For Kids Brain Health Network.

Sadie started life as a child at risk. Exposed to alcohol and drugs before birth, she also experienced domestic violence and neglect as an infant in her Toronto home.

Taken into care and placed with a foster family at 21 months, Sadie (not her real name) was screened for developmental delays. Concerns were identified in four functional domains (areas of ability): communication, gross motor function (large body movements such as walking), personal-social skills and problem-solving. Her caseworker arranged referrals for speech-language and physical therapies—but the waiting list for access to these services in Toronto is nine months to a year. A diagnosis, if applicable, would take even more time.

Despite these delays, Sadie began receiving targeted intervention right away, at a crucial time in her neurological development. That’s not what usually happens when children go into care in Canada, but immediate developmental screening—and tailored developmental support—are part of a revolution in practice being instigated by Dr. Chaya Kulkarni, a KBHN researcher and the director of Infant Mental Health Promotion (IMHP) at the Hospital for Sick Children in Toronto.

“Between the ages of zero and three, more than one million new synaptic connections are created in the brain every second,” says Kulkarni, “That isn’t matched at any other time in our lives. Every interaction during this period has a decisive impact on brain architecture. Yet, it’s the time when we’re doing the least for kids. Frankly, it’s immoral that we haven’t been focusing more on this age group.”

Around seven years ago, Kulkarni and her team at IMHP set out to change that reality. They began with a simple question: who was monitoring the development of children under the age of five in Canada’s child-welfare systems?

The answer, it turned out, was no one. And very few were looking at their mental health, even though trauma, neglect and excessive stress have a lasting impact on the young, malleable brain. “These types of problems can lead to neurodisabilities even in children who came into the world healthy—and who could develop healthily with the right kinds of support,” Kulkarni says. “Not responding to issues at this stage sets the child up for poorer outcomes throughout their life.”

This is why a network of researchers, consultants and community-based partners are helping Infant Mental Health Promotion to develop, apply and evaluate a developmental support program called Hand in Hand. KBHN is supporting this work by funding studies of the program’s effectiveness, analyses of its socioeconomic impact and training/consultation opportunities for the people involved.

Hand in Hand doesn’t require waiting for access to a specialist; it can be administered by anyone who’s been trained for it, from an early-childhood educator to a social worker to a family home visitor.

Implemented during the child’s everyday life by parents and caregivers, and easy to deploy even in remote regions with few expert resources, Hand in Hand may hold the potential to alter the lifelong trajectories of Sadie and countless other kids across the country.

Continue reading this article at Kids Brain Health Network.

Photo courtesy of Megan McFadden.