Promoting Change for Young Children in Early Care Centers: Impacts of Mental Health Consultation

• In Event: Poster Session 14
  In Poster Session: PS 14 Topic - Prevention and Interventions

Abstract

Introduction: Children’s social-emotional environments impact their early development. Because most three- to five-year-old children attend daycare/preschool (U.S. Department of Education, 2019), these are optimal locations for supporting their development. Specifically, Early Child Mental Health (ECMH) programs are effective in bolstering children’s emotion regulation and social skills (Brennan et al., 2018). The current study aimed to: (a) investigate the impact of the consultation model on child outcomes; (b) examine the link between the number of consultation sessions and outcomes; and (c) discuss challenges inherent in state-wide implementation/evaluation studies.

Method: Participants were 820 racially/ethnically diverse children (Mage = 3.5; 75.5% male) in a Mid-Atlantic state, referred to the ECMH program between 2010 and 2018. Children’s primary presenting problems included oppositional defiance (47%), aggression (30%), hyperactivity/inattention (8%), and development issues/delays (7%).

Consultation sessions (M = 10.95) took place at classroom- and/or child-specific levels. Before and after completing the program, children’s parents and teachers completed the Strength and Difficulties Questionnaire (SDQ; Goodman, 1997); parents completed the Eyberg Child Behavior Inventory (ECBI; Eyberg & Pincus, 1999) as well as the Parenting Stress Index (PSI; Abidin, 1995); teachers completed the Sutter-Eyberg Student Behavior Inventory (SESBI; Funderburk et al., 1998); and all parties completed a questionnaire regarding their satisfaction and perceptions of change. The final sample included 400-600 teacher-reported and 200-500 parent-reported responses.

Results: Repeated-measures ANOVAs showed a reduction in both parent-reported total difficulties (SDQ) as well as parent- (ECBI) and teacher-reported (SESBI) instances of children’s problematic behavior (p < .001), in both frequency and intensity.
Further, these analyses revealed a reduction in parental stress (i.e., PSI; p < .001). Finally, teachers, directors, and parents reported overwhelming support and satisfaction following the program. For instance, more than 96% of directors, teachers, and parents reported high levels of satisfaction with services.

Hierarchical multiple regression analyses revealed that the number of consultation sessions only moderated parent reports, specifically parent-reported total difficulties (SDQ) and parental stress (PSI). Consultations did not moderate any teacher-reported outcome.

Discussion: In the context of prior research, these findings suggest that early childhood consultation services are feasible and effective means of supporting children’s social-emotional climates and impact such distal factors as parental stress. In the current study, the number of consultant sessions (i.e., dose) moderated decreases in parent-reported difficulties as well as parental stress but did not moderate teacher-reported outcomes. There are several possible interpretations. Perhaps children with more severe behavioral issues receive more services (i.e., high doses). Results may also suggest that significant change can generally be accomplished in as few as 10 consultation sessions. Considering the increased focus on provision of early childhood behavioral health services, these findings are important. The results of this study are discussed in context of existing ECMH literature and the challenges inherent in implementation/evaluation research. Limitations of using archival data are also noted, including the lack of a control group, varying data collection fidelity, missing data, and substantial heterogeneity within the children, consultants, centers, and services provided. Directions for future implementation and research are discussed.

Authors

• Zachary Mark Meehan, University of Delaware
  Presenting Author

• Noel Shadowen, University of Delaware
  Non-Presenting Author

• Timothy Fowles, University of Delaware
  Non-Presenting Author

• Ryan Beveridge, University of Delaware
  Non-Presenting Author

• Leigh Andrews, University of Delaware
  Non-Presenting Author