Dr Nick Kowalenko, psychiatrist and key note speaker at the upcoming Growing Edge: Pre-schooler mental health symposium, talks about developments in the field, including his perspective on temperament and personality in infant mental health.

What new developments are there in early childhood mental health and wellbeing?
“There is generally a greater understanding and knowledge that the early years are foundational for good social and emotional wellbeing across the lifespan. Early intervention early in life, early in the course of the social or emotional problems or vulnerability, changes development for the better.
Advances in neuroscience now provide evidence to support psychological theories/perspectives of early childhood development. For example – exposure to trauma and neglect will affect not only behavioural and emotional outcomes but also the growth and structure of the brain. The proposed Healthy Kids Check (social and emotional well-being component) to be introduced in 2014 will provide a routine check for all young children aged 3.5 years to 5 years to make sure they’re on track to be ready for school.”

Is the approach to mental health and wellbeing promotion for infants much different for older children in early childhood?
“The approach is similar. Minimising risk factors and building on protective factors within families to strengthen the relationships between caregivers and their children. For infants, mental health promotion would ideally begin while the mother is still pregnant. So – in vulnerable families identifying risk factors and building on the protective factors to hopefully strengthen the relationship between the caregiver and infant. By this we aim to minimise the incidence of psychopathology throughout childhood development and into adolescence and adulthood. Older children in early childhood can also develop their social skills with peers and sustain well-being and build on their relationships with those that care for them.”

How is the infant mental health field sensitive to temperament, personality and mental health status?
“In Infant Mental Health we consider all the biological, social and psychological factors contributing to family situations – temperament, personality and mental health status would therefore be considered using this framework. Temperament is one aspect of mental health in early childhood. Children will bring their own unique personality characteristics or temperament into the relationship with their caregiver. This may influence how the caregiver responds and interacts with their child. Parent’s personalities also shape how they relate to their infants. We refer to this as the ‘fit’ between parent and child. Mental health status (eg autism or Post Traumatic Stress Disorder) can increase the burden of parenting. There’s a two-way relationship and, sometimes, for example, we see demoralised parents who are finding parenting less satisfying with their children with difficulties (eg autism) because they reciprocate less than their other kids. This can often be greatly assisted with interactional coaching and other interventions and support.”

How do families become sensitive to their children's individual preferences, strengths and temperament over time?
“Families need to be supported to recognise that their child is unique. Rather than following scripted regimes and programs, families need to be sensitive to – and respond to - their individual child’s needs. Look, listen and learn; watch, wait and wonder: these are all approaches to slowing down the speed of parent-child interactions. Parents readily get overwhelmed by the demands of family, work, domestic tasks and caring for others and when they slow down, let their infants lead them in play (for brief periods) they are often greatly surprised by what they observe their young children doing, by how much they enjoy engaging them and by their skills in seeking out interactions with their parents, and their playfulness, turn taking.
Use of video clips often helps parents stand aside and observe their infants and gives them more space to breath, quietly observe their infants, and describe what their options might be about how to respond. Early childhood care staff are often very helpful (partly because of their vast experience) in suggesting alternative ways for parents to respond to infants or in helping in a lot of other ways and sometimes.”

You are speaking at The Growing Edge: Pre-schooler mental health symposium in October. What can professionals look forward to from the session?
“The symposium will highlight the evidence emerging in Australian pre-schoolers for the effectiveness of early intervention and its longitudinal benefit on both anxiety and depression through childhood and adolescence. This will be considered in the light of international advances. Promoting mental health and wellbeing in the context of intergenerational stress also lessens the risk of children developing anxiety and depression.
It will also cover:

  • Cutting edge information about early intervention and treatment, health policy and consumer perspectives on this emerging field.
  • Hearing a consumer perspective on how our own parenting history might impact on us as parents to our children.
  • Discovering family based early intervention approaches that address intergenerational stressors.
  • Clarifying if there’s any role for psychopharmacological treatments for pre-schoolers.
  • Learning about the evidence for long-term benefits of pre-school early intervention programs.
  • A chance to network with like-minded professionals with an interest in pre-schooler wellbeing.”

Growing Edge: Pre-schooler mental health
15 October 2013
NSW Institute of Psychiatry, North Parramatta NSW
Register today