New center aims to identify mental health vulnerabilities in toddlers

Northwestern University has launched a new Mental Health, Earlier Center at the Institute for Innovations in Developmental Sciences (DevSci), thanks to an $11.7 million award from the National Institute of Mental Health (NIMH) of the National Institutes of Health.

Co-led by researchers at the Spencer Fox Eccles School of Medicine at the University of Utah, the center will address the youth mental health crisis by targeting early signs of vulnerability to mental health problems in toddlers through routine pediatric care -; well before traditional mental health diagnoses or treatment commence.

Approximately 20% of children as young as age 3 have an identified mental health problem, according to the U.S. Surgeon General. Early warning signs prior to age 3 may mark the beginning of a negatively spiraling mental health course as children grow. But critically, these can also be reversed if addressed early with scientifically grounded developmental identification and prevention tools, according to the American Academy of Pediatrics.

Pediatric primary care is the natural clinical setting for supporting young children's mental health, as 95% of U.S. children see a pediatrician regularly. However, there are no widely established clinical standards to guide pediatricians in identifying when early emotional and behavioral struggles are more than typical growing pains. Supported by previous NIMH funding, scientists from the Mental Health, Earlier Center have created evidence-based developmental decision tools to determine "when to worry" about young children's mental health. These tools, however, have not yet been adapted for integration into clinical care.

Mental health support at this young age means fostering toddlers' self-regulation skills, like replacing frequent tantrums with more adaptive coping skills. When self-regulation 'muscles' are strong, mental health risk is reduced. Deploying this developmental health promotion framework to stave off mental health problems is non-stigmatizing, responsive to parental concerns, aligned with tenets of routine pediatric care, and sets a healthy social-emotional foundation for the life-course."

Laurie Wakschlag, developmental scientist, one of the center's principal investigators, DevSci director and professor of medical social sciences at Northwestern University Feinberg School of Medicine

DevSci is uniquely positioned to support this ambitious undertaking because its core mission is building bridges across disparate disciplines, universities and communities to accelerate the transfer of scientific knowledge to real world improvements in the health and wellbeing of children and families, Wakschlag said.

"This is a game-changing goal for the lives of millions of children in the U.S., but it is easier said than done," said implementation scientist J.D. Smith, a center principal investigator and associate professor in the department of population health sciences at the University of Utah. "That's why the center's hallmark is its partnership with pediatric health systems as co-designers of its research goals and strategies. To truly succeed in a way that can be nationally scaled, the solutions we co-create in this center must address inequities that impede access to the best available mental health services for all children and families, tailored to clinical setting workflows, with specialized family-centered communications training for clinicians."

The Mental Health, Earlier Center will drive implementation strategies with community pediatric partners that support effective and practical mental health prevention services for diverse young children and families during routine pediatric well-checks. It will serve as a national resource for research on equitable implementation of early mental-health promotion in pediatric care. Robust partnerships with three diverse pediatric health systems -; AllianceChicago, the Ann & Robert H. Lurie Children's Hospital and Nemours Children's Health -; are a signature feature of the center.

"Healthy development and children's mental health are top priorities for parents, and therefore, for primary care teams," said Dr. Matthew M. Davis, executive vice president, enterprise physician-in-chief and chief scientific officer at Nemours Children's Health and a center pediatric population health leader. "This novel center addresses parents' concerns about young children's behavior and wellbeing early in life when impact can be profound and long-lasting." 

The Northwestern Mental Health, Earlier Center joins an NIMH network of Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness (ALACRITY) Research Centers. ALACRITY centers support innovative research ideas and collaborations across disciplines to transform the care of children, adolescents and adults with serious mental illnesses. Launched by the NIMH Division of Services and Intervention Research, the ALACRITY program supports more than a dozen mental health research centers nationally. Northwestern's Mental Health, Earlier Center is the first of its kind targeting mental health prevention in early childhood in routine pediatric care.

"The launch of the Mental Health, Earlier Center exemplifies Northwestern's mission to pursue groundbreaking research with the power to transform lives," said Eric J. Perreault, vice president for research at Northwestern. "By addressing mental health vulnerabilities in young children before they escalate, this center takes an innovative, preventive approach that promotes healthy development while advancing equity in access to care. Northwestern is proud to be at the forefront of this critical research, working alongside community and clinical partners to create solutions that benefit children and families nationwide."

The Mental Health, Earlier Center is supported by the National Institute of Mental Health of the National Institutes of Health (grant P50MH132502). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.