Debunking the Myths About the Pyramid Model and Infant Mental Health

The Pyramid Model and infant and early childhood mental health (IECMH) are two frameworks that have an important common goal: supporting the mental health and social-emotional well-being of infants, young children, and their families. But inaccurate understandings of these approaches are limiting their growth—and preventing programs from using the two together to maximize their benefits.

The new book Uniting Infant Mental Health and the Pyramid Model takes on four of these persistent myths:

Myth 1: The Term “Infant and Early Childhood Mental Health” Refers to Diagnosis of Mental Illness

IECMH as a term has been misunderstood both inside and outside the infant and early childhood–serving sectors. For some, there was a worry that attention to an infant’s mental health meant “labeling” babies with diagnoses of mental illness—along with a worry that such a diagnosis might follow them throughout childhood, attaching stigma to the child.

In fact, the most widely accepted definition of IECMH comes from ZERO TO THREE and states that: “Infant and early childhood mental health is the developing capacity of the child from birth to five years old to form close and secure adult and peer relationships; experience, manage, and express a full range of emotions; and explore the environment and learn—all in the context of family, community, and culture. Nurtur­ing, protective, stable, and consistent relationships are essential to young children’s mental health” (2001).

Essentially, IECMH emphasizes that the relationships that babies form with their families and caregivers have the power to strengthen or hinder their social and emotional development. An individual’s mental health is present from the very beginning, and strong relationships can protect it. IECMH-informed concepts and practices strengthen the practitioner’s support of the infant/young child’s early relational health by attending to and supporting the relationships that impact them—often by providing therapeutic support, but not necessarily “therapy.”

Myth 2: Infant and Early Childhood Mental Health Is Not an Evidence-Based Approach

IECMH may be a relatively new field, but the research about the effectiveness of IECMH-informed approaches has grown rapidly over the past decade. Evidence-based models include:

• Attachment and Biobehavioral Catch-Up (ABC)
• Child First Child-Parent Psychotherapy
• Healthy Families
• Infant Mental Health Home Visiting
• Minding the Baby
• Nurse-Family Partnership

These models demonstrate an impact on the quality of caregivers’ responses to their infants, improvements in the infant/young child’s communication and social/emotional development, caregivers’ capacity to be reflective, reduction of child abuse risk, and other child wellness aspects. Each of these models is grounded in building supportive relation­ships with parents/caregivers to strengthen their capacities to support their babies.

Myth 3:  The Pyramid Model Is “Too Behavioral” or Based on a Special Education Approach

As the Pyramid Model for Promoting the Social Emotional Competence of Infants and Young Children was being developed, there was a great deal of concern from the field that the prac­tices and framework would not be developmentally appropriate for use with all children across a variety of settings. That’s a misconception. Although the framework was intended to be conceptually holistic to Schoolwide Positive Behavioral Interventions and Supports (SW-PBIS) and other multi-tiered systems of support (MTSS), the practices supported by the Pyramid Model come directly from the research inclusive of regular early childhood education, early intervention/early childhood special educa­tion, and IECMH.