Mental Health in Early Intervention

Early Childhood Center Research Assistant, Kayla O'Neill, interviews Occupational Therapist Nancy Simmons on Mental Well Being in Early Intervention.

Transcript

Welcome to the Early Childhood on the Go Podcasts.  Where the Early Childhood Center team shares ideas and strategies for professionals and families. Dream big, start early. Welcome to the Early Childhood on the Go Podcast. My name is Kayla O’Neill and today we are going to be talking about the Best Practices for Early Intervention and early childhood educators to support the mental well-being of parents and caregivers. We’re recording live today from the Early Childhood Center here at the Indiana Institute on Disability and Community in Bloomington, IN. And I am so excited to have a special guest today, Nancy Simmons. Why don’t you tell us a little bit about yourself? Sure, hi Kayla, thanks for having me. I am an Occupational Therapist and I work in Early Intervention and First Steps and came from southern Illinois where I practiced in Early Intervention for over twenty years. I also am a mom to three kiddos who are all adopted and that’s just setting the tone for where my personal and professional experience comes from with regard to this topic, and just a personal interest in mental well-being, mental health, and how caregiver mental health can impact the overall development of children. I think it’s such an important topic, especially I see it a lot now as I work in Early Intervention doing home visits, especially after COVID I feel like we’re seeing more parents struggling with this. And I think, as an Early Intervention provider, there’s often times where when I go into a home, I will be the only other person – adult – that parent sees for weeks at a time. We are coming – things are starting to go back to normal, but I think it’s just something that’s so important for us to talk about. Yea, I think you hit the nail on the head right out of the gate here. It’s all about connection, and connection with others as adults, as adult caregivers providing services. As an Early Intervention provider, we connect with our families on an intimate level. It’s all about that connection piece and that creates from that connection that arises our relationships. And I feel like working in early childhood – I don’t feel like when I look back at my school or a lot of the training that I did, this wasn’t a huge part of what I learned about. So, I feel like I’m needing the information on what to look for; what can I do to support? Because it’s not really embedded, at least when I trained awhile ago. I would totally agree.  For sure, that was the situation for me. I’ve always talked about the whole self, you know, being an Occupational Therapist and our framework surrounding occupational science we really do focus on the whole person. But as far as how to do that, those strategies, that’s not something that, you know, until neuroscience has been coming out in the last five years, has really supported that. So, now we’re getting some research on those strategies and some best practices to use in our professions. What’s one thing that you wish you had known at the start of your Early Intervention career about supporting mental health of caregivers? So, I think, just to tag to what we just talked about, you know, the importance of adult caregiver well-being.  How important it is and what that mental well-being has upon a child’s overall development. Not just social-emotional development, but their overall development. What can you tell us about that? I have a quote here that I wanted to share with everybody that I find really profound, “Our mental health journeys begin before we ever leave the womb and are bound up in the mental health of those who raise us.” So, that feels really powerful, and a little bit overwhelming when I think about it as a mom. But I also think there’s a lot of power in that statement – power in the sense of permission. There is not only permission for us as caregivers to take care of ourselves, our whole selves, our mental well-being, but it’s really a responsibility and it’s a gift to our children. Because when we take care of ourselves, we model self-care, we are teaching our children that – this is critical – it’s an important piece for the rest of their lives. I think that’s one thing, just tagging back to what we talked about earlier, I wish that I had known in the beginning of my career as an Early Interventionist the importance of that piece. That brain science – neuroscience, the information we have now – it just wasn’t there, we didn’t understand. When I first came out there was a lot of behavioral strategies and now it’s about the connection, about regulation, co-regulation, connection, and relationships. And I think we’re in such a unique position as people working in Early Intervention because I didn’t realize until after I became a mom that we’re working with people who are post-partum, and there’s that whole other piece that I wish I would have had more education about, post-partum and how to support. Because like you said, we are there, we’re connecting and there just wasn’t – it’s just not a big piece of training and I wish it was - now that I’m a mom that’s gone through post-partum. I would totally agree.  I’m an adoptive mom so I didn’t have that biology sense in terms of connection in the womb, however, it doesn’t matter how the baby enters your life, that importance of co-regulation. We as parents have that amazing power to be a co-regulator with our child. It’s a huge sense of responsibility – it can feel overwhelming but at the same time it’s such an important piece that hopefully it gives you permission to really focus on yourself, because you are the one, the only one who can do that. Can you just tell us a little more about co-regulation? Yea, I’d love to. So, co-regulation is this beautiful gift that all babies are born with a need to co-regulate with their caregiver. So, when a baby is born, they cry to indicate their needs. So, what do we do as parents or caregivers? We meet those needs by picking the child up, by changing their diaper, by giving them their bottle. We’re meeting their physical needs, but we’re also meeting their emotional needs in that moment. We are, it’s like a team. But in the same sense we also get something back from that because when we hug there’s this beautiful neurotransmitter, oxytocin, that gets released so it makes us feel good. So, co-regulating is just your way of co-connecting with another person. Adults co-regulate with one another. You co-regulate with your significant other. You might co-regulate with your family pet. I know I use my dogs as my co-regulators. Whenever I need some of that feedback I might go to my dogs. Your kids, as they get older, you’re still going to continue in these co-regulation relationships. But that really hopefully defines co-regulation. You can’t, one thing that I want to make sure to get across is you can’t effectively co-regulate with another being unless you yourself are regulated first. That’s the most important part. How do you think that we can help support parents to see the importance of taking care of themselves? It’s easier said than done. It’s like we all know that we’re supposed to do it, but as a parent I’m sure you feel the same thing depending on the situation. We don’t always make it a priority. How can, as an Early Intervention provider, we help them see the importance? Yea, that is tough – both as a person, as a mom, as a professional who has the gift of interacting with families through the Early Intervention program. The one thing I would say is in order to care well, we as caregivers first have to be well. Again, easier said than done. It takes intentionality on our parts to make sure that we have opportunities for that to happen. And obviously when stress is high, resources are low, then that creates obstacles or barriers for those opportunities to be well. Certainly, families nowadays are facing a lot of stressors, you know, in different capacities and so that makes it difficult. But I think that we as providers, if we can really be intentional about coaching families and coaching caregivers about understanding how critical their own well-being is as a caregiver, and taking care of themselves is important, so that they can have those healthy relationships with their child. And also, we are creating neural pathways – we are actual road architects as parents and caregivers of children. So, really, that’s a great responsibility. But how exciting to know that we have permission, we have a right to take care of ourselves so that we can create beautiful pathways for our children. So, one thing that I like to talk about with families is that analogy of a pitcher – a drink pitcher. We as caregivers are constantly pouring into others, into the lives of our children.  Children are kind of our cups that we’re pouring into. And we can’t figuratively or literally pour from an empty pitcher. The pitcher has to be filled. So, if you can figure out a community of people, again, it might be a significant other, or extended family, other immediate family members, friends, whomever your community of people is – figure out a way for them to pour into you so that you can continually pour into your child in a healthy way. Some other things that I love to talk about – interoception. That’s a whole cool topic. Interoception is our internal sense of the way our body and brain make connections on the insides. So, we take outside information and internalize that. So, that interoception tells us things about when we feel hungry, when we feel thirsty, when we feel stressed – all the good things and the bad things. So, talking about what that is – being able to notice our body signals – I think that’s a really important piece for caregivers and parents to think about, because a lot of us haven’t even heard of interoception and don’t know what it is. But once you have that awareness of your internal bodily sensations – you can teach your child. Young children can start to notice how their body feels. So, by being able to have conversations about that or even just notice body signals and have, maybe there’s gestures, just starting these conversations or discussions with a child. “It seems like you’re feeling hungry; it seems like you’re feeling thirsty.” By noticing those body signals and connecting an emotional label to that will help create those healthy opportunities, awareness opportunities, so that those needs can be met without some kind of dysregulation happening. Not that it’s going to stop it completely, but just opens up some of those conversations so that children can learn how to – in a beneficial healthy way – describe what they’re feeling. That’s very cool, is that a conversation you have with parents talking about that? Absolutely. Sounds like a great strategy – to really talk to parents about that.  You know, speaking of the things you, helping parents with interoception – what are some of the great resources that you found along the way, that you can either – you used yourself or that you shared with parents or other providers? Yea, there’s a lot of really great books, podcasts, YouTube videos, blogs, articles, you know, there’s a lot of things out there about teaching the whole child, about using things that look at the whole person. So, I know that you’re a big fan of “The Whole-Brain Child” for healthy brain development – leading to calmer, happier, healthier children. That’s one of my favorite books. Kelly Mahler is an Occupational Therapist who really has spear-headed the work within our field with interoception. She has developed some really great materials and resources, again, podcast, YouTube videos, some PD training opportunities for providers, but also some really helpful tools for families; there’s a curriculum about how to talk about interoception with very young children. How to even begin those early stages of brain-body connections, of how-to activities and conversations around that. There’s some really great children’s books out there too. Two of my favorites are “I Feel Something” by D. J. Corchin, and “Listening to My Body” by Gabi Garcia. The “Listening to My Body” is actually, there’s a YouTube video where that book is actually read. So, that’s kind of a sweet way to introduce that. And those books really talk about those brain-body connections like “I’m feeling something internally” but then put some labels to it and then opens up some conversations, again, with very young children about how to respond when you’re feeling nervous or when you’re feeling scared or sad or angry, so I like those. I think using a children’s book like that is a really unique way to not only teach the child but then the parent learns too, because many of us as children – we didn’t learn that – so we have adults that are trying to be parents, trying to do different things that we were not taught as children.  And so, I love that you’re teaching the child, but the parent is reading that too and taking that in and learning as well. And I think that’s a really developmentally appropriate fun, cool way to introduce some of these concepts that might be a little uncomfortable for parents. We’re kind of getting into some vulnerable spaces there without, hopefully it’s a good segway that’s developmentally appropriate. You’re reading a kid’s book and that’s something they can do together as a family. And you can open up that dialogue and do some training. There’s also some other fun YouTube videos I think you may know about – the Cosmic Kids Yoga. I’m a big proponent of doing a lot of brain-body work – but we’ll call it “fun” work because of making those brain-body connection through movement. There’s a lot of videos on there tailored to very young children and I know you’ve got young kids. And there are some fun characters – they’re themed and it’s just a fun way to do some movement together. And that is therapeutic in and of itself. And you can talk about, “Oh, I feel my leg moving – it’s stretching – and how does it feel?”  And you can do some different conversations around that. I’ll mention a couple of other podcasts, just because we are on a podcast. A couple that I like are the Earliest by Zero to Three, the Brain Architects – I don’t know if you’ve heard of that one. (No, I have not).  The Earliest – I’ve listened to some of those. The Earliest really takes – they have a whole segment on mental health, and the Brain Architect by the Center for Developing Child by Harvard University, is really about the neuroscience behind a lot of this brain-based work and tying it into mental health for infant, toddler, and also for families. I really like those two. What advice would you give someone trying to support a parent who’s struggling with stress and being able to raise their children? The best piece of advice I could give is just a reminder that every single person gets dysregulated and there’s nothing wrong with that. That’s just how our nervous systems are wired. That’s just part of what happens and just a reminder that we as parents, going back to that analogy with the pitcher pouring things out. I always saw myself as a piece of Velcro. I’m pouring myself out but I’m also taking things in – things are sticking to me. So, I may be taking on the dysregulation that my own child is experiencing and so, going back to some advice I mentioned earlier – you got to first regulate yourself before you can co-regulate effectively with our children. So, you know, self-care is not indulgent or selfish regardless of what society or our own personal upbringing might tell us. But really, the best way for us to teach our own children about self-care is to model it ourselves. So, thinking about your whole self, those connections between the brain-body pieces, taking that all into consideration and how important and critical these formative years are. Being sure that you are allowing self-compassion for yourself – making sure that you are giving yourself some grace. That helps in your caregiving role. Also, filling up your own pitcher. I mentioned community earlier, but it also can be things like sleep, and I know that’s hard especially when your littles are very little. Sleep, taking a shower, washing your face – sometimes, it’s just as simple as in the moment – ok, I can, I need 30 seconds I can wash my face really quick, put on some hand cream. (Music was a big one). Music, yes. If I’m feeling dysregulated music is one thing you can do. Yes, you need that separate time. If you don’t have that support, you can’t go somewhere else. Those things you can do in the moment – music is always the one that I went to. Yea, one thing I’d really like to talk to families about – this is kind of getting into the weeds and details of neuroscience – but there is a lot of conversation in the general public now, and I love that this is out there, this talking about neurotransmitters and happy hormones and how we can hack into our systems naturally. I mentioned oxytocin earlier, that’s the cuddle hormone – hugging your child, hugging your significant other, hugging your pet, that gentle caring touch – that is a good way to do self-care for yourself. If that’s not your thing – serotonin! That’s the mood transmitter that you get through sunlight or eating good things, exercise certainly can tie into that. But, again, it doesn’t have to be exercise that’s physical activity – dance! I love dancing. I love doing that with my kids. We’ve always done that since they were little and then singing out loud – things like that.  Dopamine – that’s that pleasure neurotransmitter. You can do a dopamine hack by just setting up a small goal – any sort of small thing.  I don’t know what it might be – it might be taking a shower, washing your face – but once you have that designated in your mind and you do it, you get that hit of that feel good neurotransmitter.  And then endorphins – that comes from that physical play – that physical activity. So, it doesn’t have to be a big thing to fill your pitcher but figure out what works for you. If you have, if you as an Occupational Therapist have a family that is open to having some discussions like this – that’s part of what we do in teaching families how to best care for their child. We can work with them – both the caregivers and the parents on ways that will work best for them. What is one myth that you’d like to debunk about supporting mental health as an early childhood educator? Well, that ties into my last comment. So, I think that there has been this myth that that’s not really part of our scope of practice. We’re there to treat the child. We didn’t have the training and we’re just there to treat the child. That really, I want to encourage providers, just as a reminder, Division of Early Childhood best practices really supports families’ functional relationships. We’re there to strengthen family-child relationships and to promote the child’s social-emotional development. So, when you have that knowledge of this neuroscience background that parents and caregivers have this huge impact in the critical formative years in a child’s early years, those neurological pathways. They being formed, that has a lot of impact on the future health of the child. So, I think that again will hopefully give providers permission to dig a little deeper with families that are comfortable with that. And using that coaching model – teamwork model – to facilitate those positive parent-child interactions. Well, this is so important, Nancy. Thank you so much for coming today and discussing how to support the mental well-being of parents and caregivers. It was so nice to chat with you. Yea, thanks for having me. I love talking about this topic. Thank you all for tuning into the Early Childhood on the Go Podcast, and we hope that you will join us next time. Thanks for listening to the Early Childhood on the Go Podcast from the Early Childhood Center team at Indiana University. Learn more at IIDC.Indiana.edu/ECC.