Judy Kynaston – National Project Manager, KidsMatter, Early Childhood Australia


One way to understand mental health in early childhood is looking at risk and protective factors.


Risk factors for children’s mental health can increase the chance of mental health difficulties developing. These might be things such as poor physical health, family conflict or separation, being affected by a natural disaster, experiencing trauma or abuse, or lacking friends or supportive relationships with adults.


Protective factors for children’s mental health decrease the likelihood of experiencing mental health difficulties.  Protective factors are things such as good physical health, a stable and warm home environment, a supportive family and early childhood service, good social and emotional skills, and having support from a wide circle of family, friends and community members.


The KidsMatter framework supports early childhood services to strengthen protective factors in the early years to improve children’s mental health and wellbeing.


Professor Helen Milroy - Consultant Child and Adolescent Psychiatrist

Some of the most important factors though for good mental health and good social and emotional wellbeing are relationships.  And there’s an enormous amount of evidence now that looks at attachment relationships, particularly in the early years, but also how those attachment relationships then build into other sorts of secure relationships further on in life.


Dr Nicole Milburn – Clinical Psychologist and Infant Mental Health Consultant


Children’s mental health is supported by stability.  Stability is really important for small children in particular, because if you think about a toddler who’s just starting to walk around and explore the world, there are so many new things that that toddler will see in a day.  And so if you can create some stability and predictability for the child then they don’t have to use their emotional energy wondering about what the newness is. 


Dr Nick Kowalenko - Consultant Infant, Child and Adolescent Psychiatrist  


So kids need a very strong sense of security, and in the context of that, they can usually manage a surprising array of stresses and they get that security really base one, you know, in their intimate relationships with their mum or their dad or other significant adults who are really a critical part of their lives.  That can include extended family members, it can include early childhood educators and that’s the kind of, the spring, the source, the kind of spring well from which kids can manage to negotiate much of the risks and difficulties that they face. 


Professor Helen Milroy - Consultant Child and Adolescent Psychiatrist

Given that attachment relationships are so important, then clearly what disturbs attachment relationships is also part of the risk factor. So things like abuse, separation, grief and loss, any of those adverse sorts of experiences that kids can have, can cause significant problems in mental health development, and development in general of course.  Other things that can also cause problems are when there’s also physical health problems, and other things that interfere with a child’s general development.  


Dr Sarah Mares – Consultant and Infant, Child and Family Psychiatrist


I guess children who have a number of risk factors, and particularly if those are either severe or sustained over time, are much more at risk of poor developmental outcomes than those children who might have exposure to one or two risks, which are either short or intermittent, but there’s not that sense of cumulative risk. So you’re always hoping. So all children have some risk factors, because that’s just what happens in life, but what you’re hoping is that there’s enough protective factors to balance out the impact of that risk, and to give children another kind of experience to draw on as they’re growing up.


Professor Helen Milroy - Consultant Child and Adolescent Psychiatrist

So if we then consider the interplay between risk and protective factors, I think what I tend to see, certainly working clinically is it’s not just one thing that’s happened, it’s this accumulation or cumulative stress that children experience, which actually then leads on to major problems for the child.  On the flipside, if you only have one of those things, then sometimes the protective factors are enough to safeguard the child. And there’s plenty of evidence now that something like a safe secure attachment relationship, will ameliorate the effects of poverty on a child.  So disadvantage per say is not necessarily going to cause you a mental health problem.  But disadvantage with a whole pile of other sorts of negative factors, may well contribute to a significant problem.


Dr Sophie Havighurst – Clinical Child Psychologist


So risk and protective factors are very interesting things, because you can never predict what an outcome is going to be for a child.  Because you may think “Oh this child has a number of risk factors.  They have a very, very reactive personality style, temperament style, and they have a family environment that’s not seeming to be nurturing or helping them to learn the right sort of skills there”.  But you can have at the same time some really important protective factors that are going on which might be a setting, an early childhood setting that’s really able to hold and support a child. 


If parents are really working, and carers really work in with the early childhood carers and workers, then a partnership there can really foster the child’s needs.  And then the way that early childhood workers will actually see the child and be able to recognise those and support those individual needs through in the early childhood environment.  That will actually continue to foster a good emotional development. 


Dr Nicole Milburn – Clinical Psychologist and Infant Mental Health Consultant


Having a strong and supportive relationship with a number of adults helps a child manage the world, by giving them a sense that there is a help when they need it, and therefore they will be able to trust that their needs will be met and their problems can be managed. 


Dr Nick Kowalenko - Consultant Infant, Child and Adolescent Psychiatrist  


One of the things about early childhood is that period of enormous adaptation by kids but if there are too many stresses then they can get overwhelmed.  It’s a bit like adults in one sense.  So one of the things that certainly this program tries to do is look at the ways in which we can boost protective factors, promote social health and emotional wellbeing so that kids in a sense are a bit more resistant to the kind of stresses or the risk factors that they might experience in the course of their lives.