Every child deserves a loving, nurturing environment from which they can grow and develop. Achieving that state of mental well-being is not always straightforward, and not every family is equipped to appropriately meet the individual needs of their children. Some kids adapt easily and have little trouble navigating social situations, while others need more guidance to help them build and maintain strong bonds with their peers and role models.
Northern Virginia Family Service (NVFS) is a resource for children and their parents to ensure our youngest neighbors are developing a strong mental health foundation. We provide counseling services through a number of programs, including our Early Head Start and Head Start programs, which promote healthy development and school readiness for low-income children ages 0 to 3 and 3 to 5, respectively, in both center and home environments.
NVFS Head Start mental health coordinator Diana Bermudez, Ph.D., LPC, recently participated in a panel as part of a screening of “Resilience: The Biology of Stress and the Science of Hope” to discuss Adverse Childhood Experiences (ACE) scores and the long-term health effects they can have. We asked her to share insights on assessing childhood mental health, the importance of the family dynamic and how NVFS supports local families in improving early childhood mental health development.
Q: How do you determine when a child may need counseling or mental health assistance?
A: We observe each classroom at NVFS’ Head Start Center about every other month, as well as the socialization groups for the home-based programs. Then we discuss if we have observed any concerns and what we may need to offer as a way of supporting them.
The teachers also conduct social emotional development screening when a child is enrolled. That will tell us if there are concerns before they’ve been there for 45 days, so that we can catch it as early as possible. We review them, and if there is that concerning score, we act on what kind of help we can offer this family.
Q: How do you create a strong environment to foster good mental health?
A: We use a theoretical model that is called the pyramid model. The first level of that pyramid above the base is nurturing relationships and high-quality supportive environment. For example, we manage the daily schedule of how the physical environment is laid out to promote close relationships and practice social skills. You have to have a healthy routine for the children: constructive toys or technology, healthy meals, exercise. All of that is part of the environment.
There will be about 20 percent of the general population that will have low social emotional skills. And they will need more support than just those basics. And so this model provides strategies that educators can use to help those kids build those emotional skills.
Some of them, for example, by nature, they just don’t know how to make friends. So they’re isolated or have a very hard time with self-regulation. It’s just the way they’re built, or maybe they didn’t have the role modeling in the early years. The teachers have to work extra hard with them to teach those skills very intentionally. Because some kids just pick them up by watching others in a social environment, but then some need a little bit more support.
Then there will be another 5 percent of the total population that still does not improve with those targeted interventions. This is a very small group that will need mental health treatment. So those are the ones that I work directly with in our mental health program.
Q: What types of activities do you provide for children in counseling to help with their development?
A: I introduce them to different toys and materials. And for the first three to four sessions, I don’t direct them to do anything. I just I want to see what they gravitate towards and what patterns in their play come up in a spontaneous way without any intervention. And when I have those observations, in addition to the background information that the parents have given me from the intake, then I put that all together to decide what kind of intervention I’m going to make, still through playing and art.
Most of them feel very attracted to the sandbox. They make a world, and they tell stories. That’s very therapeutic for most of them. They can resolve issues with a little bit of intervention when I see certain patterns that are not healthy. Then I bring in a character, or I change a little bit of what is happening to see how the child responds. And then the stories and narratives keep going from one session to the other sometimes. It’s really powerful.
Q: How can parents or caretakers apply this in their own homes?
A: We’re all born with a certain temperament — it’s genetic. Even within your children — same family, same environment, same parenting — there will still be some children who just will have very low social skills or a difficult temperament. So parents have to work extra hard with those children to give them the support for those social skills, maybe expose them to more social experiences that will promote that and be very intentional.
You should have actual goals for the skills that you want to develop in your children. And then if they don’t improve, then you have to seek professional help. Because it might be something more complicated that really requires an expert.
And parents are not supposed to know how to deal with that. So part of what we do when we’re working with the children who are at risk is we provide information to the parents about things that they can do that at home to support their children, like therapeutic books to read with them or involving them in cooking dinner to promote their autonomy.
We’ve seen that the results are amazing when the parents really engage with us. Even with the very difficult cases at the beginning, I have a lot of faith that they’re going to get better. But sometimes the parents don’t go for it, there’s only so much that the kids can progress. When that’s the case, those are the very sad cases.
Q: What makes NVFS’ services so unique?
A: NVFS has employed a successful model of integrated mental health services. What that means is, instead of having a mental health clinic or program where clients go separately from their early childhood center, we have a team that is part of the early childhood education team to provide the services right there.
Our programs were the first ones to do that, and because of the success we saw, it was introduced to other programs, such as Healthy Families, Intervention, Prevention and Education (IPE) and the SERVE shelter.
And we’ve seen a great response from the clients. Because it is not just a matter of convenience, it’s a matter of trusting. And that’s the most important factor when it comes to getting help for mental health issues is — somebody who you see that already is a part of a place that you trust.
Want to learn more about ACE and the long-term health effects? Check out the video below.