Longitudinal Assessment of Illinois Legislation Promoting Mental Health Consultation to Prevent Early Childhood Expulsion

• In Event: Bridging Policy, Practice, and Research for Infant and Early Childhood Mental Health Consultation

Abstract

In 2017, Illinois became the first state to pass legislation prohibiting early childhood expulsion. To date, Public Act 100-0105 remains the only law to apply across multiple funding streams and delivery models, including home, center, and school-based programs. The law explicitly points to infant and early childhood mental health consultation (I/ECMHC) as a viable intervention to prevent expulsion but no funding was allocated to increase I/ECMHC and stakeholders raised access and equity concerns.

In response, we initiated an annual evaluation of Illinois early childhood programs’ expulsion practices and administrators’ understanding of and responses to the new law. In this proposed presentation, we will report findings from three years of this evaluation of PA 100-0105. Specific to the focus of this panel, we examine changes in access to and engagement of I/ECMHC services over time and associations with early childhood expulsion rates before and after the law’s implementation. Finally, we’ll report on barriers preventing consultation use throughout Illinois.

METHOD
This presentation will draw on I/ECMHC data collected across three time points. Convenience samples of administrators from center-, home-, and school-based early childhood programs completed annual surveys each fall about program characteristics (funding, enrollment, staffing), access to and use of various resources (including I/ECMHC), and use of exclusionary discipline in the preceding 12 months. Some Year 1 administrators (N=25) also participated in follow-up interviews. Three consecutive years of data are available from a subsample of programs (N=32).

RESULTS
In Year 1, expulsion was fairly common with 35% of programs excluding one child. Overall 12.6 children were expelled for every 1,000 enrolled, a rate higher than reported national averages (Gilliam et al., 2005; Table 1). Year 2 data showed decreasing rates of formal expulsion over time, but persistent “soft expulsions” (i.e., parents being encouraged to withdraw their child or children being transitioned to other programs) due to challenging behavior. Parallel analyses will be conducted with Year 3 data.

Despite Illinois' free, statewide I/ECMHC system for all child care and preschool programs, only 44% of respondents indicated that their program had previously worked with a consultant in Year 1. In follow-up interviews, 58.8% of programs with consultation experience reported positive perceptions, but nearly a third reported excessive wait times that made utilization difficult. Some administrators reported waiting "several months" for a consultant to observe a child. In both interviews and surveys respondents consistently called for greater access to I/ECMHC.

Two years later, although data analysis is not yet complete, preliminary results indicate that utilization remains low. Of those who have not engaged a consultant in the past year, most administrators believe they have no need for services. Planned analyses will test whether these programs still engaged in exclusionary discipline. We will also test associations among consultation engagement and overall expulsion rates, and disparities in consultation engagement to prevent expulsion by child race and ethnicity.

Authors

• Kate Zinsser, University of Illinois at Chicago
  Presenting Author

• Callie Silver, Stanford University
  Non-Presenting Author

• Allison Lowe-Fotos, Ounce of Prevention Fund of Florida
  Non-Presenting Author

• Maria Estlund, Illinois Action for Children
  Non-Presenting Author

• Lori Orr, Illinois Governor’s Office of Early Childhood Development
  Non-Presenting Author