Tips to Promote Social-Emotional Health Among Young Children

Thursday, May 6 is National Children's Mental Health Awareness Day. The AAP is a co-sponsor of this event, an initiative of the Substance Abuse and Mental Health Services Administration (SAMHSA). 
The theme, "positive mental health is essential to a child" healthy development from birth,” focuses on making sure that the promotion of mental health is considered when children are young. 
To support this event, please read the list of tips that the AAP developed for parents, early childhood educators, and pediatricians. 





What Parents of Young Children Can Do:

• Catch your child being good!  Praise your child often for even small accomplishments like playing nicely with brothers or sisters, helping to pick up toys, waiting her turn, or being a good sport.
• Find ways to play with your child that you both enjoy every day. Talk with your child, tell stories, sing, and make rhymes together. It is especially important to try and reconnect for a few minutes after separations.  Include some type of regular physical activity such as a walk or bike ride around the neighborhood.
• Seek ways for your child to play with other children of the same age. Make sure they are watched by a trusted adult.
• Read with your child every day as part of a special family routine.  Turn off the television before the evening meal, have conversations with your children during the meal, get baths/showers after the meal, and read books with your children in preparation for bedtime.  This will help children to settle down and sleep well at the end of the day.
• Limit screen time to no more than two hours daily for children 2 and older.  The AAP does not recommend any screen time for children younger than 2 years of age.  Never put a TV in a child's bedroom.  Parents should watch along with older children and try to put the right spin on what their children are seeing. Young children should not be exposed to violence on TV, including on the news.   TV should not become a babysitter.
• Make time for a routine that includes regular family meals when parents and children can sit and talk about their day together. Play the "high-low" game by taking turns sharing the best and not-so-good parts of the day. 
• Provide regular bedtime routines to promote healthy sleep.  This time of day can become an oasis of calm and togetherness in the day for parents and children.
• Model behaviors that you want to see in your child.  Parents are their child’s first and most important teachers, and what they do can be much more important than what they say. Be especially careful of criticizing teachers or other trusted adults in front of the child.
• Everyone experiences anger and stress! Help your child to find acceptable ways of working through these feelings. It is okay to be mad but never okay to hit or destroy property.
• Listen to and respect your child. Remind your child that he or she can always come to you to discuss concerns, fears, and thoughts. Calmly discuss the issues and talk to your child's pediatrician with any concerns you might have as a result.

What Early Education and Child Care Providers Can Do:

• Greet each child warmly. Smile, make eye contact, and use a positive tone of voice that says you are happy to see the child.
• Be friendly and affectionate with each child. Warmth and affection can be shown through your expression, laughter, voice, and words.
• Look for each child's strengths. Make sure that your words and interactions with children are more positive than negative.
• Show children how to talk to other children and build friendships. Teach children how to handle problems with others and to ask for help when they need it.
• Teach children how to follow directions, including listening, asking questions, and finishing tasks.
• Reinforce desirable behaviors by ignoring things that are trivial, providing frequent praise when you see positive behaviors start to emerge, and modeling respectful communication.
• Provide children with opportunities to make choices when possible and help them to learn to understand the consequences of their actions.
• Talk to a child's parents early on if you observe problem behaviors.
• Some child care facilities and schools provide mental health services on site; others can help students connect with community resources and providers of these services.
• Promoting positive staff morale among child care workers can help to minimize staff turnover.  To the extent possible, maintain the same staff members for the same children.

What Pediatricians Can Do:

• Often doctors are the first people families turn to for concerns about behaviors or emotions. Recognize that the trusting relationship you have with your patients and parents can encourage parents to share concerns.  Be alert to the signs and symptoms of emotional and behavioral problems among young children as well as mental health concerns among parents. Include questions about family violence, substance abuse, and mental health history in your assessments.
• Promote the "5 Rs" of early education to families.
• Reading together as a daily family activity.
• Rhyming, playing, and cuddling together often.
• Routines and regular times for meals, play, and sleeping, which help children know what they can expect and what is expected from them.
• Rewarding everyday successes with praise.
• Reciprocal and nurturing relationships, which are the foundations of healthy child development.
• Integrate literacy promotion into practice.
• Talk with families about child care and school. Promote a 3-way partnership among the pediatrician, family, and caregivers.
• Help your patients and parents focus on the child’s assets or strengths.
• Discuss the importance of a support system and appropriate coping strategies when parents feel tired, overwhelmed, or frustrated.
• If you see signs of depression in a parent, encourage interventions and support. Remind parents that they have to take care of themselves before they can take care of their child. Depression may impair the parent’s responsiveness to the child.
• Know what resources are available in your community so that you can refer families who need support. Make connections with mental health service providers and referral sources, and have information available in the office about mental health services.

A Final Thought:
As adults, one of the greatest things we can do for our children is to make them feel good about themselves and to equip them with a wide repertoire of positive coping strategies. They learn these strategies best when they see them modeled by the important adults in their lives.