The call for help usually comes from the director of a preschool school or childcare program who has run out of ideas as to how to deal with a child’s disruptive behavior or support a child’s social emotional development. If the problem is serious enough, the child faces expulsion — an outcome that prior to 2006 was likely, but no longer is today. The small team of consultants in Southwestern Pennsylvania that responds to such calls has worked with some 400 children over the last six years and, more often than not, has been able to come up with an effective plan to help them, their parents, and teachers navigate the stormy times so they can remain in class and avoid a setback to their education.
"Our first goal is to prevent expulsion and then work to improve the social and emotional development and quality of life of the child," said Sharon Geibel, who is the director of the Early Childhood Mental Health Consultation program at the University of Pittsburgh Office of Child Development (OCD). "If we can make a change that helps the child and the rest of the class, that’s our gold standard."
The consultation program administered by OCD is part of a statewide Early Childhood Mental Health Consultation initiative that makes consultants available to all state-registered or certified early care and education facilities enrolled in Keystone STARS, Pennsylvania’s program to promote continuous quality improvement in early learning and school- age environments.
Locally, the program staffs the full-time equivalent of two consultants who cover about 2,000 early childhood education programs, facilitating screenings, making observations and providing referrals and intervention plans for children who’ve yet to enter kindergarten in Allegheny, Fayette, Washington, Westmoreland, and Greene counties. Recently, the OCD Policy Initiatives Division began another project to identify and address the social and emotional needs of young homeless children.
Policymakers and practitioners today are more aware of the need to address mental health issues among young children than ever before. Separating early symptoms of serious issues from behaviors typical of early development has always been difficult. Until a few decades ago, preschoolers and infants were considered far less susceptible vulnerable to such things as trauma and grief than older children, if at all. But advances in brain research, other studies, and experiences in early childhood education classrooms suggested otherwise.
OCD’s involvement in early childhood mental health consultation grew from a pilot program funded by The Heinz Endowments to better assess social and behavioral issues among children in early education programs and find ways to address any problems found. At the time, expulsion from preschool programs was on the rise. In fact, the rate at which young children were being expelled from early education programs was rising faster than the expulsion rate found in Pennsylvania’s high schools. And behavioral issues were the most common reason young children were being expelled. Both early behavioral issues and expulsion pose considerable risks to children’s futures, particularly to their academic progress, and improving the socialemotional development of such young children emerged as the focus of the consultation program in Southwestern Pennsylvania and across the Commonwealth. Consultants go to a classroom at the invitation of the director of the early education program the child is enrolled in and with the written permission of the child’s parent or legal guardian.
They spend several hours in the classroom on more than one occasion observing the child and classroom environment. "We not only try to get a sense of the child’s strengths, challenges,and social and emotional development skills," Geibel said, "but also the quality of the environment and the relationships that are going to support this child’s social and emotional development."
Following their observations and talks with teachers and parents, the consultants draft an action plan recommending steps that can be taken in the classroom to support the child’s social and emotional development and help resolve problem behaviors. In some cases, referrals are made for mental health and other services. Collaborating with the adults involved, including the early education director, teacher, and parent or other caregiver, is a key part of the approach. "We start with the child’s strengths," Geibel said. "By the time we are called, people often have forgotten the child has strengths. We want to remind them of that right out of the gate and to put them at ease, particularly parents. If you know the child’s strengths, then you can use the strengths to address the challenges."
State-wide, 73 percent of the children who consultants are asked to help are between the ages of 37 and 60 months and 5 percent of the requests are for children as young as 0-24 months, according to the Pennsylvania Office of Child Development and Early Learning, which funds the program. During the 2011-2012 fiscal year, self-regulation problems were the reason for 49 percent of the requests for consultation services statewide and 30 percent of requests were for aggressive behavior.
Research suggests early childhood mental health consultation is an effective way to promote socialemotional competence in young children who are having difficulty in preschool and other early learning settings. Portland State University researchers found, for example, that children who receive help from consultants show greater improvement in social-emotional development and decreased problem behaviors than children who don’t receive consultation. Teachers report feeling more competent and effective, as well as more sensitive to the needs of children. Early education programs that call in consultants also report benefits, including lower staff turnover and fewer expulsions, according to the study.
In the past year, 58 percent of the cases undertaken by Pennsylvania’s early childhood mental health consultation program cases were closed with positive outcomes, which are defined as a successful referral to another level of service or meeting the goals of the action plan. Another 36 percent of cases were closed for neutral reasons, such as the family moved or the child changed programs or entered kindergarten. Only 1 percent of the children seen by consultants were expelled from their early education program, down from 3.7 percent in 2010-2011.
OCD’s Policy Initiatives Division last year began another project to address the socio-emotional challenges of young children who are homeless or experience other housing instability in Allegheny County.
An estimated 49 percent of the children in homeless shelters throughout the county are under 6 years of age. Some are in early education programs, but many are not. As part of the project, a full-time consultant is assigned to help identify children and address the challenges they face, including finding a stable early education program in which they might thrive. "Our experience from early childhood and mental health consultation led us to think we needed to have a component to be able to have a consultant available to these families," said Geibel. "What we were seeing in terms of instability was that the children who had the most challenges were the children who had instability in their lives. How are you going to develop your sense of self when you are in different places with different people all of the time?"