1. Infant Mental Health Consultation in Early Childhood Classrooms
Summers & Chazan-Cohen-Chapter 10

2. What is Happening in Child Care?
Child Care Facts
79% of children 3 yrs old & under are cared for out of their homes
Most children under the age of 3 spend more than 35 hrs a week outside their homes
Child care has ___________ #’s of children w/special needs
Disruptive & challenging behaviors are ______________
PS children are _______________ ________________ than K-12th graders

3. Defining Early Childhood Mental Health Consultation
Early childhood mental health consultation (ECMHC) is emerging an as evidence-based intervention for______________________________________________________________ ___________________________________________________________________________
Over the last decade, the following research and practice guided definition has taken shape:
A problem-solving and capacity-building intervention implemented within a collaborative relationship between a professional consultant with mental health expertise and one or more caregivers, typically an early care and education provider and/or family member. Early childhood mental health consultation aims to build the capacity (improve the ability) of staff, families, programs, and systems to prevent, identify, treat and reduce the impact of mental health problems among children from birth to age 6 and their families. (Adapted from Cohen & Kaufmann, 2000)-

4. Early Childhood Mental Health Consultation
83% (29 states) indicate ECMH services available (and the remaining 17% indicate they are working on implementing it)
In PA, it is _______ “benefit” to _________________ participants…as easy as completing a Request for Services form with the parent’s signature!
Goal of ECMH=___________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ (Cohen & Kauffman, 2000)
ECMH is typically implemented in 3 ways
_________________ consultation (focuses on a specific child to reduce specific challenging behaviors)
_________________ consultation (focuses on the program as a whole—transitions, DAP, management)
a combination of both

5. The Mental Health Consultant…
Can be an ______________________________ _______________ in developing & maintaining classroom environments that promote social & emotional development
Has an understanding of the principles underlying not only mental health, but also ECE & child development
Should be familiar with practical aspects of group care & its impact on development
Must work to become familiar with the context & culture of each setting (i.e. program staff); enters into a partnership with the center
Works _______________________ _____________________________ as a resource & support person; develops a level of comfort, trust, & mutual respect
Helps early childhood educators _____________________ earlier (before serious problems or expulsion occur)
Discovers each teacher’s needs through careful observation & discussion w/that teacher
Strives to __________________ w/the teacher while ___________ the teacher to improve the level of/type of S/E support she provides to the child
Gives the teacher the opportunity & skills to address children’s challenging behaviors; works ________________ with the teacher
____________________________ to the teacher/center to help increase S/E development & decrease challenging behaviors
Has the ability to _________

6. Infant Mental Health Consultation Services
6 general activities are typically used across approaches (Duran & al., 2009)
1. Information gathering
2. Individualized Service Plan (ISP)
3. ISP implementation
4. Early childhood education provider and/or family education
5. Early childhood education provider and/or family emotional support
6. Linkages to services outside of consultation
Central to the consultant’s work is his/her understanding of _________________________ within the center & the relationships that will be formed & potentially altered when the consultant enters the system (Johnston & Brinamen, 2006)
It is the _________ of the consultant’s _____________ that contributes to the effectiveness of early childhood mental health consultation
an ECMH consultant cannot underestimate the importance of the relationship building with the caregivers & families with whom he/she will work with
this is the catalyst for change!

7. Infant Mental Health Consultation Services…cont’d
Information gathering
consultative work is guided by a thorough ____________
in-class observations, interviews, standardized instruments/tools (i.e. ASQ-SE)
*when working w/a specific child, _________________________________
consultants typically spend a majority of their time _______________________in the classroom
Individualized Service Plan (ISP)
also can be called the Action Plan
________________ among ECE providers, the director, parents, & the consultant is the key to successfully determining intervention strategies
at this time, the consultant _________________ to additional community resources/services (EI)
ISP implementation
consultant works closely with the teachers to _________________________________________; specific behavioral resources are provided & implemented
consultant models techniques, observes in classroom, meets with teacher in person or consults over the phone/

8. Infant Mental Health Consultation Services…cont’d
Early childhood education provider and/or family education
several consultation programs have a ___________________ to it
NE Key=offers CSEFEL Module 1 for 6 hours of training/continuing education hours
parent training may occur informally
Early childhood education provider and/or family emotional support
research has shown this emotional support to be __________________________ of ECMH consultation
consultants provide emotional support for the teachers, which results in _____________________ & burnout (Alkon et al., 2003)
ECMH has also been linked to teacher reports of increases in job satisfaction & decreases in teacher turn-over (Alkon et al., 2003)
Linkages to services outside of consultation
consultants can make referrals to other community providers/agencies (family support, early intervention, behavioral health

9. to Early Childhood Mental Health Consultation
____________________=results from confusion regarding what a consultant does & does not do (Duran et al., 2009)
Supervisory staff may lack knowledge & experience with mental health issues and may require training & support in order to provide competent & confident supervision
The ________________________ across levels to clarify goals, roles, responsibilities, & expectations
Centers & staff ______________ to consultation process & __________________ on suggestions
Finding time for staff to meet, finding a space for staff to meet, teachers getting support from director to make & maintain positive changes
The rate & depth of change that occurs in centers in terms of classroom practices as well as teacher’s & children’s behaviors
__________________________________
Consultants & teachers need to set appropriate expectations and ________________________ that often occur over the course of the consultation relationship

10. Research Findings on Early Childhood Mental Health Consultation
Current research focuses on outcomes on 3 levels: ___________________________________
Each level influences the ultimate goal of _______________________________________
Teacher outcomes
Teachers’ ___________________
research shows teachers’ self-efficacy (belief that she had the skills needed to bring about the desired outcome) increased during ECMH consultation/intervention
Teacher _______________
job-related stress-”discomforting reactions to the demands of a position and the lack of control the teacher feels over her work” (Brennan et al, 2009)…JSI tool (Job Stress Inventory)
research shows teachers report feeling less stressed & programs report higher levels of staff wellness after participation in ECMH consultation; also lower levels of burn-out & teacher turn-over
Teacher ______________
research reported positive changes in teacher competence…classroom management abilities & knowledge, instructional skills & knowledge, knowledge of & ability to support child development
Teacher-child _____________________
research has shown that classrooms with higher-quality interpersonal interactions show larger academic & developmental gains at the end of the year (Howe et al., 2008)

11. Research Findings on Early Childhood Mental Health Consultation…cont’d
Underlying goal of ECMH=_____________________________________________________________
Child outcomes
Externalizing & internalizing behavior
2 types of challenging behaviors: externalizing (hyperactivity, aggression, impulsivity) & internalizing (fearful, sad, withdrawn)
These are considered ____________ when _______________________________________________________
Research has shown that ECMH consultation decreases the externalizing behavior as measured by teacher report & child observation (Perry et al., 2010)
Research has shown internalizing behaviors have mixed results, some showing a decrease & others with no change
Social skills
Research shows an improvement in development among children in programs using ECMH consultation
Expulsion
Research shows that centers with access to an ECMH consultant reported lower rates of expulsion compared w/centers who did not have access to ECMHC
Teachers also reported a decrease in children’s challenging behaviors & an increase in their prosocial skills

12. Take Aways…
We know that early childhood mental health consultation is at its best when _______________________________
The most important role of the ECMH consultant is to be a _________________________________ in the ongoing, dynamic process of finding the best in every adult who cares for children, and the best in every child for whom teachers give their time, their energy, and their considerable care