Generalized Effects of Early Childhood Mental Health Consultation on Classroom-Level Challenging Behavior

Introduction:  The Healthy Futures project in Washington D.C. provides an embedded model of early childhood mental health consultation (ECMHC) services in 26 child development centers (CDCs).   Consultants provided both programmatic and child-specific consultation. In programmatic consultation, consultants work with teachers to improve the social and emotional climate of the classroom. In child-specific consultation, the consultant supports the teacher in gaining behavior management strategies to address an identified child.  Earlier studies have demonstrated that ECMHC is effective at reducing expulsions and challenging behaviors as well as improve  teachers’ sensitivity; this study also sought to build the evidence for generalized effects of ECMHC on classroom-level challenging behaviors.

Methods:  Data were collected by the mental health consultants at the Department of Behavioral Health and analyzed by the evaluation team at an academic institution.   Measures included the Strengths and Difficulties Questionnaire (SDQ) which assessed classroom-level challenging behaviors in the Fall and late Spring through teacher report; the Arnett Caregiver Interaction Scales (CIS) to measure changes in teacher sensitivity in classrooms receiving programmatic consultation; and the Devereux Early Childhood Assessment (DECA) to assess changes in child-level outcomes for children receiving child-specific consultation.

Results:  Consistent with findings from past evaluations, classrooms with programmatic consultation demonstrated significant improvements in classroom climate, and children who received child-specific consultation showed significantly reduced behavioral concerns and increased protective factors. No students were expelled from the 26 CDCs receiving ECMHC.  Generalized effects of ECMHC were documented:  specifically in classrooms receiving programmatic consultation, larger improvements in the CIS were related to greater reduction in the SDQ scores indicating a reduced burden of behavior problems.  In addition,  classrooms in which at least one child received child-specific consultation showed greater reductions in severe behavior problems than classrooms without child-specific consultation.  Finally, teachers receiving either programmatic and/or child-specific consultation were less likely to leave their job over the course of the school year.

Conclusions: The skills that teachers gain through ECMHC may generalize to improved management of serious behavior problems for the entire classroom. These results add to the evidence supporting the effectiveness of ECMHC and begin to document that these effects can generalize to classroom-level child behavioral functioning.