The Early Childhood Supports and Services Consultation (ECSS Consultation) is designed to build the capacity of pediatric primary care clinicians and their practices to identify risk factors, promote family well-being, and understand and respond to the behavioral and mental health needs of children birth to five years of age. Through education and consultation, the goals of ECSS Consultation are to promote early childhood well-being and support the pediatric team’s competencies and comfort with:
- Supporting healthy emotional, behavioral, and relational development in typically developing children
- Identifying young children at risk of early mental health problems
- Providing first line intervention and management of early mental health problems, including identification and support for caregivers with mental health needs
- Providing relevant resources and making effective referrals for specialty care
- Partnering with specialty services for children with more intensive mental health needs
To achieve the above goals, ECSS Consultation provides a range of services and resources individualized to meet the specific needs of the pediatric provider or practice. These include:
- Clinical consultation provided by a licensed mental health professional for general or specific clinical questions regarding assessment and management of mental health and behavioral concerns, resources, and referral information. In-person or via Zoom (TBD) To the provider, or in a brief consult with patient in partnership with the provider
- Web-based resources Provider guidance Parent handouts Screening resources Community resources
- Topic-focused education, including but not limited to: Early childhood mental health; attachment and parent-child relationships; behavioral management; developmental behavioral screening; effects of violence on young children; health equity; effective communication for provider and parents; professional burnout and self-care; parental mental health; or, you name the topic!
Note: ECSS Consultation services are intended to support, not usurp the role of the pediatric provider. Consultants cannot provide direct therapeutic services. ECSS Consultation does not replace necessary emergency services.
Why Consultation for Young Children?
Pediatric primary care professionals aspire to provide care that is comprehensive, coordinated and accessible to meet the health and developmental needs of infants and young children to ensure they achieve maximal well-being. Given their frequent contact with patients and families via well-child and sick-child services, pediatric professionals are increasingly called upon to provide first-line mental health services as well. However, because of the rapid changes that occur in early childhood, the mental health and behavioral needs of very young children may be overlooked or simply not recognized.
Research shows the importance of early recognition and intervention for the current and long-term well-being of the child. Brain development is most rapid during the first few years of life. It is estimated that synaptic connections are formed at the rate of 700/second in the early years, and 95% of brain development is accomplished by age 5. While there is still plenty of room for growth, early brain development lays the foundation for later development, and research shows that those connections are formed based on experience. For infants and young children, experiences include cognitive stimulation, adequate physical care, and, perhaps most importantly, the quality of their caregiving experiences. Infants and young children who have safe, nurturing, and stimulating caregiving are much more likely to have better cognitive, social, and even physical health outcomes compared to those who do not. Exposure to traumatic experiences, disruptions in attachment, and caregivers who, for a variety of reasons, are not able to provide safe and nurturing care are some of the risks to infant and early childhood mental health. Importantly, research shows that young children experience mental health issues at roughly the same rate as older children-10-16%.
Common mental health issues in young children, ranging from normative to clinically significant, include:
- Caregiver (parent)-child relationship problems
- Disruptive or dysregulated behavior
- Fears and anxiety
- PTSD and other trauma-related symptoms
- Mood problems: irritability, joylessness
- Difficulties with bedtime separation, toileting
- Sleep, feeding/eating problems
- Developmental delays
- Coping with medical procedures
- Behavioral and emotional issues associated with medical illness
Because early behavioral issues are associated with later problems with learning, social and emotional difficulties, and significant behavioral issues, prevention and early intervention are key. Lack of access to resources and services impairs the ability of pediatric professionals to integrate behavioral health care, and ECSS Consultation provides much needed support and guidance for addressing the mental health needs of infants and young children.
The ECSS Consultation Program (formerly named Tulane Early Childhood Consultation-TECC) was founded by Tulane child psychiatrist and pediatrician Dr. Mary Margaret Gleason. The program was modeled on the successful Massachusetts Child Psychiatry Access Program (MCPAP). MCPAP improved behavioral health access, increased the ability of primary care providers to meet the behavioral health needs of their patients, and enjoys the widespread support of providers and families alike. The MCPAP model has been adapted in over 30 states. Because of the dearth of pediatric expertise in infant and early childhood mental health in Louisiana, the Tulane Early Childhood Consultation Program was founded. The program was initially funded by public and private grants. Renewed funding has re-established TECC as the ECSS Consultation service under the umbrella of services provided by the ECSS Program.
Past Team Members
Shanique Ampiah MD
Emma Badra BS
Myra Fernando MD
Julianna Finelli, MD
Amelia Goodenough MD
Danielle Ibelema MD
Lauren Kaczka-Weiss MD
Mary Lingwall BA
Angel Norwood BS
Fiona Ritchey BS
Ana San Martin MD
Katie Sigalow MD
Monica Stevens PhD
Akanksha Thakur MD
Maegen Vincent MD
The Pediatric Primary Care Consultation service is part of the ECSS program which serves infants and young children (0-5 years of age) and families. ECSS services include specialized mental health assessment and treatment for young children and their caregivers, parenting education, and family support. By focusing on factors that can affect the ability of caregivers to provide safe, consistent, and nurturing care, the overall goal of ECSS services is to bolster the family’s ability to respond to and care for their child’s developmental, behavioral, and emotional needs. ECSS Program services, including Pediatric Primary Care Consultation, are provided free of charge to providers and to families, though grant funding by the Louisiana Department of Health, Office of Behavioral Health, in partnership with Jefferson Parish Human Services Authority.
