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Introduction: Early childhood educators continue to need support to build their capacity to promote positive social and emotional development and address challenging behavior when it occurs, without resorting to exclusion. One approach to improve the experiences and outcomes of young children through better support to educators is Early Childhood Mental Health Consultation (ECMHC). ECMHC is an evidence-based intervention that pairs a mental health professional (i.e., "consultant") with early childhood educators to build the capacity of providers to promote inclusion by supporting young children's social and emotional development. Methods: In this paper, we describe a model of ECMHC that combines data-driven action planning and an individualized approach to build educators' capacity to implement social and emotional teaching practices with fidelity. The model begins with in-context classroom observations of child engagement and teaching practices, as well as a teacher-report of child behavior. Based on this observational baseline data, a standardized formula selects a personalized set of social and emotional teaching strategies recommended for the focus of consultation, based on the strengths and challenges of the teacher and child. Strategies included foundational strategies (e.g., fostering strong teacher-child relationships), flexible strategies (e.g., using cues and visuals), and targeted strategies (e.g., supporting problem-solving skills). Consultants and teachers then collaboratively work together to select strategies to focus on in consultation, allowing for flexibility and individualization based on individual teacher and child strengths and challenges. Results: We address the following two aims: (1) examine teaching practices and children's behavior at the beginning of consultation and how these data resulted in different recommended teaching strategies, based on our standardized formula, (2) present three case examples to further illustrate how these data guided consultation to improve social and emotional teaching practices during the 2023 to 2024 school year. We found that this baseline data collection and the subsequent data-driven process for selecting strategies was feasible in that all consultants and teachers served by ECMHC were able to use it. We also found variability in baseline data and the associated ECMHC teaching strategies recommended, suggesting that the measures were sensitive to unique classroom needs and individualized recommended strategies accordingly. Discussion: We discuss how this approach allowed consultants to tailor ECMHC services to the unique strengths and challenges of each child and teacher dyad, while being firmly grounded in empirical research and previously validated assessments. [ABSTRACT FROM AUTHOR]

• Under-resourced families experience high trauma rates, which can affect learning. • TRiEE aimed to build capacity for trauma- and resilience-informed services. • Children in TRiEE centers showed large developmental gains. • Trauma-informed services are important for advancing early education equity. Enhancing access to high-quality early childhood education (ECE) represents one promising pathway toward reducing the disparities in school-related outcomes for children from under-resourced and minoritized communities. In this paper we describe the Trauma- and Resilience-informed Early Enrichment (TRiEE) initiative, an innovative community schools (CS) approach to ECE that was designed to bolster the capacity of public pre-K programs to provide holistic, family-centered, and trauma-informed services. As such, TRiEE features the integration of trained psychiatric social workers (PSWs) into one public school district's set of early education centers (EECs). We hypothesized that this approach to ECE could be positively associated with the acquisition of key skills that are foundational to children's school readiness. Student-level de-identified administrative data, drawn from the Desired Results Developmental Profile (DRDP), was obtained from twenty-four TRiEE-affiliated EECs in a large, urban public school district over the course of three academic years. Results from mixed-effects models showed that students at sites actively implementing TRiEE demonstrated significantly greater rates of improvement in socio-emotional, cognitive, and physical outcomes (all p < 0.05) in comparison to children participating in sites which were not yet actively implementing TRiEE. [ABSTRACT FROM AUTHOR]

IntroductionEarly childhood educators continue to need support to build their capacity to promote positive social and emotional development and address challenging behavior when it occurs, without resorting to exclusion. One approach to improve the experiences and outcomes of young children through better support to educators is Early Childhood Mental Health Consultation (ECMHC). ECMHC is an evidence-based intervention that pairs a mental health professional (i.e., “consultant”) with early childhood educators to build the capacity of providers to promote inclusion by supporting young children's social and emotional development.MethodsIn this paper, we describe a model of ECMHC that combines data-driven action planning and an individualized approach to build educators' capacity to implement social and emotional teaching practices with fidelity. The model begins with in-context classroom observations of child engagement and teaching practices, as well as a teacher-report of child behavior. Based on this observational baseline data, a standardized formula selects a personalized set of social and emotional teaching strategies recommended for the focus of consultation, based on the strengths and challenges of the teacher and child. Strategies included foundational strategies (e.g., fostering strong teacher-child relationships), flexible strategies (e.g., using cues and visuals), and targeted strategies (e.g., supporting problem-solving skills). Consultants and teachers then collaboratively work together to select strategies to focus on in consultation, allowing for flexibility and individualization based on individual teacher and child strengths and challenges.ResultsWe address the following two aims: (1) examine teaching practices and children's behavior at the beginning of consultation and how these data resulted in different recommended teaching strategies, based on our standardized formula, (2) present three case examples to further illustrate how these data guided consultation to improve social and emotional teaching practices during the 2023 to 2024 school year. We found that this baseline data collection and the subsequent data-driven process for selecting strategies was feasible in that all consultants and teachers served by ECMHC were able to use it. We also found variability in baseline data and the associated ECMHC teaching strategies recommended, suggesting that the measures were sensitive to unique classroom needs and individualized recommended strategies accordingly.DiscussionWe discuss how this approach allowed consultants to tailor ECMHC services to the unique strengths and challenges of each child and teacher dyad, while being firmly grounded in empirical research and previously validated assessments.

Early childhood mental health consultation (ECMHC) is a targeted prevention service that aims to build the capacity of early care and education (ECE) professionals and foster supportive environments that promote children’s social–emotional competence and improve mental health and well-being. A key challenge to delivering ECMHC at scale is navigating complex multi-level factors to maximize successful implementation and program benefits at scale. The current study describes the implementation tensions arising during the first year of a pilot ECMHC program conducted in partnership across multiple agencies and a state’s department of education. In the 2021–2022 pilot year, ECMHC was offered as a free service to ECE programs in one large region of Virginia, with the goal of examining feasibility to scale statewide in future years. Consultation was implemented in 45 preschool classrooms across 30 programs. Implementation data were collected using consultation logs and participant surveys, and 20 participants (educators, families, program directors) participated in focus groups. Three implementation tensions are highlighted in this paper: (1) ideal plans versus reality of a new ECMHC roll-out; (2) how to support ECE professionals’ practice as it relates to children’s behavior, without contributing to a deficit view that children need to be “fixed;” and (3) systemic factors in the early childhood field that undermine the implementation and effectiveness of ECMHC. For each tension, we provide context from the larger literature on ECMHC, describe relevant decision points from Virginia’s pilot ECMHC program, and present implementation data to illustrate these tensions in practice. We conclude with reflections on lessons learned that have implications for other ECMHC and SEL intervention scale-up efforts.

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. [ABSTRACT FROM AUTHOR]

Early childhood mental health consultation (ECMHC) has been promoted by the federal government as a promising model for reducing early childhood expulsions and suspensions and is now implemented by numerous states. Despite growing ECMHC proliferation, this study is only the second randomized controlled trial of ECMHC, extending the methodologies of the first to include assessment of effects on random peers. Classrooms were assigned randomly to treatment or waitlist-control condition (n = 51 classrooms, 57 preschool teachers, and 190 preschoolers). Evaluation measures were collected at both pretreatment and posttreatment, following approximately six consultation visits. Classroom and teacher outcomes were evaluated with ordinary least squares regressions, while hierarchical linear modeling was used to evaluate child-level outcomes, accounting for the nested study design. Treatment children (both the target children who prompted the referral for ECMHC and random peers) evidenced significant improvements in social and emotional skills. Promising trend findings were noted for child behavior problem reduction and teacher pedagogical approach and locus of control. No significant effects were found on likelihood of expulsion and classroom mental health climate. This is the first ECMHC to demonstrate effects on nontarget peers in a rigorous randomized controlled trial. Programmatic and methodologic limitations and implications are discussed. [ABSTRACT FROM AUTHOR]

This article presents findings from a qualitative research study exploring child care teachers' experiences receiving early childhood mental health consultation (ECMHC). As an emerging intervention in early childhood education, ECMHC is already yielding promising results, namely in helping teachers better address challenging behaviors in their classroom and promote a more nurturing classroom environment. However, there remains a lack of personal testimony from teachers who receive this intervention. Considering that teachers are the primary focus of most ECMHC interventions, the purpose of this study was to examine child care teachers' personal experiences receiving consultation. Eight child care teachers were interviewed for this study. Results from this study illuminate key interpersonal processes in the development of the consultant–consultee relationship, indicate what teachers consider to be the most helpful components of consultation, and speak to the challenges that teachers experience in consultation. By examining the personal testimony of child care teachers who have received ECMHC services, consultants and researchers can consider ways to expand and improve future implementation of ECMHC. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

ABSTRACT Little research has been done to evaluate the effectiveness of early childhood mental health consultation (ECMHC) in rural, applied settings. In this mixed-methods study, we evaluated an approach to ECMHC used in rural Southwest Kansas with individualized services for childcare providers. Twenty-nine home-based and center-based childcare providers completed measures on provider growth, perceptions of child outcomes, and satisfaction with sessions. In total, 162 data points were collected and analyzed using multilevel growth models. In addition, 16 providers participated in qualitative interviews. Both home-based and center-based providers reported very high satisfaction with consultation sessions which increased with time, although home-based providers showed significantly higher satisfaction than did center-based providers. Provider growth, encompassing personal well-being, scheduling and transitions, connections with parents, and positive discipline strategies increased significantly over time. Child outcomes, encompassing prosocial behavior, resilience, and overall well-being also improved significantly in providers' perception. ECMHC as conducted in Southwest Kansas appears to have a positive effect on childcare providers and the children in their care. [ABSTRACT FROM AUTHOR]

Telephone focus groups offer an alternative to the limitations of traditional face-to-face focus groups for conducting research with rural research participants or those who are unable to meet in a common location. Identified strengths of telephone focus groups include: the ability to engage participants that are geographically dispersed; an opportunity for participants to connect with those who they would unlikely meet otherwise; and the ability to conduct focus groups with a lower cost and increased participation rate. Despite the usefulness of telephone focus groups, this methodology may present challenges with the participation and engagement of focus group members. Using the example of a telephone focus group study of early childhood mental health consultants, this article introduces procedures for overcoming the challenges of telephone focus group participation and engagement, and it analyzes the effectiveness of those procedures for improving the participation and engagement of focus group members. This study provides lessons learned in using telephone focus groups in social work research. [ABSTRACT FROM AUTHOR]