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Integrating DC:0–5 Into State Policy and Systems: 5 Years of Progress

Dec 12, 2021

Julie Cohen and Paola Andujar, ZERO TO THREE Policy Center, Washington, DC

Abstract

States need a policy and systems infrastructure that creates a robust continuum of mental health supports and services for infants, young children, and families. One critical element of this continuum is developmentally appropriate diagnosis. DC:0–5TM: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5) is a system for classification of mental health and developmental disorders of infants and young children and is the recommended practice for the clinical conceptualization and diagnosis of children (birth through 5 years old). Over the past 5 years, states have pursued a variety of strategies to integrate DC:0–5 in state policy and systems.

Infants and young children can have mental health and developmental disorders that affect development. When a young child has a mental health disorder, it is important to identify and treat the disorder as early as possible so that impairment, suffering, and effects on overall health and development can be reduced. States need a policy and systems infrastructure that creates a robust continuum of supports and services for infants and young children. The ideal continuum includes supports addressing promotion, prevention, assessment, diagnosis, and treatment. One critical element of the continuum is developmentally appropriate diagnosis. DC:0–5TM: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5; ZERO TO THREE, 2016) is a system for classification of mental health and developmental disorders of infants and young children (see Box 1) and is the recommended practice for the clinical conceptualization and diagnosis of children (birth through 5 years old). Adopting DC:0–5 as a standard of practice can be an effective strategy for improving access to infant and early childhood mental health (IECMH) services and supports and improving outcomes for infants and young children. This is an area where states have been innovating since DC:0–5 was published in December 2016.

Box 1: What Is DC:0–5?


DC:0–5TM: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5) was created to provide developmentally specific diagnostic criteria and information about mental health disorders in infants and young children. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM, 2013) and World Health Organization’s International Classification of Diseases (ICD, 1992) are comparable classification systems for older children, adolescents, and adults. DC:0–5, published in December 2016, revised and updated Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0–3R) by expanding the age range from 3 years old through 5 years old, extending criteria to younger ages, and including all disorders relevant for young children.

This article highlights how DC:0–5 can support IECMH, discusses why and how states are integrating DC:0–5 into state policy and systems, and shares three state stories to capture some of the strategies that states have used over the past 5 years. It is important to note that this article provides a point-in-time overview. The state stories included are just a sample of the groundbreaking work going on across the United States.

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