Module 5: Risk Factors and Community Referrals

Although many prevention and best practice strategies were shared in modules 2-4, there are times when early childhood mental health consultants and the other adults in a child’s life are worried about a child’s behavior and prevention strategies are not warranting positive change. Sometimes further assessment and referral are necessary to help families and children get the support they need. Some social and emotional risk factors that should be carefully observed and discussed include:

• Little or no eye contact
• Frequent and long-lasting fussiness or irritability
• Unsmiling or withdrawn behavior
• Little or no preference for familiar adults
• Extreme, frequent and long-lasting tantrums that impede on learning and relationship building
• Lacks curiosity
• Sleeping too much or too little
• Troubles with eating/feeding- too much or too little
• Shows a regression in language, for example stops cooing and babbling.

In addition, for toddlers and preschoolers:

• Unable to use toys in imaginary ways
• Often seems sad or worried
• Fails to listen or respond
• Rarely uses words to express feelings
• Seems unable most of the time to control feelings

An important role of the early childhood mental health consultant is to be knowledgeable about community services and how to access them when risk occurs. In a national cross-site study of effective early childhood mental health consultation programs, 69% of consultants reported making at least monthly referrals to other community resources for early care and education providers and 72% reported making at least monthly referrals for families (Duran et al., 2009). Information on community-based services should be readily available to families, and consultants can help gather that information for caregivers and adults. It is important for consultants to be well informed of the array of community services available for young children. This includes knowing the eligibility criteria for the services, what services are provided, who the service contact is, costs involved, and steps for accessing services. Children can be susceptible to a wide range of behavioral and developmental risks, so it is important to have a diverse and expansive list of referral sources. This knowledge will expedite getting children and families to the appropriate source. Some possible resources to consider are:

1. Early care and education
2. Early Head Start
3. Head Start
4. School Readiness Programs
5. Other child care or education settings
6. Early intervention and special education
7. Part C
8. Special education
9. Local schools
10. Other
11. Children’s mental health services
12. Home-based services
13. Infant mental health (if separate from home-based)
14. Wraparound
15. Child case management
16. Family therapy
17. Specialty services (e.g., Children’s Mood Disorder Program)
18. Other
19. Adult mental health and substance abuse services
20. Assessment
21. Individual counseling
22. Other community services and supports
23. Child Care Resource and Referral
24. Primary health care provider/pediatrician
25. Developmental pediatrician
26. Neurologist
27. Public health (e.g., lead or fetal alcohol screening, Children’s Special Health Care Services Program, etc.)
28. Occupational therapist
29. Physical therapist
30. Speech/language therapist
31. Department of Human Services (e.g., cash assistance, child care subsidy, etc.)
32. Domestic violence program
33. Parent education and support services (e.g., divorce group)
34. Infant massage
35. National and state associations/resource centers

Questions:

1. Do you have knowledge of state and local resources that families can access when in need of additional services? If not, how might you go about accessing this information?