---

---

“If you can't find helpful information summarized here, relevant to any important or special problem pertinent to children ages 0–3, then the data do not yet exist.”

—American Journal of Psychiatry (on the second edition)


“A comprehensive reference that is a valuable addition for a developmentally oriented clinician who interacts with young children and families.”

—Journal of Developmental and Behavioral Pediatrics (on the second edition)


“Successive editions of this handbook have given us the foremost thinking in an incredibly fast-developing area. Readers of the fourth edition will be delighted by a diversity of perspectives that define an increasingly rich field. For example, new chapters on epigenetics and historical trauma deepen our understanding that the baby is an interactive traveler on a multigenerational journey. Zeanah has yet again assembled an all-star cast of authors to help us better understand and intervene at both individual and sociocultural levels. This handbook is equally indispensable to researchers, clinicians, policymakers, educators, and graduate students. With the correct classroom supports, the fourth edition is ideal for use in graduate programs and postdoctoral seminars. Its utility as a classroom text spans psychology, developmental science, education and special education, psychiatry, social work, nursing, early intervention, pediatrics, public health, and many other disciplines.”

—Walter S. Gilliam, PhD, Child Study Center, Yale School of Medicine


“Zeanah has once again brought together the leading experts in the field to provide the most comprehensive, up-to-date presentation of the science and practice of infant mental health. Chapters offer a broad view as well as specific information about early childhood development in context, risk and protective factors, assessment, psychopathology, interventions, and applications in different settings and contexts. The volume presents detailed roadmaps for clinical care, training, and advocacy. For every child psychiatry fellow and faculty member in our department, this is the core, foundational book of early childhood mental health knowledge.”

—Helen Link Egger, MD, Chair, Department of Child and Adolescent Psychiatry, and Director, Child Study Center, New York University Langone Medical Center


“As in prior editions, the fourth edition of the Handbook distills a massive body of research on neurobiological processes in the developing child and renders it digestible to readers who are less familiar with the topic. To our great fortune, coverage of neurobiology has been expanded with a cutting-edge chapter on epigenetics. Other new chapters keep pace with the rapidly evolving field of evidence-based infant mental health interventions by presenting approaches arising from varying theoretical and philosophical bases.”

—Brenda Jones Harden, PhD, Department of Human Development and Quantitative Methodology, University of Maryland, College Park


“From its pioneering first edition, this handbook established itself as the authoritative resource for the infant mental health field. Now in its fourth edition, this volume builds on the foundations of the previous editions, yet brings the reader up to date with thorough reviews of key topics. Newcomers to the field, students (both beginning and advanced), and experienced clinicians and researchers will all find the Handbook invaluable. It covers the main issues 'from cell to society,' is accurate and scientifically rigorous, and offers balanced descriptions of complex issues.”

—David Oppenheim, PhD, Department of Psychology and Center for the Study of Child Development, University of Haifa, Israel


“The fourth edition very much keeps abreast of developments in the field of infant mental health. I have read the new chapters with much enjoyment and sense of fruitfulness. The Handbook is pertinent, up to date, and a great resource for those of us working directly with infants and parents, as well as those seeking to develop the overall coordination and delivery of mental health services. All of the contributors are at the forefront of their respective areas of research and clinical activity. The Handbook is the overall textbook for our multidisciplinary training program in infant and parent mental health at the University of Melbourne. The residents and fellows in the infant mental health program at the Royal Children’s Hospital also refer to the book when providing inpatient and outpatient care.”

—Campbell Paul, MBBS, FRANZCP, Honorary Principal Fellow, University of Melbourne, Australia; Consultant Infant Psychiatrist, Royal Children’s Hospital Melbourne

---

Table of Contents

I. Development and Context

1. Infant Mental Health: The Clinical Science of Early Experience, Charles H. Zeanah, Jr. & Paula Doyle Zeanah

2. Pregnancy and Infant Mental Health, Arietta Slade & Lois S. Sadler

3. Neurobiology of Fetal and Infant Development: Implications for Infant Mental Health, Anne E. Berens & Charles A. Nelson

4. Genetic and Epigenetic Processes in Infant Mental Health, Andrew R. Dismukes, Elizabeth A. Shirtcliff, & Stacy S. Drury

5. The Neurobiology of Stress and Adversity in Infancy, Stephanie F. Thompson, Cara J. Kiff, & Katie A. McLaughlin

6. Infant Social and Emotional Development: Emerging Competence in a Relational Context, Katherine L. Rosenblum, Carolyn J. Dayton, & Maria Muzik

7. Emerging Executive Functions in Early Childhood, Jennifer M. McDermott & Nathan A. Fox

8. Wounds from the Past: Integrating Historical Trauma into a Multicultural Infant Mental Health Framework, Chandra Michiko Ghosh Ippen

II. Risk and Protective Factors

9. Poverty, Early Experience and Brain Development, Luciane R. Piccolo & Kimberly G. Noble

10. Postnatal Depression and Young Children’s Development, Lynne Murray, Sarah Halligan, & Peter Cooper

11. Parental Substance Abuse, Neil W. Boris, Kimberly Renk, Amanda Lowell, & Ellen Kolomeyer

12. Prematurity: Identifying Risks and Promoting Resilience, Prachi E. Shah, Joy Browne, & Julie Poehlmann-Tynan

13. The Effects of Violent Experiences on Infants and Young Children, Daniel S. Schechter, Erica Willheim, Francesca Suardi, & Sandra Rusconi Serpa

14. Neglect, Kathryn L. Humphreys, Lucy S. King, & Ian H. Gotlib

III. Assessment

15. Caregiver Report Measures of Early Childhood Social Emotional Functioning, Leandra Godoy, Annie Davis, Amy Heberle, Margaret J. Briggs-Gowan, & Alice S. Carter

16. Assessing the Relational Context of Infants and Young Children, Julie A. Larrieu, Melissa A. Middleton, Anna C. Kelley, & Charles H. Zeanah, Jr.

IV. Psychopathology

17. Hyperactivity, Impulsivity, and Inattention in Young Children, Mary Margaret Gleason & Kathryn L. Humphreys

18. Autism Spectrum Disorder, Marianne L. Barton & Julia Chen

19. Sensory Overresponsivity, Timothy W. Soto, Vivian M. Ciaramitaro, & Alice S. Carter

20. Communication Disorders in Infants and Toddlers, Meredith Saletta & Jennifer Windsor

21. Intellectual Disabilities, Robert M. Hodapp & Elisabeth M. Dykens

22. Sleep Disorders, Judith Owens & Melissa M. Burnham

23. Eating and Feeding Disorders in Early Childhood, Miri Keren

24. Developmental Emergence of Disruptive Behaviors Beginning in Infancy: Delineating Normal/Abnormal Boundaries to Enhance Early Identification, Dorota Biedzio & Lauren S. Wakschlag

25. Depression in Early Childhood, Joan L. Luby & Diana Whalen

26. Posttraumatic Stress Disorder in Young Children, Devi Miron & Whitney Sturdy

27. Attachment Disorders in Early Childhood, Julianna Finelli, Charles H. Zeanah, Jr. & Anna T. Smyke

28. Relationship-Specific Disorder of Early Childhood, Charles H. Zeanah, Jr. & Alicia F. Lieberman

V. Intervention

29. Child–Parent Psychotherapy: A Trauma-Informed Treatment for Young Children and Their Caregivers, Alicia F. Lieberman, Miriam Hernandez Dimmler, & Chandra Michiko Ghosh Ippen

30. The Circle of Security, Joe Coyne, Bert Powell, Kent Hoffman, & Glen Cooper

31. Attachment and Biobehavioral Catch-Up, Mary Dozier & Kristin Bernard

32. Reflections on the Mirror: On Video Feedback to Promote Positive Parenting and Infant Mental Health, Marian J. Bakersmans-Kranenberg, Femmie Juffer, & Marinus H. van IJzendoorn

33. Parent–Child Interaction Therapy, Monica Stevens & Amanda N’zi

34. Foster Care in Early Childhood, Anna T. Smyke & Angela S. Breidenstine

VI. Applications of Infant Mental Health

35. Infant and Early Childhood Mental Health Training: Updates, New Directions, Sarah Hinshaw-Fuselier, Paula Doyle Zeanah, & Julie A. Larrieu

36. Infant Mental Health in Primary Care, Mary Margaret Gleason

37. Child Care and Early Education as Context for Infant Mental Health, Allison Boothe Trigg & Angela W. Keyes

38. Infant Mental Health and Home Visiting: Needs, Approaches, Opportunities and Cautions, Paula Doyle Zeanah & Jon Korfmacher

39. Investing in Early Childhood Development and Infant Mental Health, Geoffrey A. Nagle

---

About the Editor

Charles H. Zeanah, Jr., MD, is the Mary Peters Sellars-Polchow Chair in Psychiatry, Professor of Psychiatry and Pediatrics, and Vice Chair for Child and Adolescent Psychiatry at Tulane University School of Medicine. He serves as Executive Director of the Tulane Institute of Infant and Early Childhood Mental Health. He also directs the Tulane Infant Team, a community-based intervention program for abused and neglected infants and toddlers in the New Orleans area. Dr. Zeanah has a longstanding interest in infant mental health, with clinical and research foci including the effects of adverse early experiences on the development of young children, attachment and its development in high-risk environments, psychopathology in early childhood, and infant–parent relationships. He is the recipient of honors including the Ruane Prize for Outstanding Achievement in Child and Adolescent Psychiatric Research from the Brain and Behavior Research Foundation, the Norbert and Charlotte Rieger Award for Outstanding Scientific Achievement from the American Academy of Child and Adolescent Psychiatry (AACAP), the Agnes Purcell McGavin Award for Prevention from the American Psychiatric Association (APA), and the Blanche F. Ittelson Award for Research in Child Psychiatry from the APA. Dr. Zeanah is a Distinguished Life Fellow of AACAP and the APA and a Board Member of Zero to Three. He is Visiting Professor at the University of Bucharest and the University of Glasgow.

• All titles by Charles H. Zeanah, Jr.

---

Contributors

Marian J. Bakermans-Kranenburg, PhD, Faculty of Behavioural and Movement Sciences,

Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

Marianne L. Barton, PhD, Department of Psychological Sciences, University of Connecticut,

Storrs, Connecticut

Anne E. Berens, MD, Laboratories of Cognitive Neuroscience, Boston Children’s Hospital,

Boston, Massachusetts

Kristin Bernard, PhD, Department of Psychology, Stony Brook University, Stony Brook, New York

Dorota Biedzio, BS, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

Neil W. Boris, MD, Circle of Security International, Orlando, Florida

Angela S. Breidenstine, PhD, Institute of Infant and Early Childhood Mental Health, Tulane University

School of Medicine, New Orleans, Louisiana

Margaret Briggs-Gowan, PhD, Department of Psychiatry, University of Connecticut Health Center,

Farmington, Connecticut

Joy Browne, PhD, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado

Melissa M. Burnham, PhD, Department of Human Development and Family Studies, University of Nevada, Reno,

Reno, Nevada

Alice S. Carter, PhD, Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts

Julia Chen, MS, Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut

Vivian M. Ciaramitaro, PhD, Department of Psychology, University of Massachusetts Boston,

Boston, Massachusetts

Glen Cooper, MA, Circle of Security Project, Spokane, Washington

Peter Cooper, DPhil, DipClinPsychol, Department of Psychology, University of Reading Whitenights,

Reading, United Kingdom

Joe Coyne, MClinPsych, Psychology and Counselling, Faculty of Health and Community, Queensland University

of Technology, Brisbane, Queensland, Australia

Annie Davis, MA, Department of Psychology, The Catholic University of America, Washington, DC

Carolyn J. Dayton, PhD, LMSW, School of Social Work, Wayne State University, Detroit, Michigan

Miriam Hernandez Dimmler, PhD, Department of Psychiatry, School of Medicine,

University of California, San Francisco, San Francisco, California

Andrew R. Dismukes, PhD, Department of Human Development and Family Studies, Iowa State University,

Ames, Iowa

Mary Dozier, PhD, Department of Psychology, University of Delaware, Newark, Delaware

Stacy S. Drury, MD, PhD, Department of Psychiatry and Behavioral Sciences, Tulane University School

of Medicine, New Orleans, Louisiana

Elisabeth M. Dykens, PhD, Vanderbilt Kennedy Center for Excellence in Developmental Disabilities

and Departments of Psychology and Human Development, Special Education, and Psychiatry,

Vanderbilt University, Nashville, Tennessee

Julianna Finelli, MD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Nathan A. Fox, PhD, Child Development Lab, Department of Human Development,

University of Maryland, College Park, College Park, Maryland

Chandra Michiko Ghosh Ippen, PhD, Child Trauma Research Program, University of California, San Francisco,

San Francisco, California

Mary Margaret Gleason, MD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Leandra Godoy, PhD, Division of General and Community Pediatrics and Child Health Advocacy Institute,

Children’s National Health System, Washington, DC

Ian H. Gotlib, PhD, Department of Psychology, Stanford University, Stanford, California

Sarah Halligan, PhD, Department of Psychology, University of Bath, Bath, United Kingdom

Amy Heberle, PhD, Department of Psychology, Clark University, Worcester, Massachusetts

Sarah Hinshaw-Fuselier, PhD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Robert M. Hodapp, PhD, Vanderbilt Kennedy Center for Excellence in Developmental Disabilities

and Department of Special Education, Peabody College, Vanderbilt University, Nashville, Tennessee

Kent Hoffman, RelD, Circle of Security Project, Spokane, Washington

Kathryn L. Humphreys, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee

Femmie Juffer, PhD, Education and Child Studies, Leiden University, Leiden, The Netherlands

Anna C. Kelley, PsyD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Miri Keren, MD, Geha Mental Health Center, Petah Tiqva, Israel

Angela W. Keyes, PhD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Cara J. Kiff, PhD, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles,

Los Angeles, California

Lucy S. King, BA, Department of Psychology, Stanford University, Stanford, California

Ellen Kolomeyer, MS, Department of Psychology, University of Central Florida, Orlando, Florida

Jon Korfmacher, PhD, Erikson Institute, Chicago, Illinois

Julie A. Larrieu, PhD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Alicia F. Lieberman, PhD, Department of Psychiatry, University of California, San Francisco,

San Francisco, California

Amanda Lowell, PhD, Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut

Joan L. Luby, MD, Department of Psychiatry, Washington University School of Medicine in St. Louis,

St. Louis, Missouri

Jennifer M. McDermott, PhD, Department of Psychological and Brain Sciences,

University of Massachusetts Amherst, Amherst, Massachusetts

Katie A. McLaughlin, PhD, Department of Psychology, Harvard University, Cambridge, Massachusetts

Melissa A. Middleton, PhD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Devi Miron, PhD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Lynn Murray, PhD, School of Psychology and Clinical Language Sciences, University of Reading,

Reading, United Kingdom

Maria Muzik, MD, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan

Geoffrey A. Nagle, PhD, MSW, MPH, The Erikson Institute, Chicago, Illinois

Charles A. Nelson, PhD, Department of Medicine, Children’s Hospital Boston, Harvard Medical School,

Boston, Massachusetts

Kimberly G. Noble, PhD, Teachers College, Columbia University, New York, New York

Amanda N’zi, PhD, Department of Rehabilitation Medicine, Children’s Hospital Colorado, Aurora, Colorado

Judith Owens, MD, MPH, Division of Sleep Medicine, Harvard Medical School, and Center for Pediatric

Sleep Disorders, Department of Neurology, Children’s Hospital Boston, Boston, Massachusetts

Luciane R. Piccolo, PhD, Teachers College, Columbia University, New York, New York

Julie Poehlmann-Tynan, PhD, School of Human Ecology, University of Wisconsin–Madison,

Madison, Wisconsin

Bert Powell, MA, Circle of Security Project, Spokane, Washington

Kimberly Renk, PhD, Department of Psychology, University of Central Florida, Orlando, Florida

Katherine L. Rosenblum, PhD, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan

Lois S. Sadler, PhD, RN, FAAN, Yale University School of Nursing and Yale Child Study Center,

Yale University School of Medicine, New Haven, Connecticut

Meredith Saletta, PhD, Department of Communication Sciences and Disorders, University of Iowa,

Iowa City, Iowa

Daniel S. Schechter, MD, Department of Child and Adolescent Psychiatry, NYU Langone

School of Medicine, New York, New York; Department of Psychiatry, University of Geneva Faculty

of Medicine, Geneva, Switzerland

Sandra Rusconi Serpa, PhD, Child and Adolescent Psychiatry Service, University Hospitals of Geneva,

Geneva, Switzerland

Prachi E. Shah, MD, Department of Pediatrics, Michigan Medicine, University of Michigan,

Ann Arbor, Michigan

Elizabeth A. Shirtcliff, PhD, Department of Human Development and Family Studies, Iowa State University,

Ames, Iowa

Arietta Slade, PhD, Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut

Anna T. Smyke, PhD, Institute of Infant and Early Childhood Mental Health, Tulane University

School of Medicine, New Orleans, Louisiana

Timothy W. Soto, PhD, Department of Psychology, William James College, Newton, Massachusetts

Monica Stevens, PhD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Whitney Sturdy, PsyD, Child and Family Development Center, Providence Saint John’s Health Center,

Santa Monica, California

Francesca Suardi, PhD, Child and Adolescent Psychiatry Service, University Hospitals of Geneva,

Geneva, Switzerland

Stephanie F. Thompson, PhD, Department of Psychology, University of Washington, Seattle, Washington

Allison Boothe Trigg, PhD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Marinus H. van IJzendoorn, PhD, Department of Psychology, Education and Child Studies, Erasmus University

Rotterdam, Rotterdam, The Netherlands; Primary Care Unit, School of Clinical Medicine, University of

Cambridge, Cambridge, United Kingdom

Lauren Wakschlag, PhD, Institute for Innovations in Developmental Sciences, Northwestern University,

Evanston, Illinois

Diana Whalen, PhD, Department of Psychiatry, Washington University in St. Louis School of Medicine,

St. Louis, Missouri

Erica Willheim, PhD, Department of Child and Adolescent Psychiatry, NYU Langone School of Medicine,

New York, New York

Jennifer Windsor, PhD, Faculty of Humanities and Social Sciences, Victoria University of Wellington,

Wellington, New Zealand

Charles H. Zeanah, Jr., MD, Department of Psychiatry and Behavioral Sciences, Tulane University

School of Medicine, New Orleans, Louisiana

Paula Doyle Zeanah, PhD, MSN, RN, College of Nursing and Allied Health Professions

and Picard Center for Child Development and Lifelong Learning, University of Louisiana at Lafayette,

Lafayette, Louisiana

---

Audience

Clinicians who work with parents and infants (ages 0–3), as well as students and researchers in clinical and developmental psychology, psychiatry, social work, counseling, pediatrics, and psychiatric nursing.

---

Course Use

Serves as a text in graduate-level courses.

---

Previous editions published by Guilford:

Third Edition, © 2009
ISBN: 9781462506460

Second Edition, © 2000
ISBN: 9781593851712

First Edition, © 1993
ISBN: 9780898629965

---

New to this edition:

• Chapters on genetic and epigenetic processes, executive functions, historical trauma, and neglect.
• Chapters on additional clinical problems: hyperactivity and inattention, sensory overresponsivity, and relationship-specific disorder.
• Chapters on additional interventions: attachment and biobehavioral catch-up, video-feedback intervention to promote positive parenting and sensitive discipline, parent–child interaction therapy, and home visiting programs.
• Existing chapters all rewritten or revised to reflect a decade's worth of empirical and clinical advances.