1. Michigan’s Early Childhood Mental Health Services
Sheri Falvay, Michigan Department of Community Health, Mental Health Services to Children and Families

2. Michigan’s Efforts to Support Early Childhood Mental Health
Intervention
Prevention
Promotion

3. Promotion High quality training on social-emotional development
For Child Care Providers and Parents:
MI4C/Child Care Resource and Referral
Michigan State University and
Child Care Expulsion Prevention
All funded with Child Care Development Block Grant Dollars earmarked for 0-3 Quality.

4. Promotion
Collaboration agreement between MI4C, MSU-E and CCEP was developed.
Agreed to use common Social and emotional definition across trainings:
Within the context of one’s family, community and cultural background it is the child’s developing capacity to:
Experience and regulate emotions,
Form secure relationships and
Explore and learn (adapted from 0-3)
Agreed to create an expanded state level social and emotional training committee and to involve all early childhood partners, i.e. Part C, Head Start

5. Promotion Will work on (7) training recommendations :
Use the same definition and source for the topic of temperament.
Provide referral information for all three projects at trainings.
Emphasize the importance of the caregiver’s emotional health.
Emphasize the importance of nurturing, responsive caregiving and the importance of having a primary caregiver.
Use a common source for social-emotional milestones.
Emphasize the importance of true partnerships between parents and caregivers in promoting social-emotional health.

6. Promotion 2. High quality training on social-emotional development
For Front line staff: (IMH, Mental Health consultants, Health workers, etc)
Michigan Association for Infant Mental Health Endorsement

7. Michigan Association for Infant Mental Health Endorsement

8. What is the Value of Endorsement?
Provides a level of assurance to families, agencies and the public at large that the person delivering services meets professional standards.
Provides a pathway for development in the infant and family field for the span of one’s career.
Provides a set of competencies to guide training, service and research.

9. Development of a Professional System
1997, MI-AIMH designed a 4-level framework for an interdisciplinary professional development system to recognize competency:
Infant Family Associate – Level One
Infant Family Specialist – Level Two
Infant Mental Health Specialist – Level Three
Infant Mental Health Mentor – Level Four

10. Framework for Endorsement: Component Parts
MI-AIMH identified the following endorsement criteria to assure best practice outcomes for infants, toddlers & families:
specific educational experiences
work experiences with infant, toddlers & families
competency-based, in-service training experiences
reflective supervision/consultation experiences

11. Additional Criteria for Endorsement
Infant Mental Health Code of Ethics
Reference ratings from 3 professionals
Successful completion of a 3-hour written exam for level 3 & 4 candidates
Membership in an IMH professional organization

12. Steps to Endorsement Inquiry Applications Portfolio preparation
Documentation
Endorsement

13. How is MI Infusing Endorsement?
DCH requiring Level II endorsement by 2009 for all home based staff working in early childhood
DCH, early childhood mental health consultation program (CCEP) requires all staff to be endorsed at Level II.

14. Michigan’s Efforts to Support Early Childhood Mental Health
Intervention
Prevention
Promotion

15. Prevention Early Childhood Mental Health Consultation
Child Care Expulsion Prevention
Started in 1999, the Department of Human Services (DHS) made an interdepartmental agreement with the Michigan Department of Community Health, to establish one Child Care Expulsion Prevention (CCEP) project to support the mental health needs of young children in early care and education settings.
Now- 16 project in 31 counties

16. CCEP’s Goal
“To support families and child care providers in successfully nurturing the social and emotional development of infants, toddlers and young children (0-5) who are in child care.”

17. The Cornerstones Programmatic and child-family centered consultation
Skilled consultants
Reflective supervision
Technical assistance
Evidence-based practice
Collaboration

18. Programmatic Consultation: What Do We Do?
Intake
Observation
Standardized Social and Emotional Assessment of Programs
Planning
Coaching
Build Relationships!

19. CCEP Core Trainings New (3-hour) standardized modules:
Social and Emotional
Development
Challenging Behavior
Conflict Resolution
Caring for the Caregiver

20. CCEP Child/Family Consultation

21. Child-Family Centered Consultation
Referral and Intake
Observation and Assessment
Meetings to Develop Positive Child Guidance Plans and Programmatic Plans to support child
Support for the Family and Provider to Implement Plans
Social-Emotional Trainings
Referrals to Outside Services as Needed
Follow-up Services (optional)

22. Why are Children Referred?
Children are referred for many reasons but most often for;
Aggression (25%)
For example, biting, hitting, swearing, destroying property
Regulatory issues (27%)
For example, Child has difficulty adjusting to changes in routine, does not sleep or rest as needed, has toileting problems or feeding difficulties.
Developmental concerns (23%)
For example, child is clingy, has problems focusing, does not listen to care provider or parent, impulsive, or has problems with play (initiating, maintaining)

23. What Happens with Support? (2007 data)
83% of children referred to CCEP stayed in the program. 92% percent of these children had positive outcomes (17% moved or data was not completed for extenuating circumstances)
56% stayed in the same child care setting with positive results
23% transferred to a more appropriate child care setting with agreement from all involved
13% of children “graduated” on to Kindergarten successfully or with appropriate support services
4% of the children were expelled with no follow up
Another 4% were expelled but received services at a new site from CCEP

24. Skilled Consultants & Reflective Supervision
Master’s Degree in Mental Health Related Field
Level II MI-AIMH Endorsement
Twice Monthly Reflective Supervision

25. State-Level Technical Assistance for CCEP Projects and Others
Quarterly meetings in two regional locations
Monthly Training and Evaluation meetings for administrators of CCEP programs
On-site visits
Statewide and national training
Uniform forms and materials
group

26. Evidence-Based Practice
Devereux Early Childhood Assessment for Infants, Toddlers and Preschoolers
Evaluation!
Data collection (child, care provider, family, and CCEP process)
Case Studies
Control Sample

27. Michigan’s Efforts to Support Early Childhood Mental Health
Intervention
Prevention
Promotion

28. Intervention
Home-based Services for infants-toddlers, young children (0-3, 4-7) and their parents
Infant Mental Health Services
Parent Education
Other CMHSP Services (i.e. respite, case management services, etc.)

29. What is Happening? Revised 0-3 and 4-7 access criteria
Requirement of MIAIMH endorsement for staff working in early childhood services
State level committee charged with researching social and emotional assessments to support eligibility(18 tools researched)
DECA-I/T chosen for piloting
Still researching an adult/child interaction tool

30. What is the DECA-IT?
The Devereux Early Childhood Assessment for Infants and Toddlers (DECA-IT) is a premier instrument for assessing protective factors and screening for potential risks for social and emotional development in very young children 4 weeks to 36 months.
Make sure to emphasize that this is an Assessment.
It is also strengths based. We did not put any negative items on the assessments. If a child does not have strengths in a certain area we know that that particular domain may be at risk so we would plan accordingly.
For example “does the infant engage in eye contact.” If someone scores “Never.” it would show up as a risk.

31. What Protective Factors Does the DECA-IT Measure
What Protective Factors Does the DECA-IT Measure? The Infant Assessment measures: Initiative and Attachment/Relationships The Toddler Assessment measures: Initiative Attachment/Relationships and Self-Regulation
You can mention that there are thousands of within-child pf, but that to have an efficient way to measure them, need to develop an assessment. In our three year development of the assessment of within-child pf, we came up with three categories and we named them Initiative, Self-Regulation and Attachment/Relationships. A National Advisory team made up of infant and toddler experts scanned the items and generated titles for the SE domains.

32. There are two assessments.
What Ages Does it Cover?
There are two assessments.
The Infant assessment covers from 4 weeks up to 18 months- It also has four scoring profiles:
4 weeks to 3 months
3 months up to 6 months
6 months up to 9 months
9 months up to 18 months
The Toddler assessment covers from 18 months to 36 months- It has one scoring profile

33. Is it a Viable Assessment?
The DECA-IT meets or exceeds professional standards of quality in terms of:
Reliability
Validity
The DECA-It had a national standardization sample of 2,185 infants and toddlers from across the U.S.

34. Efforts Towards Universal Use
Part C piloted the use of the DECA-I/T in combination with developmental assessment
Early Head Start has purchased kits for all sites with training to follow
All CCEP sites use the DECA for 0-3 and the Preschool DECA

35. For More Information Please Contact Sheri Falvay at:
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For information on CCEP or the DECA-I/T contact Mary Mackrain at:
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