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An Obama administration push to improve outcomes for infants and young children hasn’t done enough to help children who have experienced trauma, advocates say.

Three years ago, U.S. Secretary of Education Arne Duncan created a dedicated Office for Early Learning with the ambitious goal of “improving the health, social-emotional, and cognitive outcomes for children from birth through third grade.” The new federal office forged a unique partnership with the Department of Health and Human Services to enhance state innovation for early learning development.

Children's mental health services
Photo: Roy Sinai

However, in cities like Chicago, some early education providers say more funding is needed for early mental health services to prevent young children who are victims of violence from academic failure. Advocates say the ideal would be more early childhood centers that offer comprehensive mental health services for toddlers, like the Erie Neighborhood House in the West Town neighborhood of Chicago. Since 1995, Erie has provided mental health services for children in their early childhood program for preschoolers suffering from trauma, behavioral issues and other disorders, and includes a full-time psychologist, social worker, and nine graduate students, most from The Chicago School of Professional Psychology.

The Hechinger Report spoke with Erie’s psychologist, Elizabeth Yelen,about what mental health means for the youngest children and how treatment improves learning.

Question: Why is it important to have mental health services available at an early childhood education center?

Answer: Birth to 5 is really the most vulnerable part of brain development. I think that we need to start intervening early, because kids aren’t exposed to stuff starting at age 8, which is when a lot of treatment starts happening.

Typically, it’s when they’re born, or even prenatally. So the earlier you can get in and try to provide support for them and intervention, and work with parents, the better that would be for the child development and brain development.

Here at Erie, we see a lot of kids exposed to domestic violence. So that kind of scary, unsafe environment is already impacting a lot of their development.

Q: What is the impact on early literacy and academic achievement if those emotional problems are not treated?

A: When it’s not treated, what you end up seeing are kids that are very reactive to their environment. They’re constantly reacting. It can often look like aggression or withdrawal, depending on the predisposition of the child.

So if they’re exposed to a family situation that is unsafe, chaotic, unpredictable, at best, they’re wired to either be afraid and withdrawn? or afraid and aggressive?.

So, for a lot of the kids exposed to violence, you are going to see either the very withdrawn kids or the very aggressive kids, typically short attention spans. A lot of times, kids are diagnosed with ADHD … They’re hyper-alert and they can’t focus. They can’t concentrate. They’re moving all over the place. They’re easy to react emotionally. They’re kind of on a short fuse. So it definitely impacts the learning. It puts them at a great disadvantage if they can’t sit still.

Q: How does mental health treatment in early childhood years improve cognitive development?

A: It helps to calm them down. They have a place to go to put their feelings and their energy. And then you can have somebody that’s skilled in providing a safe environment for them that can help develop a relationship with them. It gives them a new early experience that’s not only good interpersonally, but neurobiologically.

Q: Do you work directly with the children?

A: Yes. We work with every kid that gets referred to us. We start out doing individual play therapy and assess their needs. Often times with very young kids, they do best with a one-on-one play therapist.

It’s always at least once a week, if not twice a week, for 45 minutes.

If it’s understood that the child needs more socialization with peers, then we might move him into a group. And often times when they settle down in individual therapy, they become ready to do something with a small group.

But a lot of those basic needs must be met first, so that someone is focusing on them, giving them a space to play, establishing a relationship with them, all these things calm down some of that anxiety.

Q: In addition to domestic violence, what are some other mental health issues?

A: Most of our parents are very impoverished. Parents are working double shifts. Kids are being shifted from one caretaker to another, just all those problems that poverty brings.

We see kids that are overstressed and burdened by real life problems that most people don’t deal with until they’re older. They’re very aware of what their parent issues are.

Q: Even at the age of 2?

A: Yes. At the age of 2, they can’t verbalize it obviously, but you can feel it. You can get a sense from the kid that they’re anxious or feel unsafe. They might tend to be more violent or more withdrawn. Those kids tend to stand out.

Q: How soon can you see the results of early mental health intervention? If you treat a child at 2, can you see the results at 3 or 4?

A: Yes. They just get calmer, they get more relational. They’re just more open. Sometimes it’s hard to measure. It’s something you can feel.

We try to find other ways to measure progress. We look at the nature of the play. We look at the way they relate to play therapy. We look at the progress in the classroom and you see that it transfers over.

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