Closing the Opportunity Gap for Young Children (2023) / Chapter Skim
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5 Opportunity Gaps in the Social-Emotional Development, Well-being, and Mental Health Experienced by Young Children
5 Opportunity Gaps in the Social-Emotional Development, Well-being, and Mental Health Experienced by Young Children
Pages 263-308
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From page 263... ...
First, in addressing parents' mental health and well-being, we are talking not just about formal psychiatric disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychiatric Association, 2013) , such as substance abuse disorder, depressive illness, anxiety disorder, and posttraumatic stress disorder, but also about factors that hinder well-being, such as domestic violence, daily work stress, hassles, worry about minimal material goods, lack of neighborhood safety, racism, and pessimism.
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From page 264... ...
As discussed in prior chapters, opportunity gaps, in turn, have evolved across generations through biased institutional practices. The good news is that by identifying culpable policies and practices, societal leaders can implement changes that the committee believes hold promise for reducing these opportunity gaps and hence, helping to enable healthy developmental outcomes for all children.
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From page 265... ...
. Scientific findings on child development over the past several decades have shown what kinds of environmental experiences are essential for optimal cognitive, social-emotional, and behavioral development.
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From page 266... ...
. Disparities experienced by parents in housing, education, job opportunities, health care, and access to community resources are responsible for disparities in their readiness to parent and in the resources available to them to invest in their children in ways essential to a child's development of essential competencies.
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Disparities and Opportunity Gaps in Mental Health in Early Childhood The mental health of young children is critical for their academic outcomes and general health and well-being (Mashburn et al., 2008)
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. For example, African American children are more likely to have externalizing disorders but less likely to have internalizing disorders compared with their White counterparts (Coker et al., 2009)
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As the preceding section of this chapter suggests, young children's mental health is grounded in individual, familial, and neighborhood processes, including sensitive and responsive caregiving, safe and stable home and neighborhood environments, and opportunities for supports outside the home. However, young children from families with low socioeconomic status and certain racial/ethnic backgrounds are deprived of many of these individual and environmental resources, a disparity that creates a large opportunity gap between them and children from less marginalized groups.
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From page 270... ...
. Children may also experience myriad systemic opportunity gaps, such as institutional factors -- including experiences in ECE and school, parental job quality and stability, neighborhood resources, and access to health care -- that affect children from impoverished and minoritized backgrounds (Yoshikawa, Aber, & Beardslee, 2012; Alegría et al., 2015)
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From page 271... ...
For example, robust evidence shows that ECE teachers perceive African American and Latin American children (especially African American boys) as behaviorally problematic (Gilliam, 2005; Barbarin & Crawford, 2006; Gilliam et al., 2016)
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. A key opportunity gap lies in access to and engagement in mental health care among low-income and minoritized groups (Bringewatt & Gershorff, 2010)
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underscore that African American and Latino children and youth are less likely to receive specialized mental health care for such issues as substance use and depression. These authors
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On the other hand, nonpoor African Americans were less likely than their White counterparts to receive specialty mental health care. In their proposed research agenda for improving minority children's access to mental health care, Alegría and colleagues (2015)
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approaches. Overall, a comprehensive approach is critical to address opportunity gaps in mental health for children from low-income and minoritized backgrounds.
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From page 276... ...
. In this discussion, we consider the empirical evidence supporting the effectiveness of these strategies in addressing opportunity gaps in the mental health arena for young children from minoritized groups and families with low socioeconomic status.
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From page 277... ...
For instance, compared with other children, African American and Latino children are less likely to be diagnosed with an ASD, and are more likely to be diagnosed at older ages and with more severe symptoms (Croen et al., 2002; Mandell et al., 2002, 2009; Palmer et al., 2010; Fountain, King, & Bearman, 2011; Pedersen et al., 2012)
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From page 278... ...
African American children with ADHD were less likely than White children with ADHD to initiate stimulant medication. Pastor & Reuben, 2005 21,294 children in the Latino and African American 1997–2001 National Health children, compared with Interview Survey White children, had less frequent parental reports of ADHD.
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From page 279... ...
Liptak et al., 2008 102,353 children in the 2003 Parent-reported prevalence National Survey of Children's of ASD was lower for Latino Health than for White children; rates were similar for African American and White children. Kogan et al., 2009 78,037 children included in African American children the 2007 National Survey of were less likely than White Children's Health children to have ever had or currently have an ASD.
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From page 280... ...
showed that African American, Asian/Pacific Islander, and Latino parents were less likely than non-Hispanic White parents to view emotional/behavioral problems as having a mental health basis (Kinser et al., 2018) , a view that is associated with lower rates of use of mental health services (Pachter & Dworkin, 1997; Bornstein & Cote, 2004)
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From page 281... ...
. Strengthening Families' Work Supports to Reduce Opportunity Gaps The first few months after childbirth is a period in which mothers need time away from work to recover physically and bond with their infants.
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From page 282... ...
Conversely, limited access to paid leave creates an opportunity gap for young children by limiting bonding time for parents and infants or adopted children, decreasing the time available to take care of serious health issues, elevating family stress, and exposing children to financial uncertainty, all of which can negatively affect children's social-emotional development. Although paid family leave policies benefit parents' and young children's mental health, their effects can vary.
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From page 283... ...
, calls for periodic reviews of interventions in which home visiting is the primary service delivery strategy to determine whether they improve outcomes in specific legislatively mandated domains, including maternal and child health; positive parenting practices and reductions in child maltreatment; child development and school readiness; family economic self-sufficiency; linkages and referrals to community resources and supports; and reductions in juvenile delinquency, family violence, and crime. Evaluations of home visiting programs (including those that are and are not reviewed by HomVEE)
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. Tertiary-level home visiting programs are typically therapeutic and are targeted at children and families that display mental health challenges.
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. Other home visiting programs may have a parent management orientation and coach parents to alter negative interaction patterns with their children.
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Program Strategies for Reducing Opportunity Gaps in Early Childhood Mental Health Mental health programs are another set of interventions designed to reduce the opportunity gaps and disparate mental health outcomes experienced by children and families from racially/ethnically and socioeconomically marginalized populations. The goal of infant and early childhood mental health programs is to foster the optimal social-emotional functioning of young children, specifically regarding the development of positive relationships with adults and peers, the expression and regulation of emotions, and the creation of a solid sense of identity and autonomy.
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From page 287... ...
IECMHC consultants may also collaborate with teachers and parents to create supports for children already showing challenging behavior, which may result in fewer child suspensions and expulsions. A growing evidence base is documenting the effectiveness of IECMHC at the child, teacher, school, and family levels (Brennan et al., 2008; Perry et al., 2010; Hepburn et al., 2013; Substance Abuse and Mental Health Services Administration, 2014; Center of Excellence for Infant & Early Childhood Mental Health Consultation [IECMHC]
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From page 288... ...
. School Nursing to Reduce Opportunity Gaps in School Strengthening school-based mental health systems and supports could help in addressing the growing mental and social-emotional health challenges seen in young children (Johnson, 2017; Kodzis, 2021)
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School nurses ensure that all children have access to appropriate educational opportunities regardless of their state of health. To this end, it is essential for their referral options to include comprehensive school mental health systems as well as primary care providers, mental health specialists, telemedicine, and school-based health centers (Centers for Disease Control and Prevention, 2018; National Center for School Mental Health, 2019)
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. This unequal impact has likely increased the opportunity gap for young children, exacerbating disparities in their long-run outcomes.
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From page 291... ...
Active policies and support for accessing proven programs is necessary to help all children thrive socially and emotionally and to eliminate centuries-old inequities in opportunities that are responsible for disparities in outcomes in this realm. Although there are many promising practices that can help close this opportunity gap, unequal access to services and resources that promote positive social-emotional development and well-being remains a barrier to promoting equitable outcomes for young children.
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. Inequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites.
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Child Development, 72(1)
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. An notated bibliography: The evidence base for infant and early childhood mental health consultation (IECMHC)
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. Ra cial discrimination, mental health, and parenting among African American mothers of preschool-aged children.
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A study of effective early childhood mental health consultation programs. George town University Center for Child and Human Development.
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Foundation for Child Development. Available: https://www.fcd-us.org/ prekindergartners-left-behind-expulsion-rates-in-state-prekindergarten-programs/ Gilliam, W.S., Maupin, A.N., Reyes, C.R., Accavitti, M., & Shic, F
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. Early childhood mental health consultation as an evidence-based practice.
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From page 299... ...
. Mental health consultation in child care: Transforming relationships among directors, staff, and families.
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. Skin-tone trauma: Historical and contemporary influences on the health and interpersonal outcomes of african Americans.
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. Racial/ethnic disparities in the identification of children with autism spectrum disorders.
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. Attention deficit hyperactivity disorder in African American children: What can be concluded from the past ten years?
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. Enhancing early childhood mental health primary care ser vices: Evaluation of MA Project LAUNCH.
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. The evidence base for mental health consultation in early childhood settings: A research synthesis addressing children's behavioral outcomes.
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. The role of infant and early childhood mental health consultation in reducing racial and gender relational and discipline dis parities between black and white preschoolers.
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. Expert convening on in fant and early childhood mental health consultation.
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. Social and economic determinants of disparities in professional help‐ seeking for child mental health problems: Evidence from a national sample.
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