The Infant Mental Health & Family Law Initiative (FLI) is a collaboration among professionals concerned about the health, mental health and development of Canada’s abused or neglected children under the age of three. Our goal is to bring the science of early childhood development into child welfare and family law practice through education and advocacy. Our first aim is to increase awareness of the unique developmental needs of infants and toddlers and educate professionals about the impact of maltreatment during this sensitive period. Our second aim is to provide family court judges, family law practitioners, and child welfare professionals with the resources they need to make clinically informed decisions about maltreated young children. Finally, we aim to promote collaboration among care providers who touch the lives of these children. The Initiative is supported by Infant Mental Health Promotion (The Hospital for Sick Children), Alberta Health Services, Provincial Centre of Excellence for Child and Youth Mental Health at CHEO, and the Alberta Centre for Child Family & Community Research.


IMHP defines infant mental health as the social, emotional and cognitive well being of infants and young children.
Every child has an inner life built on relationships and a developing understanding of the world around them.  Research and clinical evidence increasingly demonstrates that:

  • The early years have a unique and formative impact on development, relationships and functioning throughout life.
  • Many adverse outcomes can be prevented when parents are provided with support and information that enables them to be optimally responsive to their infants and young children.
  • When there are identified risks and disorders in young children or in family functioning, well planned early intervention can promote optimal outcomes.

Zero to Three National (U.S.) Center for Infants, Toddlers and Families defines “infant mental health” as the capacity of the child from birth to three to experience, regulate, and express emotions; form close and secure interpersonal relationships; explore their environments and; learn [1]

Three features of infant mental health have important implications for child protection:

1.     Infant mental health and development are intertwined – Infants who are not doing well emotionally tend to lag behind their peers in achieving developmental milestones[2]. Each stage of development lays the foundation for the next; therefore, children who do not have a good start in life are more vulnerable to setbacks later on. The Canadian Paediatric Society reports that more than three quarters of children in care have special health, developmental, or mental health needs that are often chronic, under-recognized, and neglected.[3] 

2.     Infants are exquisitely sensitive to stress - The confluence of research from attachment theory, psychobiology, and neurobiology has provided new insights into the impact of stress on the developing brain and the importance of the infant-caregiver relationship in helping babies regulate stress.[4]

3.     The risk factors that impede normal social and emotional development accumulate rapidly and exacerbate one another - Most mental health and emotional problems are developmental outcomes[5]. Severe emotional and behavioural problems are seldom the result of an inherent deficit or a single adverse experience; they are usually the culmination of a series of adverse events and vulnerabilities, typically beginning early in life and continuing through different stages of development.

The notion of infants experiencing mental health problems can be troubling. Many prefer to believe that very small children will quickly forget traumatic events that have occurred in their lives and there is a tendency to view infants as more resilient. While it is true that infants can and do recover from early setbacks, recent findings on brain development suggest that infants and toddlers are more vulnerable to the consequences of neglect and abuse, not less.[6]

Unfortunately, infants have limited ways of expressing their distress and their cues can easily be misunderstood or attributed to other causes[7]. Emotional scars are less readily visible in infants but are much harder to heal than physical ones. Additionally, it is more difficult to predict and document the consequences of emotional harm in infancy than it is to describe the consequences of physical abuse and neglect.


Infant maltreatment is an urgent and growing problem. According to the Canadian Incidence Study of Child Abuse and Neglect, the incidence of substantiated abuse and neglect increased 125% between 1998 and 2003 with the highest rates occurring among infants (about 28 infants per 1,000). The literature on early childhood development overwhelmingly confirms that abuse and neglect in the first years of life have profound and devastating effects on brain development and emotional functioning[8]. This leaves children much more vulnerable to learning and behavior problems in school. Individuals who recall an early childhood history of abuse and neglect are at higher risk of a host of health and emotional problems throughout the lifespan, are at greater risk for depression and addictions, and have increased mortality rates from stress related illnesses. [9]These individuals often experience difficulty sustaining relationships or employment and with parenting their own offspring.


For child protection workers - There are many challenges for child protection workers attempting to evaluate the condition and needs of very young, maltreated children and plan for their care: 1) access to infant mental health and child development specialists varies throughout the country, especially in rural regions; 2) the symptoms of emotional maltreatment and mental health problems in infancy are difficult to assess and require close collaboration between mental health, child development, and child protection services and; 3) infants with serious emotional problems often come with parents who have serious emotional problems but the two service systems rarely overlap.

For family lawyers - There are some particular challenges for family law professionals assigned to protect the rights of a maltreated infant: 1) preverbal children cannot give instructions to counsel; 2) at the present time, there are few practice guidelines specifically regarding the representation of infant clients and; 3) emotional neglect and abuse in infancy are difficult to define from a legal point of view and the damage may not be apparent for years to come. Family lawyers who specialize in child welfare cases do not necessarily receive specialized training on infant mental health or development.

For judges - Research suggests that judges are often influenced by the expressed views and wishes of children and by the testimony of expert witnesses. Infants cannot express their wishes and infant mental health expertise is not always accessible; therefore, judges may be compelled to rely on testimony from witnesses with little background or experience in recognizing serious mental health problems in the infant population.  

Recent legislative changes have significantly restricted the amount of time that children under five can spend in temporary care. While child welfare legislation varies from province to province, these changes have generally been applied across Canada. It is important to note that the legislation has not been accompanied by an increase in resources to address the needs of this vulnerable group. If anything, the legislative changes have occurred in a context of diminishing mental health and health care resources. It would be a mistake to assume that legislation alone, unaccompanied by training or practice guidelines, will solve the problem.


The Infant Mental Health and Family Law Initiative has embarked on a comprehensive national campaign to advocate on behalf of maltreated infants, educate those charged with protecting their rights and interest, and to equip care-providers with the tools and resources they need to respond effectively.

Advocacy and Education: Under the leadership of Infant Mental Health Promotion (IMHP), spokespersons for this Initiative have delivered lectures and seminars to diverse audiences of law and child protection professionals on the urgent problem of infant maltreatment. Close collaboration with concerned professionals from the judicial, family law, and child protection fields has raised awareness about the period of infancy as a unique opportunity to change the life path of a vulnerable citizen during a time of significant vulnerability.

Infant Mental Health and Family Law Resources: Professionals involved with the Initiative have collected and produced several resources for family law and child welfare professionals, including both journal articles and other widely disseminated materials.

Recommended Resources: Members of the initiative have been gathering materials and web resources that are evidence-based and of practical utility to child welfare professionals with infant clients.


Over the coming year, there is a plan to develop training modules and resources on infant mental health and maltreatment beginning with an introductory training module for new child protection workers. There will be continued advocacy for maltreated infants and toddlers through the production of fact sheets, briefs, and collection of other practical tools. The Initiative is currently working with family law colleagues to develop practice guidelines and training opportunities.

[1] Task Force on Infant mental Health (2002). Definition of infant mental health. Zero to Three, Arlington, VA,

[2] Sroufe, A., Egeland, B., Carlson, E., Collins, W.A., (2005). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. New York: The Guilford Press.

[3] Canadian Paediatric Society, Community Paediatrics Committee (2008). Special considerations for the health supervision of children and youth in foster care.Paediatrics & Child Health, 13(2), 129-32.

[4] Glaser, D. (2000). Child abuse and neglect and the brain-a review. Journal of Child Psychology and Psychiatry, 41, 97-116.

[5] Sroufe, A., Egeland, B., Carlson, E., Collins, W.A., (2005). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. New York: The Guilford Press.

[6] De Bellis, M. (2005). The psychobiology of neglect. Child Maltreatment10, 150-172.

[7] Wotherspoon, E., O’Neill-Laberge, M., Pirie, J. (2008). Meeting the emotional needs of infants and toddlers in foster care: The Collaborative Care experience. Infant Mental Health Journal, 29(4); 1-21

[8] Glaser, D. (2000). Child abuse and neglect and the brain-a review. Journal of Child Psychology and Psychiatry, 41, 97-116.

[9] Center for Disease Control (2008).  Adverse childhood experiences study.  Publications on major findings by publication year.  Retrieved May 27, 2008 from


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