Opportunities for Collaboration to Improve Services for Infants and Toddlers with Disabilities and Their Families: Collaboration Between the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) and Part C of the Individuals with Disabilities Education Act (IDEA) to Strengthen Social Emotional Development and Mental Health. Issue Brief #2. December 2024

U.S. DEPARTMENT OF E DUCATION O PPORTUNITIES FOR C OLLABORATION TO I MPROVE S ERVICES FOR INFANTS AND T ODDLERS WITH D ISABILITIES AND T HEIR F AMILIES : C OLLABORATION B ETWEEN THE M ATERNAL , INFANT , AND E ARLY C HILDHOOD H OME V ISITING P ROGRAM (MIECHV) AND P ART C OF THE INDIVIDUALS WITH D ISABILITIES EDUCATION A CT (IDEA) TO S TRENGTHEN SOCIAL EMOTIONAL D EVELOPMENT AND M ENTAL H EALTH ISSUE B RIEF #2 DECEMBER 2024 OPPORTUNITIES FOR COLLABORATION TO IMPROVE SERVICES FOR INFANTS AND TODDLERS WITH DISABILITIES AND THEIR FAMILIES I SSUE BRIEF #2 1 INTRODUCTION The Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) and the Individuals with Disabilities Education Act, Part C Program (IDEA Part C) play critical roles in supporting families and infants and toddlers with disabilities during the birth -to -three period. Collaboration between the programs at the local level may lead to benefits for infants and toddlers and their families, particularly those enrolled in both programs . Specifically, this collaboration may enhance the quality of service delivery , promote early identification, and ultimately lead to better outcomes for infants and toddlers with disabilities and their families. This technical assistance brief highlights the importance of strengthening cross-agency collaboration between MIECHV and IDEA Part C in the areas of social or emotional development and mental health and outlines key opportunities for collaboration. Specifically, cross-agency collaboration strategies for programs and providers can facilitate a holistic understanding of the services families receiv e to support mental health and social emotional development , as well as reduce instances where families receive duplicate referrals or services from both programs . The strategies outlined in this resource are based on the 2017 ED and HHS J oint Statement on IDEA Part C and MIECHV collaboration . 1 THE IMPORTANCE OF INFANT AND EA R LY CHILDHOOD M ENTAL H EALTH AND S OCIAL EMOTIONAL D EVELOPMENT AND CAREGIVER M ENTAL H EALTH Early social emotional support may help infants and toddlers develop essential skills in emotional regulation, social interaction, and cognitive functioning. Caregiver m ental health may have an impact o n the development of infants and toddlers . Mental health support for caregivers may reduce overall family stress and enhance coping strategies which may contribut e to a more supportive home environment. A holistic approach that addresses caregiver mental health and the social emotional developmental needs of infants and toddlers is intended to improve the child’s quality of life , strengthen family dynamics, and promot e resilienc y and emotional well-being for the entire family unit. 1 The joint statement was developed by t he Office of Special Education Programs (OSEP) in the U.S. Department of Education (ED) and the Maternal and Child Health Bureau (MCHB) in the Health Resources and Services Administration (HRSA) within the U.S. Department of Health and Human Services (HHS) . OPPORTUNITIES FOR COLLABORATION TO IMPROVE SERVICES FOR INFANTS AND TODDLERS WITH DISABILITIES AND THEIR FAMILIES I SSUE BRIEF #2 2 COLLABORATION IN MIECHV AND IDEA PART C: INFANT AND EA R LY CHILDHOOD M ENTAL H EALTH AND SOCIAL EMOTIONAL D EVELOPMENT MIECHV and IDEA Part C are two critical programs that support the mental health and social emotional development of infants and toddlers with disabilities and their families . Collaboration between MIECHV providers and IDEA Part C providers may maximize the effectiveness of these programs so that all infants and toddlers have opportunities to receive comprehensive, coordinated care that addresses both their developmental and social emotional needs. To promote collaboration, many IDEA Part C agencies partner with other State agencies and community programs to support mental health. In the 2023 Tipping Points Survey Part C agencies in 32 States report partnering with their State’s home visiting initiatives. Additionally, the survey indicated that 30 percent of Part C respondents report partnering with their State’s early childhood mental health initiatives. The IDEA Part C program makes funds available for States to provide early intervention services 2 to infants and toddlers with disabilities 3 and their families that are designed to meet the developmental needs of the child and the needs of the family to assist appropriately in the child’s development. When evaluat ing an infant or toddler to determine eligibility for Part C , 4 the procedures must include identifying the child’s level of functioning in each of the five specified developmental areas 5, including social or emotional development. For an infant or toddler determine d to be eligible under IDEA Part C, the Individualized Family Service Plan (IFSP) 6 developed by the IFSP team 7 must include a statement of the child ’s present level of functioning in thos e specified developmental areas, including social or emotional development, and the specific early intervention services that are necessary to meet the 2 See 34 CFR 303.13. 3 34 CFR 303.21 4 See 34 CFR 303.321. 5 34 CFR 303.321(b)(3) (The evaluation procedures must include identifying the child’s level of functioning in each of the following developmental areas listed in 34 CFR 303.21(a)(1) : (i) Cognitive development. (ii) Physical development, including vision and hearing. (iii) Communication development. (iv) Social or emotional development. (v) Adaptive development.) 6 See 34 CFR 303.344. 7 34 CFR 303.343. INFANT AND EARLY CHILDHOOD MENTAL HEALTH (IECMH): Children’s mental and behavioral health, social emotional development, and well -being during the birth -to -5 age range. IECMH encompasses a child’s capacity to express and regulate emotions, form trusting relationships, explore, and learn, within the cultur al context of family and community. E ARLY RELATIONAL HEALTH : A framework that explores the role of early relationships and experiences in healthy development across a child’s lifetime. Relationships, especially in the early years, are biological necessities to build a foundation for lifelong growth. and development. OPPORTUNITIES FOR COLLABORATION TO IMPROVE SERVICES FOR INFANTS AND TODDLERS WITH DISABILITIES AND THEIR FAMILIES I SSUE BRIEF #2 3 unique needs of the child and the family . While mental health supports are not explicitly listed as a separate service, they are embedded within several types of services that can be provided under Part C , including: family counseling and training; p sychological services; social work services ; and service coordination . The MIECHV Program funds States and jurisdictions to develop and implement evidence -based home visiting programs in local communities. MIECHV awardees are required to report on benchmark performance measures annually, which include benchmarks on the percent of caregivers enrolled in home visiting screen ing for depression using a validated tool and the percent of caregivers referred to services based on their depression screening who receive at least one service contact. Some MIECHV - funded programs also have partnerships to provide Infant and Early Childhood Mental Health Consultation (IECMHC). IECMHC is a preventive intervention that pairs specially trained mental health professionals with professionals who work with infants and toddlers . IECMHC helps service providers (such as home visitors or early care and education providers) support and facilitate healthy social emotional development. FEDERAL RESOURCES TH AT SUPPORT CROSS -A GENCY COLLABORATION IN MIECHV AND IDEA P ART C PROGRAMS There are F ederal resource guides and technical assistance centers that support infant and early childhood mental health and social emotional development . The Early Childhood Technical Assistance Center (ECTA) , funded under the Office of S pecial Education Programs (OSEP) , supports State IDEA Part C programs in developing high -quality, effective, and sustainable S tate and local systems, to implement equitable access, services, and supports for infants and toddlers with disabilities and their families that result in positive outcomes not related to race, language, income, or other demographics. The National Center for Pyramid Model Innovations (NCPMI) , funded under OSEP, aims to improve State and local capacity to implement, scale -up, and sustain effective practices and policies to equitably support the social, emotional, and behavioral outcomes of young children with, and at risk for, developmental delays or disabilities. ECTA and NCPMI both emphasize the importance of collaborative partnerships in delivering high-quality early intervention services and infant and early childhood mental health services. ECTA offers a resource that describes how State and local early intervention programs can build partnerships to implement infant and e arly childhood mental health ( IECMH ) policies and practices . NCPMI provides a wealth of resources that can be used by early intervention programs to implement the Pyramid Model and support families in promoting their child’s social, emotional, and behavioral development. OPPORTUNITIES FOR COLLABORATION TO IMPROVE SERVICES FOR INFANTS AND TODDLERS WITH DISABILITIES AND THEIR FAMILIES I SSUE BRIEF #2 4 STRATEGIES TO SUPPORT INFANT AND EA R LY CHILDHOOD M ENTAL H EALTH AND SOCIAL EMOTIONAL D EVELOPMENT THROUGH COLLABORATION BETWEEN P ROGRAMS Jointly b uild capacity around IECMH and social emotional development . Create opportunities for joint professional development for IDEA Part C and MIECHV service providers on topics related to IECMH and caregiver mental health. Programs can partner with their S t a te ’s Association for Infant Mental Health to disseminate information and build provider knowledge and capacity around IECMH through trainings. Programs can also share lists of IECMH consultants or collaborate on mechanisms to make them available for staff. The Briefing Paper: Infant and Early Childhood Mental Health and Early Intervention (Part C) provides recommendations for collaboration and workforce development. Develop shared language and processes . Define what each program means when refer encing caregiver, infant, social emotional development, and early childhood mental health and explore how those definitions are similar or different. Using shared tools across programs, such as validated postpartum depression screening tools and social emotional screening diagnostic tools for infants and toddlers , can help standardize how each program identifies caregivers and young children who meet the threshold for services and referrals. Conversations to define IECMH and ways young children may experience social emotional challenges can be facilitated by exploring ways to align processes for screening and referral, and sharing screening results, with parental consent (when needed) , between programs. Share strategies for working with families, including information about services received. With parental consent (when needed) , determine what mental health or social emotional development supports and services infants and toddlers with disabilities and their families may be receiving through IDEA Part C and MIECHV -funded programs. For example, if a family caregiver enrolled in both programs screens positive for depression during MIECHV -funded home visiting services, providers could find it helpful to know, with parental consent (when needed), whether the child is enrolled in IDEA Part C and receiving services related to social emotional development so that they can customize additional referrals as needed . Additionally, IDEA Part C and MIECHV programs can share strategies to address Do You Know? “Social development refers to a young child’s ability to create and sustain meaningful relationships with adults and other young children. Emotional development is a young child’s ability to express, recognize, and manage his or her emotions, as well as respond appropriately to others’ emotions. Both social and emotional development are important for young children’s mental health. In fact, early childhood mental health is the same as social and emotional development!” Head Start Early Learning & Knowledge Center OPPORTUNITIES FOR COLLABORATION TO IMPROVE SERVICES FOR INFANTS AND TODDLERS WITH DISABILITIES AND THEIR FAMILIES I SSUE BRIEF #2 5 behavioral health and develop aligned approaches to assist families who need support in mental health or social emotional development. For example, p rogram staff can partner to learn about their S t a te ’s policies for Plans of Safe Care to ensure the safety and well -being of infants who are identified as being affected by prenatal substance use and resources that may be available for families of young children involved in child welfare , such as Infant Toddler Courts . Coordinate on the development of IFSP s. IFSP s are developed by the IFSP team 8, comprised of the parent or parents of the child and other team members , including the child’s service coordinator, a person involved in conducting the evaluations of the child, and as appropriate IDEA Part C program therapists and providers. When appropriate and with parental consent, home visitors can also participate in the IFSP team for families who participate in Part C and MIECHV . In determining the specific early intervention services needed to meet the unique needs of a child, an IFSP team can develop an IFSP that encompass es both the mental health and social emotional developmental needs of the child and family. 9 This holistic approach may lead to more comprehensive interventions for the individual child and family. STAT E EXAMPLE In Hawaii, both IDEA Part C and MIECHV are striving to incorporate the use of mental health consultants into their respective systems. The process for establishing a framework for th is type of collaboration can be found in the Briefing Paper: Infant and Early Childhood Mental Health and Early Intervention (Part C) . Some of the strategies used by Hawaii’s IDEA Part C program have included training for all providers , through the Association for Infant Mental Health Hawaii (AIMH -HI), on the foundations of infant mental health . They have also contracted with AIMH -HI to provide reflective supervision training for all supervisors and to provide reflective supervision support for one year. Hawaii’s IDEA Part C program plans to pilot the use of licensed social workers endorsed as mental health consultants and referred to as mental health specialists (i.e., licensed clinical social workers , psychologists ). MIECHV has provided training, through the AIMH -HI , for home visitors on the foundations of infant mental health. T he Hawaii State Department of Health Home Visiting Program is working to embed IECMHC service into their MIECHV home visiting program contracts. Regular IECMHC interventions may support home visitors to manage stress, reduc e burnout and turnover , and help ensure that home visiting services are being delivered in a way that is consistent with the program's model and goals for infant and childhood mental health . 8 34 CFR 303.343 9 Although evidence -based home visiting services, such as those that are provided through MIECHV, are not services that are eligible to be funded through IDEA Part C State programs, an IFSP can identify other services that could benefit the child and family. If other services — such as MIECHV services — are not being provided, a description of the steps the service coordinator may take to assist the child and family in securing those services can be included in the IFSP. (as noted in the 2017 ED and HHS Joint Statement linked here) OPPORTUNITIES FOR COLLABORATION TO IMPROVE SERVICES FOR INFANTS AND TODDLERS WITH DISABILITIES AND THEIR FAMILIES I SSUE BRIEF #2 6 CONCLUSION Collaboration between MIECHV and IDEA Part C at the local level may lead to comprehensive, efficient, and effective mental health support to infants and toddlers with disabilities and their families. By leveraging each program ’s strengths and resources, programs may enhance mental health outcomes for children , optimize resource use, and build stronger support networks. The strategies and resources outlined in this brief are intended to help providers better understand the services available in each program and work together toward holistically supporting child and family mental health , child development, and family well- being. OPPORTUNITIES FOR COLLABORATION TO IMPROVE SERVICES FOR INFANTS AND TODDLERS WITH DISABILITIES AND THEIR FAMILIES I SSUE BRIEF #2 7 RESOURCES TO SUPPORT INFANT AND EA R LY CHILDHOOD M ENTAL H EALTH AND SOCIAL EMOTIONAL D EVELOPMENT • The American Academy of Pediatrics Early Relational Health Framework • Center of Excellence for Infant & Early Childhood Mental Health Consultation • Early Childhood Technical Assistance Center Briefing Paper on Infant and Early Childhood Mental Health and Early Intervention (Part C) • ED/HHS Dear Colleague Letter on Social- Emotional Development and Mental Health • ED/HHS Joint Policy Statement: Collaboration and Coordination of the Maternal, Infant, and Early Childhood Home Visiting Program and the Individuals with Disabilities Education Act Part C Programs (PDF) • ED/HHS Joint Policy Statement: Inclusion of Children with Disabilities in Early Childhood Programs • Embedding Infant and Early Childhood Mental Health Consultation in M IECHV Programs • Elevating Prevention and Promotion Efforts in Early Childhood Mental Health: A Case Study Series Page • Finding an IECMH Consultant to Support Your Home Visiting Program • Guidance on Creating an Effective Memorandum of Understanding to Support High -Quality Inclusive Early Childhood Systems • IDEA Part C: Early Learning and Early Childhood • IDEA Part C Model Individualized Family Service Plan (IFSP) Form • Infant and Early Childhood Mental Health and Early Intervention (Part C) • Infant and Early Childhood Mental Health Consultation in Home Visiting • Infant and Early Childhood Mental Health in Part C Early Intervention Program | National Center for Children in Poverty • National Maternal Mental Health Hotline. 1 -800 -TLC -MAMA • Postpartum Support International • Supporting Infants' and Toddlers' Emotional and Behavioral Self -Regulation • Supporting Infant and Early Childhood Mental Health & Social- Emotional Learning • Postpartum Support International • Supporting Infants' and Toddlers' Emotional and Behavioral Self -regulation | ECLKC (hhs.gov) • The Paradigm Shift to Early Relational Health: A Network Movement OPPORTUNITIES FOR COLLABORATION TO IMPROVE SERVICES FOR INFANTS AND TODDLERS WITH DISABILITIES AND THEIR FAMILIES I SSUE BRIEF #2 8 D ISCLAIMER Other than statutory and regulatory requirements included in the document, the contents of this document do not have the force or effect of law and are not meant to bind the public. This document is intended only to provide clarity to the public regarding existing requirements under the law or agency policies. This document is intended as a resource on identifying, locating, and evaluating infants and toddlers for Individuals with Disabilities Education Act (IDEA) Part C services. Further, this document doe s not provide specific guidance on Federal disability laws. This document contains resources and examples that are provided for the user’s convenience. The inclusion of these materials is not intended to reflect their importance, nor is it intended to endorse any views expressed, or products or services offered. These materials may contain the views and recommendations of various subject - matter experts as well as hypertext links, contact addresses and websites to information created and maintained by other public and private organizations. The opinions expressed in any of these materials do not necessarily reflect the positions or policies of the U.S. Departments of Education or Health and Human Services. The U.S. Departments of Education and Health and Human Services do not control or guarantee the accuracy, relevance, timeliness, or completeness of any outside information included in these materials. For the reader ’s convenience, this document contains examples of potentially useful products and resources. Inclusion of such information does not constitute an endorsement by the Departments of Education or Health and Human Services or the Federal government, nor a preference/suppor t for these examples as compared with others that might be available and be presented.