Using QRIS As A
Tool To Enhance
Children’s Social
and Emotional
Development
Geoffrey Nagle, PhD, MPH, LCSW
Allison Boothe, PhD
Tulane University
Institute of Infant and
Early Childhood Mental Health
Tulane Institute of Infant and Early Childhood Mental Health
Integrating Social-Emotional
Development in the QRIS
 Environment Rating Scales
 Social-Emotional Subscale
 Mental Health Consultation
 Reflective Supervision
 Social-Emotional Screening
 Training
 Warm Line
 Funding
Tulane Institute of Infant and Early Childhood Mental Health
Quality Start – Louisiana’s QRIS
 Recognize the quality of child care being
offered by child care providers
 Build and sustain quality child care
 Inform parents about the quality of child
care
Tulane Institute of Infant and Early Childhood Mental Health
Points to Earn Stars
Total Number of
Points
3-5
6-9
10-11
Star Rating
Social-Emotional Subscale
Tulane Institute of Infant and Early Childhood Mental Health
Environment Rating
Scales
Tulane Institute of Infant and Early Childhood Mental Health
Environment Rating Scales
Infant/Toddler Environment Rating Scale Revised (ITERS-R) – birth through 2½ years
Early Childhood Environment Rating Scale Revised (ECERS-R) – 2½ years to 5 years
Harms, T., Cryer, D., & Clifford, R. M. (2006).
Harms, T., Clifford, R.M., Cryer, D. (2005).
Tulane Institute of Infant and Early Childhood Mental Health
Each ERS Scale Assesses
 Space and Furnishings
 Personal Care Routines
 Activities
 Listening & Talking/Language-Reasoning
Skills
 Interaction
 Program Structure
Tulane Institute of Infant and Early Childhood Mental Health
Social-Emotional Subscale
 ITERS-R
 Listening and Talking
 Interaction
 Program Structure
 ECERS-R
 LanguageReasoning
 Interaction
 Program Structure
Tulane Institute of Infant and Early Childhood Mental Health
Program Standards - Scores on the ERS
(ITERS/ECERS)
Points
1
2
3
4
5
Criteria
Tulane Institute of Infant and Early Childhood Mental Health
Program Standards - Scores on the ERS
(ITERS/ECERS)
Points
1
2
3
4
5
Criteria
An average of 3.75 on the social-emotional subscale, with
no one classroom lower than 3 on the subscale
Tulane Institute of Infant and Early Childhood Mental Health
Program Standards - Scores on the ERS
(ITERS/ECERS)
Points
Criteria
1
An average of 3.75 on the social-emotional subscale, with
no one classroom lower than 3 on the subscale
2
An average of 4 on the social-emotional subscale, with no
one classroom lower than 3 on the subscale
3
4
5
Tulane Institute of Infant and Early Childhood Mental Health
Program Standards - Scores on the ERS
(ITERS/ECERS)
Points
Criteria
1
An average of 3.75 on the social-emotional subscale, with
no one classroom lower than 3 on the subscale
2
An average of 4 on the social-emotional subscale, with no
one classroom lower than 3 on the subscale
3
An average of 4.25 on the social-emotional subscale, with
no one classroom lower than 3.25 on the subscale
4
5
Tulane Institute of Infant and Early Childhood Mental Health
Program Standards - Scores on the ERS
(ITERS/ECERS)
Points
Criteria
1
An average of 3.75 on the social-emotional subscale, with
no one classroom lower than 3 on the subscale
2
An average of 4 on the social-emotional subscale, with no
one classroom lower than 3 on the subscale
3
An average of 4.25 on the social-emotional subscale, with
no one classroom lower than 3.25 on the subscale
4
An average of 4.5 on the social-emotional subscale, with
no one classroom lower than 3.5 on the overall ERS
5
Tulane Institute of Infant and Early Childhood Mental Health
Program Standards - Scores on the ERS
(ITERS/ECERS)
Points
Criteria
1
An average of 3.75 on the social-emotional subscale, with
no one classroom lower than 3 on the subscale
2
An average of 4 on the social-emotional subscale, with no
one classroom lower than 3 on the subscale
3
An average of 4.25 on the social-emotional subscale, with
no one classroom lower than 3.25 on the subscale
4
An average of 4.5 on the social-emotional subscale, with
no one classroom lower than 3.5 on the overall ERS
5
An average of 5 on the overall ERS, with no one
classroom lower than 4 on the overall ERS
Tulane Institute of Infant and Early Childhood Mental Health
Mental Health
Consultation
Tulane Institute of Infant and Early Childhood Mental Health
Acknowledgments
 Angela Keyes, Ph.D.
 Sheryl Scott Heller, Ph.D.
 Krystal Vaughn, LPC
 All of the Quality Start Mental Health
Consultants
Tulane Institute of Infant and Early Childhood Mental Health
A Primary Goal of MHC & Quality Start
 Support healthy social emotional
development.
 Social Emotional Development: Children’s
ability to experience, regulate, and express
emotions; form close and secure
relationships; explore the environment and
learn” (Parlakian, 2003, p. 2).
Tulane Institute of Infant and Early Childhood Mental Health
 Kindergarten teachers rate motivation and social
emotional skills as more important to school
success than being able to read upon entering
kindergarten. (National Institute of Early Education Research, 2008).
Tulane Institute of Infant and Early Childhood Mental Health
What is Mental Health Consultation?
 A method of supporting the healthy
development of infants and young children.
 An important component of support to
childcare centers working to maximize
quality.
 Designed to support ALL children, teachers,
and families involved in childcare.
Tulane Institute of Infant and Early Childhood Mental Health
Quality Start Model of Mental
Health Consultation
Tulane Institute of Infant and Early Childhood Mental Health
Quality Start is a Combination Model of MHC
 3 types of MHC:
 Program Centered: designed to improve
experience of all individuals involved with center
 Child Centered: designed to assess and make
recommendations about particular children
 Combination Model: uses aspects of both models
to assist center and individuals within center
Tulane Institute of Infant and Early Childhood Mental Health
Program Centered Components of The Model
 Relationships are seen as major catalyst of
change
 Interactive trainings are consistently
conducted
 MHC consistently observes in classrooms
 MHC consistently meets with director
 Consultants are available to meet individually
with staff members
 Parent meetings/workshops are available
Tulane Institute of Infant and Early Childhood Mental Health
Child Centered Components of Our Model
 MHC available to complete a child-centered
consultation when requested
 Parent permission necessary & beneficial
 MHC can:




Observe child in classroom
Interview parents/teachers/director
Make referrals when needed
Assist in designing behavior management program for class
and assist teacher in implementing
Tulane Institute of Infant and Early Childhood Mental Health
Benefits of Combined Model
 Centers often request consultation for child-
centered reasons.
 e.g., Challenging behaviors; developmental concerns
 Combined model = immediate assistance for
challenging behavior with continued assistance
across the center.
Tulane Institute of Infant and Early Childhood Mental Health
Model Components
 12 total visits. One day every other week (day =
5-6 hours).
 Centers with 8 or more classrooms receive
weekly visits with up to 24 total visits.
 All centers participating in the Quality Start
QRIS program are eligible.
 Centers serving child enrolled in CCAP receive
priority.
Tulane Institute of Infant and Early Childhood Mental Health
Work Expectations
 Each MHC carries caseload of:
 Between 7-8 centers
 Averaging between 30 and 40 classrooms
 Large centers (8 or more rooms) ‘count’ as 2
centers as visited weekly
 Each MHC is responsible for 4 trainings for
child care community per year.
 Introduction to Social Emotional Screening
 Learning Through Play
Tulane Institute of Infant and Early Childhood Mental Health
Quality Start Mental Health Consultants
 13 full time equivalent consultants across
state
 All have master’s degree in a mental health
field and hold a license.
 Primarily LCSW, LPC, of GSW license.
 Prefer clinicians who have experience with
children.
Tulane Institute of Infant and Early Childhood Mental Health
Community Agency Involvement
 Each MHC is employed through a regional
agency.
 Benefits of regional agency:
 MHC is identified as member of community at
large
 MHC can call upon unique aspects of his/her
agency
Tulane Institute of Infant and Early Childhood Mental Health
Consultant Training
 Pre-Service Training
 Full training on all aspects of MHC model
 5 interactive didactic trainings
 2 community trainings
 Shadow consultants in field
 Infant Mental Health training
 60 hours of class time in person or via
videoconferencing
Tulane Institute of Infant and Early Childhood Mental Health
In-Service Training
 Training occurs 1-2 times per calendar year
 Topics/Focus vary and have included:
 Cultural differences within centers and between MHC
and center
 Outside speakers
 Updates
 Team building
 Reflective Supervision
Tulane Institute of Infant and Early Childhood Mental Health
Consultant Supervision
 Consultants participate in:
 Individual reflective supervision two times per
month
 Group reflective supervision one time per
month
 Focus of supervision is
 Relationships with center staff
 Avoiding the “expert stance”
 Consultants who are working towards a more
advanced license maintain supervision outside
of the program.
Tulane Institute of Infant and Early Childhood Mental Health
Reflective Supervision
 Integral to program
 Goal of reflective supervision:
 to help MHCs focus on their relationships with
consultees & how those relationships support positive
change.
 MHCs are encouraged to:
 discuss challenges
 to view challenges from a variety of perspectives
 to “wonder” about methods of supporting change
within a center.
Tulane Institute of Infant and Early Childhood Mental Health
Social-Emotional
Screening
Tulane Institute of Infant and Early Childhood Mental Health
Program Standards: Social-Emotional
Development Screening
Points
Criteria
4
Complete screening for social-emotional development
with instrument from recommended list for all children
(0-5 yrs.) within 45 calendar days of enrollment and
annually thereafter. Conference with parents to review
results and provide a list of community resources.
5
Same
Tulane Institute of Infant and Early Childhood Mental Health
Staff Qualifications: Social Emotional
Screening Training
Points
Criteria
3
Directors and lead teachers complete training in
social-emotional screening of children.
4
Same
5
Same
Tulane Institute of Infant and Early Childhood Mental Health
Introduction to Social Emotional
Screening Community Training
 Rationale for universal screening
 Importance of early detection
 Identifying risk and protective factors
 Outcomes for early treatment vs. later treatment
Tulane Institute of Infant and Early Childhood Mental Health
Selection of Screening Instrument
 Recommended screeners :
 ASQ-SE (Ages & Stages: Social Emotional)
 ECSA (Early Childhood Screening Assessment)
 Age ranges of each
 Cost of implementation for each
 Psychometric properties of each
Tulane Institute of Infant and Early Childhood Mental Health
Preparing to Screen
 Who orders?
 Who completes? (e.g., teacher; parent; etc)
 Who scores?
 Who discusses results with parents?
 How to give feedback to parents.
 How to follow up? (e.g., referrals, re-
screening, etc.)
 Social-Emotional Warm line information
Tulane Institute of Infant and Early Childhood Mental Health
Program Evaluation
 Pre and post assessments are ongoing
 Staff self report
 Observational Measures (CLASS)
 Initial findings are promising
 Staff report finding MHC worthwhile & helpful
 Observed differences found in classrooms in
 Student teacher interactions
 Overall classroom climate
Tulane Institute of Infant and Early Childhood Mental Health
Mental Health Consultation:
A teacher’s perspective
 “She was very professional and at the
same time her friendly ways made her a
part of our school family. The children and
parents trusted her not only as a
consultant but also as a person who really
cares.”
 A teacher after participating in Quality Start MHC program.
Tulane Institute of Infant and Early Childhood Mental Health
Future Research
 Compare pre and post Environment Rating
Scale scores.
 Focus on social-emotional subscale
Tulane Institute of Infant and Early Childhood Mental Health
 Quality Start MHC strives to provide a
foundation for child care center staff to
support young children in their social
emotional growth.
 Evaluation data is assisting us in continuing
to move in the right direction.
Tulane Institute of Infant and Early Childhood Mental Health
Funding
Tulane Institute of Infant and Early Childhood Mental Health
Funding to Support QRIS
 Tiered Bonus Payments
 School Readiness Tax Credits
Tulane Institute of Infant and Early Childhood Mental Health
Tiered Bonus Payments
 Children in the Child Care Assistance
Program (CCAP)
 Children in foster care
 Payments are automatically issued after the
end of each calendar quarter
Tulane Institute of Infant and Early Childhood Mental Health
Tiered Bonus Payments
Star Rating
 The bonus
payment is equal to
a percentage of all
payments from
DSS for services
provided during the
quarter as follows:
5 Star
4 Star
3 Star
2 Star
1 Star (or not
participating)
Bonus
Tulane Institute of Infant and Early Childhood Mental Health
Tiered Bonus Payments
 The bonus
payment is equal to
a percentage of all
payments from
DSS for services
provided during the
quarter as follows:
Star Rating
Bonus
5 Star
20%
4 Star
13.5%
3 Star
8%
2 Star
3%
1 Star (or not
participating)
0
Tulane Institute of Infant and Early Childhood Mental Health
School Readiness Tax Credits
 Package of 4 Tax Credits
 Credits to Providers
 Credits to Directors and Teachers
 Credits to Business for Supporting Child
Care
 Credits to Parents/Consumers
Tulane Institute of Infant and Early Childhood Mental Health
Tax Credits to Providers
 102 providers benefited from the SRTC
 $1.3 million
 $12,795 per provider
 Range $750 - $81,000
Tulane Institute of Infant and Early Childhood Mental Health
Tax Credits to Teachers/Directors
 761 teachers/directors benefited from SRTC
 $1.3 million
 Average of $1726 per teacher/director
 Another 400-500 teachers were eligible and
were not at a star rated center or did not file for
the credits.
Tulane Institute of Infant and Early Childhood Mental Health
Tax Credits to Businesses
 27 businesses benefited from SRTC
 $28,000
 Average - $1000 each
 In addition, $100,000 donated to Child Care
Resource and Referral Agencies
Tulane Institute of Infant and Early Childhood Mental Health
Tax Credits to Parents
 4455 parents benefited from SRTC
 $950,000
 Average of $215 per parent (tax return)
Tulane Institute of Infant and Early Childhood Mental Health
THANK YOU
Contact Information:
Allison Boothe
aboothe@tulane.edu
Geoffrey Nagle
gnagle@tulane.edu