Opportunities to Promote Children’s Behavioral Health: Health Care Reform and Beyond: Workshop Summary 


The Patient Protection and Affordable Care Act (ACA), which was signed into law in 2010, has several provisions that could greatly improve the behavioral health of children and adolescents in the United States. It requires that many insurance plans cover mental health and substance use disorder services, rehabilitative services to help support people with behavioral health challenges, and preventive services like behavioral assessments for children and depression screening for adults. These and other provisions provide an opportunity to confront the many behavioral health challenges facing youth in America.

To explore how the ACA and other aspects of health care reform can support innovations to improve children’s behavioral health and sustain those innovations over time, the Forum on Promoting Children’s Cognitive, Affective, and Behavioral Health held a workshop on April 1-2, 2015. The workshop explicitly addressed the behavioral health needs of all children, including those with special health needs. It also took a two-generation approach, looking at the programs and services that support not only children but also parents and families. This report summarizes the presentations and discussions of this workshop.

Source: The National Academies Press

Available at: http://www.nap.edu/catalog/21795/opportunities-to-promote-childrens-behavioral-health-health-care-reform-and

HHS Launches National Center of Excellence for Infant and Early Childhood Mental Health Consultation


By Shantel E. Meek, Ph.D., Senior Policy Advisor for Early Childhood Development, Administration for Children and Families

Last year, President Obama launched My Brother’s Keeper (MBK), an initiative that brings together the public and private sectors, communities, businesses, schools, and individuals to close opportunity gaps and ensure all of our nation’s youth, including boys and young men of color, have the tools they need to realize their incredible potential. The initiative sets a vision for supporting our youth from cradle to college and career by focusing on six important milestones across the life course. The first of these milestones is ensuring that children enter school ready to learn.

The My Brother’s Keeper Task Force Report recommends building a strong foundation of social-emotional and behavioral health, fostered by warm, enriching, and secure relationships with adults like parents and early learning providers, as an integral component of entering school ready to learn. Social-emotional and behavioral health is robustly associated with school readiness and achievement and outcomes in adulthood, such as higher likelihood of high school completion, degree attainment, and lower likelihood of drug use and arrest.

At the same time, teachers and child care providers report that their most pressing training need is in fostering children’s behavioral development. In fact, only 20% of providers who serve children under age 5 reported receiving any training on facilitating children’s social-emotional growth in the past year. Lack of training and competencies in this area may contribute to higher rates of expulsion and suspensions. Data consistently show that young boys of color are disproportionately the subjects of expulsions and suspensions from early learning and school settings, which may contribute to social-emotional challenges and set them on a negative trajectory before they even step foot in the kindergarten classroom. Last year, the Departments of Health and Human Services (HHS) and Education (ED) released a joint policy statement on preventing expulsion and suspension in practices in early learning settings.

The concern for the mental health and behavioral wellness in young children of color has become even more alarming after the release of a recent study in The Journal for American Medical Association analyzing suicide rates in children over the past 20 years. Researchers found that, while the overall suicide rate remained stable, the rate for black children, ages 5 to 11, increased significantly.  Data over the past several years indicate that the suicide rate in American Indian/Alaska Native (AI/AN) youth is more than double other groups.

As a response to the pressing need for more preventive support for the early education system and the children and families it serves, this week the Substance Abuse and Mental Health Services Administration, in partnership with the Health Resources and Services Administration, and the Administration for Children and Families, three agencies within the U.S. Department of Health and Human Services, launched the new National Center of Excellence in Infant and Early Childhood Mental Health Consultation (IECMHC). The Center of Excellence (CoE), funded at about $6 million over the next four years, is tasked with building strong, sustainable mental health consultation systems in States and tribal communities across the country through the development of state of the art tools and the delivery of training and technical assistance. IECMHC is a multi-level preventive intervention that teams mental health professionals with people who work with young children and their families. The model builds the capacity of teachers and families to promote social-emotional and behavioral development and has demonstrated impacts for improving children’s social skills and adult-child relationships; reducing challenging behaviors, expulsions and suspensions; increasing family-school collaboration; increasing classroom quality; and reducing teacher stress, burnout, and turnover.

Importantly, the work of the CoE will also have a focus on tribal communities. Work will be steered by an advisory group of experts in the early childhood mental health field and will include up to four tribal experts to ensure that the work is culturally responsive to the needs of AI/AN children and their families. The unique strengths and needs of tribal communities warrant an intentional focus and strong partnership with tribal nations. As the work of the CoE moves forward, it will include a thorough consideration of racial and ethnic disparities in exclusionary discipline and other areas, and result in a set of tools and training that are culturally responsive and relevant, address issues of implicit bias, and benefit all children, their families, and their teachers.

Today’s announcement is an important step forward in boosting the quality of early education around the country, and ensuring that States and tribes can support their youngest children, including boys of color, in achieving optimal social-emotional and behavioral health and school readiness. We hope that the launch of this new CoE will spur discussion and encourage States, tribes, communities, schools, and early childhood programs to prioritize this issue. We all share responsibility for taking care of our youngest children.

Source: Administration for Children and Families, U.S. Department of Health and Human Services

Available at: http://www.acf.hhs.gov/blog/2015/10/infant-early-childhood-mental-health-consultation

Assessing Preschoolers’ Disruptive Behavior: Associations Among Teachers, TAs, and an Impartial Observer


This study examined associations among Teachers, TAs, and Observational ratings of children’s disruptive behavior. Alignment between Teachers and TAs did not predict observational measures above a single teacher’s ratings. Teachers and TAs were equally aligned with observational measures, except for ratings of oppositionality. Findings point to the importance of a multi-method assessment that gathers information from various sources, including TAs.

Source: The Center for Advanced Study of Teaching and Learning (CASTL), Curry School of Education

Available at: http://curry.virginia.edu/uploads/resourceLibrary/Assessing_Preschoolers_Disruprive_Behavior_Associations_Among_Teachers%2C_TAs_and_an_Impartial_Observer.pdf

To Prevent Bullying, Focus on Early Childhood 


How do we prevent bullying? Despite decades of study and numerous programs claiming to be the solution to bullying, few programs have actually been shown to be effective. One of the main issues is that “bullying prevention” is often a misnomer; instead of trying to stop the behavior before it begins, the focus of many programs is on reducing already high rates of bullying. By the time students enter sixth grade, the earliest grade for which nationally representative data is collected, nearly 28 percent report having been targeted in the past year. For younger children, data are far more limited, but suggestive. The National Survey of Children’s Exposure to Violence found that 20.4 percent of children ages 2-5 had experienced physical bullying in their lifetime and 14.6 percent had been teased (verbally bullied).

To actually prevent bullying before it starts, we need to focus on how bullying behaviors develop—for those engaging in bullying behaviors and those being targeted—starting in early childhood. Child Trends recently conducted a literature review and convened an expert roundtable, which NAEYC took part in, to document current understandings of the roots of bullying in early childhood. We identified key contextual factors linked to bullying behaviors, promising and evidence-based programs that help address emerging behavior, and the need for further research.

Research on bullying and early childhood development is limited. When we talk about bullying, the early childhood audience is often forgotten. There remains immense debate in the field about how to distinguish between typical, sometimes aggressive behavior that young children show and the more strategic and deliberate behaviors that define bullying. In preparing their uniform definition of bullying, the Centers for Disease Control and Prevention defined bullying as being between “school-aged youth,” recognizing that the behaviors observed in young children are often not what we traditionally think of as bullying, but are developmental in nature, as children first begin to navigate interactions with peers. Many young children who are aggressive with their peers will not engage in bullying behaviors in later childhood and adolescence. Likewise, being the target of an aggressive behavior does not mean that child will be victimized for life. Still, these early aggressions (and conversely, the early skills of sharing, listening, and empathy) are precursors to later behavior, and it is important to intervene early. More research is needed to understand the trajectory of early aggression into bullying behaviors.

Despite the limited literature, four key factors consistently seemed to be related to bullying behaviors in young children:

1) Parents’ treatment of each other, their children, and others influences how young children treat their peers. Specifically, parents’ use of harsh discipline and children’s exposure to domestic violence are related to increases in bullying behavior, while parents’ positive engagement in their children’s lives, such as through interactive play, reading, and meals together, seems to be protective against bullying behavior. Parents serve as role models for their children, and modeling empathy, concern, and care for others may help deter later bullying. Resources such as those provided by the Making Caring Common Project at the Harvard Graduate School of Education can help parents expand their own “circle of concern” and help their children do so, too. (It should be noted here that the majority of current research looks at the behaviors and characteristics of mothers; studies looking at the role of fathers are more limited, primarily because mothers are more likely to be the primary caregiver for young children and more likely to respond to the research. Some effort is being made, however, to address the role of fathers in bullying prevention.)

2) Young children exposed to maltreatment are more likely to be involved in bullying, both as the target and the aggressor. Not only can maltreatment change children’s behaviors, it has been shown to fundamentally alter the development of young children’s brain structures, which can lead to developmental deficits including in the social and emotional domains. Early intervention is critical to help stem these delays. Adults and Children Together (ACT) Against Violence Raising Safe Kids, an evidence-based program specifically aimed at helping reduce child maltreatment and promote positive parenting strategies, is one approach that shows promise.

3) Television and other media can contribute to the development of both aggression and pro-social skills. Screen time for your children is one of the most debated subjects among early childhood advocates. Research shows that increased television watching is related to increases in aggressive behavior even if the content is not inherently violent. Conversely, when shows are specifically designed to promote skills such as sharing, empathy, and other pro-social skills—shows like Sesame StreetDaniel Tiger’s Neighborhood, or in past generations, Mister Rogers’ Neighborhood—children are more likely to engage in these behaviors after viewing.

4) Building young children’s social and emotional skills and promoting welcoming classrooms can significantly reduce aggression. Evaluations of several evidence-based social and emotional learning programs for young children, such as PATHS for Preschool, Second Step, and Al’s Pals, show that helping children understand and control their own emotions, and understand those of others, can significantly reduce conflict and aggression. Even without these formalized interventions, teachers of young children (and parents for that matter) can work to reduce bullying behaviors. The Guidance Matters column in the professional journal Young Children provides a number of resources that can support these efforts.

Overall, it is clear that more attention needs to be paid to identifying, researching, and preventing the roots of bullying behavior in young children. It is only when we recognize that bullying behaviors do not simply appear in elementary or middle school, but may be part of a developmental trajectory, that will we be able to stop bullying.

Source: Child Trends

Available at: http://www.childtrends.org/to-prevent-bullying-focus-on-early-childhood/

ZERO TO THREE: Parent Portal


There is no such thing as a perfect parent. Parenting is an ongoing process of learning who your individual child is and what he needs to thrive.  Our resources are designed to help you tune in to what makes your child tick, and to guide you in thinking about the best way to meet your child’s individual needs.

  • Learn all about how development unfolds in the early years and how you can support your child’s healthy, overall growth.
  • Explore how you can help your young child learn to manage emotions, gain self-control, build self-confidence, and make great friends.
  • Discover how children are learning all the skills they need to be successful in school, starting from birth, with your loving guidance.
  • Explore everyday ways to help babies and toddlers learn important concepts, to be good problem-solvers, and to get along with others, through play.
  • Gain understanding about the root causes of some of the most common challenges parents face in children’s early years and how you can respond in ways that teach self-control and critical coping skills.
  • Read about what to expect around sleep in the early years and how to prevent and troubleshoot challenges that arise.
  • Learn about ways to manage your own emotions and reactions to your child that reduce stress–for you and your child–and that empowers you to nurture your child’s healthy development.


Available at: http://www.zerotothree.org/parenting-resources/

Promoting Optimal Development: Screening for Behavioral and Emotional Problems


By current estimates, at any given time, approximately 11% to 20% of children in the United States have a behavioral or emotional disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Between 37% and 39% of children will have a behavioral or emotional disorder diagnosed by 16 years of age, regardless of geographic location in the United States. Behavioral and emotional problems and concerns in children and adolescents are not being reliably identified or treated in the US health system. This clinical report focuses on the need to increase behavioral screening and offers potential changes in practice and the health system, as well as the research needed to accomplish this. This report also (1) reviews the prevalence of behavioral and emotional disorders, (2) describes factors affecting the emergence of behavioral and emotional problems, (3) articulates the current state of detection of these problems in pediatric primary care, (4) describes barriers to screening and means to overcome those barriers, and (5) discusses potential changes at a practice and systems level that are needed to facilitate successful behavioral and emotional screening. Highlighted and discussed are the many factors at the level of the pediatric practice, health system, and society contributing to these behavioral and emotional problems.

Source: Pediatrics, American Academy of Pediatrics

Available at: http://pediatrics.aappublications.org/content/early/2015/01/20/peds.2014-3716.abstract

Babysteps: Parenting Resources From ZERO TO THREE


No, I Want That Bowl!

As little ones grow up each day, parents may find that they tend to have their own way for everything and show little flexibility. Parents may be worried and wonder how to help. Click here to learn more about inflexibility in toddlerhood, and what parents can do with it.

On Your Lap, In Your Heart

Grandparents—whether living near or far—enjoy a special relationship with their grandchildren. Grandparents are the ones who are often willing to read the same story over and over, play a silly game, or say “who’s there” to a knock-knock joke more times than they can count. Check out ZERO TO THREE’s resources just for grandparents.

Mommy, That Man Is Fat!

Sometimes our toddlers make observations or ask questions “Why is that lady’s skin so brown?” that make adults very uncomfortable. Learn more about how to answer these typical questions from very observant 2- and 3-year olds by clicking here.

Fun for the Under-3s

Birth to 12 Months: Finger and Feet Painting.

You can do this outside or in your house. Place some large white paper or cloth on the ground or floor, undress your baby down to diaper, put her feet or hands in child-safe tempera paint, and then press gently onto the paper or cloth or let her touch the paper on her own. Many babies will enjoy the sensory nature of this activity and will want to explore. If your baby doesn’t enjoy it, clean her up and try again another time. This activity encourages sensory exploration and also works your baby’s fine and gross motor skills as she bangs, touches, crawls, and walks over the paper. Have some messy fun!

12-24 Months: Let’s Go Strawberry Picking!

From middle June till early September, it is harvest time for different types of strawberries. Take your child along with you to a farm with strawberry patches to pick some to take home. When you spot one, point it out and label it “strawberry” or observe that it’s “red.” Children learn new words and concepts through direct experience with them. When you get home, have your toddler help you wash the strawberries or hold the colander while you rinse them. After you remove the stems, hand the strawberry to your toddler to put in a bowl. This type of “cooking project” is age-appropriate and fun, while also teaching your little one about how strawberries grow, the color red, and cooperating in family routines.

24-36 Months: What Does That Cloud Look Like?

On a cloudy day,  lie down with your toddler on a blanket on a grassy spot. Look up at the puffy, white clouds and talk about the shapes you see. Ask your toddler questions: Do you see that cloud in the shape of a whale? What shape does that cloud look like? What else does it look like besides a human face? Do you see a “turtle cloud” sailing slowly across the blue sky…? This outdoor activity sparks imagination and creativity, builds language skills as you talk about the clouds and perhaps make up stories together, and—most important—fosters giggly togetherness between the two of you.



 Professional Development at Gesell Institute

August 2014

Does your staff need professional development hours?
Looking for a new idea for a staff meeting?
Are you a parent looking for information about child development?
Are you working on a CDA?

Back by popular demand, Gesell Institute is offering a four-part webinar series,and the first session is FREE!

Individuals can register in our online bookstore.

8/5/14  4-5pm EST

The Road to School Success: Promoting Self-Regulation and Social/Emotional Development FREE!

Research confirms that children need to have mastered self-control in order to be successful in school. Staying seated and quiet while the teacher is talking, being able to line-up and walk throughout the school without running ahead or misbehaving, waiting for a turn and learning that everyone cannot be first at the same time or all the time, and working independently and staying on task without being distracted or begging for help are all very difficult skills to learn. They also do not develop overnight nor are they taught through rewards and punishment. This session helps parents and teachers provide ideal activities and the right amount of structure to the environment to help each child develop self-control.

Source: The Gesell Institute

Available at: http://www.gesellinstitute.org.php53-10.dfw1-2.websitetestlink.com/scheduled-webinars/

Impact Findings from the Head Start CARES Demonstration: National Evaluation of Three Approaches to Improving Preschoolers’ Social and Emotional Competence


Head Start CARES Classroom-based Approaches and Resources for Emotion and Social skill Promotion is a national demonstration that tests the effectiveness of three program enhancements designed to improve preschool childrens social-emotional competence. The project also examines the support systems e.g., professional development model, technical assistance, monitoring that are needed to implement the enhancements as designed within diverse Head Start classrooms across the country. This report describes impacts of the CARES demonstration, focusing on outcomes during the spring of the preschool year in: 1 teacher practices; 2 classroom climate; 3 children’s behavior regulation, executive function, emotion knowledge, and social problem-solving skills; and 4 children’s learning behaviors and social behaviors. The report also explores possible impacts on pre-academic skills during preschool and social-emotional and academic outcomes during the Kindergarten year. All three enhancements had positive impacts on teacher practice and on children’s social-emotional outcomes during the preschool year, although in varying degrees and not necessarily in the expected ways.

Source: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services

Available at: http://www.acf.hhs.gov/programs/opre/resource/impact-findings-from-the-head-start-cares-demonstration-national-evaluation-of-three-approaches-to-improving-preschoolers-social

Essentials for Parenting Toddlers and Preschoolers

Parenting is hard work! But it can also be fun and rewarding. There are many things you can do to help build a safe, stable, and nurturing relationship with your child. This website will help you handle some common parenting challenges, so you can be a more confident parent and enjoy helping your child grow.

  • OVERVIEW OF ESSENTIALS: Find out more about the development of these resources
  • CREATING STRUCTURE & RULES: Set expectations using family rules, reward charts, and daily schedules
  • USING CONSEQUENCES Learn about consequences like ignoring and distraction and tips for discipline
  • COMMUNICATING WITH YOUR CHILD Get information on skills like praise and active listening
  • GIVING DIRECTIONS Encourage your child to listen by giving simple, effective directions
  • USING TIME-OUT Get tips on when, where, and how to use time-out

Source: Centers for Disease Control and Prevention

Available at: http://www.cdc.gov/parents/essentials/index.html