Child-focused infant and early childhood mental health consultation: Shifting adult attributions to reduce the risk for preschool expulsion

Infant and early childhood mental health consultation (IECMHC) in early care and education (ECE) settings is a promising approach to support young children. Although research on the effects of IECMHC is encouraging, it is limited by the complexities of the systems in which IECMHC is implemented and the variability in IECMHC models. The current study aims to clearly articulate a statewide, child-focused, short-term IECMHC model, assess consultee satisfaction, examine the effects of consultation on children's functioning in the school and home settings, and evaluate changes in teacher perceptions associated with expulsion risk following consultation. In total, 268 children ages 1-5 (69% White, 75% male) and their family and school caregivers participated in consultation in a New England state, and 95 children and caregivers were included in an evaluation subsample. Of this subsample, teachers and ECE administrators, but not families, indicated significant improvement in children's functioning from referral to end of consultation. There was also a significant decrease in children's risk of expulsion, as measured by teachers' perceptions associated with expulsion decisions. This study contributes to the IECMHC literature by providing results specific to a child-focused model of consultation and highlighting the possible role of adult attributions for children in ECE.

Suspension and expulsion in Colorado early care and education settings: Child, program, and community-level predictors

Expulsion presents a significant risk in Early Care and Education (ECE) settings due to its association with early disadvantage and frequency of use. A statewide survey was conducted to characterize ECE suspension and expulsion (S/E) in Colorado. Child, program, and community-level factors were examined as predictors of S/E, alongside preventative intervention supports capable of reducing S/E. Six hundred and sixty three licensed child care programs participated in the survey, providing information on 19,848 enrolled children, 312 suspensions, and 74 expulsions. A series of multilevel hierarchical regressions were conducted, examining predictors for S/E. Children with IEPs/IFSPs were disproportionately suspended; 2-3-year-olds were disproportionately expelled; and boys, 5-6-year-olds, and children with disabilities were disproportionately suspended and expelled. Center-based programs, lower quality ratings, and "zero tolerance" policies predicted greater use of suspension. In contrast, school-district affiliation and knowledge of how to access infant and early childhood mental health consultation (IECMHC) decreased suspension. Lower levels of regional child poverty predicted higher use of expulsion. Affiliation with a school-district, IECMH consultant-led training, and use of quality coaches predicted decreased expulsion. This study identifies the need for ongoing protection for children with IEPs/ IFSPs and the preventative interventions that mitigate risk for S/E.