By Dawn Sather, CASA IPS Clinical Lead


Can babies, toddlers and children really have mental health issues?  The short answer is “yes” they can and they do.

Not long ago the popular belief was that babies were like an empty vessel that parents could shape and mould, solely by their interactions. It was also believed that babies did not have the developmental capacity to participate in the interactions with their parents – that the interaction was one way – from parent to baby.

In the 1970s, developmental pediatrician, T. Berry Brazelton, and developmental psychologist, Ed Tronick, engaged in extensive research with babies and dispelled this belief. They discovered babies are part of an active dyadic communicative system in which the infant and parent mutually regulate and scaffold their engagement with each other. The parent-infant interactions are bidirectional – each influencing the other. Tronick would use these findings to develop the Mutual Regulation Model.

Infant Mental Health focuses on the promotion of social and emotional development in infants, toddlers and children under the age of five, as well as the early identification of problems and interventions to prevent or treat disorders.

Infant Mental Health issues present in unique ways, differently than in children, youth or adults; however, what they share in common is that day-to-day functioning can be impaired.

What does this mean for an infant or toddler? Parents are usually the first to identify problems. Parents often have two primary questions when they seek help:  Is my child developing normally? Am I a good enough parent?

Most common problems present as eating, feeding, sleeping or behaviour issues. Others appear in the parent-infant-child relationship where parents and/or infant/toddler may not feel bonded or attached to each other.

Development is very complex and multi-faceted in the early years and requires a multi disciplinary approach to practice. Infants, toddlers and young children are limited in their ability to communicate their wants and needs. Parents need to be able to read both their infant/child’s non-verbal and verbal cues. There can be a mismatch in communication when an infant/child is not able to send or read cues.

CASA’s Infant & Preschool Services (IPS) team has provided infant mental health, evidenced-based practice and treatment for over 25 years. Assessment involves identification of strengths, risks and protective factors in individuals, relationships and families.  The team also gathers collateral information from daycare and preschool to understand the infant/toddler/child function in different environments.  The central focus is on reflection and an exploration of meaning of the presenting issues. To assist in this process, the IPS team uses the Zero to Three Diagnostic Classification System DC: 0-5 to provide a developmental framework for assessment and treatment, which may or may not lead to a diagnosis. Once an assessment is completed, the IPS therapist, along with the parent, creates a collaborative treatment plan. The IPS team has access to specialized services, such as: occupational therapy, speech and language therapy, family therapy, psychology, and psychiatry.

The IPS team also facilitates the Circle of Security (COS) Parent Program. The COS is an attachment-based parent program that focusses on nurturing healthy attachment through mutual “serve and return” experiences. The focus is on becoming a “good enough” parent.

The IPS team strives to apply the fundamental knowledge of brain science and research to assist in the optimal development for the infants, toddlers, children and parents we serve.


Tronick, E. (2007). The neurobehavioral and social emotional development. W.W. Norton & Company, Inc., New York, NY.

Zero to Three. (2016). Diagnostic classification of mental health and developmental disorders of infancy and early childhood. (Rev. ed). Washington, DC: Author.