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Lillian Taylor
05 November 2018
Early Childhood Mental Health Consultation: Results of a Statewide Random-Controlled
Evaluation
“Early Childhood Mental Health Consultation: Results of a Statewide
Random-Controlled Evaluation” is authored by Walter S. Gilliam​,​ Angela N​. ​Maupin​,​ and Chin
R​. ​Reyes for the Journal of the American Academy of Child and Adolescent Psychiatry​. ​The
article outlines a hypothesis which states the introduction of early childhood mental health
consultation (ECMHC) programs in early education settings may improve classroom quality​,
decrease the instance of child behavior problems and decrease the probability of targeted
children being expelled or suspended from school​. ​The study included 176 target children
between the ages of three and four years old in 88 preschool classrooms​. ​The students selected
were 75.9% male and 24.1% female​, ​with the demographics of the participant group being 3​.​4%
Asian​, ​14​.​9% Hispanic or Latino​, ​10​.​3% black​, ​65​.​5% white and 5​.​7% other​. ​82% of the
classrooms selected were in community based childcare centers​, ​13% in Head Start centers​, ​and
5% in public schools​ ​(Gilliam, Maupin & Reyes, 2016).
This study was conducted in an experimental manner​. ​The researchers included a control
group​, ​and it was conducted via randomized control treatment design​. ​The independent variable​,
or treatment​, ​in this experiment was the receiving of ECMHC​. ​The dependent variable was the
resulting impact on classroom quality and child behavior​. ​Teachers in selected classrooms
utilized a procedure in which they were assigned to identify two target students whose behavior
prompted the need for ECMHC​. ​To measure the degree of classroom quality​, ​classrooms were
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assessed on the Classroom Assessment Scoring Scale (CLASS) domains of emotional support
and organization​. ​The evaluation of the target children was assessed through naturalistic
observation of the teacher via the Social Skills Rating System (SSRS)​, ​the Conners Teacher
Rating Scale (CTRS) and the Preschool Expulsion Risk Measure (PERM)​ ​(Gilliam, Maupin &
Reyes, 2016).
The statistical analyses used to analyze the data collected was that of independent sample
tests to measure the differences in classroom quality and hierarchical linear modeling (HLM) to
analyze child behavior​. ​The findings from these analyses supports a great deal of the author’s
hypothesis,​ ​in that the treatment group scored lower than the control group on teacher-reported
behavior problems​. ​There were significant group differences between the treatment group and the
control group in the categories of child hyperactivity​, ​restlessness​, ​impulsivity​, ​externalizing
behaviors​, ​and total problems in the classroom​. ​The figure presented after the results section of
the article presents these same findings​. ​The mean scores for hyperactivity for the treatment and
control groups were 60​.​36 and 65​.​76​,​ 60​.​14 and 65​.​41 for restlessness and impulsivity​, ​and 63​.​14
and 68​.​64 for total problems​ ​(Gilliam, Maupin & Reyes, 2016)​.
Based on the results of the experiment​, ​some aspects of the author’s hypothesis were
supported​, ​while other aspects were not supported​. ​There were no statistically significant
differences in classroom quality between the two groups and there were no remarkable
differences in PERM scores​, ​thereby not supporting those aspects of the author’s hypothesis​.
There were​, ​however​, ​significant differences in child behavior​, ​thereby supporting that aspect of
the author’s hypothesis. These findings are supported by previous literature​, ​which found similar
significant differences in treatment groups as well​, ​including lower instances of externalizing
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behaviors (Raver et al as cited in Gilliam, Maupin & Reyes, 2009 )​. ​Previous literature also
suggests ECMHC may improve teacher-reported behavior problems in early childhood education
settings (Hepburn et al as cited in Gilliam, Maupin & Reyes, 2013)​. ​The conclusion that may be
drawn from the current study suggests ECMHC may be effective in reducing externalizing
behaviors in preschoolers​. ​The implication of this conclusion is that implementing ECMHC
programs nationwide may be effective in reducing early childhood behavioral problems​. ​The
authors make suggestions for further investigation​, ​such as conducting the study with the
intention of evaluating whether ECMHC directly affects preschool expulsion rates​ ​(Gilliam,
Maupin & Reyes, 2016)​.
Eradicating expulsion as a means of punishment is a primary goal of ECMHC programs
as it is shown to not be an effective means of discipline​. ​ECMHC programs initiate inductive
discipline via concepts like the “cuddly corner” and encouraging the children to communicate
their feelings (Turner, 2016). These forms of inductive discipline motivate children to commit to
moral standards and reduce a child’s anxiety when they misbehave​.​ This development of
prosocial behavior via ECMHC initiatives may also curb aggression in young children​.​ Threats,
such as threatening expulsion,​ ​asserting power over young children​, ​and inconsistent discipline
are linked to the development of aggression​.​ The introduction of early intervention such as
ECMHC programs may be effective in breaking the cycle of hostility between teachers and
students and may promote healthy​, ​constructive ways of relating to each other (Berk, 2017)​. ​The
NPR education reporter covering the epidemic of preschool suspensions was Cory Turner​.​ One
advantage of listening to the podcast prior to writing the assignment was it gave a concise
overview of the subject matter and provided specific details essential to understanding the article.
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References
Berk, L.E. (2017). ​Development through the lifespan. P
​ earson
Gilliam, W. S., Maupin, A. N., & Reyes, C. R. (2016). Early Childhood Mental Health
Consultation: Results of a Statewide Random-Controlled Evaluation. ​Journal of the
American Academy of Child & Adolescent Psychiatry,55(​ 9), 754-761.
doi:10.1016/j.jaac.2016.06.006
Hepburn, K., Perry, D. F., Shivers, E., & Gilliam, W. S. (2013). Early childhood mental
health consultation as an evidenced-based practice: Where does it stand?. ​Zero to Three​,
33(5), 10-18.
Raver, C. C., Jones, S. M., Li-Grining, C., Zhai, F., Metzger, M. W., & Solomon, B. (2009).
Targeting children’s behavior problems in preschool classrooms: A cluster-randomized
controlled trial. ​Journal of Consulting and Clinical Psychology,77​(2), 302-316.
doi:10.1037/a0015302
Turner, C. (2016, September 5). Preschool Suspensions Really Happen And That’s Not OK
With Connecticut. ​National Public Radio.​ , Podcast retrieved from
https://www.npr.org/sections/ed/2016/09/05/490226345/preschool-suspensions-really-hap
pen-and-thats-not-okay-with-connecticut