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Key Infant and Early Childhood Mental Health Terms and Definitions

Infant and Early Childhood Mental Health - "Infant and the young child's capacity to experience, regulate, and express emotions, form close and secure relationships, and explore the environment and learn. All of these capacities will be best accomplished within the context of a caregiving environment that includes family, community, and cultural expectations for young children. Developing these capacities is synonymous with healthy social and emotional development." (ZERO TO THREE, 2017)

Adverse Childhood Experiences (ACE) Study:

This study assesses the effects of child abuse and related adverse experiences and current health status and behaviors. The study demonstrates the connection between early adverse experiences and later-life health and well-being, and household challenges. The results clearly show "Why Prevention Matters," particularly related to public health outcomes.

Attachment - "An emotional bond between a parent/primary caregiver and infant that develops over time and as a result of positive care seeking behaviors (e.g., crying, smiling, vocalizing, grasping, reaching, calling, following) and responsive caregiving (e.g., smiling, talking, holding, comforting, caressing)".

Attunement - "The matching of affect between infant and parent or caregiver to create emotional synchrony. The parent's response can take the form of mirroring (e.g., returning an infant's smile) or be cross-modal (e.g., a vocal response "uh oh" to the infant's dropping cereal on the floor).  Attunement communicates to the infant that the parent can understand and share the infant's feelings".

Angels in the Nursery - "A concept that describes positive parent-child interactions where the child feels valued, fully understood and loved." (Lieberman et al., 2005)

Ghosts in the Nursery - A psychoanalytical approach developed by Selma Fraiberg in 1975 used to describe the influence of a parent's experiences as a child where they may have been treated in a punitive or traumatic manner. These negative early childhood experiences influence their own parenting behaviors.

(Fraiberg, S., Adelson, E., & Shapiro, V., 2005)

Scaffolding - A term used to describe the interactional support and the process by which adults mediate a child's attempts to take on new learning. Scaffolding represents the helpful interactions between adult and child that enable the child to do something beyond his or her independent efforts.

Parallel Process - "The impact of relationships on relationships." What happens when two or more systems - whether these consist of individuals, groups or organizations - have significant relationships with one another. They tend to develop similar affects, cognition, and behaviors, which are defined as the parallel process.

(Sandra Bloom, The Sanctuary Model)

"Keeping The Baby In Mind" - Keeping the Baby in Mind builds on the expanding evidence pointing to the crucial importance of parents in facilitating their baby's development, and brings together expert contributors to examine a range of innovative psychological and psychotherapeutic interventions that are currently being used to support parents and their infants. IMH professionals also strive to "keep the baby in mind" as they consider the relational experiences and environmental context surrounding the baby.

(Keeping the Baby in Mind: Infant Mental Health In Practice, Barlow, 2009)

Serve and Return - Serve and return interactions shape brain architecture. When an infant or young child babbles, gestures, or cries, and an adult responds appropriately with eye contact, words, or a hug, neural connections are built and strengthened in the child's brain that support the development of communication and social skills. Much like a lively game of tennis, volleyball, or Ping-Pong, this back-and-forth is both fun and capacity-building. When caregivers are sensitive and responsive to a young child's signals and needs, they provide an environment rich in serve and return experiences.

Protective Factors - Individual qualities, capacities, coping strategies, or other environmental features family, school, community and other affiliations that make a positive contribution to an individual's resilience.

Cultural Humility - A life-long, continuous process of self-reflection, self-exploration, and self-awareness that allows one to approach another's culture/tradition/upbringing with openness, curiosity, acceptance, and respect.

Cultural Reciprocity - In the context of early care and education, this term refers to the effort of staff to understand families' cultural beliefs, and to use this understanding as a way to help promote the healthy development of infants and toddlers; including the ability to respect families' beliefs and traditions, and look for ways to meet the families' unique needs while still upholding early care and education program objectives.


DYAD - A cornerstone of Infant Mental Health, the dyad typically refers to a parent or caregiver, and a child. The dyad, and the relationship between the two, serves as the client and focus of IMH services. 

Parent-Infant Psychotherapy - A dyadic intervention (or triadic if both parents are involved) that involves targeting the parent-infant relationship (i.e., it is delivered to the parent and infant together). Parent-Infant Therapy aims to promote the development of secure relationships between infants/young children and their parents and caregivers; support the healthy physical, emotional, and cognitive development of babies; and, strengthen the capacity for each partner in the parent-infant relationship to learn and grow together.

(Fraiberg 1980; Cramer 1988; Lieberman 1991)

Continuum of Care - A service delivery model in which services and supports range from promotion to prevention as well as intervention and treatment as needed. 

Reflective Supervision - A way of practicing in which the professional is able to step back from the immediate, intense experience of hands-on work, and take time to consider what the experience really means - what does it tell us about the baby and family, or about ourselves? Through reflection we can examine our thoughts and feelings related to our work, and identify the strategies or interventions best suited to the needs and experiences of the family. (Parlakian, 2001)

Parental Reflective Functioning (PRF) - "Refers to parents' mental capacity to understand their own and their children's behavior in terms of envisioned mental states. As part of a broader concept of parental mentalization, PRF has been identified as one of the central predictors for sensitive parenting."

(Stuhrmann, et al., 2022)

Co-Regulation - "An interpersonal process in which participants continuously adjust their interactions in a coordinated pattern to co-create and maintain a positive emotional state."

In the field of IMH, supervisors aim to serve as co-regulators to their staff; professionals then serve as co-regulators to parents or other caregivers, which in turn builds the parent's capacity to serve as co-regulators to their baby.

Relationship-Based - The theoretical and developmental perspective that relationships and the interaction between caregiving adults and children have a primary role in the social/emotional development of young children. It also refers to the nature of the work between a mental health consultant and consultee, building on the collaborative relationship between the two.


(Many thanks to WI-AIMH for this collection of terms, provided through their 2023 annual IECMH Conference, Back to the Beginning.)

What Virginia Endorsed Professionals Say About the Endorsement®


Susan Gallier IMH-E®
Infant Family Associate
President, Burke Child Care Connection,
Family Day Home Owner/Provider

“I wanted to learn more about infant mental health. At the time there really was not much out there and I thought it was important to know. What changed the most for me was the way I felt when working with young children, not blaming parents or the child. Possibly never knowing why the child is acting the way they are but assuming something in the life of the child is not right and trying to help the child through a difficult time in their young life. Knowing that I am helping a young brain to hopefully be a productive adult. Feeling confident about dealing with a child and being able to speak with parents, with confidence, and then have them come to me for advice, is a great feeling.

Proud Mother

Tracy Walters, IMH-E®
Infant Family Specialist
State Coordinator for Infant and Early Childhood Mental Health, DBHDS

"What I would want other professionals to know is that even after 30 yrs. of practice with children, families and educators, I learned to look at my practice with a new lens. The information that I was able to take away gave me new inspiration, insight, and courage to continue and to enhance my current work with families and professionals.  It also allowed me to grow new skills in a profession that I have worked in for thirty years…giving me that new hope to fuel my passion and determination to insure a safe and secure environment for all children and families.


Lynn H. Kosanovich, IMH-E®
Infant Mental Health Mentor-Policy
Training & Professional Development Director:  Master Trainer, Prevent Child Abuse America

“I first sought Endorsement® at the encouragement of my supervisor with Healthy Families America (HFA).  HFA is a home visiting model for new parents that focuses on the relationship between the parents/caregivers and the child—there are over 30 HFA sites across Virginia.  Going through the Endorsement® process has broadened my thinking, encouraged my professional development through new information and ideas, and connected me to experts in the field of Infant Mental Health—all of which inform the training we at the national office provide to HFA sites and staff in Virginia and around the country.  For leaders in the field of early childhood, it is a wonderful network to be a part of!

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