Home/Resources/The Role of Infant and Early Childhood Mental Health Leaders Across Disciplines and Settings: The 2018–2020 ZERO TO THREE Fellowship Class

The Role of Infant and Early Childhood Mental Health Leaders Across Disciplines and Settings: The 2018–2020 ZERO TO THREE Fellowship Class

Aimee Hiladado, Northeastern Illinois University
Ekaterina Zoubak, Substance Abuse and Mental Health Services Administration, Rockville, MD
Melissa Buchholz, University of Colorado School of Medicine; Children’s Hospital Colorado, Aurora, Colorado
Natasha Byars, Southwest Human Development, Phoenix Arizona
Lynette Aytch, ZERO TO THREE, Washington, DC


This ZERO TO THREE Journal issue was a culminating project for the 2018–2020 ZERO TO THREE Fellowship Class. Its members—15 total—represent individuals from different states/ countries, from diverse academic disciplines, and who work in a variety of settings ranging from community-based programs to international aid institutions. Together, the class sought an opportunity to share their Fellowship experience and the role of infant and early childhood mental health (IECMH) leaders across different sectors. To that end, this journal and each article touch on the role of leadership in effecting change in the early childhood field with specific attention to IECMH systems. The articles also address common themes of diversity, equity, and social justice in the service of children and families as well as the imperative to promote these values across systems.

As part of the Fellowship experience, we learned about the importance of being adaptive leaders in an ever-changing environment. We also explored issues of diversity, equity, and inclusion; values that are reflected (and sometimes obscured) in our work with young children and families. We define and describe these terms in the context of advancing equitable access to resources and information–an embodiment of social justice–that promotes the health and well-being of all young children and their families. This element of social justice begins with individual and collective commitment and is fully realized only through informed policies and coordinated systems that understand, value, and invest in the first years of a child’s life.

Ultimately, this journal issue embodies our multifaceted vision for advancing IECMH and the early childhood field. The articles serve as an entrée to these critical discussions and offer readers an opportunity to see themselves as leaders in their own respective settings. Finally, this journal issue represents a call to action for those inspired to advance policy and systems change for infants and toddlers at the local, state, tribal, national, and even international level. We ask readers to “lead from where you are,” a mantra that has been a guidepost for the 2018–2020 Fellowship cohort.

The ZERO TO THREE Fellowship

The ZERO TO THREE Fellowship is a premier leadership experience committed to supporting the next generation of early childhood leaders in embracing a courageous, just, and collaborative approach to our shared work (ZERO TO THREE, n.d.-b). Diverse, early and mid-career (5 years to 15 years of professional experience) leaders who are eager and willing to be catalysts for systems and policy change are encouraged to apply in the competitive process that attracts applicants from across the United States and internationally. Consistent with ZERO TO THREE’s commitment to ensure that leaders reflect the broad diversity of the infant–family field, the Fellowship seeks applicants who identify as a member of an underrepresented population, serve children and families in underrepresented populations, reside in diverse geographic locations, and represent a diversity of professions. Moreover, the Fellowship seeks leaders with expertise in a range of areas that complement work in IECMH and early development including, but not limited to, public health, education, community activism, finance, journalism/public media, family advocacy, and legal system professionals.

One primary requirement of the Fellowship application is proposing a Vision for Change that outlines the applicant’s plan for addressing an IECMH need in their own respective settings and their tentative plan for effecting broad change within their scope of work. This vision must “reflect [an] aspirational goal to address important program, system, or policy issues in their professional context that impacts the lives of infants, young children, and families” (ZERO TO THREE, n.d.-c, para 1). All applications are then reviewed through a rigorous, blind, multitiered process in which the top 30 candidates then complete an interview with three members of the ZERO TO THREE Leadership Development Team. The top 15 candidates of this final pool advance, and are welcomed as part of the next ZERO TO THREE cohort and the 18-month Fellowship experience.

The Fellowship is an invaluable training opportunity, equipping members with the knowledge and skills to make significant progress toward the Vision for Change during their time in the program. Over an 18-month period, Fellows attend four 3.5-day retreats in the Washington, DC-metro area that provide a deeper dive into the following topics: Adaptive leadership; collective impact (cooperation/collaboration/partnerships); diversity, equity, inclusion and social justice; IECMH and behavioral health; local/state/federal public policy and advocacy; social marketing; parent engagement and empowerment; and reflective practice and supervision (ZERO TO THREE, n.d.-c). The retreats include time for extensive hands-on work on our respective visions and supporting each other with concrete guidance and creating lists of tasks to be completed between retreats to further advance the vision. Each retreat also involves training and active participation in self-awareness and mindfulness practice that promotes self-care and sustainability in this work.

In addition, Fellows receive monthly individualized strategic coaching that focuses on advancing the Vision for Change. Assigned readings and monthly small group virtual meetings further extend learning around core content as well as personal areas of interest that would support each Fellow’s individual professional development needs. Moreover, Fellows attend the ZERO TO THREE Annual Conference and the Annual Spring Scientific Meeting, additional professional development opportunities that can deepen content knowledge and expand professional networks.

The relationship-building and networking opportunities are also an essential benefit of the Fellowship experience. Over the 32-year history of the Fellowship, more than 300 national and international leaders have become members of this esteemed network and continue to transform programs, systems, and policies that impact young children and families broadly (ZERO TO THREE, n.d.-b). Acceptance as a Fellow cultivates a lifetime relationship with the ZERO TO THREE organization and its partners. Fellows have many opportunities to build deep and substantive relationships with ZERO TO THREE staff, board members, and Academy Fellows (alumni of the Fellowship). In doing so, they are able to learn from other experts in the field and leverage connection and partnership to advance policies and change for infants and toddlers.

The 2018–2020 Fellowship class represents individuals working across 10 states (Arizona, California, Colorado, Florida, Illinois, Montana, New York, North Carolina, Ohio, Tennessee), at the national level, and 4 countries (Canada, Fiji, Ghana, and Sierra Leone). We are leaders in community-based programs, medical and academic institutions, statewide training networks, within federal programs, and in international policy institutions.

Our areas of interest are diverse, with Fellows specializing in pediatric behavioral health; domestic violence; early childhood workforce development; trauma; immigrant/refugee mental health; and delivery of IECMH programming to rural, Indigenous, and in international preschool settings. We also reflect diversity in our representation of racial/ethnic, religious/faithbased, and LGBTQ communities as well as our years in the field and range of academic training.

The rich diversity of our cohort assisted our learning through the Fellowship because the differing approaches to promoting IECMH resulted in deep insights that supported self-reflection, and advanced our vision in invaluable ways. Our cohort found allies with a shared passion for infants and toddlers as well as a close-knit group bonded by friendship and personal experiences. This was one of the most unexpected and welcomed gifts of the Fellowship — colleagues and like-minded individuals who also became friends, sustaining each other in the challenging effort of changing systems and celebrating the big and small wins in our work.

Each Fellow came to this work with an aspirational vision and intention to mobilize change in service of very young children and their families. Photo: ZERO TO THREE

Adaptive Leadership: Advancing the IECMH and Early Childhood Field

Adaptive leadership is defined as “the practice of mobilizing people to tackle tough challenges and thrive” (Heifetz, Grashow, & Linsky, 2009, p. 14). This was the first lesson in our cohort’s Fellowship experience and one that resonates across the articles in this issue. Each Fellow came to this work with an aspirational vision and intention to mobilize change in service of young children and their families. We also understood the need for additional training in this area; it was a shared catalyst for applying to the Fellowship that would provide concrete knowledge on leadership, collective impact, policy/advocacy, and operationalizing plans for systems change.

Our cohort’s visions were bold. Collectively, we sought to broadly educate on the importance of IECMH and equitable access to early prevention services. We aspired to build health systems that recognized the importance of the first 3 years of life and the unique needs of pediatric cancer patients and children with special needs while striving to integrate IECMH tenets into service structures. We pursued opportunities to highlight and address the adverse impact of trauma among young children, including those who have experienced homelessness, domestic violence, and immigration trauma. We have been up for the task of innovation, building the first village preschool in Sierra Leone and elevating the needs of indigenous communities throughout Canada and the Unites States. We aspired to be champions in workforce and professional development, building networks and Communities of Practice whose members could be frontline early childhood leaders across communities and providing innovative coaching supports in infant and early childhood classrooms and home-based programs. In addition, we sought to effect change through policy, advocacy, and consultation on the national and international stages.

To begin this work, we leaned on the research of experts in adaptive leadership and collective impact that were introduced to us during the Fellowship. These experts agree that success in any endeavor to change systems requires a deeper understanding of the organizational and cultural structures (i.e., people, social institutions, and policies) that block change. We had to learn the mechanics of diagnosing the systems we sought to change in service of infants and toddlers. This examination included dissecting structures that promote opportunities and those that maintain dysfunction.

The adaptive challenges (i.e., challenges grounded in values, beliefs, and loyalties) were those that required the most attention and training for the Fellows. For many of us, the changes we sought to see in our respective programs involved understanding values that drive behavior, loyalties that block change even when changes are ideal and necessary, and the real fear of change that perpetuates stagnation; all examples of adaptive challenges (Heifetz et al., 2009). At the same time, we needed to reflect on our roles as leaders in the very same systems we hoped to change. In short, we needed to become adaptive leaders defined as a person who understands that cultivating new environments demands new strategies and skills, and who can mobilize change (Heifetz et al., 2009).

Subsequently, the Fellowship involved ongoing intensive work around adaptive leadership; cultivating assessment skills; designing interventions that reflect the premises of collective impact; and developing the technical skills of “acting politically” while communicating clearly, succinctly, and effectively. We had to strengthen our ability to negotiate and lean in to tough decisions while building networks of allies and inspiring audiences who see themselves in the shared vision for infants and toddlers. Lastly, we had to be explicit about how we would create a safe and nurturing space for ourselves, given that visionary systems change is hard, personal, and draining. Mindful and reflective practice was thoroughly integrated into all major components of the Fellowship retreats and professional development opportunities.

The premises of adaptive leadership are central for the ZERO TO THREE Fellowship and are a focal component of the journal. Unsurprisingly, each article explores adaptive leadership across contexts, population, and professional roles given our deep training in exploring how to promote our visions for very young children using a systems-level perspective. We take a deeper dive to unpack the challenges influencing IECMH and early childhood service delivery and access across settings. At the same time, we highlight important lessons and opportunities discovered in our work that can equally be translated to other communities and settings.

Mindful and reflective practice was thoroughly integrated into all major components of the Fellowship retreats and professional development opportunities. Photo: Erin Lucas

Promoting Diversity, Equity, and Social Justice: Our Responsibility for Generations of Infants and Toddlers

ZERO TO THREE’s mission is “to ensure that all babies and toddlers have a strong start in life…[W]e envision a society that has the knowledge and will to support all infants and toddlers in reaching their full potential” (ZERO TO THREE, n.d.–a, para 1). The goals of the Fellowship are parallel. In order for this to be fully realized, we, as a collective, must acknowledge the important role of diversity, equity, and inclusion in our work with families.

There is a reality in which access to resources and services that promote early development are disproportionately unavailable to very young children and their families based on a variety of sociocultural dimensions such as race, class, gender, religion, LGBTQ status, immigration status, and geography. Laws and policies (both formal and informal) that reflect a long history of structural racism continue to perpetuate social injustice and inequity in ways that place infants and toddlers at risk for life-long vulnerabilities. We are challenged to make space for diversity-informed, equitably minded work, and to examine our own contributions to the status quo. The magnitude of these issues demands our attention, thus we intentionally focus on issues of diversity, equity, and inclusion in our work because promoting the well-being of all young children will never be achieved without dedicated focus and action upon these values.

Advancing equity and promoting social justice begin with the self, recognizing how personal perspectives and actions either combat or perpetuate and maintain systems that oppress and harm others. Broadly addressing social injustice in the IECMH field also requires a deep examination of our own professional settings and the local, state, national, and global policies that govern our work in the field. To this end, the articles examine the relevance of diversity, equity, and inclusion as reflected in different professional contexts (e.g., academic research institutions, medical settings, and in community-based programs). We embed these values in considerations of how to better serve vulnerable populations including immigrant/refugee, rural, and Indigenous communities. We integrate these values as we examine workforce development, the building of inclusive workplaces, cultural alignment of early childhood interventions, and programmatic and fiscal policies and priorities related to early childhood and IECMH.

Parallel to the Fellows’ position that anyone can lead from where they are, we equally believe that all IECMH stakeholders– families, practitioners, researchers, administrators, policymakers, and advocates–can promote a more inclusive and equitable society for infants and toddlers. This aspirational goal, however, cannot be met without intentional and persistent action on the part of many adaptive leaders with passion for this work. Fortunately, we have frameworks, research, and practice expertise that is highlighted across articles to inform us moving forward.

Lessons for the Field

The articles in this issue of the Journal cover a range of leadership topics. Still, there are common lessons that are shared in advancing an IECMH agenda focusing on equity and inclusion. The following list reflects these broad lessons:

  • Find your allies. Collaboration and strong partnerships are necessary in any effort to change the status quo.
  • Understand the landscape. Resist the desire to take action immediately when seeking to influence large-scale changes in your organization or community. Take the time to observe and reflect on relationships, the culture of structures you seek to change, and historical beliefs and social forces that influence individual and group dynamics.
  • Manage risks. Change requires taking risks so “act politically,” (p. 133) find allies and “name the losses at risk” (p. 96) because transparency promotes connection (Heifetz et al., 2009).
  • Shared vision. Help others see themselves in the vision for infants and toddlers and keep the work at the center of their attention when the work of promoting change gets challenging and there are setbacks.
  • Intentionality. Be intentional in addressing issues of diversity, equity, and inclusion. This includes the way we speak about families, the intentional way we include diversity in how we hire into our programs, the way we design professional development programs, and how we do research.We must put effort into ensuring under-represented voices and experiences have a clear platform to be heard and understood, as well as to inform the field.
  • Self-awareness and self-care. To engage in the hard and messy work of changing systems and policies that advance IECMH priorities requires tremendous emotional, physical, and psychological investments. Mindfulness practice that promotes self-awareness and self-care is a critical strategy for remaining effective in the work and a necessary skill that can be cultivated over time.

There is no singular formula for promoting the well-being of infants and toddlers across communities, yet we hope this journal issue, its articles, and broader lessons contribute to the ongoing dialogue necessary in advancing positive change. This collective expertise can be leveraged in advancing IECMH and social justice, reminding us to move from knowledge to action. The members of the 2018–2020 ZERO TO THREE Fellowship Class strive to promote IECMH for all families we have the privilege of serving and to build capacity and adaptive leaders within the larger community. Together, we hope to empower and encourage readers to lead from where you are.


This article was co-authored by Ekaterina Zoubak in her personal capacity. The opinions expressed in this article are the author’s own and do not reflect the official views of the Substance Abuse and Mental Health Services Administration, the Department of Health and Human Services, or the United States government.


The 2018–2020 ZERO TO THREE Fellowship Class is deeply grateful to Lynette Aytch, the director of the Leadership Development Institute, for her time and commitment to the program. Through Dr. Aytch’s leadership, we Fellows received thoughtful mentorship, rich learning opportunities, and opportunities to challenge ourselves and others in a reflective space that she helped cultivate. Thank you Lynette!

“Wherever you are, there you are.” —Lynette Aytch, 2020

Author Bios

Aimee Hilado, PhD, LCSW, is a licensed clinical social worker and academic researcher specializing in immigration trauma and immigrant/refugee mental health. Dr. Hilado is an associate professor of social work at Northeastern Illinois University where she teaches and conducts research on the importance of early development, early childhood and adult mental health, social support, and culturally sensitive clinical practice with immigrants and refugees. She is also the founding clinical director of the RefugeeOne Wellness Program, a mental health program established in 2011 for immigrants and refugees at the largest refugee resettlement agency in Chicago. In addition, Dr. Hilado continues to present nationally and publish in the areas of mental health, home visiting, and culturally sensitive clinical practice; her most recent edited book is Models for Practice With Immigrants and Refugees: Collaboration, Cultural Awareness, and Integrative Theory.

Ekaterina Zoubak, MA, currently serves as a federal project officer for Project LAUNCH (Linking Action for Unmet Needs in Children’s Health), the Infant and Early Childhood Mental Health and Mental Health Awareness Training grant programs. In this capacity, Ms. Zoubak works closely with states, territories, tribal organizations and governments, and a variety of other organizations and entities to advance infant and early childhood mental health and maternal mental health efforts. She is the lead for projects related to American Indian and Alaska Native communities within the Project LAUNCH program and the coordinator for Indigenous Project LAUNCH. Ms. Zoubak has been involved in various cross-agency federal initiatives and efforts focused on early childhood and children’s mental health. Prior to joining the Substance Abuse and Mental Health Services Administration, she provided group and individual mental health services to children and adolescents within schools and psychiatric settings. She holds a bachelor’s degree in psychology and a master’s degree in clinical psychology.

Melissa Buchholz, PsyD, is a licensed clinical psychologist and assistant professor at the University of Colorado School of Medicine in the Harris Program for Child Development and Infant Mental Health. Dr. Buchholz is passionate about disseminating health promotion and prevention activities for young children and has spent her career focusing on integrating early childhood behavioral health services into medical settings, specifically pediatric primary care. Dr. Buchholz is particularly interested in improving access to behavioral health care for young children and building comprehensive systems of care for young children and their families. Dr. Buchholz is the director of HealthySteps for the state of Colorado and has worked to scale this model across the state since 2012. In addition, she provides consultation and technical assistance to assist pediatric practices with expanding behavioral health services to include a focus on young children and their families. She actively advocates for young children and their families locally and nationally.

Natasha Byars, MS, MSW, LICSW, is an assistant director at Southwest Human Development, overseeing the Professional Development Institute at Educare Arizona. This innovative effort seeks to address gaps and foster partnerships to provide high-quality early childhood education professional development and coaching across the state, ultimately leading to better, more equitable child outcomes. Ms. Byars also serves as faculty for the Harris Infant and Early Childhood Mental Health Training Institute and on the Arizona Early Childhood Professional Development Project ECHO Action Team. Prior to moving to Phoenix, Ms. Byars led the Massachusetts Young Children’s System of Care Project at Boston Public Health Commission, collaborating across the state to integrate infant and early childhood mental health (IECMH) teams into primary care and support IECMH professional development and capacity building in communities and systems. She was a Project LAUNCH clinician and Department of Psychiatry Social Work Fellow at Boston Children’s Hospital, has consulted on international SEL curriculum development, and worked in an Indigenous village preschool in Chiapas, Mexico. Ms. Byars earned a master’s degree in child development from Erikson Institute and a masters of social work from Loyola University Chicago. She holds the principles of inclusion, representation, and honoring families as central to her work.

Lynette Aytch, PsyD, is an early childhood professional committed to the healthy development, care, and education of young children, particularly those living in poverty, children of color, and children with disabilities. She is currently director of the Leadership Development Institute at ZERO TO THREE. In this role she supports the ZERO TO THREE Fellowship Program and the Academy of ZERO TO THREE Fellows. Prior to ZERO TO THREE, Dr. Aytch was director of organizational development at the North Carolina Partnership for Children (NCPC), where she provided primary leadership in the design, implementation, and evaluation of an organizational development initiative to strengthen executive leadership, governance, community engagement, and financial sustainability of the statewide network of Smart Start partnerships. Prior to NCPC, Dr. Aytch was assistant director of the National Center for Early Development and Learning (NCEDL), a 5-year, $14 million grant from the US Department of Education housed at the Frank Porter Graham Child Development Institute at the University of North Carolina-Chapel Hill. In addition to administrative responsibilities, she was the lead researcher on a project focused on the quality of early intervention services for infants and toddlers with disabilities. Prior to NCEDL, she worked as a school psychologist in Camden, New Jersey, focused predominately on children preschool to 3rd grade.

Suggested Citation

Hilado, A., Zoubak, E., Buchholz, M., Byars, N., & Aytch, L. (2020). The role of infant and early childhood mental health leaders across disciplines and settings: The 2018–2019 ZERO TO THREE Fellowship class. ZERO TO THREE Journal, 40(5), 5–10.


Heifetz, R. A., Grashow, A., & Linsky, M. (2009). The practice of adaptive leadership: Tools and tactics for changing your organization and the world.Boston, MA: Harvard Business Press.

ZERO TO THREE. (n.d.-a) Our mission and vision. Retrieved from source

ZERO TO THREE. (n.d.-b). ZERO TO THREE Fellowship. Retrieved from source

ZERO TO THREE. (n.d.-c). ZERO TO THREE Fellowship: Core content. Retrieved from source

ZERO TO THREE Journal: Vol 40 No 5

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