Project Summary/AbstractThis R34 resubmission proposes to develop and examine a mental health service model for families ofinfants/toddlers with developmental delay that reduces risk for mental health problems, and in turn, enhancesreadiness for preschool. Infants/toddlers with developmental delay exhibit significantly higher rates ofdisruptive behaviors, peer problems, impulsivity, and academic failure. Their parents also are at elevated riskfor mental health problems and child maltreatment. Families of infants/toddlers with developmental delay aremore likely to live in poverty with limited access to services, and most receive government-funded, home-based Early Intervention (EI) services (i.e., Part C of the Individuals with Disabilities Education Act). Wepropose to leverage the unique position of Infant-Toddler Developmental Specialists (ITDS), front-lineproviders of EI services, to support parent-infant/toddler interactions and reduce family risks for mental healthproblems. Based on a rich empirical literature, we selected Child-Directed Interaction (CDI), the first phase ofParent-Child Interaction Therapy, as an evidence-based intervention to increase positive parent-infant/toddlerinteractions and reduce negative interactions. CDI aligns with the training, role, and function of ITDS, andresponds to the needs of referred families. We will collaborate with EI provider agencies toward a servicemodel that emphasizes initial training, ongoing supervision, and quality assurance to facilitate infant/toddlermental health (social, emotional, behavioral competence) and parent mental health (anxiety/depression,parenting stress, caregiver strain). We will examine feasibility, fidelity, and acceptability of the proposed modelto identify facilitators and barriers to service delivery, and we will examine its promise compared to services asusual (n = 4 agencies, 16 ITDS, 112 families). In light of the extensive needs and depleting resources faced byfamilies of infants/toddlers with developmental delay, the proposed work provides a unique opportunity toenhance the natural role and capacity of a skilled EI workforce to provide high quality services that minimizemental health problems and facilitate healthy child and family trajectories.
