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Early Childhood Mental Health Consultation: Results of a Statewide Random-Controlled Evaluation
Abstract
Objective:
Despite recent federal recommendations calling for increased funding for early childhood mental health consultation (ECMHC) as a means to decrease preschool expulsions, no randomized-controlled evaluations of this form of intervention have been reported in the scientific literature. This study is the first attempt to isolate the effects of ECMHC for enhancing classroom quality, decreasing teacher-rated behavior problems, and decreasing the likelihood of expulsion in targeted children in early childhood classrooms.
Method:
The sample consisted of 176 target children (3-4 years old) and 88 preschool classrooms and teachers randomly assigned to receive ECMHC through Connecticut's statewide Early Childhood Consultation Partnership (ECCP) or waitlist control treatment. Before randomization, teachers selected 2 target children in each classroom whose behaviors most prompted the request for ECCP. Evaluation measurements were collected before and after treatment, and child behavior and social skills and overall quality of the childcare environment were assessed. Hierarchical linear modeling was used to evaluate the effectiveness of ECCP and to account for the nested structure of the study design.
Results:
Children who received ECCP had significantly lower ratings of hyperactivity, restlessness, externalizing behaviors, problem behaviors, and total problems compared with children in the control group even after controlling for gender and pretest scores. No effects were found on likelihood of expulsion and quality of childcare environment.
Conclusion:
ECCP resulted in significant decreases across several domains of teacher-rated externalizing and problem behaviors and is a viable and potentially cost-effective means for infusing mental health services into early childhood settings. Clinical and policy implications for ECMHC are discussed.
... Addressing young children's challenging behavior is frequently cited as contributing to higher levels of teacher stress and is a primary need for teacher professional development [9,10]. Infant and early childhood mental health consultation (IECMHC) is an approach with a growing body of evidence of its effectiveness for supporting teachers in adopting classroom and practices individualized to the child for promoting children's social competence and decreasing incidences of challenging behaviors [11][12][13]. ...
... There is evidence that children with multiple disabilities in Head Start programs perform better with regard to academic and language skills by kindergarten compared to those with multiple disabilities who do not participate in Head Start [20]. Assessing the impact of IECMHC models on children with and without disabilities ensures that consultation models are promoting equitable outcomes for all children [11]. ...
... However, the sample included fewer Black teachers compared to the national childcare worker population [39], and the geographic region where this study was conducted may limit the generalizability of the findings to more diverse settings. The high proportion of Hispanic participants (87.5%) provided a unique opportunity to understand the program's impact on this underserved population, addressing a gap in the literature on culturally responsive early childhood interventions [11]. ...
Background/Objectives: High-quality inclusive education is important for promoting the positive development of children with disabilities in early childhood care and education (ECCE) settings. However, ECCE teachers may not have the knowledge and skills to manage challenging behaviors in young children, especially those with disabilities. Infant and Early childhood mental health consultation (IECMHC) is one mechanism to support the professional development of teachers. This study explored the impact of an evidence-based IECMHC program, Jump Start Plus COVID Support (JS+CS), on outcomes for teachers in classrooms including children with disabilities. Methods: Utilizing a RE-AIM framework, we examined the extent that JS+CS impacted teacher outcomes related to classroom practice and teacher attitudes after the initial intervention period. In addition, we examined the extent that the classroom children with disability ratio moderated the impact of the intervention on teacher outcomes. Using a cluster randomized controlled trial in a sample of 138 racially and ethnically diverse teachers in 31 ECCE centers, we examined the reach, effectiveness, adoption, and implementation of JS+CS. Results: The results indicate that the JS+CS program shows promise as an intervention to support ECCE teachers working in classrooms with children with disabilities, particularly in improving teacher safety practices, behavior management skills, and resiliency coping. In addition, the program was adopted equally in classrooms that served children with and without disabilities. Conclusions: This is a unique contribution to the literature given that no previous IECMHC programs have examined adoption in classrooms serving children with disabilities. Further investigation is needed to determine the specific factors that impact program implementation considering that this study was conducted during various phases of the COVID-19 pandemic.
... For childcare centers to meet this basic need, teachers/staff needed support, resources, and consultation to provide them with strategies on how to support healthy child development and behavior (Natale et al., 2023). Prior to COVID-19, support to childcare centers was typically provided through in-person support and early childhood mental health consultation models (Gilliam et al., 2016;Natale et al., 2020). However, during the pandemic, many childcare centers restricted outside visitors into their centers to reduce risk of transmission of COVID-19. ...
... Early childhood mental health consultation models such as the Georgetown Model of Early Childhood Mental Health Consultation (ECMHC) aim to build the capacity of early childhood educators to promote young children's social-emotional development and effectively address challenging behaviors (Upshur et al., 2009;Heller et al., 2011). Within ECHMHC models, mental health consultants work collaboratively with early childhood programs, such as childcare centers, to enhance the skills and knowledge of educators, foster positive teacher-child interactions, and create supportive classroom environments that nurture children's social-emotional well-being (Gilliam et al., 2016;Conners-Burrow et al., 2017). The Georgetown Model operates at multiple levels, including programmatic consultation to improve overall program quality, classroom-level consultation to enhance teacher practices and classroom climate, and child-specific consultation to address individual children's needs (Upshur et al., 2009;Heller et al., 2011). ...
... Mental health consultants use a strengths-based, collaborative approach to build relationships with early childhood educators and provide ongoing support, guidance, and professional development (Raver et al., 2008;Duran et al., 2010). The model has demonstrated positive outcomes, such as reduced teacher stress, improved teacher-child interactions, and decreased challenging behaviors in young children (Heller et al., 2011;Gilliam et al., 2016;Conners-Burrow et al., 2017). ...
Introduction
Childcare center closures during COVID-19 impacted education for approximately 40 million children nationwide. Unfortunately, COVID-19 restrictions significantly limited the extent that outside personnel could provide in-person support to educators, resulting in the need for innovative approaches to meet childcare centers’ needs. A virtual robotic telepresence approach was applied to early childhood consultation models to promote child resilience while mitigating COVID-19 risks. The goal of this study was to examine how training influenced consultants’ and childcare staff uptake of the virtual robotic telepresence consultation approach and their acceptance of this technology.
Methods
Ten early childhood consultants received multimedia/simulation training and weekly communities of practice related to virtual telepresence robotic consultation. Telepresence robotic consultation equipment was deployed to 16 childcare centers in a diverse multilingual metropolitan area as a part of a larger randomized controlled trial. Consultants trained childcare staff (14 center directors and 58 teachers) on how to receive virtual telepresence robotic consultation. Demographic information and measures of technology acceptability and uptake were collected from childcare staff and consultants. A mixed methods approach was used including multilevel modeling and focus groups to examine consultation uptake, acceptability, barriers, and facilitators of virtual telepresence robotic consultation implementation.
Results
Consultants and childcare staff generally perceived the virtual telepresence consultation approach to be useful and easy to use. Consultant perceptions of the acceptability of technology did not change over time. Childcare staff, center, and consultant factors impacted the uptake of the virtual robotic telepresence consultation approach and childcare staff acceptance of the technology. Focus groups revealed that consultants believed that additional hands-on training with childcare staff would have benefited implementation and expressed a desire for a hybrid approach for consultation.
Discussion
Perceptions of telepresence robotic consultation acceptability are discussed, including future recommendations for training.
... The Early Childhood Mental Health Consultation (ECMHC) theory of change serves as the conceptual framework (Fig. 1). ECMHC, through mental health consultants, has proven effective in addressing young children's behavioral health by building the capacity of childcare teachers to develop the attitudes and skills necessary to effectively support the development of resilience in young children [24][25][26][27]. The JS + CS Toolkit is organized into four pillars that work together to build resilience by improving psychosocial coping through Self-Care and Trauma-informed Behavior Supports and disaster recovery practices by improving Safety and Communication practices. ...
... Family COVID-19 precaution behaviors will be measured using a dichotomized checklist of caregiver reported behaviors that follow CDC recommendations and adult and child vaccine uptake and confidence (if emergency authorization is approved for 1-3-year-olds) measured by specific items from the NIH Rapid Acceleration of Diagnostics (RADx) COVID-19 Common Data Elements Survey [60][61][62]. According to ECMHC, child development outcomes are mediated by teachers' practices (measured by implementation of JS + CS strategies assessed through the Health Environment Rating Scale-Classroom (HERS-C) and teachers' self-efficacy and beliefs (both measured by the Childcare Worker Job Stress Inventory described below) [24][25][26][27]. ...
... Prior ECMHC and JS research suggests that improving classroom practices impacts child development [25,40,63]. Classroom practices Table 1 Toolkit pillars, goals, and example strategies. ...
Background
The COVID-19 pandemic has had negative psychosocial impacts on young children; teachers in childcare centers continue to be overwhelmed by how to address the downstream psychological effects children are experiencing. This randomized controlled trial will study the role of a community-based, childcare center-support system in improving resilience and mitigating the long-term impacts of COVID-19 on children's development.
Methods
This study will be modeled on a successful Early Childhood Mental Health Consultation (ECMHC) intervention which utilizes mental health consultants to deliver a Jump Start+: COVID 19 Support (JS + CS) virtual toolkit to childcare centers in Miami-Dade County via a Kubi robot. The toolkit comprises four strength-based strategies likely to be effective in improving resiliency following disasters: Safety Planning, Effective Communication, Adult Self-Care, and Trauma-Informed Behavior Support. Our first aim will utilize a cluster randomized trial to examine the effectiveness of JS + CS on improving the psychosocial functioning of young children, as compared to an obesity prevention intervention control group. Children will be followed at 6, 12, 18, and 24 months. The second aim will examine the mechanisms that contribute to effective uptake by teachers of the JS + CS support strategies on child outcomes. The third aim will explore implementation barriers/facilitators as well as potential societal contextual factors (e.g., vaccine uptake) to help centers serving disproportionately affected minority communities recover from and prepare for future crises.
Conclusion
This design will inform the refinement and scaling of JS + CS and generalize impacts to other childcare center interventions in the context of disasters.
... There is some evidence that it increases home visitors' knowledge of children's social-emotional development and behaviors (Center for Prevention Research & Development, 2011;Goodson et al., 2013;Lambarth & Green, 2019), but this is based on selfreported retrospective data from home visitors. Indeed, few studies have used experimental or quasi-experimental designs to evaluate IECMHC (e.g., Conners-Burrow et al., 2012;Egeren et al., 2011;Gilliam, 2014;Gilliam et al., 2016;Reyes & Gilliam, 2021), and none of these studies with comparison groups included home visiting programs. In addition, research on IECMHC has not examined how it promotes change, indicating a need for additional rigorous evidence documenting its effects. ...
... When teachers perceive children's behavior negativelywhether because of implicit bias and/or developmentally inappropriate expectations-they tend to have difficulty establishing positive relationships with those children (Coplan et al., 2015;Dobbs & Arnold, 2009;Yoder & Williford, 2019). Thus, the disproportionate expulsion of boys of color from early childhood programs may be a provideror classroom-level outcome rather than a child outcome (Albritton et al., 2019;2005;Gilliam et al., 2016;Meek & Gilliam, 2016;Zinsser et al., 2019). If implicit bias plays a role in teachers' disciplinary practices, reflective capacity may be a mechanism through which IECMHC affects change in their views, behaviors, or both (A. ...
... In some studies, the consultants who delivered the intervention also collected the data (Shivers, 2015), limiting the data's validity. Studies that measure child outcomes by teacher report rather than independent assessments raise the question of whether child behavior changed, or teacher perceptions of child behavior changed (Conners-Burrow et al., 2012;Gilliam et al., 2016;Perry et al., 2010). Many previous studies of IECMHC did not measure variables, like reflective capacity, which may be important in mediating or moderating the outcomes of interest. ...
Infant and Early Childhood Mental Health Consultation (IECMHC) aims to improve early childhood professionals' abilities to promote children's mental health through relationship building and collaboration. Using a longitudinal, matched-comparison group design, a 3-year pilot study of a cross-system, embedded model of IECMHC assessed teachers and home visitors in intervention and comparison programs in reflective capacity, burnout, and perceptions of children's behavior. A sample of 136 staff (n = 72 intervention group; n = 64 comparison group; 21% Black; 51% White; 28% Latina/Hispanic) participated in surveys over a 21-month implementation period. A subsample of staff (n = 26) participated in interviews that included a narrative measure of reflective capacity; and a smaller subsample of teachers only (n = 21) completed assessments of children. Staff in the intervention group significantly increased reflective capacity after 21 months. For the staff interview subsample, receiving the intervention predicted lower levels of burnout at 12-15 months post-baseline. Among teachers completing child assessments, those with higher reflective capacity rated children's behaviors more positively than teachers with lower reflective capacity. We conclude that this IECMHC model successfully improved reflective capacity in staff. Future research should investigate reflective capacity as a potential mechanism of change for IECMHC.
... A limitation of the research around consultee capacity is the lack of significant findings for impact on the consultee in either of the two RCT studies conducted to date (Gilliam, 2016;Reyes et al., 2020) as well as the absence of disaggregated analyses to determine whether these changes are equitable to consultees of color. Future research should seek to better understand those null findings, engage in disaggregated analysis, and explore the aforementioned additional constructs of interest. ...
... A wide range of measures have been used, including the Devereux Early Childhood Assessment -Clinical (DECA-C), Strengths and Difficulties Questionnaire, and the Sutter-Eyberg Student Behavior Inventory. The majority of studies of child outcomes have been conducted with predominantly White samples (Bender et al., 2017;Gilliam et al., 2016;Shamblin et al., 2016), few have been conducted with predominantly Black samples (Williford & Shelton, 2008), and other racial/ethnic groups are poorly represented (see for exception Beardslee et al., 2010); further disaggregation by race/ethnicity is rare (see for exception Shivers et al., 2021). ...
... Next, many studies have reported that children's challenging behaviors tend to decrease after consultation (Perry et al., 2010). For example, the randomized control trial (RCT) of Connecticut's consultation program demonstrated significant decreases in hyperactivity, restlessness, and externalizing behaviors among children who received consultation compared to control group children (Gilliam et al., 2016). This finding has been replicated using other designs and a variety of measures. ...
Infant and Early Childhood Mental Health Consultation (IECMHC) is an evidence-based service in which consultants build capacity for early childhood professionals and programs to promote the social-emotional development of infants and young children. This paper describes the current state of the evidence for IECMHC, mapping the evidence to a new theory of change from the Center of Excellence (CoE) for IECMHC. There is a substantial literature base regarding the effects of consultation on outcomes for infants and young children; yet the evidence for consultation's specific mechanisms of change, moderators of impact, and reductions in disparities have been understudied. The authors identify gaps in the scholarly literature, articulate next steps for research, and conclude with a call to action for IECMHC researchers to expand rigorous studies to the range of settings in which IECMHC is implemented and to center social justice in the research questions, methods, and dissemination.
... Despite the increasing popularity of ECMHC nationally, there is very little rigorous research documenting its impact (Albritton et al., 2018;Brennan et al., 2008;Perry et al., 2010). In a randomized control evaluation of the Early Childhood Consultation Partnership (ECCP) model of this intervention approach conducted by Gilliam and colleagues, the classroom quality of teachers and outcomes of children in classrooms that received 4-6 h of consultation a week for eight weeks were compared to outcomes for teachers and children in waitlist control classrooms following standard educational practice (Gilliam et al., 2016a). Children whose teachers received consultation had significantly lower ratings of hyperactivity, restlessness, and problem behaviors compared to controls based on teacher ratings. ...
... Children whose teachers received consultation had significantly lower ratings of hyperactivity, restlessness, and problem behaviors compared to controls based on teacher ratings. There was no observed difference between the two conditions in classroom quality as rated by observers on the Classroom Assessment Scoring System (CLASS) (Gilliam et al., 2016a). However, the authors note that this null finding may have been the result of a measurement issue and the CLASS may not have been sensitive enough to detect change. ...
... Specifically, children in schools where ECMHC was provided were rated by their teachers as exhibiting higher levels of social-emotional competence and were observed by their teachers as exhibiting fewer self-regulation problems. These findings are consistent with previous research on ECMHC (Gilliam et al., 2016a;Raver et al., 2009Raver et al., , 2011Williford & Shelton, 2008). In the only randomized-controlled trial of ECMHC, Gilliam and colleagues also used teacher ratings of children's behavior to measure the effects of consultation and found that children in the intervention classrooms were rated as higher functioning on measures of social-emotional competence and behavior compared to those in control classrooms (Gilliam et al., 2016a). ...
Early childhood mental health consultation (ECMHC) is a capacity-building intervention that aims to enhance the quality of young children’s affective environments in order to promote children’s social, emotional, and behavioral health. In this study, the effects of ECMHC on children’s social–emotional and early academic outcomes over the course of one academic year were evaluated in 20 classrooms (15 intervention and 5 comparison) with 38 teachers (29 intervention and 8 comparison), and 390 children (282 intervention and 108 comparison; Mage = 46.71 months old) across 3 schools. Observations, teacher ratings, and direct assessment were used to evaluate children’s social–emotional skills and early academic outcomes. A three-level model that accounted for the nesting of children within classrooms within schools found that children in intervention schools had more positive classroom behavior, fewer observed social–emotional challenges, and higher academic achievement in math, literacy, and writing at the end of the school year. Our findings suggest that this model of ECMHC is an effective way to spread out the expertise of mental health professionals and improve the social, emotional, and academic outcomes for children in the school setting. This is particularly important for marginalized and under-resourced communities who often face higher levels of adversity and mental health needs with fewer available resources as a result of structural factors including racism and underinvestment of public funds.
... Similar findings have been observed in classrooms with higher proportions of Latinx children (Gilliam & Shahar, 2006). Findings for African-American children may be explained by implicit bias, as more recent research found that teachers are more likely to anticipate behavioral issues in African American boys (Gilliam et al., 2016). Additionally, across ECE settings and for all racial-ethnic groups, boys are consistently more likely to be suspended (USDE, 2016) and expelled (Gilliam, 2005;Greenberg & Ash, 2012;Hampton, 2008). ...
... Descriptive and correlational analysis were conducted on study variables using SPSS (version 24). A multilevel modeling (Bryk & Raudenbush, 1992) approach was used to examine the effects of ECE program characteristics on suspension and expulsion rates, in keeping with a number of studies investigating the use of expulsion (e.g., see Davis et al., 2018;Gilliam et al., 2016;and Green et al., 2006). A growing literature supports several contributing factors to S/E, the full understanding of which necessitate statistical methods that can manage the nested structure and co-occurrence of factors. ...
... In addition to providing content, IECMH consultants commonly integrate a consultative stance in training, supporting reflection on situations or behaviors providers find challenging. It may be that these trainings introduce reflection that disrupts negative narratives motivating removals such as teachers' perceptions of child behavior or family needs, teachers' implicit biases (Downer et al., 2016;Gilliam et al., 2016), stress, or depression, all of which have been identified as robustly related to expulsion (Gilliam & Shahar, 2006;Silver & Zinsser, 2020;Zinsser et al., 2019). Reducing other known relational mediators of S/E such as bias, stress, and depression may also be mechanisms by which IECMH consultants either through consultation or trainings reduce the use of S/E. ...
Expulsion presents a significant risk in Early Care and Education (ECE) settings due to its association with early disadvantage and frequency of use. A statewide survey was conducted to characterize ECE suspension and expulsion (S/E) in Colorado. Child, program, and community-level factors were examined as predictors of S/E, alongside preventative intervention supports capable of reducing S/E. Six hundred and sixty three licensed child care programs participated in the survey, providing information on 19,848 enrolled children, 312 suspensions, and 74 expulsions. A series of multilevel hierarchical regressions were conducted, examining predictors for S/E. Children with IEPs/IFSPs were disproportionately suspended; 2–3-year-olds were disproportionately expelled; and boys, 5–6-year-olds, and children with disabilities were disproportionately suspended and expelled. Center-based programs, lower quality ratings, and “zero tolerance” policies predicted greater use of suspension. In contrast, school-district affiliation and knowledge of how to access infant and early childhood mental health consultation (IECMHC) decreased suspension. Lower levels of regional child poverty predicted higher use of expulsion. Affiliation with a school-district, IECMH consultant-led training, and use of quality coaches predicted decreased expulsion. This study identifies the need for ongoing protection for children with IEPs/ IFSPs and the preventative interventions that mitigate risk for S/E.
... Infants and toddlers can experience mental health issues like regulatory problems (e.g., sleeping and feeding issues, attachment difficulties; externalizing behaviors like aggression and defiance; internalizing issues like depression and anxiety; and posttraumatic stress symptoms Izett et al., 2021). These challenges can impact many other aspects of the child's development, and related behavioral difficulties can also result in suspension and expulsion from early care and education centers (Gilliam et al., 2016). Factors that precipitate IECMH problems include child risk factors like health problems and a difficult temperament; family risk factors like insensitive parenting, parental mental health concerns, and family violence; and societal and community risk factors like poverty, lack of resources, and racism (Berry et al., 2021;Izett et al., 2021). ...
... In this setting, IECMHC has been found to reduce children's behavioral problems and expulsion risk (Silver et al., 2023). However, only one RCT has been conducted, and though it found that IECMHC reduced ratings of children's hyperactivity, restlessness, externalizing behaviors, and problem behaviors, it did not reduce the likelihood of expulsion (Gilliam et al., 2016). IECMHC in early care and education settings can also improve teacher outcomes like job stress, knowledge, efficacy, and competence, family outcomes like fewer days missed at work to address childcare issues, as well as program outcomes like reductions in staff turnover and improvements in classroom climate (Center of Excellence in Infant and Early Childhood Mental Health Consultation, 2020b; Silver et al., 2023). ...
... The focus on consultative services may occur at the child, family, or program levels (Cohen & Kaufmann, 2000). In ECMHC, a consultant with mental health expertise collaborates with early childhood teachers/staff, programs, and families to improve their ability in prevention, identification, and intervention and to lessen the impact of mental health problems in young children (Gilliam et al., 2016). ...
... In the classroom-based ECMHC, the direct interaction between the early childhood teachers and mental health consultants leads to positive changes, and such change in teachers' skills and knowledge results in favorable outcomes in promoting children's social-emotional development (Williford & Shelton, 2008). The collaboration of expertise from both early childhood teachers and mental health consultants is vital to better children's outcomes (Icovino & Esralew, 2019), such as improvement of social skills, reduction of challenging behaviors, prevention of suspensions and expulsions (USDHHS & USDOE, 2016), and lower ratings of hyperactivity, restlessness, externalizing behaviors, problem behaviors, and total problems (Gilliam et al., 2016). In addition, ECMHC is effective in reducing teachers' stress, burnout, and turnover (USDHHS & USDOE, 2016) and increasing self-efficacy, competence in addressing challenging preschool behaviors, and sensitivity toward students (Brennan et al., 2008). ...
The mental health of students with disabilities has received increasing attention, yet it is difficult for early childhood teachers to identify young children with mental health issues and access support. Research has shown the lack of timely intervention might cause more serious emotional issues later. The interplay of disability, young age, and mental health issues complicate the teaching of early childhood teachers. The purpose of this article is to highlight the difficulties early childhood teachers are experiencing when a child with special needs requires additional support services for social-emotional and behavioral concerns. Barriers or challenges that exist to accessing mental health services for young children and their families are discussed. Through the use of vignettes, we present six strategies to assist early childhood special education professionals in addressing the mental health needs of young children, including 1) recognizing the warning signs of mental health needs for early identification and intervention, 2) utilizing screening tools to detect a child’s mental health needs, 3) selecting and providing school-based supports, 4) monitoring the child’s response to school-based mental health supports, 5) collaborating with mental health professionals and partnering with families, and 6) securing additional networks and resources to support children with special needs.
... Pre-kindergartner suspension and expulsion rates can be up to three times higher than the K-12 rate (Gilliam, 2005;. Racial disparity and implicit bias in expulsion and suspension have been identified as concerns (Office for Civil Rights, 2014;Gilliam et al., 2016), with Black boys being suspended or expelled at rates up to four times higher than their white and female counterparts ; U.S. Department of Education Office for Civil Rights, 2014). Additionally, recent discussions based on reports released by the African American Policy Forum and the Center for Intersectionality and Social Policy Studies address similar dimensions of Black girls' vulnerabilities that are frequently overlooked by their absence in the conversation (African American Policy Forum & Center for Intersectionality and Social Policy Studies, 2015; Morris, 2012). ...
... As noted above, there are significant racial disparities in expulsion and suspension rates (Office for Civil Rights, 2014; Gilliam et al., 2016), with Black boys being suspended or expelled at rates up to four times higher than their White and female counterparts Office for Civil Rights, 2014) and, in some places, the expulsion and suspension rates for Black girls exceed those indicated for Black boys (African American Policy Forum & Center for Intersectionality and Social Policy Studies, 2015). However, discussing/addressing racism and implicit bias are skills that have been largely underdeveloped in the workforce. ...
... While social distancing measures are vital for containing the spread of COVID-19 and is necessary to ease the burden on health systems, policymakers and university administrators must work with public health experts to identify psychological services and initiatives to provide mental health support to adolescents and college students. One intervention recently studied that may be used in pre-school settings is the early childhood mental health consultation (ECMHC), which has been found to significantly lower ratings of hyperactivity, restlessness, externalizing behaviors, and problem behaviors among children under 6 years old [41][42][43][44]. ECMHC is a preventative intervention that places mental health consultants in early childcare settings and pairs these consultants with families to address a child's individual needs and increase their social and emotional health [42, Using all possible combinaƟons of these search terms 1.) college students or undergraduate or graduate, 2.) coronavirus or COVID-19, and 3.) mental health or depression or stress or PTSD or insomnia or mood, arƟcles were idenƟfied through search on PubMed and Collabovid: n = 2921 ...
... In a pandemic where there are far more children in need of mental health support than we have capacity to serve individually, it is important to invest in mental health programs that can have positive effects across a larger population. Studies have shown that ECMHC is effective and being used across child care centers, Head Start/Early Head Start centers, home visiting programs, primary care settings, elementary schools (kindergarten through third grade), and community outreach programs [41,45,46,48]. Healthcare providers should also expand their clinical services and offer preventive support and early intervention to be prepared for the rise in mental health issues. ...
The COVID-19 pandemic led to a worldwide lockdown and school closures, which have placed a substantial mental health burden on children and college students. Through a systematic search of the literature on PubMed and Collabovid of studies published January 2020–July 2021, our findings of five studies on children and 16 studies on college students found that both groups reported feeling more anxious, depressed, fatigued, and distressed than prior to the pandemic. Several risk factors such as living in rural areas, low family socioeconomic status, and being a family member or friend to a healthcare worker were strongly associated with worse mental health outcomes. As schools and researchers discuss future strategies on how to combine on-site teaching with online courses, our results indicate the importance of considering social contacts in students’ mental health to support students at higher risk of social isolation during the COVID-19 pandemic.
... Zira okul öncesi eğitime devam eden dezavantajlı çocuklarda en sık görülen problemler arasında dikkat eksikliği, hiperaktivite, dürtüsellik, saldırganlık, anksiyete, uyum ve duygu düzenleme problemleri yer almaktadır. Eğer çocuk daha önce erken müdahale programlarından birinden yararlanmışsa erken dönemden daha az problem davranışını okul öncesi eğitim ortamına taşımakta ve bu avantajlı durum dezavantajlı çocuklarla daha hızlı yol alınabilmesine olanak sağlanmaktadır (Gilliam, Maupin ve Reyes, 2016;Reiss, 2013;Ritblatt, Hokoda ve Van Liew, 2017). ...
... Okul öncesi dönemde bu ruh sağlığı problemlerine yol açan risk faktörlerinin okul öncesi eğitim sırasında büyük ölçüde önlenmesi elzemdir çünkü okul öncesi eğitim sırasında giderilemeyen davranış sorunları sonraki gelişim basamaklarına aktarılmaktadır. Bu aktarımlar da dezavantajlı çocuklar için akademik, sosyal ve duygusal gelişimde önemli aksamalara neden olduğu için klinik endişe kaynağı olarak değerlendirilmektedir (Gilliam, Maupin ve Reyes, 2016). ...
Her çocuğun eğitim, sağlık, barınma gibi temel gereksinimlere erişebilmesi ve
cinsel, fiziksel, psikolojik ve diğer sömürülere karşı korunması anayasal haklarıdır. Bu haklar anayasal güvence altına alınmış olsa da pek çok dezavantajlı çocuk risk faktörleri nedeniyle bu haklarına erişememektedir. Risk faktörleri sebebiyle de dezavantajlı
çocuklar fırsatlara erişebilmek ve gereksinimlerinin giderilmesi için başta psikolojik
danışmanlar olmak üzere pek çok profesyonelin desteğine gereksinim duyar. Bu destek
doğumun ardından geçen ilk 3 yılda ebeveyn-çocuk müdahalelerini içeren erken dönem
müdahale programları ile, 3-6 yaş nitelikli okul öncesi eğitim programına erişimlerinin
sağlanması ile, okul çağında ise okul devamının sağlanması, akademik ve akademik
olmayan becerilerin kazanılması ile sağlanmaya çalışılır. Nihayetinde de hedef tüm eğitim süreçlerinde çocukların ruh sağlığını korumak ve yetişkinliğe geçişlerinin sancısız
olmasıdır.
... Given the prevalence of young children experiencing SEB concerns and the impact of these concerns on lifelong learning, behavior, and health, a multi-level equity-centered intervention like infant and early childhood mental health consultation (IECMHC) is an underutilized support [19,45,46]. This multi-level intervention is delivered by mental health consultants trained in early childhood development and the core principles of infant and early childhood mental health consultation (IECMHC). ...
Early intervention services are a critical support for young children experiencing developmental delays and disabilities. Due to myriad negative social and economic conditions, some infants and young children, namely Black, Indigenous, and other children of color, as well as those experiencing poverty, are at greater risk of experiencing a developmental delay or disability and experiencing issues of access to needed services and supports within and beyond early intervention programs. Due to these systemic issues, these infants and young children are more likely to have caregivers experiencing mental health concerns and issues of access to services and supports. Early childhood serving programs are faced with meeting the behavioral health needs of families experiencing cumulative vulnerabilities. Some early intervention (EI) programs are partnering with infant and early childhood mental health (IECMH) providers to meet mental health needs. IECMH consultation (IECMHC) is a multi-level support that aims to build the capacity of early childhood programs to meet the needs of young children, families, caregivers, and staff. IECMHC has an intentional focus on promoting and ensuring equity, specifically more equitable systems. It focuses on addressing inequities impacting young children and their caregivers, thus strengthening these essential collaborations. This paper highlights research demonstrating the importance and collective power of IECMHC in early intervention programs to advance behavioral health and equity.
... Preschool teachers are a natural resource to promote social emotional skills of young children (Bulotsky-Shearer et al., 2020). Over the past decade, early childhood programs such as the federal Head Start program in the U.S. have increasingly invested in teacher professional development programs such as infant early childhood mental health consultation models (Gilliam et al., 2016) or practice-based coaching (Snyder, 2022;Snyder et al., 2015) focused on supporting children's social-emotional skills and reducing challenging behavior. ...
Introduction
In partnership with an urban school district Head Start program, we created a set of intervention supports that built upon the strengths of the district program services already in place.
Methods
We conducted a randomized control trial to test the use of natural helpers (teachers, special education coaches, and curriculum specialists) participating in practice-based coaching and monthly communities of practice, to augment a districtwide universal social-emotional program, The Pyramid Model for Promoting Social and Emotional Competence in Infants and Young Children. Participants included 53 preschool teachers and 519 preschool children, across 26 classrooms, and 9 schools in a high poverty area of the district. Teachers were randomized to a waitlist control or intervention condition. Intervention teachers participated in practice-based coaching and monthly communities of practice over the course of two years.
Results
Significant effects were found on participating intervention teachers’ observed increased implementation of positive social-emotional practices in the classroom, decreases in red flags (observed teaching behaviors counter to the Pyramid Model), and increased teacher reports of self-efficacy in the intervention group, compared to control teachers. No significant impacts on child classroom behavior problems, self-regulation, or approaches to learning skills were found for children enrolled in intervention classrooms, compared to children in the control classrooms.
Discussion
Future directions for research and implications for practice are discussed.
... In contrast, only about half of the included studies that reported on internalizing behaviors found evidence of improvement within this domain, a noteworthy finding given the relatively higher prevalence of internalizing disorders (Egger & Angold, 2006). More recent evaluations have reported similar findings (i.e., improvements in externalizing but not internalizing problems), additionally noting no significant changes in terms of overall classroom mental health climate or likelihood of student expulsion (Gilliam et al., 2016;Reyes & Gilliam, 2021). However, improvements in terms of child initiative and interpersonal relationships have been described (Reyes & Gilliam, 2021). ...
Behavioral health problems in children interact bidirectionally with academic and social functioning, which uniquely positions schools to provide wide-reaching behavioral health services. Within the Multi-Tier Systems of Support (MTSS) Model, schools provide services to children at various levels, including preventative interventions for all students to enhance socio-emotional well-being, targeted interventions for students with emerging mental health concerns or vulnerabilities, and intensive treatments for students with severe problems. Many models of school behavioral health interventions currently exist, such as Positive Behavior Interventions Support, Behavioral Health Team, Community and School-Based Behavioral Health Service, and the Mokihana program, which focus on reducing externalizing behavior, increasing positive behavior, and enhancing community collaborations. While there are many benefits to school-based behavioral health interventions, including multidisciplinary treatment, accessibility, and cost-effectiveness, there are special challenges associated with school-based interventions including limitations on intervention targets and logistical constraints. Interventions in school settings also need to be implemented with sensitivity to prevent stigmatization of students receiving care, improve parental buy-in, and increase teachers’ understanding of mental health. More resources are required to train professionals specifically in the school-based setting, enhance supervision, and rigorously evaluate the effectiveness of school-based interventions. Moreover, there is a need for more interventions targeted at preschool-aged children and internalizing issues such as anxiety and depression, and more attention and sensitivity to issues of diversity, inclusion, and equity. Recommendations and future directions are discussed.
... The Spearman correlation value of 0.626 shows a positive correlation with a strong strength of influence. 27,28,29 Conclusion 1. There is an influence of perceived ease of use on interest in use 2. ...
Background: Children are an important asset for a nation, so the education and care provided must be able to improve the quality of children in the future. Child Protection Law no. 23 of 2002 explains that every child has the right to receive growth and development monitoring without exception. Early detection of deviations in growth and development needs to be done, one of which is by using digital-based growth and development e-Reports. Objective: The e-report product produced can increase efficiency and effectiveness, helping teachers, homeroom teachers, cadres or health workers in managing the SDIDTK program so that valid, practical and effective digital-based e-Report applications can be obtained. Research methods: The research design for the development of digital-based growth and development e-reports was carried out referring to the development of the 4D model which includes define, design, develop and disseminate. Results: There is an influence of perceived usefulness on interest in using the child health e- report application Conclusion: e-Report can be used to check children's health and growth and development at the PAUD unit level to increase the scope of monitoring children's health and SDIDTK Keywords: e-reports, growth and development
... Similarly, a handful of correlational studies have shown associations between Pyramid model implementation and lower reported disciplinary actions by programs (Clayback & Hemmeter, 2021;Vinh et al., 2016), but the model is not widely available in Illinois and difficult to implement fully without supports (e.g., practice-based coaching; Hemmeter et al., 2016). Likewise, infant and early childhood mental health consultation (IECMHC) has a large literature base (for a recent systematic review, see but the evidence of its direct impact on expulsion rates is mixed (Gilliam et al., 2016;Hoover et al., 2012;Reyes & Gilliam, 2021). ...
Over the past decade, numerous reports have indicated pervasively high rates of early childhood expulsion nationwide. In response, state and federal policymakers have enacted various measures to ban or reduce reliance on such exclusionary discipline. Prior evaluations of the implementation of one such legislative ban on expulsion enacted in Illinois in 2018 showed partial reductions but relied only on program administrator-reported data. Parents ( N = 16) of children (43.75% children of color) expelled from Illinois early childhood programs before and in the years since the 2018 legislative ban were interviewed about their experiences. Parents in both groups reported similar incidents regarding how and why children are excluded, how programs communicated with parents about children’s behavioral concerns, and how programs assisted (or did not) with accessing resources and supports that may enable a child to be retained. Findings indicate that expulsions continue to happen despite the ban and families’ experiences were essentially unchanged and negative. Findings hold implications for the implementation of similar policy efforts across the country.
... Fortunately, EHS/HS are effective vehicles for linking children and families with mental health services. HSPPS require provision of infant and early childhood mental health consultation, which is linked to reductions in children's behavioral challenges (32). Infant and early childhood mental health consultants partner with EHS/HS teachers to promote children's mental health via classroom practices and with case managers, teachers, and families to address children's behavioral concerns (33). ...
Given the importance of health to educational outcomes, and education to concurrent and future health, cross-systems approaches, such as the Whole School, Whole Community, Whole Child (WSCC) framework, seek to enhance services typically in K-12 settings. A major gap exists in cross-systems links with early care and education serving children birth to age 5. Both pediatric health systems and early family and child support programs, such as Early Head Start (EHS) and Head Start (HS), seek to promote and optimize the health and wellbeing of infants, toddlers, preschoolers, and their families. Despite shared goals, both EHS/HS and pediatric health providers often experience challenges in reaching and serving the children most in need, and in addressing existing disparities and inequities in services. This paper focuses on infant/toddler services because high-quality services in the earliest years yield large and lasting developmental impacts. Stronger partnerships among pedicatric health systems and EHS programs serving infants and toddlers could better facilitate the health and wellbeing of young children and enhance family strengths and resilience through increased, more intentional collaboration. Specific strategies recommended include strengthening training and professional development across service platforms to increase shared knowledge and terminology, increasing access to screening and services, strengthening infrastructure and shared information, enhancing integration of services, acknowledging and disrupting racism, and accessing available funding and resources. Recommendations, including research-based examples, are offered to prompt innovations best fitting community needs and resources.
... In Connecticut, the Early Childhood Partnership Program (ECCP), an ECMHC model studied in randomized controlled evaluations, was found to have positive effects on child behaviors (Gilliam et al., 2016a), with similar results replicated in a statewide randomized controlled evaluation in Ohio . Additionally, positive behavioral interventions and supports (PBIS) have shown similar promising results. ...
Childcare is an essential service. Through the pandemic, early childhood educators endured intense financial pressure and coronavirus risk to support children through a formative stage in development. In an already under-resourced profession, such strain leads to increasing numbers of teachers feeling they have no alternative but to expel a child when faced with behavioral challenges exacerbated by the pressures of the pandemic. Soaring rates of early childhood expulsions and their disproportionate negative effects on marginalized communities are testimony to an industry at breaking point. The provision of funding mental health supports such as Early Childhood Mental Health Counseling and resources to early childhood educators is essential if we are to support those most vulnerable in our society.
... IECMH-C has also been associated with decreased levels of concern regarding children's behaviors Reyes & Gilliam, 2021) and increased quality of teacher-child interactions (Virmani et al., 2013). Each of these effects of IECMH-C should theoretically reduce the use of exclusionary discipline, but recent evaluations of consultation as a strategy for reducing expulsions instead show mixed results (Albritton et al., 2019;Gilliam et al., 2016;Hoover et al., 2012;Perry et al., 2008;Reyes & Gilliam, 2021). ...
Early childhood expulsions are a systemic issue in early care and education (ECE) that have negative consequences for children, families, ECE programs, and communities. The Ohio Preschool Expulsion Prevention Partnership (OPEPP) represents one state's attempt to reduce the incidence of early childhood expulsions using infant and early mental health consultation distributed statewide in a hub-and-spoke arrangement. The study merges records from the first four years of OPEPP implementation (N = 569 expulsion prevention referrals) with child care licensing data (N = 3408 ECE programs) and data from the American Community Survey to assess OPEPP's reach in both the hub and spoke regions and identify what program and community characteristics were associated with OPEPP uptake. We found that 16.7 % of center-based ECE programs operating in Ohio between April 2016 and December 2019 participated in OPEPP, but distribution of referrals was uneven, with 36 % of ECE programs in the hub participating but just 10 % of programs outside of the hub doing so. ECE programs with higher quality ratings had greater odds of participating in OPEPP, as did ECE programs outside of the hub area that accepted publicly funded child care reimbursements. The differences in participation rates and predictors of participation between the hub and spoke regions suggest a need to explore how the hub-and-spoke arrangement of OPEPP may need to be adjusted to reach ECE programs outside of the hub region more effectively and have implications for other large-scale early childhood expulsion prevention efforts.
... While school psychologists typically are trained in evidence-based consultation frameworks widely implemented in K-12 contexts, they rarely receive consultation training with early childhood interventionists or families with infants and toddlers (Albritton et al., 2019). Although the literature is limited, evidence suggests that the implementation of evidencebased infant and toddler consultation frameworks is associated with reduction in challenging behaviors (Gilliam et al., 2016;Poole et al., 2012) and improved social skills (Perry et al., 2008), decreased activity levels , decreased expulsion and suspension from early childhood programs (Gilliam, 2005), and teachers' increased use of praise . Moreover, multiple studies have demonstrated that school psychologists and school psychology graduate students can be effective consultants in early childhood settings beyond Part C, such as in Head Start classrooms Poole et al., 2012) and preschool classrooms (Sheridan et al., 2006). ...
... The program itself starts with children of age 2 to 3 years old, and the program is about a year to a year and a half long. According to Todd (2016) and Gilliam (2016), toddlers of age 3 are a critical age to interact with the concept of race and ethnicity, and that children expressed bias around the age of 4 to 5 years old. ...
Problem Statement: The current education structure has many issues, and one of the prevalent yet serious issues is the negative influences on preschoolers' development, with a wide variety of educational programs available, there should be program(s) that helps to reduce any negative impacts on child's growth as well as to create a practical structure and system for the children's family and school. Problem Description: There are various pedagogy and schooling emerge based on preschoolers' race, family background, and status, the education settings and environments can also vary such as urban and suburban, many research also pointed out that it is often People of color receive unequal treatment when they encounter in systems "like health care and education and also have less access to high-quality education and health services, economic opportunities, and pathways to wealth accumulation. All of these reflect ways in which the legacy of structural racism in the U.S. has created conditions that disproportionately undermine the health and development of children and families of color." (Developing Child, 2022) Developmental Association: Recent research has been investigating racial bias, and its relationship with schooling as well as other systems, and it has been found that "when focusing primarily on children of color-Black children and children who are members of the global majority-due to the disproportionate impact of social position factors (e.g., race, gender, ethnicity) and social stratification mechanisms (e.g., racism, oppression, discrimination) on development. In addition, children of color have developmental outcomes that are more often negatively affected by these factors and mechanisms" (García Coll et al., 1996). With disadvantaged starts and constant experiencing stressful responses, Black preschoolers often undergo high levels of pressure and anxiety, this not only influences their overall development such as language and literacy learning, cognitive development, and critical thinking, but it also has impacts on their health both mentally and physically. Situate the Problem: Stakeholder Identification: With racial bias as the principal issue, several stakeholders are influenced and affected by this problem. There are three main stakeholder groups that I should focus on, which are the children, specifically the preschoolers of all gender and ethnicity, the parents, and the school educators or teachers. I also need to consider including the people who are currently working to address this problem, such as policymakers, researchers, and professionals. Population Description: With the preschoolers in focus, we need to include all children aged from 1 to 5 years old, especially with children that experienced being sent home for behavior issues. For parents, we need to include all parents, such as single-parent households, and same-sex parents households. For educators or teachers, some research has pointed out that not all teachers were trained to facilitate children's social-emotional growth and other development, on top of that, with misinformation or inadequate tools, it is more likely the teachers or educators are experiencing breakdowns. Background:
... Sources of support might include instructional, technology, or emotional support from school administrators or districts [23,83]. Time spent in reflective supervision provided by school psychologists, mental health consultants, or social workers may protect teachers against stressors' adverse effects [89,90,91]. These characteristics or benefits may help reduce teacher stress and also potentially improve teacher physiological health. ...
... Sources of support might include instructional, technology, or emotional support from school administrators or districts [23,83]. Time spent in reflective supervision provided by school psychologists, mental health consultants, or social workers may protect teachers against stressors' adverse effects [89,90,91]. These characteristics or benefits may help reduce teacher stress and also potentially improve teacher physiological health. ...
... Specialized trainings include a wide range of activities such as workshops, conferences, video presentations, discussions, and tutorials that are meant to provide information that will impact educators' practices. Coaching and consultation practices involve an individual educator partnering with a coach or consultant to improve skills and practices through observations, reflections, problem-solving, goal-setting, and feedback (Artman-Meeker et al., 2015;Brennan et al., 2008;Elk & Page et al., 2019;Fuchs & Fuchs, 1989;Gilliam et al., 2016a;Sheridan et al., 2006;Snyder et al., 2015;Shannon et al., 2021). Typically, coaching directly targets the implementation of specific practices or interventions, while consultation aims to address a concern or goal determined collaboratively with the intent of building the capacity of educators and programs (Brennan et al., 2008;Sheridan et al., 2009;Snyder et al., 2015). ...
Unlabelled:
Early childhood educators are expected to provide the children in their centers high-quality care and preparation for later school success. At the same time, nearly a third of children enter early care and education settings displaying challenging behaviors, which in turn impacts educators' stress levels and wellbeing. It is then unsurprising that classroom management and providing behavioral supports are consistently identified as areas where educators require further training upon entering the workforce. The purpose of this study is to conduct a systematic review of the empirical literature on professional development (PD) approaches targeting these areas for early childhood professionals. Forty-two studies were identified as meeting inclusion criteria and were coded for strategies targeted, the context and characteristics of the PD series, and the research design and outcomes utilized. Findings revealed that studies were highly variable in terms of targeted strategies, format of administration, training dose, research design, educator and child samples, and reporting practices. The majority of studies were conducted with educators from Head Start and public preschools and utilized research staff in the administration of the PD approaches. This indicates a need for more high-quality empirical evidence on PD approaches that cater to the larger early childhood workforce and centers' needs. Implications for researchers and early childhood mental health professionals and administrators are discussed.
Supplementary information:
The online version contains supplementary material available at 10.1007/s12310-022-09562-x.
... Distinguishing features of IECMH consultation include (a) a developmental framework focusing on the socioemotional experience of young children (e.g., the meaning of behavior in communicating child needs); (b) core concepts related to the developmental impact of trauma on mental health; and (c) equity principles addressing the diversity of familial and cultural influences on child functioning (Cohen & Kauffman, 2005;Mondi & Carlson, 2019). Previous work has linked IECMH consultation in ECE settings to reduced rates of child behavior problems (Conners-Burrow et al., 2012;Gilliam et al., 2016;Perry et al., 2008Perry et al., , 2010Upshur et al., 2009), increased child socioemotional skills (Conners-Burrow et al., 2012;Perry et al., 2008;Reyes & Gilliam, 2021), increased satisfaction and perceived self-efficacy among staff (Brennan et al., 2008;Conners-Burrow et al., 2012;Heller et al., 2011), higher quality interactions between children and staff (Virmani et al., 2013;Brennan et al., 2008;Conners-Burrow et al., 2012Heller et al., 2012), and lower rates of child suspension and expulsion Upshur et al., 2009). ...
Previous research has underscored a need to understand the experiences and decision‐making processes that contribute to suspension and expulsion in early care and education settings, particularly among young children of color. The present study conducted qualitative interviews with 20 center‐ and family‐based childcare providers from the Minnesota Early Care and Education (MECE) study. Participants were asked about challenging child behaviors that they have encountered, their perceptions of these behaviors and how they manage them, and their thought processes around suspension and expulsion. Overall, the most frequently reported categories of challenging behaviors were physical aggression and noncompliance/defiance/arguing. The most commonly reported perceived causes of challenging behaviors were typical child development and parenting problems. The primary reported strategy for addressing challenging behaviors was connecting with the child, with relatively few providers reporting using other evidence‐based strategies. Finally, the most commonly reported reasons for considering suspension or expulsion were the providers feeling they had exhausted options and could not meet the child's needs, and the child's behavior being perceived as dangerous to self or others. Implications for future research and practice (including increased support services for childcare providers) are discussed.
... Infant and Early Childhood Mental Health Consultation (IECMHC) is an effective strategy to support childcare centers in promoting the positive social-emotional development that is vital for children's growth (Albritton et al., 2018;Gilliam et al., 2016;Upshur et al., 2009). IECMHC is a multifaceted approach (program-, classroom-, and childlevel consultations) in which IECMH Consultants build program directors' and classroom teachers' capacity to effectively address children's social and emotional needs through positive and supportive interactions in early childcare and education settings (Duran et al., 2009). ...
IECMHC can and should be a vehicle that promotes greater equity in access to high quality relationships within an early classroom environment. It is important to consider consultation through a racial equity lens to ensure that it is integrated in all levels of work. The goal of the study was to replicate the results from other IECMHC programs with a diverse, largely Latinx, population. The Jump Start program was given the unique opportunity to adapt the Georgetown Framework of Infant and Early Childhood Mental Health Consultation to a multicultural population in Miami. A total of 88 early learning programs and 244 teachers participated. Services were provided in English, Spanish, and Creole at the program- and classroom-level. Pre- and post-data were collected at both levels. Significant improvements at the program- and classroom-level were found post-consultation. Consultants demonstrated fidelity to core program practices while providing culturally and linguistically competent service. The current study replicated findings regarding the effectiveness of IECMHC while expanding results to a diverse metropolitan community. Key features of program success may be attributed to the use of highly trained consultants, action planning, fidelity monitoring, and enrollment of programs that were ready and have a champion for IECMHC.
... Dufrene et al. (2012) reported an Early Childhood Mental Health Consultation (ECHMC) intervention involving routine classroom activities improved teacher-child relationships through an increased rate of teacher praise and effective instruction. In a randomized control trial study, Gilliam et al. (2016) noted lower rates of hyperactivity, restlessness, externalizing behavior, and problem behavior for children receiving the ECMHC intervention compared to those in waitlist control classrooms. ...
This study evaluates a consultation coaching model aimed to improve positive-learning environment practices and teachers’ instructional style and affect in early childhood (EC) classrooms. Teachers in 15 EC classrooms participated as consultees. The consultative coaches received training that included learning (a) specific content based on evidence-based practices in positive and preventative classroom strategies, (b) coaching practices, and (c) implementation processes. Consultative coaching targeting research-based Tier I positive support environments and instructional social-emotional learning strategies occurred over an 8-week period, and included baseline and ongoing observations, feedback, and joint planning with the EC teachers. Observations using multiple measures examined the influence of coaching. Pre- to post-consultation data suggest this model holds potential for (a) increasing positive, preventative classroom qualities and (b) fostering positive change in teachers’ instruction. Implications and future directions for an efficacy trial to confirm causal hypotheses regarding the role of consultative coaching practices in EC classrooms are addressed.
... Mental health consultants use classroom observation, case and group consultation, training, and linkages to community services. Studies on IECMHC show improvements in children's social and emotional skills and classroom quality and reductions in challenging behaviors, suspensions and expulsions, provider stress, burnout, and turnover (Brennan et al., 2008;Gilliam et al., 2016;Perry et al., 2009). ...
Exposure to severe, chronic, and cumulative adversity during sensitive periods of development such as early childhood places children at immediate risk of harm and has been linked to many of the most common physical and mental health problems later in adulthood. However, recent advances in neuroscience, developmental psychology, social work, and related fields demonstrate that early childhood is also a period of great opportunity for promoting resilience in development, as early life experiences have a strong influence on young children’s brain development, gene expression, social and emotional well-being, and learning. This chapter provides an overview of resilience theory and related frameworks for understanding competence in the face of adversity and provides examples of evidence-based interventions and protective factors that are aligned with this approach. Extrapolating from the scientific literature to date, we discuss implications for nurturing resilience among young children and their families and related implications for policymakers, practitioners, and researchers. Finally, we consider next steps for growth in the field.
... IECMHC's positive outcomes include improved teacher-rated child behavior and classroom climate, increases in teacher-reported developmentally appropriate knowledge, enhanced teacher-child relationships, increased teacher job satisfaction and reduced stress (Brennan et al., 2008;Conners-Burrow et al., 2013;D.F. Perry et al., 2010;Gilliam, 2007;Gilliam et al., 2016;Gilliam & Shahar, 2006). IECMHC has been linked with reduced preschool suspension and expulsion rates (D. ...
Infant and early childhood mental health consultation (IECMHC) is a national model with proven positive outcomes for children, teachers and classrooms, as well as effectively addressing racial inequity in preschool suspension and expulsion rates. This paper discusses recent efforts in the Maryland IECMHC program to deeply and systematically address equity and increase consultant capacity to understand and address racial inequity within early childhood settings.
The use of Infant and Early Childhood Mental Health Consultation (IECMHC) has grown dramatically over the past decade to support the skills and reflective capacity of adults who care for infants and young children birth to kindergarten entry. Research to date has shown promise for IECMHC to support children's social and emotional development. However, there is a gap in the published research that articulates how fidelity to a specific statewide IECMHC model impacts desired outcomes for adult caregivers or the infants and children they serve. This article, which articulates the process that Colorado used to develop its own IECMHC model, is the first step in filling this gap in the research. The step‐by‐step approach to model development can be used by other states undertaking similar efforts to create models that are geared toward a variety of settings, such as early education, home visitation, or health care. Colorado is beginning statewide implementation of the model that resulted from this process and will soon start evaluating the fidelity of that implementation. This process creates the groundwork for ultimately tying implementation of an articulated IECMHC model to outcomes for adults and the infants and children they care for.
Background
Early childhood experiences have a significant influence on children’s cognitive, social, emotional and physical development, making them crucial for their overall development. It has been suggested that early childhood education (ECE) is an essential intervention to improve certain developmental parameters. Although research on the advantages of ECE on social and cognitive domains is already available, more research is needed to determine how ECE affects certain developmental outcomes such as motor function, linguistic ability, emotional reactivity, cognitive function and body mass index (BMI) Z -scores. This systematic review and meta-analysis aim to evaluate the impact of ECE on various child development outcomes.
Materials and Methods
Following PRISMA guidelines, we performed an exhaustive search across PubMed, Scopus, Web of Science and Cochrane Library databases to identify randomised controlled trials (RCTs) that assess the effectiveness of ECE on child development outcomes. Six RCTs were ultimately included in our analysis. Data extraction and quality assessment were conducted meticulously, with the ROB2 tool utilised to ascertain the risk of bias in the studies.
Results
Our meta-analysis integrated data from 1595 participants across the included studies. The results revealed a significant improvement in motor function, with a pooled mean difference (MD) of 1.47 (95% confidence interval [CI]: 0.29–2.65, P = 0.01), and language ability, with a pooled MD of 1.27 (95% CI: 0.03–2.52, P = 0.04). Emotional reactivity also showed significant enhancement, with a pooled MD of 0.19 (95% CI: 0.06–0.32, P = 0.004). Cognitive function improvements were significant, with a pooled MD of 2.58 (95% CI: 1.0–4.16, P = 0.001). However, changes in BMI Z -scores were not statistically significant, with a pooled MD of − 0.01 (95% CI: −0.19–0.17, P = 0.91).
Conclusion
The systematic review and meta-analysis demonstrate that ECE significantly benefits motor function, language ability, emotional reactivity and cognitive function in children, with no discernible impact on BMI Z-scores. These findings confirm the value of ECE in supporting early developmental milestones, underscoring the need for integrating high-quality ECE programmes into early childhood policy and practice.
The present study validated a newly developed easy‐to‐use observational instrument, the Health Environment Rating Scale‐Early Childhood Consultation‐Classroom version (HERS‐ECC‐C), to measure the quality of the classroom environment within early care and education centers participating in a mental health consultation program in a diverse area of the southeastern United States. Using a confirmatory factor analysis, three factors emerged capturing critical aspects of a high‐quality classroom environment and demonstrated good reliability: (1) Supportive Practices, Positive Socioemotional Practices, and Classroom Management ( α = .88), (2) Health and Family Communication ( α = .79), and (3) Individualizing to Children's Needs ( α = .80). Criterion‐related validity was established through concurrent associations between the three HERS‐ECC‐C subscales and the domains of the Classroom Assessment Scoring System (CLASS) and predictive associations with the Childcare Worker Job Stress Inventory. The HERS‐ECC‐C Supportive Practices and Health and Family Communication subscales were associated with all three CLASS domains, and the Individualizing to Children's Needs subscale was associated with the CLASS Instructional support domain. Higher HERS‐ECC‐C subscale scores were associated with lower teacher‐reported job stress. Findings provide initial evidence to support the use and continued development of the HERS‐ECC‐C as a tool to evaluate programs and classrooms engaged in mental health consultation professional development interventions.
Infant and early childhood mental health consultation (IECMHC) in early care and education (ECE) settings is a promising approach to support young children. Although research on the effects of IECMHC is encouraging, it is limited by the complexities of the systems in which IECMHC is implemented and the variability in IECMHC models. The current study aims to clearly articulate a statewide, child‐focused, short‐term IECMHC model, assess consultee satisfaction, examine the effects of consultation on children's functioning in the school and home settings, and evaluate changes in teacher perceptions associated with expulsion risk following consultation. In total, 268 children ages 1–5 (69% White, 75% male) and their family and school caregivers participated in consultation in a New England state, and 95 children and caregivers were included in an evaluation subsample. Of this subsample, teachers and ECE administrators, but not families, indicated significant improvement in children's functioning from referral to end of consultation. There was also a significant decrease in children's risk of expulsion, as measured by teachers’ perceptions associated with expulsion decisions. This study contributes to the IECMHC literature by providing results specific to a child‐focused model of consultation and highlighting the possible role of adult attributions for children in ECE.
Teaching is a stressful profession given teachers’ competing demands. Due to COVID-19, teachers struggle to balance maintaining a safe classroom environment and the traditional child-directed focus of early education. The purpose of this study was to examine the effectiveness of an adaptation of Infant/Early Childhood Mental Health Consultation (IECMHC) on reducing teachers’ stress and examine associations between teacher stress and classroom practices. Measures were collected at baseline (T1) and 6-months post-intervention (T2) using the Childcare Worker Job Stress Inventory, an observational measure of classroom practices (Health Environment Rating Scale), and teacher-child interaction quality (Classroom Assessment Scoring System). Regression analyses revealed that teacher-reported Job Resources were associated with higher Classroom Organization at T2. Findings suggested that providing mental health consultation may be an important first step in improving quality classroom practices, particularly those practices that support children’s social-emotional and behavioral development.
Infant and Early Childhood Mental Health Consultation (IECMHC) is a preventative, capacity‐building intervention in which mental health professionals partner with early childhood professionals to indirectly improve the environments and relationships that young children experience. Prior research has demonstrated that IECMHC is associated with positive outcomes for children, teachers, and classrooms. Over the past decade, IECMHC implementation and research have expanded, warranting an updated review. The current paper provides an update of the IECMHC evidence base. Included studies (n = 16) were systematically gathered, screened, and coded for context, intervention characteristics, methods and measures, outcomes across ecological levels, and alignment with the IDEAS Impact Framework's guiding questions. Our analysis replicates prior reviews, describing the positive impact of IECMHC on outcomes such as child externalizing behavior, teacher self‐efficacy, and teacher‐child interactions. Beyond updating prior reviews, this analysis describes emerging, nuanced findings regarding the mechanisms of change and the differential impact of IECMHC. We augment our review with descriptions of evaluations that did not meet our inclusion criteria (e.g., IECMHC in the home visiting context, unpublished evaluation reports) to provide context for our findings. Finally, we provide policy and practice implications and articulate an agenda for future research.
Young children (birth to age 5) are more likely to be expelled or suspended than school-aged children, but we know comparatively little about the precursors to and prevention of exclusion in early childhood settings. Furthermore, what research has been conducted has not been systematically synthesized to inform policy and funding decisions. The present review seeks to determine how early childhood exclusion is defined and assessed in the academic literature. Studies measuring early childhood suspension or expulsion were systematically gathered and coded for study characteristics, definitions, and measures of exclusionary discipline and disparity, and factors associated with exclusion rates. Results (n = 20) show an accelerating pace of inquiry that attends to multiple levels of the ecological system (children, teachers, and programs) across diverse settings (home-, center-, and school-based care). Additional research that draws on data spanning multiple types of early care and education settings is needed to inform legislation and intervention funding decisions.
Early childhood is a critical period during which children learn to regulate and manage emotions and actions, develop and maintain social relationships, and interact effectively with others (Scott-Little, Kagan, & Frelow, 2006). Children who know how to use appropriate behavioral and emotional strategies and effectively interact with others are more likely to develop positive relationships and be accepted by peers later on (Odom, McConnell, & Brown, 2008). Emotional well-being and competence is one of the key areas of development that goes through significant changes over the early childhood period (Hyson, Copple, & Jones, 2006; Keane & Calkins, 2004), and thus, researchers and practitioners in the field of early care and education add a significant emphasis on this area of development. Early learning guidelines and standards of most states in the United States include the domain of social-emotional development, and early childhood educators regularly assess and document children’s developmental trajectories and progress of emotional competence (Oberle & Schonert-Reichel, 2017; Scott-Little et al., 2006). In this chapter, we describe supports for young children’s emotional well-being and positive behavior, promising strategies and interventions used in early care and education settings, the well-being of early childhood educators1 that impacts children’s emotional competence, and the importance of engaging families in promoting children’s emotional well-being and positive behavior.
The purpose of this exploratory interview study was to examine the perceptions and experiences of 12 teachers related to the suspension and expulsion of preschoolers in private early childhood programs. Thematic and constant comparative methods were used for data analysis. Results indicated that teachers had a range of experiences with suspension, from children being sent out in the hallway temporarily to out-of-school suspensions lasting up to a week. Most participants also had expelled a student because of challenging behavior. Themes that emerged regarding factors that influenced suspension and expulsion decisions were inadequate supports, safety concerns, perceptions of a child’s needs, and discipline policies and procedures. Teachers also discussed supports they had in place, supports that were lacking, and the effect that suspensions and expulsions had on their students and themselves. Implications for research and practice are discussed.
This paper focuses on outcomes for Infant and Early Childhood Mental Health Consultation (IECMHC) provided to early education teachers as part of a tiered statewide expulsion prevention initiative. In a sample of 360 children (83.3% male, 66.6% White, 88.1% with clinically elevated externalizing behavior at baseline) at risk for expulsion, outcomes from consultation are described, including expulsion outcomes and changes in child behavior. Multiple regression was used to explore the role of teacher engagement in the IECMHC process on child-level behavioral outcomes. Of the referred children receiving IECMHC, 3.9% were expelled. From pre- to posttest, teachers reported significant reductions in behavior concerns (both frequency and the perception of the behaviors as “problematic”) and expulsion risk (based on teacher perception of child behavior). Teacher engagement in the IECMHC process was a robust predictor of change in child outcomes, with greater engagement associated with improvements in child behavior problems and prosocial skills.
Every year in the United States, millions of young children under the age of 5 are exposed to potentially traumatic events that threaten their safety, security, and well-being. Decades of scientific research clearly demonstrate the pervasive negative consequences of trauma exposure on young children’s neurocognitive, psychosocial, and physical development, with adverse effects extending into adulthood. In addition, early childhood trauma is now widely recognized as a significant public health concern warranting comprehensive intervention. Federal, state, and private early care and education (ECE) programs serve a large number of the 0 to 5 population and can mitigate the harmful consequences of trauma exposure for children’s health and well-being. The literature on early childhood trauma should guide the creation of policies that strengthen ECE, enabling the delivery of high-quality, equitable, trauma-informed care to young children prior to formal school entry.
Retaining a child at grade level has become increasingly popular, consistent with the emphasis on accountability and standards in elementary education. This article provides a comprehensive review of the research examining the academic and socioemotional outcomes associated with grade retention. Following a brief historical overview of previously published literature reviews, a summary of studies published between 1990 and 1999 is provided. A systematic review and meta-analysis of 20 recent studies includes: outcome variables (i.e., achievement and socioemotional adjustment), age or grade of retained population, matched or controlled for variables in analyses with comparison groups, and the overall conclusion regarding the efficacy of grade retention. Results of recent studies and this meta-analysis are consistent with past literature reviews from the 1970s and 1980s. In addition to a summary of the results, the discussion addresses the disparity between educational practice and converging research regarding grade retention and suggests directions for practice. This review encourages researchers, educational professionals, and legislators to abandon the debate regarding social promotion and grade retention in favor of a more productive course of action in the new millennium.
Mental health services embedded within school systems can create a continuum of integrative care that improves both mental health and educational attainment for children. To strengthen this continuum, and for optimum child development, a reconfiguration of education and mental health systems to aid implementation of evidence-based practice might be needed. Integrative strategies that combine classroom-level and student-level interventions have much potential. A robust research agenda is needed that focuses on system-level implementation and maintenance of interventions over time. Both ethical and scientific justifications exist for integration of mental health and education: integration democratises access to services and, if coupled with use of evidence-based practices, can promote the healthy development of children.
must be able to understand the feelings of others, control their own feelings and behaviors, and get along with their peers and teachers. Children need to be able to cooperate, follow directions, demonstrate self-control, and "pay attention." Unfortunately, many students preschool experiences do not fully support their social and emotional development. This policy brief describes the importance of social and emotional development for children in their earliest years and as they grow older and describes the characteristics of those preschool education programs that best support these aspects of development.
This article focuses on a particular educational context, the school, and how characteristics of the structure and organization of high schools influence students' academic development. The emphasis is on a type of quantitative inquiry called school effects research. It describes a methodology that is most appropriate for conducting studies of school effects in particular and educational contexts in general: hierarchical linear modeling (HLM). Two previously published studies are used as heuristic examples of school effects studies conducted with HLM methods. Both studies use large and nationally representative longitudinal data from the National Education Longitudinal Study of 1988 to explore school effects on learning and its social distribution by student socioeconomic status. Study 1 focuses on the effects of high school size on learning. Study 2 focuses on how teachers' attitudes, taken as a collective property of the social organization of schools, influence both learning and its social distribution. Implications for both policy and research are discussed.
Investigated agreement between mothers, fathers, teachers, and children on equivalent forms of a standardized measure of behavioral and emotional problems. Ninety-eight children, age 13 years, completed the Youth Self-Report (Achenbach, 1991d). Their mothers and fathers completed the Child Behavior Checklist (Achenbach, 1991b), and their teachers completed the Teacher Report Form (Achenbach, 1991c). Children generally reported the most problems and teachers the least. Agreement was highest between mothers and fathers on internalizing and externalizing problems, and lowest for rater pairs involving teachers on internalizing problems. Analyses of a multitrait-multimethod matrix for ratings of internalizing and externalizing problems indicated good convergent validity, large rater effects, and weaker discriminant validity. Conditional probabilities for agreement on deviant and nondeviant scores indicated that ratings by no informant could substitute for those of any other rater. Teacher ratings of externalizing problems were the best predictor of referral for mental health services.
In response to (a) an increasing need to support children with emotional and behavioral challenges in childcare settings and (b) the high rates of expulsion among preschool children, mental health consultation in early childhood settings is becoming an increasingly popular intervention strategy. At the same time, there is little agreement or empirical evidence to help early childhood program managers and other professionals make decisions about the most important characteristics and services that mental health consultants should provide. The current study presents findings from a nationally representative survey of 74 Head Start programs and 655 Head Start directors, staff members, and mental health consultants to use in addressing this gap. Using Hierarchical Linear Modeling (HLM), the authors present results suggesting that the single most important characteristic of mental health consultants is their ability to build positive collaborative relationships with program staff members. The frequency of consultant activities was important, primarily because consultants who provided more frequent services were reported to have more positive relationships with staff members. These results were significant even after controlling for program-level characteristics, such as program size, budget for mental health services, and ratio of consultant hours to number of children.
We sought to quantify the effectiveness of special education services as naturally delivered in U.S. schools. Specifically, we examined whether children receiving special education services displayed (a) greater reading or mathematics skills, (b) more frequent learning-related behaviors, or (c) less frequent externalizing or internalizing problem behaviors than closely matched peers not receiving such services. To do so, we used propensity score matching techniques to analyze data from the Early Childhood Longitudinal-Study Kindergarten Cohort, 1998-1999, a large scale, nationally representative sample of U.S. schoolchildren. Collectively, results indicate that receipt of special education services has either a negative or statistically non-significant impact on children's learning or behavior. However, special education services do yield a small, positive effect on children's learning-related behaviors.
Children with learning disabilities in four types of special education settings were compared in terms of social acceptance, number of friends, quality of relationship with best friends, self-concept, loneliness, depression, social skills, and problem behaviors. Two of the placements (In-Class Support and Resource Room) were for children with mild to moderate learning disabilities and involved between 30 and 90 minutes of special education per school day. The other two placements (Inclusion Class and Self-Contained Special Education Class) were designated for children with severe learning disabilities and involved at least a half-day of special education. Children in the more inclusive placements had more positive social and emotional functioning. Children receiving In-Class Support were more accepted by peers, had higher self-perceptions of mathematics competence, and fewer problem behaviors than children receiving Resource Room Support. Children in Inclusion Classes had more satisfying relationships with their best school friends, were less lonely, and had fewer problem behaviors than children in Self-Contained Special Education Classes.
There has been growing interest in identifying very young children at risk for early and persistent trajectories of antisocial
behavior. This interest has been motivated by several studies on early- versus late-starting antisocial youth (Moffitt, 1993;
Patterson, Capaldi, & Bank, 1991). Several researchers have documented that compared to late starters, who begin delinquent
activity in mid- to late-adolescence, early starters show a more persistent and chronic trajectory of antisocial behavior
extending from middle childhood to adulthood.
Increasing numbers of young children are being expelled from child care settings because of their problem behavior. Access
to mental health consultation is related to lower rates of expulsion, but additional data are needed to document the pathways
through which mental health consultation reduces the risk of expulsion. We report on outcomes from a 4-year project designed
to reduce the number of children expelled for problem behavior in a large suburban county in Maryland. Two master’s-level
professionals provided behavioral consultation to child care providers who identified nearly 200 children at imminent risk
for expulsion. Child care providers rated children’s social skills and problem behaviors at referral and discharge using the
Preschool Kindergarten Behavior Scales and the Brief Infant Toddler Social Emotional Assessment. Statistically significant
increases in social skills and reductions in problem behaviors were seen for children who received individualized consultation.
More than three-quarters of the children who were at risk for expulsion were able to be maintained in their current child
care placement; of those that changed placements, only half (n=13) were removed involuntarily. These findings provide additional support for mental health consultation as a promising
strategy to reduce the risk for expulsion for young children with problem behaviors.
Posted 3/30/2001. The authors reviewed scores of primary prevention programs to identify preventive interventions that had undergone quasi-experimental or randomized trials and been found to reduce symptoms of psychopathology (aggression, depression, or anxiety) or factors commonly associated with an increased risk for later mental disorders. In this review, the authors identify and describe 34 universal and targeted interventions that have demonstrated positive outcomes under rigorous evaluation. The authors go on to examine common characteristics of successful prevention programs and make recommendations based on these characteristics for policy and practice in school- and community-based prevention of childhood psychopathology. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
The present study evaluated the efficacy of a multicomponent, classroom-based intervention in reducing preschoolers' behavior problems. The Chicago School Readiness Project model was implemented in 35 Head Start classrooms using a clustered-randomized controlled trial design. Results indicate significant treatment effects (ds = 0.53-0.89) for teacher-reported and independent observations of children's internalizing and externalizing behavior problems. Moreover, there was some evidence for the moderating role of child gender, race/ethnic group membership, and exposure to poverty-related risk, with stronger effects of intervention for some groups of children than for others. Findings contribute to a growing area of research on poverty and preventive intervention in early childhood.
Although comorbidity with specific learning disabilities is less frequent than commonly reported, externalizing behavior disorders--particularly attention-deficit hyperactivity disorder (ADHD)--often overlap with various indices of academic underachievement during childhood. Furthermore, by adolescence, delinquency is clearly associated with school failure. Because the link between behavioral and learning problems often appears before formal schooling, and because the co-morbid problems predict a negative course, early intervention is a necessity. Controlled treatment investigations with youngsters who show these combined problems are rare, and such studies present a host of methodologic and practical problems. I discuss issues surrounding multimodality treatment programs and the potential for long-term interventions to break cycles of school failure and externalizing behavior.
Programs to reduce or prevent juvenile delinquency have been generally unsuccessful. Apparently the risk factors that make a child prone to delinquency are based in too many systems--including the individual, the family, and community networks--to make isolated treatment methods effective. Surprisingly, longitudinal studies of some early childhood intervention programs suggest they may help to reduce future delinquency. These programs take an ecological approach to enhancing child development by attempting to promote overall social competence in the many systems impacting on children. Not engaging in criminal acts is one indicator of competence that is related to others, such as being successful in school and in personal relationships. Evaluators must gather more data to confirm this unanticipated benefit of comprehensive interventions.
The aim of the current study was to examine the effects of early childhood mental health consultation (ECMHC) on teacher-level and child-level outcomes in the context of a partnership between community mental health centers in three regions of Arkansas and publically funded early education programs (14 intervention sites and 4 comparison sites). From 2005 to 2008, 193 teachers participated in the study, along with 1,448 children. Data-collection activities included structured classroom observations, teacher ratings of children's strengths and behavior, and teacher surveys to assess satisfaction with ECMHC services. Results suggest that teachers were highly satisfied with the consultation services and that teachers receiving the intervention had lower levels of permissiveness and detachment, with a trend toward higher levels of sensitivity in interactions with children in their classroom. In terms of child outcomes, we found that by the third year of the project, children at intervention sites were rated by their teachers as having fewer behavior problems and more protective factors.
Early childhood mental health consultation (ECMHC) has become a common approach to delivering mental health services and supports for young children, their families, and the early care and education community. While many states and communities are implementing some form of ECMHC, the evidence base is still developing. One obstacle to building a rigorous evidence base has been a lack of focus on fidelity measurement, and one barrier to fidelity assessment has been a lack of a common framework for the essential components of effective ECMHC. This article briefly summarizes the development of a conceptual model for effective ECMHC based on a qualitative study of six ECMHC programs with positive outcomes (F. Duran et al., 2009 ). The common components and processes derived from those six programs are then used to articulate an approach for operationalizing fidelity. Specific examples of strategies used to support fidelity by three of the six programs are highlighted. We close with a discussion of the implications of these approaches and suggestions for next steps in defining a consensus‐based model for measuring fidelity to ECMHC services.
Abstracts translated in Spanish, French, German, and Japanese can be found on the abstract page of each article on Wiley Online Library at http://wileyonlinelibrary.com/journal/imhj .
The present study sought to examine whether preschool children's emotion regulation, problem behaviors, and kindergarten behavioral self-regulation in the classroom were predictors of kindergarten achievement scores. The children (N = 122, 47% male and 63% European American) who were participating in an ongoing longitudinal study, were seen at both a preschool and kindergarten assessment. The present study examined the relation between parent report, teacher report, and laboratory measures of regulation and children's achievement test scores. Children's emotion regulation and behavioral self-regulation in the classroom were related to all measures of achievement. The relation between preschool emotion regulation and kindergarten achievement was mediated by behavioral self-regulation in the kindergarten classroom. In addition, all measures of regulation were correlated, suggesting that some children who have difficulty regulating their behavior in one setting (such as home) may also have difficulty with regulation in other settings (such as school).
Research Findings: Early childhood mental health consultation aims to reduce problem behaviors and improve social skills in young children primarily through changes in the classroom environment and teacher practices. We conducted a systematic review of the literature and identified 14 rigorous studies that reported on child-level outcomes. These studies had at least one of the following characteristics: publication in a peer-reviewed journal, use of a randomized control trial design, or inclusion of a comparison group. Across these studies, there was variation in the approaches to consultation, qualifications of the consultants, and intensity of the services provided. Overall, early childhood mental health consultation services were consistently associated with reductions in teacher-reported externalizing behaviors. Findings related to reductions in internalizing behaviors were mixed. Teacher ratings of prosocial behaviors were improved in the majority of the studies that reported on this domain. Practice or Policy: This research synthesis underscores the importance of documenting the specific approaches to early childhood mental health consultation that are being implemented to allow for replication of effective models. Areas for future research improvement include increasing rigor through studies that contain independent assessments of children's behaviors, isolating key components of effective consultation, and identifying consultant qualifications and characteristics that lead to child behavior changes.
A growing number of children are entering kindergarten without the skills that enable them to be successful in an academic setting. However, it is not children's cognitive skills that concern educators; it is their social and emotional skill deficits that are most troublesome. This article discusses how family and community risk factors can inhibit social and emotional development (i.e., skills that children need to control their behavior in the classroom) in young children, discusses how relationships provide the foundation for social-emotional skill development, and highlights a number of strategies and programs that educators and policymakers need to be aware of in order to help children who are headed toward a trajectory of school failure because of their social and emotional skill deficits.
Rates and predictors of preschool expulsion and suspension were examined in a randomly selected sample of Massachusetts preschool teachers (N = 119). During a 12-month period, 39% of teachers reported expelling at least one child, and 15% reported suspending. The preschool expulsion rate was 27.42 per 1000 enrollees, more than 34 times the Massachusetts K-12 rate and more than 13 times the national K-12 rate. Suspension rates for preschoolers were less than that for K-12. Larger classes, higher proportion of 3-year-olds in the class, and elevated teacher job stress predicted increased likelihood of expulsion. Location in a school or Head Start and teachers' positive feelings of job satisfaction predicted decreased likelihood of expulsion. Expulsion was relatively rare in classes where both class size and teacher job stress were low. A higher proportion of Latino children in the class and lower teacher job satisfaction predicted an increased likelihood of suspension. Implications are discussed regarding policy, prevention, and future research.
Expulsion is the most severe disciplinary sanction that an educational program can impose. Results are reported from a national study of 3,898 prekindergarten classrooms (81.0% response rate), representing all of the nation's 52 state-funded prekindergarten systems currently operating across 40 states. Weighted results indicated that 10.4% of prekindergarten teachers reported expelling at least one preschooler in the past 12 months, of which 19.9% expelled more than one. Nationally, 6.67 preschoolers were expelled per 1,000 enrolled. Although this rate for state-subsidized prekindergarten is lower than what has been previously reported for child care programs, the prekindergarten expulsion rate is 3.2 times the rate for K-12 students. Rates are reported for each of the states and state prekindergarten systems represented. Significant cross state variability in expulsion rates was found, possibly due in part to differences in how state prekindergarten systems are structured. Rates were highest for older preschoolers and African-Americans, and boys were over 4½ times more likely to be expelled than were girls. Expulsion rates were lowest in classrooms in public schools and Head Start and highest in faith-affiliated centers and for-profit child care. The likelihood of expulsion decreases significantly with access to classroom-based mental health consultation. Although there has been considerable media attention to the issue of young students – kindergarteners and preschoolers – being suspended or expelled from their educational programs, almost no research exists on the topic. As a result, it has been impossible to estimate the number of preschoolers (children ages 3-years to 4-years old) expelled from school or to determine which preschoolers are most at risk for this disciplinary action. As the complete and permanent removal of a student from an entire educational system, expulsion is the most severe disciplinary response that any educational system can impose on a student. Transferring students with behavior problems to other educational settings (e.g., self-contained special education programs, alternative schools, etc.) is not considered expulsion. Rather, expulsion represents a complete cessation of educational services without the benefit of alternative services provided by or through the educational program that has expelled the child. In the case of kindergarten through 12 th grade students in public schools, expulsion is typically the last of a series of disciplinary actions that ultimately culminates in the student being barred from attending any educational programming in that school system. Very little research exis ts on expulsion at any grade level, but the dearth is even more pronounced for children younger than kindergarten. One of the first efforts to collect data on expulsion prior to kindergarten (Grannan, Carlier, & Cole, 1999) was conducted as part of Michigan's Child Care Expulsion Prevention Program, which dispatches mental health consultants to classrooms where children are at immediate risk of expulsion. Surveys were mailed to 127 directors of "preschools and daycare facilities" in the Detroit area. A rate of 27.5 expulsions per 1,000 children enrolled in child care centers was obtained, but the survey suffered from a low response rate of 28%. The first statewide study of expulsion in child care and early education sites was conducted in Massachusetts during the 2001 school year (Gilliam & Shahar, in press). Paper surveys were mailed to a geographically stratified random sample of 185 preschool teachers, of which 64% responded (n = 119). Results indicated that 39% of teachers reported expelling at least one child from her or his class over the previous 12 months. Most of the teachers who reported expelling a child expelled only one child during that time, whereas 25% expelled two or more. When the number of preschoolers expelled was compared to the number of preschoolers enrolled in those classes, an expulsion rate of 27.4 per 1,000 children enrolled was found – a rate nearly identical to that which was previously reported for child care programs in the Detroit, Michigan area. In order to provide a context for this rate, the rate of preschool expulsion was compared to the rate of expulsion in public schools in Massachusetts and across the nation. The rate of expulsion for Massachusetts preschoolers was more than 34 times the rate of expulsions for children K-12 in Massachusetts (0.80 expulsions per 1,000 students) and more than 13 times the national K-12 rate (2.09 expulsions per 1,000 students).
This succinct and jargon-free introduction to effect sizes gives students and researchers the tools they need to interpret the practical significance of their results. Using a class-tested approach that includes numerous examples and step-by-step exercises, it introduces and explains three of the most important issues relating to the practical significance of research results: the reporting and interpretation of effect sizes (Part I), the analysis of statistical power (Part II), and the meta-analytic pooling of effect size estimates drawn from different studies (Part III). The book concludes with a handy list of recommendations for those actively engaged in or currently preparing research projects.
This study reports the findings of a pilot demonstration project called Together for Kids, which used a mental health consultation model to address the needs of young children with challenging behaviors who are identified in preschool classrooms. The study was conducted in four preschool programs and one Head Start program serving children ages 3–5, including both private-pay families and those using public subsidies. Rates of significant behavior problems as assessed by preschool teachers using a standardized scale were high, with 34% of all children enrolled in preschool classrooms in these sites over a 3-year period identified at-risk of externalizing or internalizing problems. Classroom teachers, as well as individual children and families identified as at-risk, were provided services, including, classroom observation and teacher training, individual child assessment and therapy, family assessment and support, and referrals for other family needs. Analysis of outcomes for 47 children and families with externalizing behavior problems who received individualized consultation, compared to 89 control children, and analysis of outcomes of a matched group of 19 intervention and 19 control children, revealed that the intervention was associated with significant improvements in classroom aggressive and maladaptive behavior, and growth in adaptive behavior. Improvements in child behavior were associated with total hours of individual child services provided, and with improvements in child developmental skills. Significant reductions in the rate of children suspended or terminated from child care programs were also found. Implications for further development of models of early childhood mental health consultation are discussed.
Research on the prevalence, course, and correlates of behavior problems in preschool children was examined. Prospective epidemiological studies and follow-up studies of clinical/high risk samples indicate that serious externalizing problems identified early often persist. Negative, inconsistent parental behavior and high levels of family adversity are associated with the emergence of problems in early childhood and predict their persistence to school age. Studies are examined from a developmental perspective and integrated with research on optimal parent-child relationships. The severity of initial problems and family context are related to different developmental outcomes.
The search for ways to prevent juvenile crime in the United States has become a matter of national urgency, as the incidence of serious offenses continues to rise. Most prevention initiatives focus on late childhood or adolescence. Such initiatives may be missing an important additional opportunity to intervene earlier in children's lives. This review of literature from criminology, psychology, and education shows that there exist key early childhood factors which are associated with later antisocial or delinquent behavior and that early childhood programs which seek to ameliorate the effects of those factors can prevent later antisocial or delinquent behavior. In particular, the review focuses on programs which have demonstrated long-term effects on antisocial behavior or delinquency. These programs have in common a combination of intensive family support and early education services, and effects on a broad range of child and family risk factors for delinquency. Moreover, there is promising evidence of their cost-effectiveness. As one element in a comprehensive plan to address poverty and other environmental causes of crime, programs combining family support with early education show promise in lessening the current devastating impact of delinquency on America's children and families.
This study examined the controversial practice of grade retention and children's academic and behavioral adjustment using data from the Quebec Longitudinal Study of Kindergarten Children. We employed an autoregressive modeling technique to detect the impact of being held back during primary school on subsequent academic performance and behavioral development until age 12 years. The results indicate both a short- and long-term negative influence on academic performance for boys and girls. Children's anxious, inattentive, and disruptive behaviors persisted and, in some cases, worsened after grade retention. These prospective associations were long lasting and more pronounced when grade retention occurred early in primary school. Boys were more vulnerable to the negative influence of grade retention on academic performance and classroom disruptiveness. Disruptive behavior in girls was comparatively less associated with long-term consequences than boys. Nevertheless, girls experienced both short- and long-term academic performance problems in the aftermath of grade retention. Children's prosocial behavior appeared unaffected by grade retention. These results are independent of what would have been expected by the natural course of academic and behavioral development.
The aim of this study was to investigate the toddler and preschool predictors of early peer social preference. Behavioral and social functioning were examined in a sample of children across the toddler and preschool years from parent and teacher observations. Kindergarten social behavior and peer social preference were assessed in the children's kindergarten classrooms using standard sociometric techniques. Results indicated that parent report of toddler externalizing behavior and teacher report of preschool problem behavior, as indexed by aggressive behavior, social skills, and emotional regulation, were predictive of peer liking in kindergarten. However, this relation was mediated by specific behaviors evidenced in the kindergarten classroom. For boys, overt aggression mediated these relations. For girls, sharing and engaging in sneaky behavior in kindergarten mediated the relation between preschool problem behaviors and peer status. These results indicate that specific behaviors displayed in the peer group account for the relation between early problem behavior and peer status. Moreover, these data point to the importance of considering gender when examining developmental trajectories and outcomes.
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