Luke is independent and likes to flit from activity to activity, person to person. But he shows little interest or attention in anything and fends off affection. Perhaps his biggest problem is that he avoids eye contact. Luke is a perfect candidate for therapy.
And, he’s 2.
When Kristin Mathis adopted her Luke from Russia, she knew her family was about to experience an adjustment. She steeled herself to bring home a child with a completely different temperament, background and personality. After all, the seasoned Carrolton mom of three had adopted children already, and Mathis knew understood what it would take to raise a baby — and even how to get through the terrible twos.
What she did not know was that her family’s newest addition would face the additional hurdle of overcoming psychological issues. And he would need the help of the entire family, as well as trained professionals.
Luke’s antisocial behaviors are common traits among children who suffer from infant mental health issues (zero to 3), and can be particularly heartbreaking for families trying to bond with new babies. And, they affect a much broader population of newborns than just those adopted.
In late 2006, the nonprofit Interdisciplinary Council on Developmental and Learning Disorders and the U.S. Centers for Disease Control collaborated on a report that outlined early intervention strategies for emotional and developmental challenges. In it, the researchers found that 17 percent of all U.S. children suffer from some sort of developmental of behavioral disability. The study also revealed that less than half of these children had their conditions diagnosed before starting school, meaning that many or our children’s developmental and mental health issues are likely present from the earliest ages.
Infant therapy sounds ominous, but before descending into new-parent panic mode, it’s important to consider the facts about this aspect of your child’s health. Mental health issues can easily go undetected, but no one gets your baby better than you … so what do you need to know?
Not a New Problem
Therapists are increasingly treating younger children — even before they are potty trained. The field of mental health is not new, but recent emphasis on everything from brain development to postpartum depression have renewed interest in moving the field from the couch to the crib. It’s not enough anymore to solely focus on cognitive and motor developmental skills. Parents are eager to boost social and emotional development, as well, catch potential psychological disorders earlier (such as autism, which can now be spotted as early as 6 months of age).
So what does a healthy baby’s mind look like? Essentially, we see it as on target social-emotional development, according to the Texas Association for Infant Mental Health (TAIMH. And, although it may seem like a little playtime and cuddling is just what the doctor orders for this kind of growth, infants can, in fact, harbor anxiety just like adults. It’s a crucial time with their relationship-building skills budding during this time, as well.
What it really comes down to is attachment and temperament.
“We, as the primary parents, are responding to them [babies] and helping them become comfortable,” says Marnie Stone, current TAIMH director and Early Childhood Intervention program director for special care and career services.
Positive interactions, that can be as simple as just smiling or cooing back when a baby is happy, are building pleasure, Stone describes. These responses are actually helping to create pathways in the brain that are the basis for positive mental health.
Early Intervention Is Key
While many babies face normal bouts of eating and sleeping problems, as well as excessive crying, these issues could also be signs of neurological trauma.
If you have an unhappy baby, you’ve got to figure out why — and assess your own happiness, too. It’s about “connectedness with the parent as the primary caregiver,” says Dr. Marjorie Milici, a local pediatrician and mother of two young children, one of whom experienced similar issues.
Babies who are discontented and don’t show a strong connection to mom or dad, like Luke Mathis, for example, are not likely to grow out of it, as with other infancy issues. If you have an unhappy baby, she cautions, then you are likely to have an unhappy toddler and an unhappy family. "These are the kids who get kicked out of preschool. They have trouble forming friendships,” says Milici.
Stone concurs, adding that babies who don’t receive emotional intervention early are more likely to seek attention in unhealthy ways as they grow up — a pattern that Mathis noticed in Luke, also.
So why on earth would your baby be unhappy if you’re parenting by the book? Aren’t all babies bouncing bundles of pure joy?
Well, yes – and no.
Milici says the vast majority of babies are happy. However, the notion of babies being born as “blank slates” is a thing of the past. “Personality is programmed,” she asserts, so not only do babies have different temperaments from the womb, but they also have very dissimilar thresholds for stress. Babies who have difficulty feeding, who are underweight, who seem colicky and don’t sleep regularly could be experiencing anxiety.
If you’re wondering what kind of stress an infant has to deal with, the answer is: your stress.
Being a new parent is nerve-racking, says Barbara Moss, former TAIMH executive director, and babies pick up on mom and dad’s worry. So, if lack of sleep is leaving you more irritable than usual, you may start to see this reflected in your child’s behavior. Anything in a marriage that causes conflict, from money troubles, to relocating, to relationship challenges can also impact infant mental health.
Renowned pediatrician and Texas-born author T. Berry Brazelton addresses some of these challenges in his recently revised volume, Touchpoints, Birth to Three. His first touchpoint (or age milestone) is the end of pregnancy, during which, he suggests, the family should focus on possible tension and challenges in their lives, and plan to address them before the baby’s arrival.
How much help is available (i.e. grandparents, babysitters)? When will the mother return to work? How will the finances change? These questions, among others, Brazelton says often get pushed to the back burners when the preparations for birth and delivery intensify. Left unaddressed, though, these issues can lead to strain in marriages and leave a new baby feeling undue angst.
And, not to be overlooked as a cause of infant anxiety: postpartum depression. Mental Health America estimates as many as 20 percent of new moms experience symptoms of depression. North Texas psychiatrist Urszula Kelley cautions that this is likely to affect attachment and mom’s ability to make a good, mutually fulfilling connection with her child.
Also of concern: A 2007 study by the University of Missouri-Columbia and the University of Texas-Austin found that unresolved loss in new mothers can impact their parenting and attachment to their babies. Such unsettled matters can lead to behavior that frightens babies (scary voice changes, sudden movements or even lack of a playful demeanor) and stunts their social-emotional development.
So what to look for? According to the CDC and Interdisciplinary Council report, in the first three months, parents should pay attention to how a baby looks at them; how the baby responds to voices and faces; and how easily is the baby soothed? And, after those initial months, milestones to look for include a baby who is generally happy when he sees his parents and is beginning to initiate his own sounds, laughter and eye contact.
Giving Baby Every Advantage (Even Therapy)
When adults are stressed, we have a variety of outlets for coping. Whether you go for a jog, enjoy a glass of wine or write in a journal, there are plenty of ways to reclaim your sanity. But your baby doesn’t have any of those outlets. So, what can you do to preserve her mental health (and yours) and keep her on track for social, emotional, language and other types of development?
Because infant mental health is largely about relationships, Milici suggests interaction is key. And this starts at home. “You don’t have to have a lot of expensive toys,” although plenty of playtime is essential, and “it’s never too early to start reading to them,” says Milici. For Stone, it can be as simple as just “being reciprocal with children.” Smile for smile; coo for coo.
Also critical, Milici says, is making sure parents take time for themselves. Mom and dad need to be happy, healthy and fulfilled, because “the goal is the parents should be able to enjoy the baby,” she advises.
Stone suggests setting up support networks, giving you a time and place to deal with your tension. If you have someone to talk to or a method of release when stresses arise, your anxiety won’t take attention away from your relationship with your baby.
Infant massage is another tool to help baby process uneasiness and aid development. If you still have a despondent tot, however, Kelley suggests keeping a list of concerns and consulting your pediatrician.
In fact, the TAIMH holds biannual conferences to educate pediatricians, health professionals and social workers about the oft-mysterious affliction of infant mental health. This year’s educational summit brought Brazelton to Dallas to share his “touchpoints” with the medical community. The goal is to turn anyone who touches the lives of infants and their families into an advocate for infant mental health — to make early intervention a reality.
In some cases a visit with a therapist or social worker, like Kelley, may prove beneficial for building emotional intelligence. “Sometimes the therapist comes to the home and models to the mother different ways of responding to the child,” Kelley offers. She explains that the parenting style the mother has with her baby is often a repetition of how she was mothered herself. “It is possible that it wasn’t a very good relationship for her, therefore she will find the baby quite frustrating,” urges Kelley.
The Mathises worked with Early Childhood Intervention to treat Luke. With a skilled therapist coming into their home once a month, Mathis says she learned to play “baby games” with her little boy (rather than the traditional notion of talk therapy).
“We did a lot of touching; we did lotion; we did walking; we did face-to-face talking,” she describes, adding that the emphasis on skin-to-skin contact helped her foster attachment with Luke and nurtured his comfort level.
Mathis says she began to see a difference in Luke’s temperament and attachment after only two months, but is quick to add that it’s an ongoing process. Now, she says, “He seeks us out immediately when he needs something; he gives spontaneous affection.” And, his eye contact has come a long way, too.
And, as Luke makes progress, Mathis says she’s become a more flexible mother, as well. “I know I have more respect for the natural bonding process,” she admits.
“As parents, sometimes we think ‘why can’t they just tell me what’s wrong?’” offers Stone. But the reality of the birth to 3-year period is that parents have to learn to respond to their baby’s cues.
Because, as Moss says, “These first relationships are like templates for our whole life.”
