1. Head Start and Mental Health Introduction for MSW Interns and other mental health students

2. Objectives  Develop basic understanding of the Head Start Program and implementation of Mental Health Services  Brief History  Performance Standards  Infant Mental Health  Mental Health Consultation within Early Childhood  PBIS  Screening  Program structure and roles  And resources

3. History  1965- The war on poverty gives birth to a comprehensive preschool program known as Head Start  1972-Performance Standards lie the foundation of the services to be provided by programs

4. Performance Standard 1304.24 (a) Mental Health Services (1)Grantee and delegate agencies must work collaboratively with parents by: (i)Soliciting parental information, observation and concerns about their child’s mental health; (ii) Sharing staff observations of their child and discussing and anticipating with parents their child’s behavior and development including separation and attachment issues; (iii) Discussing and identifying with parents appropriate responses to their child’s behaviors; (iv) Discussing how to strengthen nurturing, supportive environments and relationships in the home and at the program; (v) Helping parents better understand mental health issues; (vi) Supporting parents’ participation in any needed mental health interventions.

5. 1304.24 (cont.) ( 2) Grantee and delegate agencies must secure the services of mental health professionals on a schedule of sufficient frequency to enable the timely and effective identification and intervention in family and staff concerns about a child’s mental health; and (3) Mental health program services must include a regular schedule of on-site mental health consultation involving the mental health professional, program staff, and parents on how to: (i) design and implement program practices responsive to the identified behavioral and mental health concerns of an individual child or group of children (ii) Promote children’s mental wellness by providing group an individual staff and parent education on mental health issues (iii) assist in providing special help for children with atypical behavior or development and (iv) utilize other community mental health resources needed.

6. What is Infant Mental Health? Infant/Early Childhood Mental Health Capacity to experience, regulate and express emotions; Form close and secure interpersonal relationships; and Explore the environment and learn. Synonymous with healthy social and emotional development.

7. What is Mental Health Consultation?  Mental health consultation in early childhood settings is a problem solving and capacity-building intervention implemented within a collaborative relationship between a professional consultant with mental health expertise and one or more individuals with other areas of expertise, primarily child care center staff. Early childhood mental health consultation (ECMHC) 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 birth to age 6 and their families." (Cohen & Kaufmann, 2000, p.4)  now also emphasizes collaboration with families as well as staff

8. Positive Outcomes of ECMHC  Reducing problematic behavior in young children;  Increasing young children's social skills;  Decreasing expulsions from ECE settings;  Building behavior and classroom management skills of ECE providers;  Enhancing parent ability to manage problem behaviors; and  Reducing turnover in ECE staff.

9. Values that are commonly associated with an effective approach to children's mental health services, including ECMHC, are:  All young children deserve to spend their days in a safe, stable, caring, and nurturing environment.  A safe, stable, caring and nurturing environment is crucial to promoting healthy social and emotional growth and resiliency to protect young children from psychological harm, and to create caring conditions conducive to appropriate social and emotional well being.  The quality of the child's many relationships with parents and other important people in their life is critical to positive social and emotional development.  The mental health of a child's parents and caregivers is important in meeting the mental health needs of very young children.  Families are considered to be full participants in all aspects of design, implementation, and evaluation of programs and services for their young children.  Early childhood mental health services are responsive to the cultural, racial, and ethnic differences of the populations that they serve.  Practices build on, promote, and enhance the strengths of the individual, the family, and early care and education staff (Hepburn and Kaufmann, 2005).

10. Consultative Strategies Role is not to “fix” or do for families or staff  Educate  Collaborate  Support implementing strategies  Provide Emotional Support  Facilitate referrals These are ALL relationship based!

11. Early Childhood Mental Health Consultation Tutorials:  Tutorial 1: Strengthening Early Childhood Mental Health Consultation in Head Start and Early Head Start Programs Tutorial 1: Strengthening Early Childhood Mental Health Consultation in Head Start and Early Head Start Programs  Tutorial 2: Defining Early Childhood Mental Health Consultation and the Consultant Role Tutorial 2: Defining Early Childhood Mental Health Consultation and the Consultant Role  Tutorial 3: The Effective Mental Health Consultant Tutorial 3: The Effective Mental Health Consultant  Tutorial 4: Mastering the Consultative Stance Tutorial 4: Mastering the Consultative Stance  Tutorial 5: Partnering with Families in Early Childhood Mental Health Consultation Tutorial 5: Partnering with Families in Early Childhood Mental Health Consultation  Tutorial 6: Recognizing and Supporting the Social and Emotional Health of Young Children Birth to Age Five Tutorial 6: Recognizing and Supporting the Social and Emotional Health of Young Children Birth to Age Five  Tutorial 7: Recognizing and Addressing Trauma in Infants, Young Children, and their Families Tutorial 7: Recognizing and Addressing Trauma in Infants, Young Children, and their Families  Tutorial 8: Developing a Vision and Strategic Planning for Early Childhood Mental Health Consultation Services Tutorial 8: Developing a Vision and Strategic Planning for Early Childhood Mental Health Consultation Services  Tutorial 9: Implementing and Evaluating ECMHC Services Tutorial 9: Implementing and Evaluating ECMHC Services  Tutorial 10: Cultural and Linguistic Competence in Early Childhood Mental Health Consultation Tutorial 10: Cultural and Linguistic Competence in Early Childhood Mental Health Consultation www.ecmhc.org

12. PBIS: Positive Behavior Interventions and Supports Tiered system that supports children’s social emotional development and success

13. Teaching Pyramid  PBIS is based on a hierarchy of needs and interventions as outlined by the Teaching Pyramid from the Center on the Social Emotional Interventions for Early Learning (CSEFEL).  Nurturing and Responsive Relationships and High Quality Supportive Environments.  Targeted Social Emotional Supports.  Intensive Interventions.

14. Program Wide PBIS  Three universal rules  Be Safe  Be Kind  Be Careful with our Things  Monitored system through Mental Health Team to ensure fidelity  Ongoing training and supports  Resources available include books, posters, mascots

15. Mascots  Rocky the Raccoon was created during the PBIS initiative in Rockingham County Head Start. He has become the mascot in the classrooms representing the PBIS program. Staff refer to the 3 classroom expectations as Rocky’s Rules. Each classroom has a Raccoon puppet that is about 3 feet long. He acts as a visual reminder. Some classrooms integrate him into classroom photos.  Tucker is a turtle from the book Tucker Turtle Takes Time to Tuck and Think. The classrooms have a hand sized puppet of Tucker to use with the book or keep in the alone zone as a reminder of the steps to calm down. There are visuals used in the classroom such as the 4 step poster.  Bumble the Bee is the PBIS mascot in Hillsboro county. Classrooms have the finger puppet to utilize in the classroom. The classroom expectations have been termed the 3 Bee Rules (Be Safe, Be Kind, Be Careful with our Things). The visuals of the rules or associated with PBIS have typically included bee images.

16. Screening 1304.20 (b)(1) Screening for developmental, sensory, and behavioral concerns. In collaboration with each child’s parent, and within 45 calendar days of the child’s entry into the program, the program must obtain linguistically and age appropriate screening procedures to identify concerns regarding a child’s developmental, sensory, behavioral, motor, language, social, cognitive, perceptual, and emotional skills.  Ages and Stages Questionnaire: Social Emotional  ASQ:SE addresses seven social-emotional areas: self- regulation, compliance, communication, adaptive behaviors, autonomy, affect, and interaction with people  Screening tool for 3 to 66 months of age  Ages and Stages Questionnaire-3  ASQ-3is a reliable tool for screening infants and young children for developmental delays during the crucial first 5 years of life  developmental screening tool for children 1 month to 66 months

17. Program Options Head Start (3-5 years)  Part-Day Head Start  Part-day program 3 ½ to 4 hours  September to June  Full-Day Head Start  Centers open 7am to 5pm to accommodate working parents  Full Year

18. Program Options Early Head Start (prenatal to 3 years)  Home Based  Weekly home visit with home visitor  Center Based  Full Day, Full Year program for working parents

19. Roles  Center Director  Has responsibility for daily operations of center(s)  Supervises staff within center(s)  Teacher  Early Childhood Education Degree  staff administers Head Start components in a classroom through lesson plans, screening, assessment, etc.  Co-teacher model with 2-3 teachers per classroom  Family Worker  Typically holds a degree in psychology or human service  Maintains communication with families in 1 or 2 classrooms (up to 36 families)  Acts as a resource for all parenting related issues  Liaison between families and teachers  Maintains child’s file

20. Roles  Home Visitor  Early Childhood Education  Working in a family coaching style to promote child development in the home  Responsible for family worker tasks as well  Assistant Teachers  Early Childhood Education credits or degree  Support classrooms through direct interactions and maintaining routines  Are not responsible for documentation on a regular basis  Float

21. Management Structure  Child Development Director  Supervises Content Specialists and oversees the Head Start and Early Head Start program (and Child Care Resource and Referral)  Operations Manager  Supervises Center Directors  Works in collaboration with the Child Development Director to oversee the function of the program  Fiscal and Administrative Support Specialist  Supervises Billing Clerk

22. Specialists  Health and Nutrition Specialist  Registered Dietician  Responsible for promoting and implementation of Health and Nutrition Content  Supervises the Health Coordinator and Food Service Coordinator  Early Childhood Specialists  Responsible for promoting and implementation of Education and Disability Content  Hiring, training, and technical support for teaching staff  Support for children with disabilities including tracking IFSP and IEP and supporting staff

23. Specialists  Family Service Specialist  Responsible for promoting and implementation of Family Service Content  Supervises Bilingual Support Specialist and ERSEA Coordinator  Hiring, training, and technical support for family service staff  Family Engagement Specialist  Responsible for promoting and implementation of Family Engagement Content  Supports program initiatives to increase family engagement (Good Guys, Read-s-thons, etc.)  Monitors In-Kind

24. Mental Health Content Specialist  Social Emotional Support Specialist  Responsible for promoting and implementation of Mental Health Content  Provides Mental Health Consultation to families and staff  Licensed Social Worker  Responsible for promoting and implementation of Mental Health Content  Provides Mental Health Consultation to families and staff  Supervises MSW interns  Meets the HS performance standard for Mental Health Professional

25. Resources http://snhschilddevelopment.weebly.com Program website for staff www.csefel.vanderbilt.edu The Center on the Social Emotional Foundation for Early Learning www.ecmhc.org Early Childhood Mental Health Consultation www.challengingbehavior.org Technical Assistance Center on Social Emotional Intervention for Young Children (TACSEI) www.zerotothree.org ZERO TO THREE is a national nonprofit organization that provides parents, professionals and policymakers the knowledge and the know- how to nurture early development. http://eclkc.ohs.acf.hhs.gov Office of Head Start An Office of the Administration for Children and Families Early Childhood Learning and Knowledge Center

26. Questions?