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Evaluating Early Childhood Mental Health Consultation Evaluation and Expansion in Connecticut

This study evaluates the effectiveness of Early Childhood Mental Health Consultation (ECMHC) in reducing expulsion rates in Connecticut preschools. It explores the services provided by ECMHC and presents the results of three statewide randomized controlled trials.

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Evaluating Early Childhood Mental Health Consultation Evaluation and Expansion in Connecticut

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  1. Walter S. Gilliam, PhD October 27, 2010 The Edward Zigler Center in Child Development and Social Policy Child Study Center Yale University School of Medicine Evaluating Early ChildhoodMental Health Consultation Evaluation and Expansion in Connecticut

  2. The Rationale for ECMHC in CT Expulsion Rates (per 1,000) (1 in 36) (1 in 149) (1 in 476) Gilliam, WS & Shahar, G (2006). Preschool and child care expulsion and suspension: Rates and predictors in one state. Infants and Young Children, 19, 228-245. Gilliam, WS (2005). Prekindergarteners left behind: Expulsion Rates in state prekindergarten programs. FCD Policy Brief, Series No. 3. Available: www.fcd-us.org/resources/resources_show.htm?doc_id=464280

  3. State PreK Expulsion Rates Connecticut 16% of Classrooms 12 Expulsions per 1,000 Enrolled (1 in Every 81 Preschoolers) 7th Highest State in the Nation

  4. Access to Support Associated with Decreased Expulsion Rates Gilliam, WS (2005). Prekindergarteners left behind: Expulsion Rates in state prekindergarten programs. FCD Policy Brief, Series No. 3.

  5. Early Childhood Consultation Partnership • Created in 2002 – Funded by DCF & SDE • Availability: All CT child care & ece programs serving 0- to 5-year olds • Referral-source: child care directors (teachers & parents) • Services: Child/classroom-focused consultation, Teacher training, Home-based component • Consultants: 10-20 MA-level throughout state • Dosage: Brief (3 months), intense (6-8 hrs/wk) • Supervision: Group, Individual, Agency-based

  6. Evaluated in 3 Statewide RCTs • Study #1 (2005-2007) • Preschool (3-4 yo) programs in CT • Study #2 (2008-2010, finishing) • Preschool (3-4 yo) programs in CT • Study #3 (2008-2010, finishing) • Infant/Toddler (0-2 yo) programs in CT • Inclusion: Requesting ECCP; Consenting • Exclusion: Prior ECCP treatment

  7. Sample Sizes

  8. Sample Characteristics

  9. Study 1 Evaluation Measures • Classroom Quality & Interactions • Early Childhood Environment Rating Scale (ECERS-R) • Arnett Caregiver Interaction Scale (CIS) • Teacher Beliefs and Feelings • Parental Modernity Scale • Child Care Worker Job Stress Inventory • Teacher Depression (CES-D) • Child Behavior Problems • Conners Teacher Rating Scale – Long Form (CTRS-LF) • Social Skills Rating System (SSRS)

  10. Study 1 Results (Target Children) (F = 10.68**; d = 0.57) (F = 10.62**; d = 0.51) (F = 4.05*; d = 0.34) (F = 4.33*; d = 0.39)

  11. Study 1 Results (Summary) • Positive Effects on • Teacher-rated Externalizing Behaviors • No Effects on • Non-Externalizing Child Behaviors • Internalizing Behavior Problems • Prosocial Behaviors • Classroom Environment • ECERS-R (all domains) • Arnett Caregiver Interaction Scale (all domains) • Teacher Beliefs and Feelings • Authoritarian Beliefs • Job Stress, Control, and Satisfaction • Depression

  12. Studies 2 & 3 Measures • Classroom Quality & Interactions • Classroom Assessment Scoring System (CLASS) • Preschool Mental Health Climate Scale (PMHCS) • Target Children [+Random Peers] • Conners Teacher Rating Scale – Long Form (CTRS-LF) or Infant-Toddler Social Emotional Assessment (ITSEA) • Social Skills Rating System (SSRS) [+Random Peers] or Brief Infant-Toddler Social Emotional Assessment (BITSEA) • Preschool Social Behavior Scale (PSBS) • Preschool Expulsion Risk Measure (PERM) [+Random Peers] • Time Sampling (Structured Activities & Free Play) • (Relational Aggression, Oppositionality, Disruptive Behavior) • Home-School Collaboration • Family Involvement Questionnaire • Parent Satisfaction with Educational Experiences

  13. Studies 2 & 3 Measures (more details) • Time Sampling • Each -- 30 segments (10 sec on, 10 sec off) • Relational Aggression (Free Play) • Any verbal or nonverbal behavior that (a) excluded others from play or encouraged others to exclude a child or (b) threatened to exclude or ignore. • Oppositionality (Structured Activity) • Includes defiance or refusal to follow adult directions, arguing with adults, and temper outbursts in response to adult directives. • Disruptive Behavior (Structured Activity) • Includes behaviors that are not necessarily in response to adult directions, but are either impulsive, show difficulty sustaining attention or waiting turn, disturbs other children, or displays an emotional or behavioral outburst. • Condition-Blinded Objective Raters

  14. Studies 2 & 3 Measures (more details) • Home-School Collaboration • 11 items, 4-point Likert Scale (rarely-always) • Alpha = .81 • Example items: • “The parent talks to the teacher about how the child gets along with his/her classmates at school.” • “The parent talks to the child’s teacher about the child’s accomplishments.” • “The parent talks with the child’s teacher about personal or family matters.” • (Family Involvement Questionnaire; Fantuzzo, Tighe, & Childs, 2000)

  15. Effect Sizes for Studies 1-3PRELIMINARY Effect Sizes: Trivial, Small, Medium, Large Effect estimates for Studies 2 and 3 are preliminary and based on incomplete data.

  16. Conclusions (so far) • Positive or Likely Positive Effects • Teacher-rated externalizing behaviors in targets (P & I/T) • Observed oppositionality & disruptive behaviors (I/T) • Home-School Collaboration (P & I/T) • Null or Likely Null Effects • Teacher depression and job stress (Study 1 only) • ECERS-R, CLASS (P & I/T) • Too Close to Call at This Time • Teacher-rated externalizing behaviors in random peers (P & I/T) • Not Yet Examined • Preschool Mental Health Climate Scale (PMHCS) • Preschool Expulsion Risk Measure (PERM) • All parent-rated forms

  17. The ECCP Evaluations in Sum • What we have going for us • ECCP is brief and well-defined • ECCP is popular (built-in waitlist controls) • ECCP is stable and well-supported • ECCP is a willing evaluation participant • State support &funding for evaluation • What we have as challenges • Fluid programs (especially infant/toddler) • Need more/better measures (fidelity) • Evaluation funds still shoestring (for RCTs)

  18. Walter S. Gilliam, PhD The Edward Zigler Center in Child Development and Social Policy Child Study Center Yale University School of Medicine 230 South Frontage Road PO Box 207900 New Haven, CT 06520-7900 Phone: 203-785-3384 Email: walter.gilliam@yale.edu For reports, please visit: www.ziglercenter.yale.edu

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