Maryland’s Early Childhood Mental Health Consultation Project:
Supporting the academic and social-emotional success of preschoolers
February 2011
What is Early Childhood Mental Health Consultation (ECMHC)?
Early Childhood Mental Health Consultation (ECMHC) is designed to improve the ability of early care and education
(ECE) program staff and families to address mental health problems, particularly behavioral, in children birth-five
years. Services include:
 observation and assessment of the child and the classroom environment
 referring children and families to Maryland’s Infants and Toddlers program, Child Find, and other appropriate
mental health services
 training and coaching of early care and education providers to meet children’s social and emotional needs
 assisting children in modifying behaviors
 helping providers retain and serve children with behavioral and other mental health needs
ECMHC has two general approaches:
1) child- and family-focused consultation – targets the behavior of a specific child in an ECE setting
2) classroom-focused or program consultation – targets overall teacher-child interaction within ECE classrooms
Who is receiving consultation in
Maryland?
In Fiscal Year 2010, MSDE reported:
Child Specific Consultation:
 724 Children
o 73% boys
o 72% between 3 and 5 years old
Classroom/Program Consultation:

350 Classrooms
o 20,524 children exposed to ECMHC
o 3,720 early care and education staff
had ECMHC at their programs
Number of children receiving
child-specific consultation
16-20
11 to 15
6 to 10
3 to 5
1 to 2
ECMHC reduces expulsions among
preschoolers.
In Maryland, only 3% of children who received
child-specific consultation (in FY10) were expelled,
and 81% remained in their current early childhood
program. All children who receive child-specific
ECMH consultation are at risk of expulsion.
An average of 1.2 children per 1,000 were expelled
from Maryland ECE programs since the
implementation of ECMHC. This compares to a rate
of 6 expulsions per 1,000 children in a national
survey of state-subsidized pre-schools (Gilliam,
2005).
Maryland’s ECMHC Evaluation
The Maryland State Department of Education is funding the evaluation of Maryland’s ECMHC in order to
better define the Maryland model of ECMHC and to understand its impact on children’s behavioral and
school outcomes. The evaluation is being led by researchers at the University of Maryland and Georgetown
University, working in collaboration with community and Minority Business partners.
Evaluation data is gathered upon initiation of consultation services and again at 4 months or discharge.
What are the most critical findings of Maryland’s ECMHC Evaluation to date?
1. ECMHC improves preschool climate
ECMHC has shown a significant, positive
impact on all aspects of classroom
functioning measured by the Preschool
Mental Health Climate Scale (PMHCS,
Gilliam, 2007).
5
4
3
2
1
Baseline
Follow-up
These improved domains are all critical to
children’s school success, particularly for
students with emotional and behavioral
challenges.
Mean SDQ Rating Across Classrooms
1.8
2. ECMHC improves children’s social and
behavioral problems in the classroom
ECE classroom teachers rated the extent and
impact of child problem behaviors in the
classroom using the Strengths and Difficulties
Questionnaire (SDQ), a measure of children’s
social-emotional behavior.
1.75
1.7
The reduction in mean levels of problem
behavior on the SDQ from baseline (preconsultation) to follow-up (post-consultation)
was highly significant.
1.65
1.6
1.55
1.5
Baseline
Follow-up
A reduction in children’s behavior problems in a
classroom promotes a more productive learning
environment for students, and reduces teacher
stress.