Expert answer:Preschool Behavior Problems Paper

Solved by verified expert:APA format. Read the study by the Yale Child Study Centerand (attached) answer the given questions in essay form(attached). Please be sure to listen to the NPR story first to “front-load/preview” what you’ll be reading in the actual empirical article. Read the Yale Study. Then, answer the questions posted using the information you found in the journal article itself.Papers should be around 2 pages, double-spaced (3 pages max!)Listen to the following NPR Story: http://www.npr.org/sections/ed/2016/09/05/490226345/preschool-suspensions-really-happen-and-thats-not-okay-with-connecticut (Links to an external site.)I’ll do question #15. Don’t worry about it. I attached the rubric.
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Preschool Article Questions
Instructions: Read the assigned article on dealing with problem behavior in preschool children. After reading the
article, write answers to the following questions. Use complete sentences and be sure to proofread your paper for
grammar and spelling mistakes. Several of these questions can be answered briefly. Others require more detail and at
least a few sentences or a paragraph. Reference this article and our text at the end of the assignment in APA format.
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15.
Who were the authors of this study and when and where was it published?
Explain at least one hypothesis presented in the article regarding the present study (not something already
done)?
How many participants were in the study?
Who were the participants (e.g., number, age, gender, SES, other demographics)?
Was the study correlational or experimental? Justify your answer.
What was the independent variable(s)? What was/were the dependent variables?
What materials and procedures were used in the study? Did participants complete a specific survey, take part
and observed in a specific setting (naturalistic? Structured?), undergo a procedure? complete a specific protocol,
were they interviewed, etc.?
What statistical analysis was used to analyze the data collected? Report the findings that relate to the
hypothesis/es you presented in question 4.
Did the author(s) find a significant effect? If so, what group differences were significant?
What did you learn from the figures (graphs) or tables in the results section?
Was the study authors’ hypothesis stated in question 2 supported? How so or how not?
Were the results consistent with the previous literature discussed in the introduction of the article? Explain.
What can you conclude from this study? What implications does it have? You have a friend studying early
education. What would tell him/her about this study?
Did the author(s) make any suggestions for further investigation if their discussion section? If so, what
suggestions were made?
How did this study relate to our readings for class? Apply at least two ideas/findings/concepts from your class
readings to this article (1-2 paragraphs here to connect this article with class reading. Do NOT just list concepts
or quote text for tie ins). Paraphrase sources, you make the connections for the reader.
16. Who was the National Public Radio (NPR) education reporter on this story? Explain one specific advantage
you found of listening to the NPR report of research (other than it taking less time!) in addition to reading the
article alone?
NEW RESEARCH
Early Childhood Mental Health Consultation: Results of a
Statewide Random-Controlled Evaluation
Walter S. Gilliam,
PhD,
Angela N. Maupin,
Objective: Despite recent federal recommendations calling for increased funding for early childhood mental
health consultation (ECMHC) as a means to decrease
preschool expulsions, no randomized-controlled evaluations of this form of intervention have been reported in the
scientific literature. This study is the first attempt to isolate
the effects of ECMHC for enhancing classroom quality,
decreasing teacher-rated behavior problems, and
decreasing the likelihood of expulsion in targeted children
in early childhood classrooms.
Method: The sample consisted of 176 target children (3–4
years old) and 88 preschool classrooms and teachers
randomly assigned to receive ECMHC through Connecticut’s statewide Early Childhood Consultation Partnership (ECCP) or waitlist control treatment. Before
randomization, teachers selected 2 target children in each
classroom whose behaviors most prompted the request for
ECCP. Evaluation measurements were collected before
and after treatment, and child behavior and social skills
and overall quality of the childcare environment were
assessed. Hierarchical linear modeling was used to
O
n December 10, 2014, the US Department of
Health and Human Services and the US Department of Education issued a rare joint policy and
recommendations statement1 during the White House
Summit on Early Childhood Education. This joint policy
statement called for a drastic decrease in early childhood
expulsions. Specifically, it mentioned early childhood mental
health consultation (ECMHC), an intervention in which
qualified mental health providers serve early childhood
teachers and professionals as classroom-based consultants,
as a promising intervention for decreasing and ultimately
eliminating preschool expulsions. Unfortunately, no
randomized-controlled evaluation of ECMHC has been
published in the scientific literature to support this recommendation. Furthermore, the Departments of Labor, Health
and Human Services, and Education and Related Agencies
Appropriations Bill 2016 (July 10, 2015)2 called for the US
This article is discussed in an editorial by Dr. Jeff Q. Bostic on
page 749.
Clinical guidance is available at the end of this article.
An interview with the author is available by podcast at www.jaacap.org
or by scanning the QR code to the right.
www.jaacap.org
Chin R. Reyes,
PhD
evaluate the effectiveness of ECCP and to account for the
nested structure of the study design.
Results: Children who received ECCP had significantly
lower ratings of hyperactivity, restlessness, externalizing
behaviors, problem behaviors, and total problems
compared with children in the control group even after
controlling for gender and pretest scores. No effects were
found on likelihood of expulsion and quality of childcare
environment.
Conclusion: ECCP resulted in significant decreases across
several domains of teacher-rated externalizing and problem behaviors and is a viable and potentially cost-effective
means for infusing mental health services into early
childhood settings. Clinical and policy implications for
ECMHC are discussed.
Key words: early childhood mental health consultation,
preschool children, behavioral outcomes, early childhood
education, preschool expulsion
J Am Acad Child Adolesc Psychiatry 2016;55(9):754–761.
Department of Health and Human Services and Department
of Education to highlight evidence-based approaches to
decrease suspension and expulsions in all US early care and
education programs. The present study is the first true
randomized-controlled evaluation designed to isolate the
effects of ECMHC on decreasing the challenging classroom
behaviors that often lead to expulsions, thus addressing a
federally recognized urgent need.
Severe behavior problems during the preschool years
are meaningful predictors of continued behavior problems,
poor peer standing, and academic difficulties during
kindergarten,3,4 later elementary school, and middle
school.5,6 Externalizing and internalizing behavior problems in young children that occur frequently and intensely
are of clinical concern because they result in significant
disruptions to academic, social, and emotional development.7,8 Externalizing behaviors include inattention, hyperactivity, impulsivity, aggression, emotional lability, and
oppositionality, whereas internalizing behaviors often
include anxiousness, shyness, perfectionism, and sadness. Although highquality early education and intervention
programs can prevent severe behavior
problems in young children from lowincome communities and families,9-11
some preschoolers unfortunately begin
JOURNAL
754
PhD,
OF THE
AMERICAN ACADEMY OF C HILD & ADOLESCENT PSYCHIATRY
VOLUME 55 NUMBER 9 SEPTEMBER 2016
EARLY CHILDHOOD MENTAL HEALTH CONSULTATION
their early education programs with severe behavioral
problems already present. Classroom behavioral difficulties increase the likelihood of a child being removed
or expelled. In fact, preschoolers (3–5 years old) are
expelled at a rate more than 3 times that of students
in grades kindergarten through 12,12 limiting at-risk
children’s ability to participate fully, access, and benefit
from the early educational experience.13 Given the adverse
consequences of behavioral difficulties in early care
and education settings and the frequency of these difficulties, it is becoming increasingly important to target
mental health service delivery directly to those classroombased settings.14
Findings from a national study of prekindergarten
teachers indicated that teachers who reported having an
ongoing relationship with a classroom-based or on-site
mental health provider (such as a psychologist, psychiatrist, social worker, or other mental health provider working
within a consultative relationship with the teacher) were
approximately half as likely to report expelling a preschooler
compared with teachers who reported no such support.12
The pronounced difference of expulsion rates in classrooms
where teachers had access to mental health services suggests
that integrating mental health services into preschool classrooms can be a viable option and deserves further consideration. Unfortunately, only 23% of these teachers reported
regular classroom access to a mental health consultant.12
Thus, ECMHC could be an effective way to reach a larger
percentage of classrooms, decrease severe behavior problems in early education and childcare settings, and decrease
the likelihood that children with challenging classroom behaviors will lose services through expulsion and suspensions.15 Compelling evidence of ECMHC effectiveness has
been a severe limitation for the field and dissemination efforts. The present study addresses previous methodologic
limitations through a first-of-its-kind statewide randomizedcontrolled evaluation of ECMHC.
ECMHC, described in detail elsewhere,16-20 is an indirect
service delivery model that emphasizes ongoing problem
solving and collaboration between an early childcare and
education teacher and a mental health professional.
Although ECMHC is increasingly being implemented and
evaluated across several states,21 currently there are no
published reports of the effectiveness of ECMHC using
rigorous evaluation methods. In 2 comprehensive reviews of
all studies of ECMHC conducted from 1985 to 2008, 53
published and unpublished investigations of ECMHC were
identified.22,23 However, only 14 of the reviewed studies
used quasi-experimental methods, reported on child outcomes, and focused on ECMHC in classrooms serving children from birth to 6 years. Furthermore, only 1 of the 14
studies involved a published randomized-controlled experiment.11 Unfortunately, that study incorporated ECMHC
within a larger multicomponent classroom-based intervention over 20 weeks, making it impossible to isolate the effects
of ECMHC.
In general, modest improvements in teacher- and parentreported child behavior problems and social skills have been
reported.21,23 Specifically, Raver et al.11 found significant
JOURNAL OF THE AMERICAN ACADEMY OF C HILD & ADOLESCENT PSYCHIATRY
VOLUME 55 NUMBER 9 SEPTEMBER 2016
treatment effects, with children displaying lower externalizing behaviors, improved internalizing behaviors, and
observable improvements in aggressive and disruptive behaviors compared with children in the control group when
ECMHC was integrated into a multi-classroom intervention
program, including a separate teacher training component.
Similarly, several quasi-experimental studies have reported
significant decreases in teacher-rated externalizing behavior
after ECMHC.24-26 For internalizing problems, findings have
been inconsistent, with only some studies reporting improvements in internalizing behavior following ECMHC.11
However, differences in the ECMHC model, intensity, and
duration, instances in which ECMHC was embedded as a
part of a larger array of services, and lack of comparison
groups severely limit conclusions and generalization.
Further, none of the studies used rigorous experimental
designs capable of documenting ECMHC effects in isolation.
Early Childhood Consultation Partnership
The Early Childhood Consultation Partnership (ECCP) is an
ECMHC program available to staff at all public and private
early care and education centers serving young children
(infants to 5-year-olds) throughout Connecticut and is funded by the state. Typically, services are requested by childcare center directors or staff when there are behavioral or
social-emotional concerns for individual children or
classroom-wide behavioral management challenges. The
mental health consultation focuses on the overall socialemotional atmosphere within the classroom, behavioral
concerns for individual children, a parent component, and
classroom-wide behavioral management challenges.
At the time of this evaluation, the ECCP service model
was 8 weeks long, with 4 to 6 hours of classroom-based
consultation per week provided by 1 of 10 supervised
masters-level consultants supported by the ECCP, plus a
week-12 follow-up visit. The intervention is manual based
and menu driven based on individualized needs of teachers
and classrooms.27 In addition to providing teacher training
on various behavioral and social-emotional topics, the
consultation has 2 main areas of focus: improving teachers’
skills in classroom-wide behavior management and
providing direct consultative support to the teacher in
addressing the challenging classroom behaviors of identified
children who prompted the request for services. The specifics of the ECCP intervention methods are described in
detail in the ECCP intervention manual.27
During this evaluation, ECCP services were delivered by
a total of 10 consultants. At the time of the present evaluation’s start, all 10 consultants held a master’s degree in a
mental health or other human services-related field, mainly
in psychology or social work. All were trained mental health
clinicians, and 6 of the 10 consultants held or were eligible
for clinical professional licenses in counseling, marriage and
family therapy, or clinical social work. Consultants received
different ECCP-specific training sessions from communitybased content experts, organized into 13 training units
(childcare, family daycare and family/friend/neighbor care,
assessing quality of care, child mental health, health promotion, children with special needs, abuse and neglect, adult
www.jaacap.org
755
GILLIAM et al.
learning, adult resiliency, consultation, team building, partnering with systems, and community planning). Consultants
were provided regular clinical supervision by ECCP group
supervision, ECCP individual supervision, and agencybased supervision provided within the consultants’ host
mental health agencies.
Pilot Evaluation of ECCP
The ECCP was evaluated in a pilot statewide study using a
randomized crossover treatment design from 2005 through
2007 with 2 cohorts and using pretests and posttests (Gilliam, Maupin, and Reyes, unpublished material, May 3,
2016). Classrooms randomized to the control condition
during cohort 1 received the ECCP during cohort 2 as the
treatment condition, preventing true randomization for
cohort 2. However, results from this pilot evaluation were
promising—teachers who received ECCP services rated improvements in preschool students’ hyperactivity and restlessness/impulsivity during cohort 1. Surprisingly, these
same findings did not replicate during cohort 2. Instead,
improvements in oppositional and total externalizing
behavior were seen in children in classrooms with ECCP
services compared with control classrooms during cohort 2.
The lack of replication from one cohort to the next was likely
due to the limitations the crossover design placed on the
analytic approach. Moreover, no significant findings for
classroom quality measurements were found during the 2
cohorts, making it difficult to discern the mechanisms
through which ECCP was effective. Thus, understanding the
influence of ECCP on children and classroom variables is an
important next step to creating the evidence base for
ECMHC.
The Present Study
The purpose of the present study was to evaluate rigorously
the effectiveness of a statewide system of ECMHC (ECCP)
on decreasing challenging child classroom behaviors in a
statewide randomized-controlled evaluation and improving
overall classroom quality including teacher–child interactions by addressing previous methodologic limitations
from the pilot evaluation. The present study is the first true
statewide randomized-controlled trial to evaluate the effectiveness of ECMHC on the improvement of classroom
quality and reduction of child behavioral problems. Based
on findings from the pilot evaluation, the authors hypothesized that teachers in classrooms receiving the ECCP would
report significant decreases in identified child behavioral
problems compared with teachers randomized to the control
condition. In addition, because the ECCP is an indirect
model of consultation in which the ECCP consultant primarily is working directly with the teacher rather than the
child or family, the authors hypothesized improvements in
the quality of teacher–child interactions and the quality of
the classroom environment in addition to improvements in
child behavioral problems. In the present study, the Classroom Assessment Scoring System (CLASS) was used as the
observational measurement of classroom quality, given its
focus on teacher–child interactions and classroom quality
associated with the focus of early childhood mental health
consulting, an improvement from the pilot study that relied
on the Early Childhood Environment Rating Scale—Revised,
which might have been too global a measurement to capture
subtle classroom differences. This study has significant implications for addressing the overwhelming rates of preschool expulsions, increasing access to mental health care
through the provision of mental health services in early
education programs, and improving outcomes in at-risk
young children.
METHOD
Study Design and Research Participants
The ECCP was evaluated in a randomized-controlled treatment
design using pretests and posttests conducted from 2008 through
2010. Study inclusion criteria were that the program must have had
a regularly meeting classroom-based component and the classroom
served predominately children 3 to 5 years old, although older and
younger children also could be served. The only exclusion criterion
was that the classroom must not have been located at a buildinglevel site that had previously received ECCP services.
ECCP referrals and services were processed through a centralized management system that developed and oversees the ECCP
and recruits, trains and supervises consultants. Classrooms and
early childcare programs were recruited through the normal ECCP
channels (i.e., from consultants’ membership in various early
childhood organizations, advisory board memberships, communitybased organizations, and meetings) and through fliers describing the
evaluation study. Once a site director or classroom teacher contacted
the centralized management organization to request ECCP services
owing to a classroom-wide or child-specific concern, they were
enrolled in the evaluation study and received services immediately
or shortly thereafter (after a 3-month evaluation). Before randomization and the pretest, teachers were instructed to identify 2 target
children in their classrooms whose behaviors most prompted their
request for ECCP services. Then, a face-to-face meeting occurred
among the parent, center director, and classroom teachers to discuss
identified concerns, develop a plan for consultation, and obtain
parental consent. Two children were identified per classroom for the
present study to allow for standardization across classrooms.
Eighty-eight classrooms and teachers satisfied the inclusion
criteria and were randomized using a random number generation
procedure to the treatment (n ¼ 44; received ECCP services) or
control (n ¼ 44; no ECCP services) condition. Classrooms in the
control condition received ECCP services after the evaluation (after 3
months). In total, 176 students (88 in treatme …
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