


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Sometimes when a baby is late in

his or her development,

a little help can make a

big difference

“We spend so much time directing and correcting, and not enough time connecting…”


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What We have Learned from 15 Communities Across Canada

We have good data about infant and early mental health in Canada.

a) Don’t know

b) Disagree

c) Somewhat agree

d) Agree


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To document for the first time, based on the multi-sectoral agencies and practitioners working with young children at the community level:

• Current infant mental programs, services and initiatives

• Opportunities to strengthen programs, services and initiatives

• State of knowledge and expertise

• Organizational policies that reflect the science of infant mental health and those that do not

• These reports contain:• the most current profile of infant and early mental health in

Canada

• Multi-sectoral views on infant and early mental health

• Identification of consistent themes

• Identification of opportunities where infant and early mental health can be better supported


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EDUCATIONPre-K

ProgramsSchool Boards

PUBLIC

HEA

LTH YO

UNG

PAREN

T SU

PPORT

SERVICES

HOSPITALS AND

COMMUNITY HEALTHSERVICES

Who was at the Community Table?

• Assessing Readiness and Commitment

• Existing IMH knowledge within the community

• Identifying IMH champions

• Multi-disciplinaryparticipation necessary

• CAPC/CPNP Programs –only government funded programs inclusive of infants/toddlers


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• Communities were invited to participate

• Certain stakeholders were required (health, education, child protection….)

• Standard templates guided all table discussions

• Communities had to review and edit reports until all members were happy

Niagara Region (ON)

Ottawa (ON)

Simcoe County (ON)

Muskoka‐Parry Sound (ON)

Regent Park (ON)

Durham Region (ON)

Lac‐La Ronge (SK)

Simcoe Indigenous & Metis (ON)

Timiskaming District (ON)

Algoma District (ON)

East York (ON)

Etobicoke (ON)

Langley (BC)

Cochrane (ON)

Timmins (ON)


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AGENCIES- Child Protection Agencies- Child Care Centres- Early Intervention and Rehabilitation

Services - Public Health Units- School Boards- Hospitals and Community Health Centres

- Adolescent Parent Support Agencies - Indigenous Specific Agencies and Programs

(Both on and off reserve) - Family Shelters- Elder’s Council - Children’s Mental Health Agencies

Total # of community

tables: 15

Simcoe Indigenous &

MetisLa Ronge Timiskaming Cochrane Timmins

5 Indigenous Tables

Total # of participants:

357

Total # of

agencies: 225


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1. The current system of supports for families is fractured - increased communication and transparency between sectors is imperative

2. There is a need for increased awareness surrounding IMH across a wide range of disciplines and professional bodies(e.g., post-secondary education sector, medical professionals, early interventionists, etc.)

3. Knowledge is limited and varied - Those working with infants and families come from various backgrounds with various levels of training and no common body of knowledge of infant mental health and early development


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4. There is a need to generate a pool of relevant resources for agencies

5. Ensure screening with a strong social emotional component -Screening initiatives, protocols and tools for developmental screening and are not consistently available or used


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6. Waiting lists are a significant concern and often derail development further leaving those referring feeling they have done something while leaving parents feeling they can’t do anything without the “expert”.

7. Transparency is key to collaboration and effective referral

8. Agencies are often unaware of existing programs and services within their own or how to help families engage with services. Pathway documents that help practitioners and parents would be helpful.


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9. Need for a shared standard of practice regarding organizational policies and practices that support infant mental health in order to identify gaps and opportunities

10. Must reach out to higher level stakeholders (e.g., government, ministry, LHIN) to instill widespread policy changes

11. Creating and circulating not just culturally -sensitive but culturally meaningful services and resources


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12. Communities are taking interest in establishing an evidence base on screening and developmental support planning

13. Need for reflective practice and supervision to support staff well-being and prevent burnout

1. Limited knowledge on FASD and intergenerational transmission - significant risk factors among indigenous populations Screening

Informed developmental planning

2. Need for culturally-sensitive and meaningful resources and services that integrate knowledge from elders, world views, beliefs, values and spiritual traditions


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• Environmental scan of public awareness messages about infant and early mental health

• Paper on what do we know about the mental health of three to six year old children

• Kids Brain Health Canada – RCT currently underway looking at a response protocol for vulnerable children

• Niagara study looking at implementation of screening and Hand in Hand

• Call to Action on Behalf of Maltreated Infants, Toddlers and Preschoolers

• Review of Best Practice Guidelines

• Development of materials to support those working with Indigenous children and their families

• Study Days featuring hot topics

• Community Mapping in Niagara and Thunder Bay


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Thank you for your time!

Evaluation Notes

Session 1 – Introduction to Infant and Early Childhood Mental Health – Chaya Kulkarni

Please use the form below for notes and your records.

To log your participation be sure to enter your session feedback at: https://surveys.sickkids.ca/surveys/?s=EL8737CJYH

Keeping Track! Session 1: Date Completed: _________________________

Please rate the following statements

1 Strongly Disagree

2 Disagree

3 Neutral

4 Agree

5 Strongly Agree

The presentation met the stated goals and objectives:

The topic was interesting, stimulating and thought provoking:

The presenter communicated in a clear, concise and well organized manner, at an appropriate level for this audience:

The presentation dedicated sufficient time for interactive learning:

The presenter effectively addressed questions:

The presenter was prepared and knowledgeable in delivering the subject matter:

The style of the presentation was effective and engaging:

The audio visual aids enhanced the presentation's learning outcomes:

The session was relevant to your work and daily practice:

The strategies and knowledge presented will be used in your work:

Some of the information presented was new:

The presentation met or exceeded your expectations:

Would you like more training on this topic?

Based on your experience would you attend or recommend another IMHP event?

Overall this presentation was (1 = poor, 5 = excellent):

Session 1 – Content Quiz Questions 1) An infant’s mental health begins to form...

a. During pregnancy b. Immediately after birth c. After the first birthday d. After the second birthday

2) Early adversity, in the absence of protective factors, is guaranteed to result in greater resilience in

a child.

True or False

https://surveys.sickkids.ca/surveys/?s=EL8737CJYH

Evaluation Notes

Session 1 – Introduction to Infant and Early Childhood Mental Health – Chaya Kulkarni

3) A child who experiences more than four risk factors early in life is... a. At the same level of risk for poor developmental outcomes as a child in a loving home. b. At no greater risk for poor developmental outcomes. c. At a greater risk for poor developmental outcomes. d. Is guaranteed to have poor developmental outcomes.

4) Risk for poor early mental health can only be screened for by a psychiatrist.

True or False

5) The bio-developmental model helps practitioners understand: a. Why nature can be ignored in understanding developmental challenges. b. How early experiences influence brain and overall development and influence a child's

developmental trajectory. c. How a child's developmental trajectory is mostly influenced by nature. d. Why other theories of development are inadequate and should be discarded.

Documents

2018/19 Infant Mental Health · implementing infant mental health into program design and delivery and how to overcome some of the existing barriers. Learning Objectives : 1. To become