Pathways to prevention: A training and technical assistance initiative to increase program capacity to address infant mental health issues in Early Head Start.

This article provides an overview of a training and consultation program aimed at enhancing the capacity of Early Head Start (EHS) and Migrant and Seasonal Head Start (MSHS) programs to address infant mental health issues from a promotion, prevention, and treatment perspective. This program was implemented by the Early Head Start National Resource Center (EHS NRC), operated by ZERO TO THREE. The EHS NRC is funded by the Head Start Bureau to provide a diverse array of training and technical assistance support services to Early Head Start programs throughout the country. In the fall of 2001, ZERO TO THREE was funded to design and implement the Pathways Initiative. While ZERO TO THREE was not funded to test the efficacy of the Pathways Initiative as a research intervention similar to other papers described in this special issue, we worked creatively to identify resources that allowed us to engage an external evaluator to look at both process and outcome measures. This paper describes the consultation program, evaluation activities, and key lessons learned.

Infant mental health: an interdisciplinary framework for early social and emotional development.

We review historical factors that led to the creation of the interdisciplinary field of infant mental health. The history of infant mental health is linked to transformations in scientific knowledge about infancy that emerged primarily in the 20th century, particularly with respect to social and emotional development. Contemporary challenges for the infant mental health field focus on research, practice, and policy issues that reflect these shifts and impact our understanding of the dynamic social, emotional, and cultural forces that shape early development.

The Patient Protection and Affordable Care Act: an opportunity to address barriers that impact pediatric practice.

Pediatricians are uniquely positioned to partner with parents as they rear and nurture their young children. This article addresses the barriers that influence the pediatrician's ability to engage in developmental guidance during regular well-child visits. Challenges related to the current structure of pediatric training programs are discussed, as well as the economics of extending time with families, and the real limitations associated with insurance reimbursement policies that make it difficult for pediatricians to focus on developmental preventive care related to social and emotional development. Recent changes in the public policy arena provide an opportunity to overcome barriers. Specific provisions are described within the Patient Protection and Affordable Care Act that have the potential to enhance opportunities to address social and emotional development through the provision of developmental guidance to parents with very young children.