Infant-Parent and Early Childhood Mental Health: Faculty Expertise and Innovation
Can you recall memories of life before learning to crawl or walk? For most, the answer is probably “no.” For example, we often can’t remember preschool playmates or being gifted the must-have-toy for our first birthday. However, because of the body’s somatosensory system, we can recall whether we felt loved, had a sense of safety, or how family spoke to us. Infant mental health focuses on these earliest experiences—the good and the bad—of a child from birth through the age of five. And, for most people, research shows that these experiences during the early years tend to influence the rest of our lives.
At the forefront of training for infant mental health outcomes is a collaboration between the University of California Davis Continuing and Professional Education (CPE), the Parent-Infant & Child Institute (PICI) in Napa, and the Neurosequential Model Network (NMN). For 22 years, the trio has offered the UC Davis CPE Napa Infant-Parent & Early Childhood Mental Health Fellowship—an intense, 15-month transdisciplinary program for clinical and educational professionals working closely with infants, their families, and caregivers. This specialty training program has been honored with state and national awards.
For well over a decade, Jerilyn Callen, OTD, OTR, Clinical Associate Professor for the Department of Occupational Therapy in Baylor University’s Robbins College of Health and Human Sciences, has had an interest in mental health. She completed the prestigious fellowship in April 2024.
“A dear friend and colleague completed the fellowship in 2023 and urged me to check it out. Throughout her cohort we kept in contact, and after much prayer and discernment I decided to apply,” she recalled. “Being a fellow is to be part of a niche group of practitioners who recognize the power that mental health, resiliency, and interdisciplinary work can have on children—the future of this world.”
The Napa Fellowship focuses on improving mental health models of care through evidence-based research, assessment, and intervention techniques. It teaches a holistic approach and a deeper understanding of relationship-based therapies, spurred by clinicians and educators across a variety of disciplines from all around the world. Courses take place virtually, one full weekend per month. Callen was struck by the opportunity to hear from and interact with some of the most preeminent “luminaries” in the world of infant mental health, including Bruce Perry, MD, PhD, a pediatric psychology and trauma scholar, and Kristie Brandt, CNM, DNP, a psychiatric pediatrician and founder of the Napa Fellowship.
Occupational therapy has deep roots in mental health, and the profession is constantly changing, utilizing new strategies to help daily life flourish. That said, Callen says the focus on infant mental health is fairly new to the profession.
“Mental health is for everyone, of every age. As occupational therapists we understand the distinct connection between mental health and function,” she explained. “The introduction of formalized mental health attention—and care to the youngest in our population—is relatively new. In a post-pandemic world, we see the need more than ever to have mental health services to help reduce future health conditions and improve the lives of children and their caregivers!”
As a typical child matures, they learn how to connect with others, how to cope with problems, and how to regulate their emotions. These relational, developmental, and emotional milestones tend to be a strong indicator of their wellbeing. However, when hardships like developmental needs, trauma, and environmental factors enter the picture, it can greatly impact a person’s health and wellbeing well into adulthood. In 1998, the adverse childhood experiences (ACE) study showed a direct link of negative childhood experiences, like exposure to abuse or household dysfunction, to adult risk-behavior and chronic disease often leading to early death.
“We know, because of studies like the ACE study, that mental health challenges impact not only emotional and psychological health but also physical health. We know that those who experience ACEs are several times as likely to have mental health issues, diabetes, cancer, heart disease, etc.,” she stated. “For many decades, people assumed children did not ‘remember’ traumatic events or did not have mental health issues and were naturally resilient. With more research and a deeper look into the parent-child dyad we see that things like trauma and mental health conditions have both genetic and situational linkages. More than ever, we are learning that investments in childhood mental health pay dividends over time.”
Due to this chain reaction, it is important to recognize potential problems early on and intervene quickly to help restore wellbeing—to create safe, stable, and nurturing environments and relationships. In pediatric occupational therapy, intervention models of care include play, resiliency building, and sensory integration. Occupational therapists also prioritize the caregiver-infant relationship, help educate the family, and provide recommendations to accessible support systems within the community.
“Early intervention is known—across the spectrum of healthcare—to be one of the most impactful ways to mediate and remediate concerns,” she said. “Every child’s mental health is a public health concern. My aim is to inform my students so that the next generation of occupational therapists can be proactive to the needs of our most vulnerable clients.”
In addition to evidence-based education, Callen said the Napa Fellowship focused on development of interdisciplinary teams tasked with implementing trauma-informed and mental health-based care in the communities in which the fellows live, work, and practice.
“I learned the impact and importance of leveraging resiliency at the earliest stages of development. The child-caregiver dyad is the center of mental health. The biggest factor is consistency and willingness to work as a cohesive team to ensure optimal outcomes,” she said. “As a therapist I realized my lack of true understanding, as well as how to leverage the strength of occupational therapy and those of my colleagues, to shore up the most vulnerable in our population. And, as a parent, I also learned how to be the best version of myself as a parent.”
Callen is taking her personal commitment to ongoing professional development a step further, as she plans to share the knowledge she gained through the fellowship. Currently, she is working on a manuscript for publication, and she also just secured a book proposal with a major publisher.
“This will empower occupational therapy clinicians who want to implement some of the things I learned through the fellowship into practice,” she shared. “I am excited to have found this work—and I look forward to sharing it nationally, internationally, and through my work at Baylor with our students.”