ACTIVITY: Three Perspectives: The Cultural Context of Early Childhood Mental Health Consultation

ACTIVITY: Three Perspectives: The Cultural Context of Early Childhood Mental Health Consultation

teachers and toddlers

Below is a brief scenario that represents three perspectives – parent, ECE provider, and consultant – to illustrate the cultural context of early childhood mental health consultation. Review the scenario and respond to the questions that follow:

Vignette: Pia’s Shoes

Rose comes to pick up her daughter, Pia, at the child care program. Immediately, she is upset that, once again, her 13 month-old daughter is not wearing her shoes. Instead, of on her feet, Pia’s dressy shoes are in the cubby just like they’ve been the last number of times Rose has come to the center. Rose is very frustrated and upset. She has asked the teacher on several occasions to make sure that Pia wears her shoes at all times, except when she takes a nap. In the community where Rose grew up, wearing shoes was important to avoid stepping on sharp cactus thorns and catching colds.

Mary, the teacher, had explained that she believes that the best thing for a child who is learning to walk is to go barefooted because bare feet are better for balance and control. At the time, Rose did not question Mary’s position, but expected Pia to be wearing shoes as she had requested. In addition to feeling disrespected today, Rose has been finding it more difficult to manage Pia at home, where she now insists on taking off her shoes.

There is tension between Rose and the teacher. Pia looks back and forth between her mother and teacher uncertainly, then cries and resists being comforted by either one. Rose picks Pia up, gets her shoes out of the cubby, and tells Mary she will find someone in her neighborhood to care for Pia during the day. Mary is upset and confused about what just happened and hopes Rose will bring Pia back to the child care center.

The mental health consultant, Dr. Romero, who was in the classroom at the time, observed the interaction between Rose and Mary as well as Pia’s reaction. While Dr. Romero is in agreement with Mary’s perspective on the benefits of bare feet for balance and control, she recognizes that in her own experience as a child, dressy shoes were a sign of a well-loved and well-cared for child in a family that may have limited means. Dr. Romero suggested that she and Mary meet to discuss what happened and plan to meet together with Rose. (Adapted from Pulido-Tobiassen & Gonzalez-Mena, 1999, used with permission)

Activity Questions

  1. What personal/professional cultural perspectives are presented by each party?
    • Family?
    • ECE Provider?
    • Mental Health Consultant?
  2. What seem to be the sources of the diverse perspectives for each party?
    • Family?
    • ECE Provider?
    • Mental Health Consultant?
  3. What are the challenges for the consultant and the consultation process?
  1. Family:  Children should wear shoes at all times except while sleeping; being  barefoot is dangerous to health and well-being; parents make the decisions about their children’s care; parents may not question teacher’s opinions out of respect; neighborhood-based kith and kin care will understand and follow family/community customs.ECE Provider:  Children new to walking develop balance and control better in bare feet, child development is the primary goal of care; parents accept teacher’s opinions as child development experts; tension between caregivers is confusing and stressful for young children.
    ECMH Consultant: Children new to walking develop balance and control better in bare feet, child development is one goal of care; dressy shoes can be a symbol of loving care; exploring the perspectives of both parties is important for Pia’s return to care. 

    Family:  Family experience, family values, health beliefs, power/respect relationship between parents and teachers, sense of community

  2. ECE Provider: Child care profession, child development, developmentally appropriate practicesECMH Consultant: Child development, developmentally appropriate practices, family experience, family values, professional consultative role
  3. Challenges/approaches for the consultant include the:
    • Examining and understanding the diverse perspectives that are present
    • Reaching out to Rose and have her agree to meet
    • Helping Rose and Mary understand each other’s perspective
    • Improving clear communication between Mary and Rose
    • Reducing the tension between Mary and Rose
    • Exploring Pia’s different experiences at home and the ECE program and continuity of care concerns
    • Balancing a child development perspective with respect for cultural values, beliefs, and customs
    • Rebuilding respect and trust between the Mary and the Rose
    • Helping Rose deal with Pia’s challenging behavior at home
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This product was developed [in part] under grant number 1H79SM082070-01 from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.