The skills that turn good intentions into effective consultation
A short, interactive tour of what an infant and early childhood mental health consultant actually needs to know and do, ending with a quick quiz.
The eight competencies at a glance
Consultation draws on eight connected areas of skill, from the consultant’s role and foundational knowledge to equity, reflection, and systems change.
- Role of the IECMH Consultant
- Foundational Knowledge
- Equity and Cultural Sensitivity
- Reflective Practice
- Child and Family-Focused Consultation
- Classroom and Home-Focused Consultation
- Programmatic Consultation
- Systems-Wide Orientation
Read the Summary of Consultant Skills for Each Competency
| Category | Summary of IECMH consultant skills |
|---|---|
| 1. Role of the IECMH Consultant | Understands and can convey how IECMHC is a mental health specialization and service that is distinct from other activities in which mental health professionals may engage. Demonstrates an ability to strengthen the capacity of staff working in programs and other settings serving infants, young children, and families to support the social, emotional, and relational health of infants, young children, and families in a range of settings. (In the context of this document, unless otherwise noted “relational health” describes the mutual emotional connections established by healthy interactions between or among infants or young children, early childhood providers, caregivers, family members, and program and other setting staff that contribute to infants’ or young children’s overall mental and physical well-being.) Partners with families and staff in working to prevent mental health problems from developing or worsening and/or in responding effectively to existing mental health concerns. Partners with staff and program or other setting and systems leaders to build more equitable systems by addressing implicit bias, increasing positive relationships between early childhood providers and infants and children with different abilities and from diverse racial/ethnic and language backgrounds, monitoring and using disaggregated data to reduce disparities, and developing and implementing new policies that support positive and equitable experiences for all young children. |
| 2. Foundational Knowledge | Draws from a broad and diverse knowledge base to understand infants, young children, families, and staff with different abilities and from diverse racial/ethnic and language backgrounds, and how they relate to one another. Turns to a variety of disciplines and theories to inform the direction of consultation. |
| 3. Equity and Cultural SensitivityLabeled “Equity and Inclusion” in the source summary table. | Understands broad and local historical and systemic dynamics that have generated racialized disparities in outcomes for infants, young children, and families. Works with others to improve their understanding of how infant, young child and adult race/ethnicity, primary language, culture (beliefs, values, voice, communication style, behavioral norms, and attitudes), abilities, biases, disposition, and life circumstances (e.g., poverty and domestic violence) impact the learning environment. Additionally, understands how adult-infant/young child interactions shape the quality of relationships, infants’ and young children’s learning experiences, and disciplinary decisions but also how contextual variables such as community context, history, and systems shape adults’ and infants’/young children’s experiences. Explicitly and intentionally acts on this understanding to create equitable and positive experiences for all infants and young children, including those from historically marginalized and oppressed communities. |
| 4. Reflective Practice | Thinks about and questions personal biases, assumptions, and experiences before, during, and/or after consultative interactions. Considers the influences on and perspectives of others (e.g., infant, young child, family, staff) in the context of consultation, including how these may vary based on infant, young child, family, staff, and consultant ability, race/ethnicity, and language background (i.e., “what might this experience have been like for the infant, young child, staff member, or caregiver?”). Promotes reflective practice with consultees, using this experience-based learning to support consultees’ professional growth and development. Commits to a journey of ongoing self-exploration to understand how one’s culture, background, race, and other social identities (including issues related to privilege and power) impact the way IECMH consultants see themselves and others. |
| 5. Child and Family-Focused Consultation | Collaborates with families and/or program or other setting staff to understand and respond effectively to an infant’s or young child’s mental health needs, behavioral difficulties, and/or developmental challenges or to a caregiver’s mental health needs. Partners respectfully with families and staff to understand the context and nature of a particular family’s life to enhance the infant’s, young child’s and family’s well-being. Takes time to understand how race/ethnicity, primary language, culture, abilities, disposition, and life circumstances (e.g., poverty and domestic violence) influence the infant’s, young child’s, or family’s experiences and the program’s or other setting’s and system’s role in hindering or supporting wellness. Resists applying a deficit-based perspective to infants, young children, and families who are from historically marginalized and oppressed communities by committing to learn about authentic community strengths and adaptive responses to poverty, historical trauma, and other racialized experiences. |
| 6. Classroom and Home-Focused Consultation | Collaborates with families and program staff to promote equitable, warm, and trusting relationships, consistent routines, and development-enhancing interactions that positively impact program and home climates. Understands and values the roles that race/ethnicity, primary language, culture, abilities, disposition, and life circumstances play in supporting infants’ and young children’s social and emotional development and incorporates a family’s culture and primary language into non-home settings to build continuity for infants and young children into their experiences at home and in other settings (e.g., classrooms). |
| 7. Programmatic Consultation | Maintains a systemic approach and aims for program-wide impact through a focus on multiple issues that affect the overall quality and equity of programs or settings serving infants, young children, and families. Works to enhance programmatic functioning by assisting program administrators and/or staff in considering the program’s or setting’s overall social and emotional climate; solving issues that affect more than one infant or young child, staff member, and/or family; collecting and using disaggregated data to track program-wide disparities in both opportunity and the ways in which young children are disciplined, and supporting the development and implementation of policies that create more equitable experiences for infants, young children, and families. |
| 8. Systems-Wide Orientation | Works within and across systems, integrating equity and mental health concepts and supports into the environments where infants and young children spend time. Maintains awareness of the systems within which IECMHC occurs, and considers these contexts when seeking to understand factors that promote or hinder the process of change. Works to strengthen bridges between systems serving infants, young children, and families to facilitate access to comprehensive and integrated care. |
Tribal Considerations
Although some tribes have IECMH consultants who are from the community and are tribal members themselves, due to both the newness of the IECMHC field and the general lack of IECMH consultants nationally, tribal programs may obtain the services of a consultant who is new to tribal work. In the latter case, programs can take some or all of the following steps to integrate a consultant into ongoing efforts to support infants, young children, and their caregivers:
- Provide a cultural guide or mentor: someone the IECMH consultant can go to with questions, to learn about the community, and to engage in ongoing reflection. A simple explanation of why things happen in a certain way may clear up potential misunderstandings, and consultants will appreciate the opportunity for guidance so they may avoid inadvertent errors. Consultants may also find their own previously held assumptions or perceptions shifting, and an opportunity to discuss, question, and ponder those assumptions and perceptions will support their personal development.
- Provide a tour of the community, including housing areas and the places often frequented by infants, young children, and their families (e.g., youth center, family resource center).
- Provide the consultant with the history of the tribe or tribal community, and share any historical information that may be relevant to the work the consultant will do. Knowledge of the historical context can aid consultants in understanding present-day dynamics. For example, information about the Indian Relocation Act and its consequences is helpful for a consultant working in an urban Indian Center.
- Provide the consultant with culturally based resources appropriate for them to use. For example, if consultants are aware that a traditional dance troupe includes young children, they may recommend participation for a child who will benefit from this activity.
- Increase the consultant’s awareness of potential referral sources by providing a list of tribal service providers and tribal agencies serving infants, young children, and families, including wrap-around services and county-based services used by tribal families.
- If the consultant will provide program-level or organizational-level consultation, describe the governing structure of the tribe or Indian Center (e.g., tribal council, governing board, organizational divisions), and clarify how the program or organization fits within this overall framework.
About the competencies
How the competencies were developed
Faculty and colleagues at the Georgetown University Center for Child and Human Development developed the first national IECMHC competencies in 2015, with funding from the Office of Head Start. They were updated in 2020, after review by a wide range of professionals in the field. This page presents the 2020 edition.
Download the 2015 Edition (PDF)
Infant and Early Childhood Mental Health Consultation: Competencies
Over the last decade, infant and early childhood mental health consultation (IECMHC) has emerged as an effective and evidence-based strategy to promote infants’ and young children’s positive social and emotional development and behavioral health. IECMHC has also been shown to play an important role in helping to prevent, identify, and reduce the impact of mental health problems among infants, young children, and their families. And it has the potential to reduce racial/ethnic, gender, language, or disability-based disparities in infant and young child outcomes, which are undergirded by inequitable distribution of opportunity, by supporting those who make decisions about infants and children. IECMH consultants work not only with individual infants and young children but also with programs or settings as a whole, by focusing on issues that affect the program’s or setting’s overall quality and equity. And they also work within and across systems serving infants, young children, and families.
Increasingly, states, tribes, communities, programs, and other settings have adopted IECMHC in early care and education (ECE) settings as well as in other settings typically frequented by infants, young children, and their families (e.g., pediatric settings, hospitals, homeless shelters, child welfare programs). Several states, tribes, and regions have a long history of successfully implementing IECMHC and have developed their own guidelines related to job-specific qualifications, education, and training. As the field expands, there is a growing need and desire for a national consensus on IECMHC competencies that explicitly focus on building more equitable systems for all young children.
Georgetown University Center for Child and Human Development (GUCCHD) faculty and colleagues developed the first version of IECMHC national competencies in 2015 with funding from a training and technical assistance (T/TA) grant from the Office of Head Start, provided under the auspices of the National Center on Health. GUCCHD produced a second version as part of the first Center of Excellence for IECMHC. The IECMHC competencies presented here represent an updated version of national competencies for IECMH consultants. The 2020 competencies have been reviewed by a wide range of professionals in the field, and the content of the 2015 competencies has been updated and edited.
These competencies represent an important step toward building a national consensus on the knowledge and the array of foundational skills and abilities needed to become a competent IECMH consultant. They were originally developed primarily for IECMHC in ECE and home visiting (HV) programs, but they can and should be used in other settings where IECMHC occurs (e.g., pediatric settings, hospitals, homeless shelters, child welfare programs).
We recommend using the competencies in two ways: (1) to supplement or extend guidelines and expectations within established local or statewide IECMHC programs engaged in building an equity-focused, qualified IECMHC workforce and (2) in new efforts to create IECMHC programs to support building the IECMHC workforce in places where one does not yet exist. In addition, the competencies may help to further distinguish guidelines for the field of IECMHC from those that have been developed for other fields, such as infant mental health,Note 1 and to clarify the difference between IECMHC and other types of services offered that support infants, young children, and families.Note 2
These IECMHC competencies may also help
- Influence the hiring, supervision, and evaluation of IECMH consultants.
- Guide professional development, training, and coursework.
- Enhance quality and increase professional credibility of IECMHC.
- Encourage awareness of the importance of racial equity at all levels of IECMHC.
These newly developed IECMHC competencies describe a distinct specialization that combines both infant and young child mental health competencies and other consultation competencies. They represent the most up-to-date compendium of attributes, knowledge, and skills needed to become a competent IECMH consultant. These competencies have been reviewed using an equity rubric to help ensure they equip consultants with the knowledge and competencies they need to address systemic racism and inequitable distribution of opportunity. Ultimately, through refinements over time, they may be used to increase clarity in the field, resulting in specialized training and enhanced or new financing mechanisms to support IECMHC in a variety of settings serving infants, young children, and families. The competencies may also be the first step toward developing a national credentialing system and academic programs specifically designed to train IECMH consultants.
Notes to the 2020 edition
- 1. Korfmacher J. 2014. Infant, Toddler, and Early Childhood Mental Health Competencies: A Comparison of Systems. Washington, DC: Zero to Three.
- 2. U.S. Department of Health and Human Services, Administration for Children and Families. N.d. A Guide to Effective Consultation with Settings Serving Infant, Toddlers, and their Families: Core Knowledge, Competencies, and Dispositions. Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families.
Source: Competency text is reproduced from Infant and Early Childhood Mental Health Consultation: Competencies, Center of Excellence for Infant and Early Childhood Mental Health Consultation (2020 edition).
Where to go next
See where your own practice stands with the Consultant Self-Assessment. The Practical Certificate in IECMHC turns these eight competencies into supervised, day-one-ready practice. It is built by the people who wrote the national competencies.