Most children can be gloomy or irritable at times. But for some children and even infants, difficulties in personality or mood can be more serious. These problems are sometimes related to a medical condition or to a developmental delay. They also may result from a traumatic event.
Whatever the cause, we understand how stressful and confusing it can be when your young child is having trouble. We are here to help relieve these problems in children up to age 5, and prevent them from worsening as children grow up.
Why Choose Us
At the Infant and Toddler Mental Health Program (ITP) at Children’s National Hospital, we diagnose personality and mood conditions early and design treatments specifically for your child. Features of our program include:
- Unique, specialized psychiatric services for young children. We are one of only a few providers in the region specializing in psychiatric treatment for preschool-age children and in specialized therapies for this age group such as Parent-Child Interaction Therapy (PCIT), a best practice therapeutic approach for young children with behavioral difficulties and their parents. Our feeding disorders clinic is one of only a few of its kind in the U.S. that specializes in treating infants and toddlers.
- Compassionate, personalized care for each patient and family. Our Infant and Toddler Mental Health specialists consider each child’s individual situation and always treat you and your family as part of the team. We take the time to help you understand your child’s diagnosis and treatment and to answer any questions you may have. Our care supports your child’s emerging abilities and helps him or her grow into a healthy and happy child.
- Internationally known for our results. The defining work on feeding disorders in young children was written by our director, Irene Chatoor, M.D.. Children who need specialized expertise and child-focused care are referred to us from the Washington, D.C., area, across the nation and around the world.
- Close collaboration with skilled specialists. Our team works closely with a variety of specialists who add perspective to your child’s care. They can include occupational therapists and speech-language therapists, as well as experts from fields such as developmental psychology, developmental pediatrics, autism spectrum disorder and sleep disorders.
Identifying mental health issues in children is complex. Children’s National offers two care paths that draw on multiple resources for your child.
Comprehensive Assessment and Intervention
Comprehensive assessment and intervention services help with a broad range of behavioral issues and stressful conditions that may affect infants through the first years of life. Parents or medical providers, may have concerns about:
- Exposure to loss
- Feeding problems
- Sleeping difficulties
- Withdrawn behavior
You child’s first meeting with specialists may last up to two hours. It will include a psychiatric assessment. At that time we observe your child during a play session and cleaning up toys afterward. After this meeting, we give general feedback and advice for parents.
The underlying reasons for a child’s distress and/or behaviors can be complex.
A thorough evaluation usually requires at least three visits. Afterward we may recommend or provide:
- Connections to school and community resources. We provide referrals for school-based services, such as DC Early Stages, Maryland Child Find, and Virginia Infants and Toddlers Connections. We also work with school administrators to help them provide services for your child. That can include letters of recommendation for school-based interventions, such as individualized educational plans (IEP), and referrals to educational advocates such as the Children’s Law Center.
- Daycare or preschool consultations
- Individual treatment strategies. This can include highly effective approaches such as parent-child interaction therapy (PCIT), which is provided by PCIT-certified therapist Leandra Godoy, Ph.D.. Applied behavioral analysis (ABA) can result in positive behavior changes in children with autism spectrum disorder. We also may recommend play therapy.
- Medication, if needed. Some children benefit from medications focused specifically on their condition. Psychiatrist Bhavin Dave, M.D., can prescribe the right medication for your child and monitor how he or she responds.
- Multidisciplinary care. We can connect you and your child with other providers, such as specialists in autism spectrum disorder, developmental psychology, developmental pediatrics, speech-language therapy, and occupational therapy. We may also refer your child to our Sleep Center.
- Education for parents. Experts at Children’s National help parents understand how issues such as developmental delays and medical problems can lead to emotional or behavioral issues in young children. They also explain your child’s specific diagnosis and how it usually affects children as they grow.
- Parenting support groups. Our parent support group gives parents an opportunity to share and learn from each other in an atmosphere of compassion, respect, confidentiality and mutual support.
Our multidisciplinary feeding disorders team was established more than 15 years ago. Since then it has helped hundreds of families.
Feeding disorders in infants and young children under the age of 6 can come from a physical problem, an emotional issue or both. Assessment and care for infants and young children with these disorders can help them avoid health problems and improve their emotional well-being as they grow. Feeding disorders can include:
- Refusing to eat
- Aversions to specific foods
- Spitting up or vomiting in infants
- Difficulty sucking or swallowing in infants
- Gastro-esophageal reflux
Children with these problems may weigh too much or too little, or be normal weight. Infants may fail to gain weight and thrive. Older children may fall behind the normal growth curve.
New patients are first seen by a nurse specialist in gastroenterology. This nurse will consider your child’s medical, behavioral and nutritional issues. We also look at how well your child can control his or her lips, tongue and jaw muscles (oral-motor development). This screening will include a physical exam.
After the initial report from the nurse specialist, your child will have visits with specialists in several areas of care relevant to his or her condition. We may look further into his or her oral-motor and psychiatric issues. At this time, we will observe your child from behind a one-way mirror as he or she eats and plays.
Once we complete the comprehensive evaluation, the entire team meets with you to provide feedback. Our recommendations can include:
- Guidance for parents in feeding management
- Medical treatment
- Oral-motor therapy
- Referral to day treatment or inpatient care, if needed
For a new appointment for comprehensive assessment and intervention, call 202-476-5544. For follow-up appointments or questions, call 202-476-2486.
For a new appointment with the multidisciplinary feeding disorders team, call 202-476-5544.