An Evaluation of an Early Childhood Mental Health Consultation Model in Low-Income Neighborhood Schools

Introduction: The goal of early childhood mental health consultation (ECMHC) is to enhance the quality of young children’s affective environments in order to promote their social, emotional and behavioral health. Rather than pulling out children for individual mental health services, ECMHC works with teachers and families to build their internal capacities and skills. Several research syntheses have documented positive effects of the approach on children, teachers and programs (Brennan et al., 2008; Perry et al., 2010). This study builds on previous models by using a more rigorous data-driven approach and collecting data at multiple time points across the school year. The evaluation also includes measures of process variables that have previously been theorized in the literature, but not measured.

Method: A quasi-experimental evaluation of the Georgetown model of ECMHC is currently being implemented in preschool classrooms in six public charter preschool programs in Washington, DC (ages=32-68 months, M=47.04; 99% African American). The academic year is divided into four, 8-week consultation cycles. Each cycle includes a cohort of three teachers in each school. Eligibility is based on consultant ratings of classroom climate using the Preschool Mental Health Climate Scales (Gilliam, 2008) and behavior management. All classrooms in a school are observed at the beginning of each cycle and are eligible if their scores reflect a need for support.

Results: Preliminary analyses from a pilot study conducted last year indicates significant differences by consultation dosage within intervention schools in school climate (e.g. teacher trust) and child functioning (e.g. child attention problems). Outcomes from the current year will include independent observations of classroom quality (CLASS) and teacher and observer ratings of student functioning collected at the beginning and end of the school year. In addition, consultants will evaluate teachers’ practices four times during the year. Process measures of the consultation alliance and consultation activities are also collected. Each school will serve as its own pre-intervention comparison using the previous year’s data. A series of 2 and 3-level repeated measures hierarchical linear models will be conducted to compare the post-test outcomes for schools this year (post-intervention) to their scores from last year (pre-intervention). Models will account for the clustering of students within classrooms and classrooms within schools.

Conclusions: This study has the potential to expand the field’s understanding of how to systemically promote mental health and social-emotional learning in early childhood and to shed light on the process mechanisms that may influence the effectiveness of the intervention.