What Works: Using Evidence and Practice

What Works: Using Evidence and
Practice-Based Interventions to Support
Social Emotional Health
The Head Start Act
• Comprehensive health, educational, nutritional, social, and
other services needed to aid participating children in
attaining their full potential, and to prepare children to
succeed in school
Healthy Children
Ready To Learn
• In a comparison of school readiness outcomes for
Head Start children and eligible children on the wait
o The Head Start children scored significantly better in School
Readiness measures
o Parent reports of health outcomes also showed significant
differences between the 2 groups with the Head Start
families group reporting more healthy responses
ACE Study: Major Findings
Increases in ACE score associated with increased risk for
the following health problems:
Alcoholism and alcohol
Chronic obstructive
pulmonary disease
Fetal death
Health-related quality of
Illicit drug use
Ischemic heart disease
Liver disease
Risk for intimate partner
Multiple sexual partners
Sexually transmitted
diseases (STDs)
Suicide attempts
Unintended pregnancies
FACES data
• Parents
o Majority of parents do not report depressive symptoms
o About 40% report some symptoms, 19% report moderate symptoms
• Staff
o Majority of HS teachers do not report depressive symptoms, about 1/3
report some symptoms
o 16% report moderate to severe symptoms
Surgeon General’s Vision
for Children’s Mental Health
• Project Head Start
• Carolina Abecedarian Project
• Infant Health and Development Program
• Elmira Prenatal/Early Infancy Project
• Primary Mental Health Project
• Other Prevention Programs and Strategies
Head Start Performance Standards
Early Childhood Health and Development
1304.20 Child Health and Development
1304.21 Education and Early Childhood Development
1304.22 Child Health and Safety
1304.23 Child Nutrition
1304.24 Child Mental Health
• Integrates all educational aspects of the health,
nutrition, and mental health services into program
• Ensures that the program environment helps children
develop emotional security and facility in social
• Enhances each child's understanding of self as an
individual and as a member of a group;
• Provides each child with opportunities for success to help
develop feelings of competence, self-esteem, and
positive attitudes toward learning; and(
• Provides individual and small group experiences both
indoors and outdoors.
Head Start Performance Standards
Mental Health
1304.24 (a) (1) Work Collaboratively with Parents
1304.24 (a) (2) Must Secure the Services of Mental Health Professionals.
to enable the timely and effective identification and
intervention in family and
staff concerns about a
child’s mental health
1304.24 (a) (3) must include a regular
schedule of on-site mental
health consultation
Where and When Do You Integrate Social
Emotional Well Being into Your Work?
Teachable Moments
for Social Emotional Well Being Activities
Art Activities
Behavior Management
Blocks and Table Toys
Circle Time
Clean Up Time
Dramatic Play
Field Trips
Home Visits
Large Motor Play
Music and Movement
Outside Time
Parent Meetings
Quiet/Nap Time
Sensory Play Materials
Staff Training
Work Collaboratively with Parents
The Head Start Parent, Family, and Community Engagement
Children will:
• Engage and maintain positive adult-child relationships and interactions
• Engage and maintain positive peer relationships and interactions
• Display levels of attention, emotional regulation, and behavior in the classroom that are
appropriate to the situation and supports available
• Learn and internalize classroom rules, routines and directions
• Develop and display a sense of self, confidence in their abilities and a strong identity that is
rooted in their family and culture.
• "Each baby is born into a unique family that has its
own culture and history, its own strengths and its
own way of coping with stress and adversity."
Parlakian & Seibel, 2002
My Culture
• Small group activity
Supporting Resilience
Help build a positive vision of future.
Affirm your support.
Help the family develop a plan to reduce effects of external stressors.
Evaluate which stressors are producing the most disruption of family interaction and routines.
Facilitate identification of resources and strategies to reduce the impact of stressors.
Identify family and other natural supports.
CSEFEL Pyramid Model
To Strengthen the Capacity
of Head Start and Child Care
to Promote the Social and
Emotional Foundations of
Early Learning
• Strong, clear communication strengthens
partnerships. How we communicate with
families both verbally and non-verbally sets a tone
for how partnerships develop.
1304.24 (a) (3)
Mental Health Consultation
ECMH Consultation
• Indirect mental health intervention for infants,
toddlers and preschoolers
• Focused on young children in ECE settings and
their caregivers
• Collaboration between a professional consultant
with mental health expertise and consultees
Types of ECMHC
• Child/family-centered consultation:
Focuses on a particular child with
challenging behavior and/or the family of
that child
• Programmatic consultation:
Focuses on a general program or
classroom issue that impacts the mental
health of staff, children and/or families
Cohen & Kaufmann, 2000
Common Goals of ECMH Consultation
• Reduce the impact of
mental health problems
among young children in
ECE settings
• Build the capacity of ECE
staff, programs, and families
to promote young children’s
healthy social/emotional
development and address
challenging or troubling
What ECMHC “Isn’t”
Formal diagnostic evaluations
Therapeutic play groups
Individual therapy
Family therapy
Staff therapy
Family support groups
CSEFEL Pyramid Model:
Promoting Social Emotional Competence in Infants and Young Children
Breaking it Down:
Nurturing Relationship
“an enduring emotional bond to
one or two specific people in
whose presence
I feel safe to explore new activities,
ideas, feelings, and to whom I want
to return when stressed.”
High Quality Supportive
What Would You See
Talk at your tables and
come up with one or two
examples of what
“Quality Supportive
Environments” look likeput your post it on the
flip chart
CECMHC Resources for
Quality Supportive Environments
Infant Family Posters
Infant Staff Posters
Toddler Family Posters
Toddler Staff Posters
Preschool Posters
Putting it Into Practice
Where do you see these tools fitting
into your training and coaching work?
Targeted and Intensive Supports
CECMHC Resources for
Targeted and Intensive Intervention
Let’s Observe- Michael a Toddler
Walking Through the Process
Let’s Reflect for Michael
What Does Social Emotional Development
Look Like As Children Enter School?
A sense of confidence and
Ability to develop good
relationships with peers and
adults/make friends
Ability to persist at tasks
Ability to follow directions
Ability to identify, understand, and
communicate own
Ability to constructively manage
Development of empathy
What happens when children don’t
have these skills?
Emotional Literacy
…the ability to
understand, and
express emotions
in a healthy way
“If a child doesn’t know how to read, we teach.”
“If a child doesn’t know how to swim, we teach.”
“If a child doesn’t know how to multiply, we teach.”
“If a child doesn’t know how to drive, we teach.”
“If a child doesn’t know how to behave, we……..... ……….teach?………punish?”
“Why can’t we finish the last sentence as automatically as we do the others?”
– Tom Herner (NASDE President ) Counterpoint 1998, p.2
So. . .How do we teach it?
• What are you doing now?
Use Songs and Games
Sample Song
• If you are happy and you know it…add
new verses to teach feelings
If you’re sad and you know it, cry a tear.”boo hoo”
If you’re mad and you know it, use your words “I’m mad”
If you’re scared and you know it ask for help, “help me”
If you’re happy and you know it, hug your dad
If you’re tired and you know it, give a yawn.
Jim Gill “I’m So Happy I Could Growl”
How Schedules and Routines Support
Social and Emotional Development
• Schedules and Routines:
o are an important part of each day
o meet children’s basic needs
o provide opportunities for learning and development
o provide predictability, help infants and toddlers learn what
to expect (from people and the environment)
o help children develop a
sense of security and control
o support competence and
How to Structure Schedules and Routines to
Support SE Development and Prevent
Challenging Behavior
• Schedules
Have a consistent schedule
Minimize transitions
Prepare children when there will be a change
Use visual cues if children need them
Create opportunities for “playing” with your child
How to Structure Schedules and Routines to
Support SE Development and Prevent
Challenging Behavior
Structure routines so they have a beginning, middle, and end
Make them fun!!!!!!!!!!!
Teach children the expectations of the routine
Use visual cues if needed
Involve children in daily routines such as preparing a meal or
provide them with something to do
o Use routine activities to strengthen relationship with your child
o Use routine activities to teach new skills
o Prepare children for transitions
Wash hands
Visual Schedules
1. Turn on water.
3. Get soap.
2. Wet hands.
4. Rinse hands.
5. Turn off water.
6. Dry hands.
7. Throw away towel.
8. Go play.
Children with a Strong Foundation
in Emotional Literacy:
• tolerate frustration better
• get into fewer fights
• engage in less destructive
• are healthier
• are less lonely
• are less impulsive
• are more focused
• have greater academic
Direct Teaching of Feeling Vocabulary
Enhancing Emotional Literacy
Direct Teaching
Indirect Teaching
Use of Songs and Games
How would you feel if…?
Checking In
Feeling Dice and Feeling Wheel
Use of Children’s Literature
The tippy top of the Pyramid
What a Licensed Mental Health Professional Does
• Parent-Child Interaction Therapy
• Child-Parent Psychotherapy
• Dyadic therapy
Promote staff wellness so that they can
provide support to children and families in Head
Start programs.
• Taking Care of Yourself
Knowing Your Stressors
• What is stress?
• What causes me stress?
• What are some ways you deal with stress?
• A good end to the day
Healthy and Read to Learn
Neal M. Horen, Ph.D.
This document was prepared under Grant #90HC0005 for the U.S. Department of
Health and Human Services, Administration for Children and Families, Office of Head
Start, by the National Center on Health.