Birth to Three Clinic and Early Childhood Mental Health Program

Dr. Kroupina and Patient

Program Overview

The Birth to Three Clinic and Early Childhood Mental Health Program (BTT program) is the first in Minnesota and one of few pediatric programs nationally emerging from the combined knowledge of two domains—normative neurodevelopment and early childhood mental health—applied within the novel context of pediatrics. We generally serve children ages 0-3 years with a history of early adversity and toxic stress. Without adequate buffering and protective factors, these children are at risk for long-term mental health and neurodevelopmental challenges; however, young children’s brains are also uniquely adaptable and capable of developing new brain connections. With timely identification and intervention, we can help lessen the impact of adverse or stressful experiences on early development.

Housed in the Masonic Institute for the Developing Brain (MIDB) and associated with MHealth Fairview Masonic Children’s Hospital, our program strives to offer an innovative model of pediatric care that includes an early childhood mental health component informed by brain development research. Rather than specializing in one disorder, we take a broad approach to mental health care and support young children and their families by providing evidence-based clinical assessment and intervention services, translating research into innovative clinical practice, and offering clinical training and educational programs. 

Families who may benefit from our clinical services include, but are not limited to, those with young children who have experienced: 

  • Hospitalizations or complex medical conditions
  • Foster care or adoption
  • Traumatic or highly stressful life events 
  • General family stress
  • Emotion regulation difficulties  

Clinical Services

If you believe your family could benefit from our clinic services, please consult your child’s pediatrician or call 651-365-8400 to schedule an initial appointment. 

Outpatient Clinic

  • Assessments–our outpatient clinic specializes in comprehensive social-emotional and developmental assessments. These evaluations typically involve 2-3 appointments and a combination of caregiver interviews, semi-structured behavioral observations, and developmental testing. At the end of the assessment process, we provide individually tailored recommendations to support each family and child. These recommendations may include external community referrals for mental health treatment.

  • Therapeutic Interventions–for medically and developmentally complex cases, we provide several evidence-based interventions (in-clinic or via telehealth). The early relationship between caregiver and child lays the foundation for lifelong emotional and behavioral well-being. Using the most effective interventions for young children, we support the caregiver-child relationship to promote emotion regulation and help buffer or protect children from future stress. Our work is informed by a variety of early childhood treatment modalities, including:

    • Attachment and Biobehavioral Catch-up (ABC)
    • Child-Parent Psychotherapy (CPP)
    • Circle of Security-Parenting (COSP)

Specialty Clinics

  • Adoption Medicine Clinic (AMC): In conjunction with an interdisciplinary team, our clinicians provide brief mental health consultations for foster or adopted children and their families through the University of Minnesota Adoption Medicine Clinic.  To schedule an appointment with the Adoption Medicine Clinic, please call 612-365-6777 
  • Pediatric Follow-Up Clinics:For children receiving medical care through the M Health Fairview System, our providers offer early childhood mental health services through specialized pediatric clinics.

Education & Training

DC:0-5 Training

Dr. Kroupina is a national expert and certified trainer in the DC:0-5 Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood. She provides a two-day DC:0-5 manual training for graduate students, interns, and postdoctoral fellows in developmental psychology and neurodevelopmental-focused programs. Dr. Kroupina also holds an annual DC:0-5 certification training for faculty and providers, which helps promote a comprehensive and cohesive diagnostic approach across the university and state.

Michigan-Minnesota Early Childhood Assessment (M2ECA) Learning Collaborative

In conjunction with University of Michigan Zero to Thrive Program, we developed a ​semi-structured, developmental, and relationship-based assessment approach that incorporates and expands upon DC:0-5 training to advance the field of early childhood mental health. Trainees within our two programs have the opportunity to participate in a virtual learning collaborative. This training aims to build clinicians’ abilities and competencies in conducting early childhood mental health assessment, developing clinical formulations, and sharing recommendations with caregivers and families.

Annual Symposia

The BTT Program hosts an annual symposium focused on child development and early childhood mental health in a broader healthcare context. Traditionally, we invite two expert speakers on child development and one speaker who addresses clinical implications and innovations. Symposium offerings are available to medical providers and practitioners in the area.

Medical Residents

  • We offer a two-week pediatric rotation in the BTT Program for medical residents interested in learning about early childhood mental health across different pediatric settings–including our specialty outpatient clinics and inpatient care models. 
  • All medical residents on the Developmental Pediatrics rotation spend one day with our program and learn how generational trauma, abuse, neglect, and/or caregiving transitions impact early development and mental health. 
  • For medical residents who complete a rotation in the Adoption Medicine Clinic, we provide additional education on attachment, trauma, and mental health disorders in this population. 
  • Together with experts from the University of Minnesota, we developed an online course for medical residents to learn about early child development as well as the prevalence, presentation, and key interventions for early childhood trauma and mental health concerns. Residents can earn continuing education (CE) credits for completing the course. If interested, please contact Erin Newling: newli015@umn.edu 

Postdoctoral Training

We regularly have 1-2 postdoctoral training positions, depending on grant funding and availability. Applicants must hold a PhD in clinical child psychology with experience in research and a particular focus on early risk and resilience factors. Postdoctoral fellows work with our multidisciplinary teams, conduct research, and engage in clinical work in inpatient and outpatient settings. Clinical training focuses on understanding and implementing diagnostic classification of mental health and developmental disorders of infancy and early childhood (DC:0-5); early developmental and relational assessment techniques; and evidence-based interventions that promote emotion regulation and secure attachment relationships. Clinical hours are supervised by our licensed psychologists.

Graduate Student Practicum

Graduate students from the University of Minnesota Institute of Child Development may complete a year-long practicum rotation with training opportunities in diagnostic classification of mental health and developmental disorders of infancy and early childhood (DC:0-5), early childhood mental health assessment, and evidence-based relational interventions for young children. Clinical hours are supervised by our licensed psychologists. Interested students can apply on an annual basis.

Undergraduate Field Experiences

In order to promote diversity, equity, and inclusion, we offer an undergraduate internship program for underrepresented students with interests in pre-medical/clinical training. Internships typically require a 1-2 year commitment, with opportunities for involvement in clinical work, research, and education efforts. This program is a direct partnership with the Institute of Child Development.

Global Outreach

Our clinic works in global outreach to support early childhood development and mental health worldwide. We are currently partnering with Dr. Catherine Abbo, PhD to establish the first early childhood mental health program in Uganda. 

Translational and Global Research

Dr. Kroupina is involved in several NIH-funded research projects taking place in Kampala, Uganda to understand the behavioral correlates of differing treatment protocols for children with co-occurring malaria, HIV and iron deficiency.