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Vol 42 No 2 Diagnosing Mental Health and Developmental Disorders in Infants and Toddlers: A 5-Year Retrospective on DC:0–5

Dec 13, 2021

This Issue and Why It Matters–Kathleen Mulrooney, Lindsay Usry, and Julie Cohen

The issue of mental health disorders in very young children is complex, often uncomfortable, and sometimes controversial. However, clinicians and researchers agree that even during infancy, children can suffer emotional and behavioral disturbances that impair development, harm relationships, and interfere with healthy functioning. ZERO TO THREE has been at the forefront of guiding practitioners in diagnosing mental health and developmental disorders in very young children since the publication of the first classification system for infants and toddlers in 1994. The diagnostic classification manual has been revised several times over the ensuing decades, and most recently, DC:0–5TM: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5) was released in 2016 and updated (Version 2.0) in 2021.

Clinicians and allied professionals have attested to the utility of DC:0–5 for understanding mental health and developmental disorders in very young children, and have voiced an appreciation for the comprehensive, multiaxial approach that is the framework of DC:0–5. Early childhood professionals from virtually all 50 states in the US have purchased DC:0–5, and many states have integrated DC:0–5 at the policy and systems levels through workforce development efforts and standards, development of crosswalks for Medicaid reimbursement, incorporation into electronic health record systems, and some requiring or recommending the use of DC:0–5 as the developmentally appropriate diagnostic classification system for children from birth through 5 years old. ZERO TO THREE’s official standardized DC:0–5 training curricula (see have resulted in the training of more than 3,000 early childhood professionals in the United States and have had international reach throughout Africa, Asia, Australia, Europe, the Middle East, and North America. The manual has been translated into nine different languages and currently five more translations are underway.

This issue of the Journal spotlights the 5-year anniversary of DC:0–5 through stories from clinical practice, examples of state policy and systems initiatives, workforce development efforts, and lessons about cultural context and use of DC:0–5 internationally. Two additional articles in this issue explore innovative efforts to promote infant and early childhood mental health through home visiting. One article details a model for engaging parents during pregnancy and the perinatal period by providing resources, emotional support, and learning experiences to optimize parent and baby well-being. The other article emphasizes the importance of early identification of developmental concerns and provides strategies for developmental screening during challenging times, such as the disruptions brought about by the Covid-19 pandemic.

We hope you enjoy this issue of the Journal and invite you to share your reflections in Letters to the Editor .

Kathleen Mulrooney, Guest Editor, Director of Infant and Early Childhood Mental Health Strategy, ZERO TO THREE

Lindsay Usry, Guest Editor, Director of Infant and Early Childhood Mental Health Strategy, ZERO TO THREE Policy Center

Julie Cohen, Guest Editor, Associate Director, ZERO TO THREE Policy Center

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