|
Back to Regulations
INTRODUCTION TO 1304.24
Head Start embraces a vision of mental wellness. The objective
of 45 CFR 1304.24 is to build collaborative
relationships among children, families, staff, mental health professionals,
and the larger community, in order to enhance awareness and understanding
of mental wellness and the contribution that mental health information
and services can make to the wellness of all children and families.
The Child Mental Health standards, 45 CFR 1304.24(a), cover working
collaboratively with parents, securing the services of mental health
professionals, and developing a regular schedule of on-site mental
health consultations involving mental health professionals, program
staff, and parents.
Rationale:
Anticipating and understanding a child's behavior and development
helps parents and staff respond in a manner more likely to enhance
the child's development. This rationale serves 1304.24(a)(1)(i)-(iv).
Related Information:
See 45 CFR 1304.51(g) for information on agency confidentiality policies.
See 45 CFR 1304.40(b)(1)(ii) on accessing community mental health
services for the family.
Guidance:
Staff communication with parents draws upon parents' knowledge of
their child's development, and respects their parenting strengths,
values, culture, and childrearing approach. Relevant information shared
in the family partnership agreement process, or drawn from the child's
records, is incorporated into discussions. Communication about a child's
mental health can occur through formal and informal opportunities,
such as during home visits, staff-parent conferences, or parent meetings.
For many families, issues related to mental health are sensitive ones,
and must be approached with care. When staff take time, however, to
establish rapport and to build trusting relationships with parents,
the parents may learn to feel more comfortable discussing issues related
to mental health.
Discussions between parents and staff focus on a variety of topics,
including:
- developmental and cognitive phases, and typical behaviors or
concerns associated with each phase,
- the child's special interests, needs, and strengths,
- any changes in the child's behavior, mood, or physical appearance
which may reflect recent experiences, and
- any information on health conditions that may influence the
child's behavior.
The information drawn from these discussions is used to help individualize
services for each child.
When appropriate, a mental health professional is consulted to
discuss a particular concern with parents and staff.
Related Information:
See 45 CFR 1304.21(b)(1) about the development of secure relationships,
particularly 45 CFR 1304.21(b)(1)(i) as it relates to attachment issues.
Guidance:
Staff have many opportunities to exchange information with parents
on child development and growth. In formal and informal settings,
information on the following topics can be presented.
- The typical development of young children.
- Information provided to parents helps them understand some behaviors
that they may view as problematic, such as attention seeking and
saying "no," as part of a temporary phase that plays a positive
role in the child's development.
- The development of individual children.
- When parents and staff understand and respect each child's particular
abilities and temperament, undue pressure on both parents and
children can be avoided. For example, some children develop motor
skills faster than their peers, while others are able to control
strong feelings at an earlier age than most. Training and information
can help parents and staff recognize when each child is ready
to achieve a particular skill or needs special help.
- Supporting parenting in the first few months following a birth.
- This period may be a time of stress, as parents adjust to new
roles and cope with challenges such as limited sleep. Enlisting
a family member or finding someone who can assist new parents
with the care of their new baby and with other household responsibilities
can ease this transition.
- Recognizing and understanding behavior that is an expression
of their child's response to a stressful situation.
- It is helpful to understand that sudden changes in a child's
behavior may be the child's response to a stressful situation.
- Ways to assist parents in helping children deal with separation
issues.
- To help the child during separation, encourage parents to spend
time in the facility with their child; bring tangible reminders
of home and family, such as a favorite toy or photos; assist the
child to play out themes of separation and reunion; and reassure
the child about his or her parents' return. Parents, too, may
experience anxiety over separation from their children. Staff
help parents with such separation anxiety by validating their
feelings, and by encouraging parent participation in the program.
- Attachment issues.
- To facilitate secure relationships and attachments to adult
caregivers, consistent care from a small number of adults is advised.
Agencies arrange for the same teacher to remain with the infant
or toddler for the longest possible time in the program.
Related Information:
See 45 CFR 1304.21(a)(3)(i)(C) and (D) about setting clear limits
and respecting others, and 45 CFR 1304.52(h)(1)(iv) on using positive
methods of child guidance.
Guidance:
Staff and parents share positive approaches they employ to respond
to a child's behavior. Staff responses to parent inquiries provide
an opportunity to explore and to model alternative approaches and
techniques.
The behaviors that adults demonstrate are those which will be internalized
and emulated by children. Staff discuss with parents the fact that
parenting, while most often a fulfilling experience, also can be
difficult and stressful, and that a parent's response to stress,
just like responses to other behaviors, will be imitated by children.
Training and information about age-appropriate behaviors and varying
individual temperaments helps parents and staff both to determine
appropriate responses and to model those behaviors. For such reasons,
the following should be kept in mind:
- Developmental changes.
- Healthy social and emotional development depends upon how children
view themselves, as well as the extent to which they feel valued
by others. When adults have realistic expectations about a child's
behavior, they respond with a variety of interventions that set
constructive limits and help children to achieve self discipline.
Providing children opportunities to succeed lays the foundation
for healthy development.
- Environment.
- Day-to-day warmth and responsiveness from staff and parents
influences a child's ability to recognize and to act upon his
or her feelings. A comfortable, safe, interactive environment
increases a child's sense of competence and control.
- Positive techniques of guidance.
- Undesirable behaviors, while a normal part of growing up, should
be discouraged or redirected. The following strategies reflect
best practices for responding to inappropriate behaviors
- anticipation of and elimination of potential problems,
- redirecting a child away from a conflict or negative event
to a more positive activity,
- offering the child choices among activities that are acceptable
to parents,
- helping a child learn about the logical or natural consequences
of their actions, and
- encouraging respect for the feelings and rights of others.
Positive techniques are more effective than competition, comparison,
or criticism. Rather than attempting to "stop" a child's negative
behavior, positive techniques help him or her to find and practice
skills that will help now and in the future. It is for that reason
that Head Start programs never use corporal punishment. Staff work
with parents to help them understand the negative effects of corporal
punishment on self-esteem, and to find alternatives in the home.
There are many differences of opinion about parenting, and there
is no single "best way" to parent. It is important, however, that
children receive consistent messages that are respectful of the
child and of family values, customs, and traditions.
Related Information:
See 45 CFR 1304.21, Education and Early Child Development, and, in
particular, standards (a)(1)(iii), (a)(3)(i)(A), (a)(3)(i)(D), (b)(1)(ii),
(b)(2)(i), (c)(1)(iv), and (c)(1)(v), for additional information on
supportive environments and nurturing relationships.
Guidance:
When interacting with children, adults support the development of
trust, self-esteem, and identity by expressing respect and affection
toward the child and by demonstrating responsiveness to his or her
experiences, ideas, and feelings. Examples of respectful and responsive
behaviors, which depend upon the developmental level of the child,
include:
- Smiling at the child;
- Quickly comforting an infant in distress; and
- Nodding at a toddler in need of reassurance.
Establishing a supportive environment also involves assisting children
to become comfortable, relaxed, happy, and involved in play and
other activities. Staff and parents help children deal with anger,
sadness, and frustration by comforting them, identifying and reflecting
on their feelings, and helping them to use words, instead of acts
of anger, to solve problems and disputes.
Positive social behavior among children, such as cooperation, is
fostered by adults through modeling, coaching, and encouraging,
rather than through lecturing, criticism, and punishment.
Rationale:
Better understanding of mental health issues increases the likelihood
that parents value and use the mental health information and services
available to them. This rationale serves 1304.24(a)(1)(v)-(vi).
Related Information:
See 45 CFR 1304.40(f)(4) on discussing mental health issues with parents.
Guidance:
Agencies take a variety of steps to understand mental health issues,
by:
- Providing opportunities for parents to learn about and participate
in mental wellness activities;
- Providing access to mental health professionals through ongoing
parent activities;
- Working with parents to develop support groups; and
- Helping parents access community mental health resources.
Related Information:
See 45 CFR 1304.40(f)(4)(iii) on parent involvement in planning and
implementing any mental health interventions for their children.
Guidance:
There are many ways that staff support parent participation in mental
health interventions. Some of these include:
- Finding opportunities for parents to learn about the mental
health professional, such as at the orientation for parents and
at a variety of meetings and events throughout the year;
- Assisting parents to break down barriers to services, including
- attending an orientation meeting with the mental health
provider,
- locating the transportation or child care needed to participate
in services, and
- finding assistance to pay for interventions; and
- Discussing the importance of interventions for the mental health
of the entire family. Communicate to families that staff members
are available to discuss mental health issues and to provide parents
with information about how the program protects the confidentiality
of the information they may choose to share.
Rationale:
When grantee and delegate agencies have an ongoing relationship with
a mental health provider, or with a group of providers, they are better
able to secure appropriate services in a regular and timely manner.
This rationale serves 1304.24(a)(2).
Related Information:
See 45 CFR 1304.41(a)(2)(ii) for information on community partnerships
with mental health providers. See 45 CFR 1304.52(d)(4) for additional
information on mental health staff qualifications.
Guidance:
Grantee and delegate agencies make arrangements for mental health
professionals to be available to help the program. Mental health professionals
represent a variety of disciplines, including, but not limited to:
- psychiatry,
- psychology,
- psychiatric nursing,
- marriage and family therapy,
- clinical social work,
- behavioral and developmental pediatrics, and
- mental health counseling.
Head Start agencies augment the services of mental health professionals
with services from individuals with the backgrounds, skills, and
interests that can support program goals for promoting mental health.
By consulting with their mental health professionals, agencies can
determine: which services may be provided only by licensed or certified
mental health professionals; which activities may be provided under
the supervision of such a mental health professional; and which
activities do not require the direct supervision of the mental health
professional, such as parent education groups.
Schedules need to be frequent enough to allow the mental health
professional to become familiar with the needs of children requiring
assistance, to provide information and consultation, and to help
locate any needed treatment or service in a timely fashion.
Rationale:
Regularly scheduled mental health services help to ensure that day-to-day
program practices promote mental health. This rationale serves 1304.24(a)(3)
and 1304.24(a)(3)(i).
Guidance:
See 45 CFR 1304.24(a)(3)(i)-(iv) for guidance on implementing this
standard.
Related Information:
See 45 CFR 1304.20(b) on developmental screenings. See 45 CFR 1304.21(c)(2)
about developing a program that supports individual children.
Guidance:
Through a combination of planned activities and spontaneous interventions,
the mental health professional assists staff and parents to help children
practice skills that foster mentally healthy development.
Regular meetings with appropriate staff and parents provide the
mental health professional with opportunities to:
- Develop and implement training on how to assess the child's
strengths and needs, and on how to plan developmentally appropriate
activities that are based upon valid findings;
- Make curricula enhancements. For many topics, such as reducing
stress, resolving conflicts, and coping with violence, the mental
health professional can provide recommendations on appropriate
resources;
- Make recommendations on resources related to mental health education
that would be helpful to home visitors and appropriate for group
socialization activities;
- Implement practices responsive to infants and toddlers and their
rapidly changing needs; and
- Hold periodic conferences with parents and staff to share ideas
for supporting children who have been identified as needing special
help.
Rationale:
A well-planned education program on mental health issues enables parents
and staff to be supportive of children's mental wellness. This rationale
serves 1304.24(a)(3)(ii).
Related Information:
See 45 CFR 1304.40(f)(4) on a mental health education program; and
see 45 CFR 1304.21(c)(1)(iii) on integrating mental health education
into program activities.
Guidance:
Grantee and delegate agencies, with the assistance of mental health
professionals, provide a variety of opportunities for parents and
staff to learn about mental health issues, including specific guidance
on how to seek help. Staff and parents are encouraged to seek individual
assistance, either by scheduling an appointment or by participating
in group education opportunities. Families and staff also are encouraged
and supported in strengthening ties with each other, and with extended
family members.
Parent group meetings provide excellent opportunities to discuss
approaches that parents have found helpful in their efforts to meet
their children's needs. Parents may, in turn, be helped by talking
about their own experiences and by learning from one another, as
well as by reading and listening to materials presented in workshops
or during formal presentations by guest speakers. Parent group meetings
also provide opportunities to include and seek guidance from extended
family members or persons recognized as mentors by cultural tradition
(e.g., Tribal elders and spiritual healers).
Information about mental wellness can focus on a wide variety of topics including:
- childrearing practices and concerns,
- childhood fears,
- helping children adjust to changes in family circumstances,
and
- domestic violence.
Posting a schedule of agency visits by mental health provider(s)
gives parents and staff the opportunity to speak with them in an
informal manner.
Rationale:
Because children with atypical development may present unfamiliar
behaviors, parents and staff benefit from opportunities to discuss
with the mental health professional ways of structuring the child's
program and implementing strategies that will foster development.
This rationale serves 1304.24(a)(3)(iii).
Related Information:
For further guidance on serving children with recognized disabilities,
see 45 CFR 1304.20(f)(2), 45 CFR 1304.21(a)(1)(ii), 45 CFR 1308.19
and 45 CFR 1308.21.
Guidance:
Mental health professionals provide information on and assistance
with identifying situations that require treatment. Professionals
also help make appropriate referrals, visit homes (to provide suggestions
for modifying the home environment), observe classroom or group socialization
experiences (to provide suggestions for modifying the program to meet
the needs of the child), and support parents and staff in their efforts
to help the child.
For some children who are recognized as having a disability, mental
health professionals help parents and staff gain access to community
agencies, to ensure that the Individualized Education Program (IEP)
or Individualized Family Service Plan (IFSP) is properly implemented.
All work is performed in collaboration with the content area expert
in disability services.
Rationale:
The mental health professional assists staff and families to make
contact with and to take advantage of any and all existing resources
that promote the healthy development of children. This rationale serves
1304.24(a)(3)(iv).
Related Information:
See 45 CFR 1304.41(a)(2)(ii) for information concerning community
partnerships.
Guidance:
The mental health professional who provides regular on-site consultations
assists staff to locate providers for an individual child or family
who would benefit from such services. The Health Services Advisory
Committee also may be of assistance in locating community mental health
resources.
In addition, the mental health professional assists agencies in
accessing community resources by training staff in the referral
process. This understanding of and knowledge about how to navigate
the system can provide staff enhanced credibility with the involved
agencies. In addition, the mental health professional acts as a
liaison between the specific agency in question and the program,
and advocates for the child and the family should the process slow
down or become unsatisfactory.
A mental health professional, in accordance with the standards of ethical conduct
for his or her practice, on occasion, may be required to decline
providing services to a potential client to avoid a conflict of
interest. In other cases, the professional may determine that the
client's needs fall outside his or her scope of expertise. In both
types of instances, the mental health professional can work with
the agency to secure appropriate services through referrals.
Last Modified: 10/03/2001
| HSB Home
| Site Map
| Help |
|
