In California’s child welfare system, nearly half of all children who enter out-of-home care do so before their fifth birthday.1 Infants entering care before three months of age spend 50% more time in care than older children.2 This age group also accounts for most child fatalities among families with prior child welfare involvement. The resources in this birth-to-five toolkit are designed to help social workers and others working within or alongside California’s child welfare agencies better understand the developmental, relational and environmental needs of young children in care.
1 Live Births in California (2023); National Center for Health Statistics (2023); Children with Entries to Foster Care Rates (CDSS, 2023); California Child Population by Age (KidsData.org., 2023).
2 Wulczyn, et al., (2011).
Table of Contents
Please note: Several links in this Toolkit go to external sites.
All Policy Letters and Notices Issued by the California Department of Social Services (CDSS)
Please note that all links in this section direct to the CDSS website, where the content resides.
Developmental Screenings and Referrals:
ACL 06-54: Policy and procedures to refer young children under the age of three with a substantiated case of child abuse or neglect to the early start program.
ACL: 15-11: Recording developmental and mental health screening, referral, and plan intervention information in the child welfare services/case management system.
ACL 24-35E: Clarifies language on the referral form requirements when submitting mental health referrals to mental health plans (MHPs) and to expand upon definitions used.
Lanterman Developmental Disabilities Services Act (Lanterman Act) Services:
ACIN I-13-22: Dual agency children provisionally eligible to receive Lanterman Developmental Disabilities Services Act services.
ACL 25-51: Expansion of provisional eligibility for dually served children.
Working with Substance Exposed Infants:
ACL 17-92: Comprehensive Addiction Recovery Act of 2016 amendments to the Child Abuse Prevention and Treatment Act.
ACL 20-122: New changes in the Child Welfare Services/Case Management System (CWS/CMS) to document the development of plans of safe care for infants affected by prenatal drug exposure or a Fetal Alcohol Spectrum Disorder.
Wraparound:
ACIN I-38-20: Early childhood wraparound resource guide for serving children from birth to five years.
Early Childhood Development
Please note that all links in this section will direct to websites outside of UC Davis Human Services.
Browse early childhood development resources in the following categories:
- Attachment and Relationships
Young children develop in the context of relationships that they have access to in their environment. The resources shared below are a starting point to support you in gaining a deeper understanding of the critical importance that consistent, co-regulating relationships have for young children as well as considerations related to navigating crisis and change from their perspective.
Tronick's Still Face Experiment
from the University of Massachusetts - Boston
Narrated by Ed Tronick. This video presents the still face experiment, which is a psychological study demonstrating the impact of a caregiver's sudden withdrawal of emotional responsiveness on an infant.• Access this video on YouTube
Still Face Experiment with Dads
from the Children’s Institute International (CII)Still face with dads; narrated by Richard Cohen. A re-creation of Tronick's still face experiment that highlights that young children form meaningful relationships with a variety of caregivers, including mothers, fathers, and other consistently available, nurturing adults in their environment.
Seeing the World Through Babies' Eyes in Times of Crisis and Change
from Parent and Infant Relationship Service (PAIRS)Seeing the world through babies’ eyes in times of crisis and change. The recorded panel consisted of experts from LEAP's Parent and Infant Relationship Service (PAIRS). In the webinar, they cover issues including: 1) Babies in crisis and change; 2) Being the voice of the baby; 3) Supporting the parents
Trust-Based Relational Intervention
Trust-Based Relational Intervention (TBRI) is a, trauma-informed, holistic care model developed by Dr. Karyn Purvis and Dr. David Cross at Texas Christian University (KPICD) designed to support children and youth who have experienced trauma, abuse, or neglect. It uses a three-pillar approach—Connecting (attachment), Empowering (physical needs), and Correcting (behavioral, often utilizing the IDEAL response)—to foster trust, felt safety, and emotional regulation.
• The Attachment Cycle (Training) on Vimeo
• TBRI® Animate: Attachment- Neurodevelopment
The development of the brain and nervous system is foundational to lifelong physical and mental health and shapes the trajectory of all major outcomes. The following resources introduce the context and process of neurodevelopment in infants and young children and underscore the importance of brain development in shaping practice and policy decisions that impact our society.
Newborn Brain Development: Newborn Activities
from First 5 CaliforniaThis First 5 California resource highlights how a newborn’s brain develops through everyday interactions, bonding, and responsive caregiving during the earliest months of life. It offers practical, family-friendly information about brain growth, developmental milestones, and simple ways caregivers can support learning through talking, reading, singing, and play. The webpage also emphasizes the importance of early relationships and nurturing experiences in building a strong foundation for lifelong development.
• Access at the First 5 California website
How-To: 5 Steps for Brain-Building Serve and Return
from the Harvard Center on the Developing Child
"Serve and return" refers to a dynamic, two-way interaction between a child and a caregiver in which they take turns engaging in communication. It is a foundational process for healthy brain development: the child “serves” by initiating communication through a look, sound, gesture, or movement, and the caregiver “returns” by responding in a way that acknowledges and builds upon the child’s serve.• Access this video on YouTube
The Baby Brain Map
from ZERO TO THREE
An interactive tool designed for early childhood professionals, caregivers, and advocates. This resource makes it easy to explore how early experiences shape development and offers simple, practical ways to support healthy growth and emotional well-being.
• Access at the ZERO TO THREE website
Understanding Brain Development in Babies and Toddlers
from ZERO TO THREE
An accessible resource that provides foundational knowledge to help understand brain development in babies and toddlers.
• Access at ZERO TO THREE websiteWhy the First 2 Months Are Crucial for a Baby's Development
from the Oprah Winfrey Network
A conversation between Oprah Winfrey and Dr. Bruce Perry on why the first 2 months of life are crucial for a baby’s development.- Developmental Milestones
Birth to 5 Years Milestones
from the CDCThis resource contains videos and details specific milestones throughout the first five years of life.
• Milestone Moments Checklist- Infant and Early Childhood Mental Health
For some young children and families, risks to well-being are present, and in some cases, mental health and developmental disorders can emerge even in the earliest months and years of life. The mental health and well-being of parents and caregivers are essential to the well-being of infants and young children. Early recognition, support, and intervention help optimize each child’s unique potential.
Advancing Infant and Early Childhood Mental Health
from ZERO TO THREE
This website is a landing page exploring issues for children ages 0-3.
• Visit the ZERO TO THREE website.
Adverse Childhood Experiences (ACEs) in Early Childhood
Adverse Childhood Experiences (ACEs), or exposures to relational and situational trauma early in life, have significant impact on the lifetime incidence of mental, physical, developmental and relational challenges. The following content addresses how an understanding of childhood trauma and adversity can be a meaningful lens through which the fields of public health, mental health and child welfare can view promotion, prevention and intervention efforts.
Please note that all links in this section direct to external pages.
Understanding ACEs with Dr. Nadine Burke Harris
California’s first Surgeon General Dr. Nadine Burke Harris speaks about the science behind Adverse Childhood Experiences and toxic stress and why there is hope for healing—at any age.
Pat Levitt: Why Early Matters (at the 2015 Simms/Mann Institute Think Tank)
Access the full presentation on YouTube
Dr. Pat Levitt discusses research showing that early life experiences influence social, emotional and learning skills, and how these skills come together to help children succeed in the real world.
PACES (Positive and Adverse Childhood Experiences) Connection
This is a community resource aimed at raising awareness, preventing and healing trauma, and promoting the positive childhood and community experiences that help build healthier communities.
ACES (Adverse Childhood Experiences) Too High
News and commentary about the science of positive and adverse childhood experiences.
California Department of Public Health
Adverse Childhood Experiences data page.
Access website
Therapeutic Support
Early childhood is a pivotal period of child development that begins before birth through age 5. This period is one of the most impactful, due to the rapid brain development that occurs during this developmental stage. A child’s environment, relationships and early experiences affect the developing brain and physiological systems, with all of these connected systems responsible for the child's current and future well-being. Behavioral and therapeutic supports and services for our youngest Californians are vital for their lifelong holistic health and wellness.
Please note that all links in this section direct to external pages.
Alicia Lieberman: Dyadic Interventions (at the Simms/Mann Institute Think Tank)
Dr. Alicia Lieberman discusses how dyadic treatments are the most effective interventions.
Child-Parent Psychotherapy (CPP)
CPP Video
Dr. Trasie Topple (LCSW, Ph.D.) discusses how Child-Parent Psychotherapy can benefit children.
CPP Website
This website explores the dyadic, attachment-focused therapeutic approach for young children (birth-5) and their parents/caregivers.
Circle of Security Parenting (COSP)
This parenting program is aimed at supporting the connection between young children and their parents/caregivers.
Positive Parenting Program (PPP)
Triple P is designed to be with parents on every step of their journey, providing help and guidance to families when they need it. It aims to create supportive family environments, and to prevent, as well as treat, behavioral and emotional problems in children and teenagers.
Policy
When considering young children with involvement in child welfare systems, significant efforts are aimed at promoting healthy development, preventing mental health problems and providing effective culturally responsive, family centered and equitable supports and interventions as needed. The resources provided below are intended to inform the development of policies aimed at meeting the specialized needs of young children in care and/or to serve as examples of field-leading policy currently being implemented.
Note: Please ensure to follow all State Guidance when developing county policy. Early Childhood All County Letters and All County Information Notices issued by The California Department of Social Services are available in the first section of this Toolkit.
Please also note that all links in this section direct to external pages.
Safe Babies, a Program of Zero to Three
- Policy Framework
- Policy Brief – Foundations of Well-Being: Policy Strategies for Integrating Infant and Early Childhood Mental Health into Child Welfare
- Infant and Early Childhood Mental Health (IECMH) Guiding Principles
- Webinar: The Critical Role of Parent Partner Programs: Policy and Practice Considerations Materials
Policy Guide (0-5)
Child welfare policy and practice guide for children aged birth to five developed and utilized by the Los Angeles County Department of Child and Family Services.
Accelerating Statewide Change: Advancing Infant and Early Childhood Mental Health in State and Local Systems (Pedigree Fund)
This brief features the voices of Washington state's systems leaders, advocates, policymakers, researchers and other stakeholders sharing their own experiences and reflections regarding advancing important cross-systems coordination, integration and quality improvement efforts for Infant and Early Childhood Mental Health. Within are recommendations that the state can use to continue to strengthen this work to promote social-emotional well-being and lead to more equitable outcomes for young children and their families.
Learn more at Pedigree Fund website
Podcast: LaCrisha Rose & Chrystal: Tipping on Parent Leadership
LaCrisha Rose from Pratt, West Virginia, and Chrystal Tipping from Ventura, California, talk with Sanaa Sharrieff about their paths to parent leadership, protective factors and how those experiences have impacted their parenting and their relationships with their kids, partners, and extended families.
Perinatal Health
- Perinatal Health
- This Office of the California Surgeon General webpage connects families, caregivers and providers to a wide range of maternal health resources available before, during, and after pregnancy. It includes information on mental health support, healthcare services, financial assistance, community programs, and statewide initiatives focused on improving outcomes for mothers and infants. The site also highlights California’s efforts to reduce preventable maternal deaths and address disparities in maternal health through education, prevention, and coordinated care.
• Access perinatal health resources (link is external) - Perinatal Mental Health and Well-Being
Perinatal mental health refers to the mental well-being of individuals during pregnancy and the first year after childbirth. It encompasses a range of conditions, including depression, anxiety and psychosis that can affect individuals during this period. These conditions can have significant impacts on both the individual and their child, highlighting the importance of early identification and treatment.
California Department of Public Health
This California Department of Public Health webpage provides information and resources focused on maternal mental health during pregnancy and the postpartum period. It highlights common mental health challenges new and expecting parents may experience, including anxiety, depression, and emotional distress, while emphasizing that support and treatment are available. The site includes crisis support information, screening tools, educational materials, community resources, and guidance for both families and health professionals to promote early intervention and healthy parent-child relationships.
• Access perinatal mental health resources (link is external)
Parents Under Pressure: The U.S. Surgeon General's Advisory on the Mental Health and Well-Being of Parents• Access website at the Office of the Surgeon General (link is external)
Marta's Story
A personal account of lived experience with perinatal mental health symptoms and their impact from a parent's perspective.
• Watch video (link is external)
• Access maternal health resources (link is external)- Postpartum Support
- This California Surgeon General initiative encourages communities to support new mothers through simple, meaningful acts of care during the postpartum period. The “One Small Thing” campaign highlights how everyday gestures, such as delivering a meal, helping with chores, or checking in, can reduce isolation and strengthen maternal well-being. The webpage includes practical ways to participate, downloadable resources, and information about the connection between social support, maternal mental health, and preventing maternal deaths.
• Access postpartum support resources (link is external) - Perinatal Substance Use Disorders
Parents experiencing perinatal substance use disorders (SUDs) are often accompanied with biases, significant stigma and marginalization associated with addiction in pregnancy. These impact both patients and the professionals supporting them, as professional working in the field often suffer from a lack of best-practice addiction medicine training. The content below aims to share perspectives from parent leaders with lived experience, as well as best practices for supporting parents experiencing SUDs that come into contact with child welfare systems.
Presentation: Supportive Care for Perinatal Substance Use• Access presentation (link is external)
Fetal Alcohol Spectrum Disorder (FASD)
Fetal Alcohol Spectrum Disorder (FASD) is often under-recognized and can be mistaken for conditions such as Autism, ADHD, or Oppositional Defiant Disorder. Research suggests that nearly 18 percent of children in the child welfare system may be impacted, which can affect placement stability and permanency when behaviors are misunderstood. This webinar provides child welfare, Wraparound, mental health, and behavioral health professionals with foundational knowledge to better understand FASD, recognize common behavioral patterns, and support families with empathy while reducing stigma around prenatal alcohol exposure. Participants will also explore strategies for identifying possible FASD and connecting families to appropriate diagnostic and support services.
• Access Webinar
• Webinar MaterialsPregnancy & Parenting with a Substance Use Disorder: Bri's Story
Individuals struggling with a substance use disorder during pregnancy are people. Each one has a unique story that healthcare professionals can learn from to better serve other patients facing similar challenges. Bri shares her raw and emotional journey through pregnancy with a substance use disorder and how these challenges led her to the path of recovery.• Watch video (link is external)
Consultation and Support
Complex Care Individual Case Coaching and Consultation (from the UC Davis Resource Center for Family-Focused Practice)
These tailored sessions offer targeted support for complex child welfare cases and are designed to meet the unique needs of each request. Depending on the issue, support may include one-on-one consultation with a UC Davis RCFFP specialist, or a collaborative session with a panel of subject matter experts and representatives from the California Department of Social Services (CDSS). Each consultation is structured to provide practical, strengths-based guidance grounded in and aligned with state expectations.
Implementation and Practice
- Safe Baby Court
- KQED Article on Los Angeles County Safe Baby Court
• She Almost Lost Custody of Her Baby; a Unique LA County Court Gave Her a Second Chance
Safe Babies Court: From Implementation to Evaluation
• An Approach for Children Birth to Three Years of Age in Dependency Court - Bench Cards
- The National Council of Juvenile and Family Court Judges (NCJFCJ)
• NCJFCJ Website (includes training for judges on ECM Community Supports) (link is external) - Engagement
Irving Harris Foundation:
• Meaningful Family Time Suite of Resources (link is external)
• Diversity-Informed Tenets for Work with Infants, Children and Families (link is external)
Zero to Three: Why Engaging Fathers Matters (link is external)
Los Angeles County Department of Child & Family Services: Children Aged Birth to Five Policy and Practice Guide (link is external)
Erikson Institute: FAN tool developed by Erikson's Fussy Baby Network becomes a national model (link is external)
- Considerations for Safety, Trauma and Attachment
- For young children, even small changes can feel huge, and they often need strong support to adjust. Since many kids cannot yet say what they need, it is up to adults to slow down and reflect. If children could speak for themselves, these are some of the questions they might ask us to consider before a move, so they can do well in what comes next.
• S.T.A.N.D. with Me Guide to Helping Young Children with Transitions (link is external)
Resources
Please note that all links in this section direct to external websites
- Programs Supporting Maternal, Child and Family Well-Being
- California Department of Public Health: Maternal, Child and Adolescent Health
This California Department of Public Health webpage provides an overview of programs and initiatives within the Maternal, Child and Adolescent Health (MCAH) Division that support the health and well-being of California families. It includes resources focused on maternal health, infant and child health, adolescent wellness, home visiting, breastfeeding, perinatal equity, oral health, and services for children and youth with special health care needs. The site also highlights statewide efforts related to prevention, health education, data collection, and equitable access to care for families across California communities.
• Access the website
California Department of Public Health: California Home Visiting Program
The California Department of Public Health's, California Home Visiting Program (CHVP), supports expectant parents and families with young children through voluntary, evidence-based home visiting services. The program connects families with trained professionals who offer guidance on parenting, child development, health, and family well-being during pregnancy and the early years of a child’s life. The site also describes the different home visiting models used across California and highlights how these services help strengthen protective factors, support healthy development, and reduce the impact of adverse childhood experiences (ACEs).
• Access the website - Education
Early Start Program
The Early Start (ES) program is California’s early intervention program for infants and toddlers with developmental delays or at risk for having a developmental disability, and their families. Early start services are available statewide and are provided in a coordinated, family-centered system.
• Access the Early Start website
Head Start
Head Start is a federally funded early childhood education program that provides comprehensive services—including education, health, nutrition, and family support—to low-income children (ages 0-5) and their families.
• Access the Head Start website
- Medi-Cal
DHCS Resources
• Dyadic Services as a Medi-Cal Benefit
• Doula Services as a Medi-Cal Benefit
• Mental Health Services DivisionCDSS Resources
• Medi-Cal and Child Welfare
• County Child Welfare Points of Contact
• Enhanced Care Management and Community Supports Referral Pathways
• Bridge Program
• Child Welfare for Medi-Cal Providers
CalAIM Resources• CalAIM Medi-Cal’s Strategy to Support Health and Opportunity for Children and Families
• Enhanced Care Management Tri-Fold Brochure for Child Welfare and Foster Care
• Enhanced Care Management Tri-Fold Brochure for Youth and Caregivers
CDPH Resources
• WIC- Family Safety and Violence Prevention
CDSS Resources
• Safely Surrendered Baby
• Shaken Baby Syndrome
• Domestic Abuse Resources and Training
• Office of Child Abuse Prevention
CDC Resources
• Intimate Partner Violence Prevention
Stop It Now
This organization provides education to communities as proactive measure to reduce sexual abuse
How Can We Improve This Toolkit?
This Toolkit is intended to be an evolving set of effective tools and resources. CDSS will continue to work with partners to update the Toolkit with timely, relevant and useful information. The CDSS and our partners look to all counties, providers and organizations to provide feedback and ideas. Please submit your suggestions and feedback to us.
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