Abstract

1. Behavioral Mental Health Consultative Services in Early Childhood Education Stephanie Marshall, M.S.Ed., Danielle Rubinic, M.S.Ed., Kristin Rezzetano, M.S.Ed., & Kara McGoey, Ph.D. Duquesne University Discussion Abstract Results This poster presentation will focus on the availability and use of behavioral mental health consultative services (BMHCS) in private early childhood education settings. BMHCS promote implementation of systems-level prevention practices. Surveys are used to measure availability and use of services. Results indicated a need for BMHCS including behavioral intervention, play therapy, parent training, and crisis intervention. Session attendees will learn the availability of services, effectiveness of existing services, areas of need, and implications for implementation. Results indicated a strong need for various behavioral mental health services, including counseling, play therapy, and parent training. Specifically, 95% of respondents indicated that play therapy and parent training are the most needed services. Counseling followed with 80% of respondents indicating a need. Early childhood center staff indicated a need for more services for early intervention purposes, with only 30% of respondents indicating visits by a behavioral mental health consultant (BMHC) daily, weekly, or monthly. Furthermore, only 33% of sites had contact information to reach a BMHC when needed. Results indicate that the majority of directors make contact with the BMHC, over either teachers or parents, yet many staff were unsure whose responsibility it was to contact the BMHC. Slightly more than a quarter of staff surveyed (28%) had received general training from a BMHC prior to the study. Of these staff, 14% felt they still could not manage the behaviors independently after consultation had ended. The majority of staff that had received consultation services reported being satisfied with the effectiveness of the consultation. The most common behaviors for which staff would seek help from a BMHC included hyperactivity, stubbornness/oppositionality, excessive anger, and aggression. More covert behaviors such as excessive shyness, unusual crying, trouble toileting, and aches and pains of unknown cause were rarely reported as behaviors of concern. Table I. Needed Services BMHCS are indispensable in promoting implementation of systems-level prevention practices. In early childhood centers, these services help staff and caregivers learn and deliver effective childcare methods efficiently in order to foster appropriate social, emotional, and behavioral growth in children. According to the questionnaires distributed to early childhood centers in the greater Pittsburgh area, it is evident that there is a strong need for BMHCS within early childhood education settings. Specifically, results indicated that there is a significant need for counseling, play therapy, and parent training services above all other options. While a little over half of all the sites surveyed reported receiving regular visits from a BMHC (usually weekly or monthly) and knew where to find their general contact information as a whole, many of the individual staff members within each site were unaware of having a consultant or how to get in touch with them. In addition, despite the fact that almost 30% of all individuals surveyed had some general training on how to work with challenging behaviors from a BMHC, almost one quarter felt that they were still not prepared to handle the behaviors. In terms of specific behaviors exhibited within the early childhood settings, hyperactivity, stubborn or oppositional behavior, excessive anger, and aggression (such as hitting, kicking, and pushing), were the most prevalent. These behaviors were found in the classrooms of 50-70% of all respondents. In addition, when asked if they would seek help from a BMHC on these specific behaviors, a significant amount of staff members indicated that they would, more so than any of the other behaviors listed. These included: excessive shyness, unusual crying, extreme mood swings, extreme immaturity, inadequate self help skills, excessive fears, resistant to being touched, inappropriate sexual actions, lack of age appropriate play, accident prone, excessive tantrums, excessive irritability, self-abusive behavior, trouble toileting, sudden behavior change, prefers to be and play alone, and aches and pains without physical cause. It is clear that BMHCS’s are warranted in early childhood centers and are not available as often as needed in these settings. Early childhood settings should recognize the importance of having a BMHC in their center, and BMHC’s need to make sure they are providing adequate services to address the needs that staff feel are most pressing in their daily experiences with children. Introduction The Former President of the National Association of School Psychologists (NASP), Bill Pfohl, focused the 2005-2006 convention theme on the concept that prevention is an intervention. When applied to early childhood, this assertion suggests that the prevention of academic and behavior problems provides the best opportunity for successful developmental outcomes. Behavioral mental health consultative services (BMHCS) can provide an effective means of implementing systems-level prevention to ensure that the maximum number of early-learners is reached regardless of special education status. However, the consultative needs of local, private childcare providers are not apparent in the literature. Mowder, Unterspan, Knuter, and Goode (1993) found a substantial need for consultation services within Head Start programs., specifically in terms of social-emotional development. However, Head Start Centers have direct access to a mental health consultant whereas private childcare centers do not. In general, early childhood teachers must have the skills to work with children who have challenging behaviors in the preschool setting. Many may lack training or experience in working with young children who present pervasive behavioral or emotional issues (Nelson, 2001). A recent report examined 3,898 prekindergarten classrooms and presented alarming statistics: prekindergarteners are expelled 3.2 times as often as students in kindergarten through 12th grade (Gilliam, 2005). Green, Everhart, Gordon, and Gettman (2006) have asserted that BMHCS are gaining popularity because of the need to support children in childcare settings as well as the need for control over high expulsion rates in preschool settings. Methods References Participants and Setting Surveys were distributed to staff (N = 171) in 15 private early childhood education centers. A total of 80 surveys were returned, resulting in a response rate of 47%. Participants were 96% female and 94% Caucasian (3% African American). In terms of teacher qualifications, 19% of participants held an Early Childhood Certification. Additionally, 25% had obtained at least an associate’s degree, 41% a bachelor’s degree, and 53% a master’s degree. The majority of participants (58%) reported earning $20,000-29,000 per year. The average years of teaching experience per participant was 8.58 years (SD = 7.98 years). Measures The survey was designed by the current researchers to measure the availability and use of BMHCS in private early childhood education centers, as well as educators’ satisfaction with such services they have received. The survey also attempted to identify common challenges faced by early childhood educators regarding difficult behaviors and, subsequently, areas of need. Surveys were presented in multiple choice and Likert-scale formats and took approximately 15 minutes to complete. Gilliam, W. S. (2005). Pre-kindergarteners left behind: Expulsion rates in state pre-kindergarten systems. New Haven, CT: Yale University Child Study Center. Green, B. L., Everhart, M., Gordon, L., & Gettman, M. G. (2006). Characteristics of effective mental health consultation in early childhood settings: Multilevel analysis of a national survey. Topics in Early Childhood Education, 26 (3), 142-152. Mowder,B.A., Unterspan, D., Knuter, L., and Goode, C. (1993). Psychological consultation and Head Start: Data, issues, and implications. Journal of Early Intervention, 17(1), 1-7. Nelson, M. S. (2001). Mental health consultations in the preschool daycare center. Child and Adolescent Psychiatric Clinics of North America, 10, 45-53.