Sheri Martin Chen’s toddler loves to draw, but a year or so ago, he developed a troubling new habit. 

When the 3-year-old attempted to form the smooth arc of a circle, for example, he didn’t have the skills to draw it as neatly as he imagined it in his head. He’d burst into a temper tantrum.

“He would kind of flip out,” recalled Martin Chen.

The boy — who has a twin sister, and is now 4 years old — is precocious, with an intense desire to know and understand the world around him (The Seattle Times isn’t using the boy’s name to protect his privacy). But he was endlessly frustrated. Sometimes, he would ask Martin Chen to draw for him because he “couldn’t do it perfect enough.” She described the perfectionist behavior to the family’s pediatrician, who recommended a behavioral intervention for families called Parent-Child Interaction Therapy (PCIT).

The advice led Martin Chen and her husband, Yi Chen, to Youth Eastside Services, a nonprofit that offers a variety of evidence-based therapies, substance use treatment and education programs to youth and families in East King County. It was early 2021, before vaccines were widely available, and YES said they could do remote therapy on Saturdays, which would accommodate Martin Chen’s rigid schedule as a high school teacher.

“Usually they observe the parent and the child interacting, and so it would be a little more difficult remotely,” said Martin Chen, who lives in Sammamish. “But we could do it. They were really trying to adapt.”

Martin Chen was having her own trouble feeling confident about parenting. Most of her extended family was far away — Martin Chen is from Kansas. And she didn’t feel like she had family wisdom to draw from. Growing up, she’d never been responsible for taking care of siblings or cousins. 

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Chen, who was raised in China and grew up with younger siblings, was more confident in his parenting style. But he had different assumptions than Martin Chen about how they’d raise their kids. And when their son erupted — throwing toys, or melting into tears — neither of them knew how to respond. They worried their son wasn’t learning how to cope with certain challenges, and that they didn’t have the skills to help him regulate his emotions. 

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They began working with Christine Pace, an early childhood behavioral health therapist at YES, who watched them interact with their children over video. Because Martin Chen and Chen speak to their children primarily in Chinese, one of them would explain to Pace in English what the rest of the family was talking about. 

Remote therapy isn’t perfect, but the family found a rhythm after a few observation sessions. Pace would coach the couple on how to use a variety of parenting skills. Martin Chen and Chen would ask Pace questions. Then, they’d troubleshoot. 

Martin Chen’s natural parenting tendencies were more permissive, while Chen’s were more authoritative. But the couple found the therapy inclusive of both their ideas. More importantly, Pace gave them new tools to handle difficult moments, like chaos at bedtime. 

One of the most important takeaways, Chen and Martin Chen agreed, is the concept of “special time” between children and their parents. This idea involves structured five-minute interactions. A parent offers their child a number of open-ended, creative activities, like playing with Legos or drawing. The child chooses what they want to do, then leads the play time. Parents imitate or encourage their children, but don’t ask leading questions or direct them.

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“Kids don’t get a sense of control in their day-to-day life. We tell them, ‘You have to go to school, you have to eat your vegetables,’” Pace said. “We’re finding these little pockets where we can increase [their sense of control] actually decreases the big behaviors that are coming out.”

Families who work with Pace bring concerns about serious issues, like divorce, family separation or trouble transitioning to school. In general, transitions are tough for young children, who often show their feelings through tantrums or misbehavior. The added layer of the COVID-19 pandemic left room for more disruption than usual: Martin Chen and Chen’s family, for instance, moved from California to Seattle because of the pandemic. Their children switched preschools several times. 

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Helping families develop secure, stable relationships gives children a “solid anchor” amid so much uncertainty, Pace said. 

Intervening early, before unhealthy behaviors become ingrained, can help children develop positive, lifelong skills. Research suggests the type of sensitive parenting Martin Chen and Chen learned helps children foster healthy relationships with other people in their lives — and decreases risk for depression, anxiety, conduct disorder and childhood aggression.

YES is one of 13 nonprofit organizations that share in The Seattle Times’ Fund for Those in Need campaign. The organization was founded in 1968 — it was called Heads Up back then — as a way to help youth who were using drugs. It has since expanded to offer a broad range of mental and behavioral health services, many of which are covered by insurance. About 35% of YES clients use Medicaid to pay for services; the agency doesn’t turn down families without insurance, or who can’t pay for services. In 2020, the agency provided services in 15 languages; 53% of youth who use YES services are people of color.

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In Washington, youth mental health concerns reached crisis levels during the pandemic; in March, Gov. Jay Inslee declared a youth mental health crisis.

Like many nonprofits, YES has scaled back in-person services following government stay-at-home orders. Through its Early Childhood Behavioral Health program, for instance, YES served 182 families in 2019 — but only 81 in 2020. The program has worked with 118 families so far this year, Pace said. Across all its programs in 2020, YES reached more than 24,000 people, including 4,822 children, adolescents and young adults who received direct services.

The agency is trying to ramp up its services, and is returning to some in-person therapy sessions, said David W. Downing, CEO of YES. But most of its services remain remote for the families of young children who aren’t eligible to be vaccinated against the coronavirus.

Youth Eastside Services

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Youth Eastside Services serves people from birth to age 22, and their families, through a variety of behavioral health services. The agency offers evidence-based mental health care, substance use treatment and education programs. For more information: youtheastsideservices.org

$25 helps two families receive a Parent-Child Interactive Therapy (PCIT) manual in their native language.

$50 helps pay for a gift card reward for a youth in recovery who achieves a sobriety goal.

$100 helps a teen struggling with suicidal thoughts begin their recovery with an intake assessment appointment.

$200 helps children learn healthy coping skills by underwriting an in-school presentation facilitated by a licensed YES therapist.

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The consequences of the pandemic on young children — how a lack of socialization and routine, for example, has affected behavior and learning — may be tough to quantify for at least a few years, Downing said.

So far, he said, many of the children he’s seen go through YES programs during the pandemic “have done fairly well and the prognosis is probably fairly high and strong.” But, he cautioned, there are “other kids that have really not responded as well.” 

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“Are they going to bounce back from that?” he said. “It’s hard to know.”

Back at home, Martin Chen and Chen have noticed significant improvements in their children’s nighttime routines and eating habits. Getting on the same page about how to discipline the kids, and how to play with them in a way that gives the kids agency, has also helped dissolve tension in their marriage. 

Their son has moved on from circles to drawing cars, tractors and rocket ships. A recent sketch reads like a work-in-progress instead of an attempt at perfection: he’s drawn a series of green cars, each with differently shaped bodies and windows. 

“Now he does everything by himself … every day he designs at least 10 different types of cars,” Chen said. “I’m really impressed by his curiosity.”