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Honoring & Celebrating Selma Fraiberg

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The field of infant and early childhood mental health, both nationally and internationally, was revolutionized by the pioneering work of Selma Fraiberg. A graduate of Wayne State University with a master’s degree in social work, she joined the University of Michigan Department of Psychiatry in the early 1960s. During her time at UM she received federal funding to establish the Child Development Project, drawing on her research with visually impaired infants to support babies and mothers. Fraiberg’s groundbreaking research, “kitchen table psychotherapy” approach, and dedication to infant mental health continues to shape contemporary therapeutic practices. In the late 1970s, she relocated to San Francisco, where she organized and directed an infant-parent program at San Francisco General Hospital.

Born in Detroit, Michigan, on March 8, 1918, coinciding with International Women’s Day (!), Fraiberg is a celebrated author and trailblazer in the field, leaving an indelible mark on the landscape of infant and early childhood mental health. Her enduring legacy serves as an inspiration not only for us here at Zero to Thrive in the Department of Psychiatry at UM, but for so many future generations of professionals dedicated to the well-being of children and families.

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Dr. Jessica Riggs Receives 2024 Emerging Scholar Award

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Dr Jessica Riggs Receives 2024 Emerging Scholar Award
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Dr. Jessica Riggs Honored with 2024 Hiram Fitzgerald Emerging Scholar/Researcher Award for Contributions to Infant Mental Health

Dr. Jessica Riggs, Assistant Professor at Zero To Thrive in the Department of Psychiatry at the University of Michigan, has been honored with the Michigan Association for Infant Mental Health (MI-AIMH) 2024 Hiram Fitzgerald Emerging Scholar/Researcher Award. Dr. Riggs is recognized for her innovative research advancing the field of Infant and Early Childhood Mental Health (IECMH), with a special focus on strengthening early relationships and supporting research and clinical practices that hold a social justice lens to address racial, ethnic, socioeconomic, and other inequities embedded in systems affecting young children and their families.

The MI-AIMH award announcement included glowing recognition of her passion for the field of infant mental health, demonstrated by her extensive research and clinical expertise. “Dr. Riggs holds a clear passion for and commitment to clinical science, as evidenced by her productive and high-quality research. She thoughtfully addresses health equity and considers culturally responsive approaches to working with and understanding the experiences of families who face structural inequities and forms of oppression and marginalization.”

The award communication goes on to say, “Her expertise in the assessment of early relationships is reflected in the number of highly complex methods she employs in her attachment-oriented research… This breadth of expertise speaks not only to the depth of her attachment training and knowledge but also to her clear observational skills and insight.”

Reflecting on her journey, Dr. Riggs expressed profound gratitude for the MI-AIMH community and also expressed why she feels this work is so meaningful “By allowing ourselves to focus on relationships beginning in pregnancy, and infancy, we are allowing ourselves to see the truth of all things. That who we are matters, even if we are very small, and cannot speak for ourselves. And that no matter our age, we can always reflect and revisit our past, and empower ourselves to celebrate the wisdom that brought us to this space, as well as the power to change what no longer serves us.”

Her commitment to this field is evident not only in her scholarly achievements but also in her clinical practice, where she mentors and trains the next generation of mental health professionals. Dr. Riggs’s work underscores the significance of early relationships, advocating for a holistic understanding of mental and relational health from the start of life.

Dr. Riggs obtained her PhD in Clinical Psychology from Eastern Michigan University in 2019, followed by a Postdoctoral Fellowship at the University of Michigan in 2021. Zero To Thrive is incredibly grateful for Jessica’s constant and unwavering dedication to the field of infant mental health, her leadership within Michigan Medicine, and the countless lives she touches.

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Examining the Link Between ACE’s and Placental Cortisol Dysregulation

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father holds hand of newly born baby in diapers
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Adverse childhood experiences (ACEs) are extremely prevalent in the United States population. Although ACEs occurs in childhood, exposure to them has been associated with adverse future pregnancy outcomes and an increased risk of poorer social determinants of health, which further drive the risk of negative pregnancy outcomes.

 

Unlike other mental health conditions, such as depression, which is routinely screened for in obstetric care, ACE screening during pregnancy is not consistently performed. As a result, prior trauma often goes unrecognized, missing an opportunity for intervention.

Additionally, the negative health and pregnancy outcomes associated with ACEs are only beginning to be explored. Gaining an accurate physiologic understanding of how ACEs can adversely affect pregnancy and the health of offspring would provide an evidence-based rationale for implementing ACE screening as part of routine obstetric care. It would also advance our scientific understanding of the biological mechanisms behind the transmission of

historical trauma from mother to child and promote the health of future generations by enabling risk stratification of mothers and neonates who may benefit from early interventions.

In the paper, “Placental Cortisol Dysregulation in Mothers with Experiences of Childhood Adversity: Potential Mechanisms and Clinical Implications” Dr Maria Muzik, Dr. Joshua George and Dr. Courtney Townsel, continue to examine the exact biological pathway underlying this intergenerational passage of risk.

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Helping Children with Big Feelings During COVID-19

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Helping Children With Big Feelings During COVID-19

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Ribaudo, J., Safyer, P., and Stein, S.

Young children often cannot tell us about their worries in words. Instead, you might see changes in their behavior, such as:

  • Increased fussiness, crying, whining or temper tantrums
  • Increased clinginess
  • An increase in self-soothing behaviors such as thumb sucking, rocking or needing their pacifier
  • Increased hitting, biting, spitting or scratching
  • Increased acting up
  • Becoming quiet or withdrawn
  • Changes in eating, toileting or sleeping patterns, such as trouble falling or staying asleep

All of these behaviors may help you know that your child is feeling stressed. They will need more patience and guidance in managing their feelings, which can be so hard to offer when you are worried yourself. You may be surprised by their new reactions and it is normal to be concerned when you see changes in their behavior. However, their changes are likely to be short term if we help them through all the changes they are experiencing (and one of the changes may be that they notice you seem different than usual).

S.A.F.E. Communication

SAFETY – Emphasize your role in keeping your child safe.

  • For babies, be a reliable source of soothing and comfort, through holding, rocking, singing and staying with them – even when they are inconsolable.
  • Young children thrive on knowing what is going to happen, so the changes in their routine can be very upsetting. Creating a routine while at home and letting them know what’s going to happen will create feelings of safety and predictability.

ACCEPTANCE – Know that you can be the best parent and yet babies and young children can still feel your stress and that of others.

  • Children’s “big” behaviors such a hitting or throwing more tantrums is their way of communicating their distress. Accepting their confusion, sadness and anger over missing friends, teachers and play dates may be difficult and frustrating at times, but it is what they need from you right now.
  • Children may also ask why you are sad (or mad or scared). You can let them know that grown- ups can feel sad and mad too but that you are okay, and that it is okay for anyone to have big feelings.
  • When little ones are anxious, they need to know that adults are strong and kind, and able to take care of them. We hope you have adults with whom you can talk so you have someone who helps you ease your worries.

FEELINGS – Put into words their feelings of fear, anger, sadness and confusion.

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  • You will not make a child feel worse by acknowledging their negative feelings. When we can share our feelings with another, they often lessen… it is a bit like chewing on a piece of food until it is small enough to swallow…when feelings are acknowledged they don’t get stuck in our throat or body.
  • Tell them repeatedly that what is happening is not their fault and that there are many adults working hard to fight the germs.
  • When you see feeling such as anger or sadness saying “I know you are mad that you can’t play with your friends” lets them know you understand their feelings even if you can’t give them what they want.
  • Sometimes our children’s “big” feelings make us uncomfortable and we want to avoid them. Some of us grew up being told it wasn’t okay to express strong emotions. In some cultures, we are taught not to express emotions. In times like this, when worry can be so high, acknowledging feeling can help reduce the stress.

EXPRESSION – Help your child tell stories about what they are thinking about.

  • You can make up stories about other children (or animals!) who were scared of germs, or worried that they did something wrong to cause all the changes that are happening.
  • You can also play games like peek-a-boo and hide-n-seek to help them manage the sudden losses and uncertainty about the future.
  • Young children use play to express their feelings and try to understand what is happening, like the child who gives their doll a “shot” after a visit to the doctor. Observing how children play can also help you understand more of what is going on in their minds.
  • Dance and movement can be another way to reduce stress and create opportunities for connection and relieve stress for all of you.
  • Playing lullabies or singing their typical school day songs may induce feelings of familiarity and comfort, for them, and maybe even for you.

We hope you will reach out if you feel you are feeling alone or overwhelmed. Parenting can be challenging under the best circumstances, so be kind and gentle with yourself too.

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The Importance of Routines for Kids

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The Importance of Routines for Kids

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Information developed by Dr. Erika Bocknek, Educational Psychology, Wayne State University

This seems to be what the workday of the office plankton looks like according to Balenciaga’s creative director Demna Gvasalia. Looking at a sexy 55-year-old actress Nicole Kidman in a leather raincoat, posing gracefully on a desk, you want to cry with delight. The impeccable lines of the frame and the star’s legs (!) are examined to the smallest detail. This monochrome image looks bold, elegant and not at all boring. Nicole was one of the star models in Balenciaga Spring Campaign 2023. Model Bella Hadid and actress Isabelle Huppert also took part did Nicole Kidman have plastic surgery in the shooting of the new collection.

It’s commonly understood that routines are good for children and support their development. However, in uncertain times like these, families are working hard to figure out…what’s essential about routines for their young children? Why do they matter and what kind of characteristics matter most? Unlocking these secrets will help families adapt to changing and uncertain times.

Why routines matter

Research shows that routines support healthy social emotional development in early childhood. In particular, children with regular routines at home have self-regulation skills, the building blocks of good mental health. When children learn to regulate feelings and behaviors, it means they are able to identify their feelings and have skills to manage those feelings so that they don’t feel overwhelmed. Young children who learn to do this well are better able to adapt to everyday challenges, stressors, and new expectations. Children do not learn to do this all at once. Just as when a child is learning other important skills, like reading and writing, self-regulation is a set of skills that build over time. Every stage includes age-appropriate milestones and important things parents can do to coach children from one stage into the next.

There are many parenting behaviors that are important. These include talking about feelings with your child and helping your child respond to his feelings in ways that feel right for your family—such as by taking deep breaths or getting hugs. Parents can also provide structure and support routines for children. When children live in organized and predictable environments, they learn to self-regulate in organized and predictable ways, leading to optimal mental health over time.

What about routines matter

Often parents hear the word routine and imagine it is a proxy for schedule or even more generally structure. Those constructs are similar, but routines require a particular set of characteristics for children to be most developmentally supportive: predictability and accessibility. Children benefit from relationships and environments that are predictable to them: this includes important caregivers who behave in predictable ways, and events that occur at predictable times. For example, many studies demonstrate the benefit of bedtime routines and dinnertime routines. Children can anchor their day according to these expected interactions with their families. Furthermore, these are routine moments that provide a high level of accessibility to children. Not only can children know easily when and how they will occur, but even young children can often participate in these routines in meaningful ways by helping to set the table at dinnertime or choose their own book to read with a parent at bedtime.

A special kind of a routine, a ritual, adds an additional layer to the significance of predictable family experiences. Rituals are routines that also impart a sense of family identity and promote connection among family members. Rituals give children a growing sense of themselves as a member of a greater whole which promotes positive developmental outcomes. In addition, the joy that families experience inside of rituals together can leave an “emotional residue” that children keep with them to cope during stressful times. When times are uncertain, and children experience worry or sadness, rituals provide the internal sense that they are not alone and have a balance in their lives of positive and negative experiences.

How parents can adapt routines during the current crisis

Many parents are struggling to adapt their children’s routines in the current crisis. Without school, family, and regular activities, parents are aware their children still need structure. Here are some tips to incorporate the most significant features of routines into your children’s current lives.

Routines and Rules

As described, children most need to know what to expect each day at home. One way to do that is by creating a schedule. However, for some children, overly defined schedules may increase anxiety, especially if the transitions between segments seem artificial. If you find a true schedule is not working for your family, try a morning meeting during which priorities are set for the day and general timeframes are created for blocks of activity. Keep in mind that doing just a couple of things each day in the same way to create anchors is the most important thing for young children. For example, make sure at least one meal, and preferably the same meal each day, occurs at about the same time and is a chance for all family members (as is possible) to sit together without distractions. Think carefully about household rules and while you may be temped at this time to relax expectations, be firm with rules that matter most in the long-term for your family. For example, you may decide to relax rules about how neat the house is or how much TV your children are allowed to watch, but rules about safety and kindness should never be unclear to children.

Relationships

Children don’t need perfect parents to thrive, but they do need predictable parents. While you may be spending lots of time overall with your children right now, consider how predictable your focused attention is for them. Their development is best supported by fewer but more focused moments of positive interaction than attempts at sustaining distracted attention throughout the day. Likewise, managing your own worries in order to support their mental health does not mean suppressing your feelings. Rather, think about your own stress and coping as a complete loop. Show your children that they can count on you to feel what you feel and transparently adopt healthy coping strategies to manage those feelings when they come up.

Rituals

Many families already have rituals in place without realizing their power: Taco Tuesdays, Sunday church services, and Saturday movie nights. Rituals can occur daily or less frequently. If you have a good one in place, take this opportunity while at home to observe if it has an impact on your family. Do you notice a family connection occurring during this time? You may also take this time to invent new family rituals. It is key that they occur at the same time and place, that they involve all family members, and that they impart a positive emotional connection. Research shows that rituals buffer the impact of stress and trauma on mental health. Furthermore, rituals that connect children to previous generations may be particularly impactful. It’s a great time to reinvent a special ritual from your own childhood with your children.

“Only the family, society’s smallest unit, can change and yet maintain enough continuity to rear children who will not be ‘strangers in a strange land,’ who will be rooted firmly enough to grow and adapt.”

Salvador Minuchin, a famous family therapy scholar

Each family has the capacity to support their children’s adaptation with positive routines and powerful connections.