ENHA HANCING T THE S HE SUPPLY O Y OF INFAN ANT T TODDLER C - - PowerPoint PPT Presentation

ENHA HANCING T THE S HE SUPPLY O Y OF INFAN ANT T TODDLER C CARE T THROUG UGH H INFANT A AND D EARLY C CHILDH DHOOD OD MENTAL H HEAL ALTH TH C CONSU SULTATI TION

NICOLA E EDGE E

UNIVERSIT ITY O OF ARKANSAS F FOR OR MED EDIC ICAL L SCIENCES ES

PROJECT PLAY

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Table Discussion

Part 1 In your state, community or program, list the kinds of changes you would like to see in infant-toddler classrooms to enhance quality Part 2 Identify some of the barriers that may be keeping those changes from occurring

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Objecti ctives Provide an Overview of IECMHC Describe the Arkansas Model of IECMHC Share data on effectiveness of ECMHC in raising quality and supporting children

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What is IECMHC?

Teams mental health professionals with child-serving professionals to improve children’s social, emotional and behavioral health and development. Builds the capacity of providers and families to understand the powerful influence of their relationships and interactions on children’s development. Consultants partner to identify and support children with and at risk for mental health challenges as early as possible.

Adapted with permission from Dr. Deborah Perry, Georgetown University

• Project PLAY is Arkansas’ ECMHC program staffed

primarily through partnerships with Community Mental Health Centers

• Services provided by mental health professional certified as

consultant to child care

• Provide system-level consultation to child care and child

welfare systems

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Prog

• grammatic/Classroom
• om

Foc

• cused C

Con

• nsult

ltatio ion

• Consultants work with teachers

to improve the care offered to all children in their classroom by helping to identify attitudes, beliefs and practices and classroom conditions that may be undermining quality relationships between teachers and children.

Classroom Consultation

• 6 month partnership
• Visits once a week
• Serve minimum licensed, quality

rated, state pre-k and Head Start

• Also offer a menu of trainings
• 2010 – prioritized ECMHC for

centers serving foster children

Project PLAY Model

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Programmatic Consultation for Staff and Programs

Classroom observation Strategies for prosocial environment Training on behavior management Support for reflective practices Promote staff wellness Address communication issues Promote team building Training on cultural competence

Adapted with permission from Dr. Deborah Perry, Georgetown University

Child-Specif ific C Con

• nsult

ltation

• When a specific child’s behavior

is of concern to parents or teachers, the Mental Health Consultant helps these adults understand, assess and address the child’s needs by developing an individualized plan with the parents and teachers.

Child Focused Consultation

• 3 month partnership
• Visits once or twice a week
• Offer short-term response plan

and longer-term prevention plan

• Linkage to other services
• Dramatically increased in 2016

Project PLAY Model

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Child- and Family- Centered Consultation

Child observations Program practices Staff support for individual and group behavior management Modeling/coaching Link to community Training on behavior management Modeling ways to support individual child Education on children’s mental health Advocacy for family

Adapted with permission from Dr. Deborah Perry, Georgetown University

What ECMHC “Isn’t”

Formal diagnostic evaluations Therapeutic play groups Individual therapy Family therapy Staff therapy Family support groups

ECE Teacher-Level Outcomes

Gain Skills

• Teaching about

Feelings

• Behavior

Management Improve Quality

• Teacher-Child

Interactions

• Staff

interactions Improve Outcomes

• Reduced staff

stress & turnover

• CLASS Scores

Adapted with permission from Dr. Deborah Perry, Georgetown University

AR Da R Data o

• n I

Improving Quality ty throu

• ugh I

IECMHC

Evaluated impact of ECMHC in 46 centers

• Majority non-participants in quality rating system
• 37% of teachers had an Associate’s degree or

higher

• Teachers had average of 8 years of experience

Later evaluated in context of expulsion prevention initiative

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Improvem ements i in Qual ality i y in AR Classrooms (N=120)

120)

TEACHER- CHILD INTERACTIONS

Sensitivity: becoming more sensitive and positive in interactions Engagement: more engaged in caring for the children Punitive Actions: use of yelling, humiliation or using harsh words. MENTAL HEALTH CLIMATE

Transitions Directions and rules Staff awareness & affect Staff-child interactions Teaching feelings and problem solving Developmentally appropriate practice

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Red educed ed D Disrupti tive B e Beh ehaviors Obser erved ed i in AR Clas assrooms

1 2 3 4

Verbal Aggression Physical Aggression Other Disruptive Behavior

3 4 5 6 7 8 9 10 All Behaviors Problems

before consultation after consultation

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Evidence of Changes in Child- and Family- Level Outcomes

Children’s Behavior Problems Prevent Preschool Suspensions & Expulsions; Improve attachment and resiliency factors Improved Dyadic Relationships Reduce Missed Work Days for Parents

Adapted with permission from Dr. Deborah Perry, Georgetown University

IECMHC t to P

• Prevent Exp

xpuls lsio ion

New policies and supports in AR to reduce suspension and expulsion IECMHC is part of support system

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57% called parent (past month) 9% expelled 43% suspended

• r expelled

2016 AR Survey

2% 3% 15% 36% 38% 6% 0% 5% 10% 15% 20% 25% 30% 35% 40% 1 2 3 4 5 >5

IECMHC REFERRALS BY AGE

“Johnny”

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Child Behavior

• Average child externalizing behaviors were well

above the clinically significant range at pre-test

• The frequency of the behaviors decreased

significantly from pre-post test 160 180 200 Pre-test Post-test

Expulsion Outcomes

67% 2% 5% 10% 10% 6%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Remained in center Expelled Planned transfer Parent withdrew child Child aged

• ut/screened
• ut/moved

Other

Financing

Triage specialists pulled from within various units within DHS/DCCECE Shifted resources to expand ECMHC to several new sites TA and ECMHC funded through CCDF and state pre- k quality improvement dollars

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naedge@uams.edu

PROJECT PLAY

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ProjectPlay.uams.edu