Externalizing Problems in Head Start Children:
An Ecological Exploration
Brenda Jones Harden
University of Maryland
Monique B. Winslow
Research Triangle Institute
Kimberly T. Kendziora
American Institutes for Research
Ariana Shahinfar
LaSalle University
Kenneth H. Rubin
University of Maryland
Nathan A. Fox
University of Maryland
Michael J. Crowley
University of Maryland
Carolyn Zahn-Waxler
National Institute of Mental Health
Running Head: Externalizing Problems in Head Start Children
The authors are grateful for the financial support of the MetLife Foundation in the
implementation of this study. We would also like to extend our gratitude to the Head Start
children, families, and teachers without whom this research would not have been possible.
Externalizing Problems in Head Start Children
Externalizing Problems in Head Start Children: An Ecological Exploration
ABSTRACT
The increased familial and environmental stressors affecting Head Start families over the
last two decades have precipitated an escalation of mental health difficulties among participant
children (Yoshikawa & Knitzer, 1997). Using an ecological framework (Bronfenbrenner, 1979),
this study explored externalizing behavior problems among a group of Head Start children in a
suburban county. Children (N=155) were assessed for externalizing behavior problems in the
home and classroom. Additionally, parents participated in interviews about a variety of
ecological factors related to children’s behavior problems. Almost one-quarter of the children
were identified by their parents as having externalizing behavioral problems in the borderline or
clinical range. Twice as many girls as boys had borderline or clinical levels of behavioral
problems. Child externalizing behavior was positively associated with child internalizing
behavior, parent psychological symptomatology, child temperament, family environment, and
exposure to community violence. Children with parent-identified externalizing behavior did
have specific social problem-solving skills deficits. Additionally, they were observed to have
high levels of specific inappropriate behavior, but did not exhibit high levels of teacher-rated
behavior problems. The implications of these findings for Head Start program planning are
discussed.
Externalizing Problems in Head Start Children
Externalizing Problems in Head Start Children: An Ecological Exploration
Children reared in poverty are experiencing unprecedented challenges to their mental
health, including exposure to family and community violence, familial drug involvement, and
dwindling community and societal resources. Current evidence points to a strong association
between adverse environmental factors, such as poverty, and externalizing (i.e., outer-directed)
behavioral problems in children (Sanson, Smart, Prior & Oberklaid, 1993; Bolger, Patterson,
Thompson & Kupersmidt, 1995). However, factors within the child (e.g., temperament) and
within the proximal ecologies of children (e.g., parent factors) seem to have a greater impact than
more distal factors, such as poverty (Shaw, Owens, Vondra, Keenan & Winslow, 1996).
Head Start, with its emphasis on serving children living in poverty, is a prime venue for
advancing research on the individual and ecological contributions to externalizing problems in
young children from low-income backgrounds. Using an ecological framework (Bronfenbrenner,
1977), we examined herein the intra-individual and environmental factors which potentially
relate to externalizing behavior problems in Head Start children. Because of the evidence on the
primacy of the family ecology, it is a particular focus of this investigation.
Externalizing Behavior in Preschool Children
Externalizing behavior problems in young children are receiving increasing empirical
attention (Campbell, 1995). Research indicates that the most prevalent mental health difficulty
in preschool children is externalizing behavior, defined as non-compliance, poor self-control, and
problematic social relationships (Campbell, 1990). Empirical interest in preschool behavior
problems has also been fueled by evidence of a link between early onset of externalizing
behavior problems and antisocial behavior disorders in later childhood and adolescence
Externalizing Problems in Head Start Children
(Campbell, 1995; Tremblay, Pihl, Vitaro & Dobkin, 1994; Patterson, Reid & Dishion, 1992;
Farrington, 1991).
Given that externalizing behavior has been identified as a major mental health concern of
the preschool years, research which investigates the rate at which this phenomenon occurs in
specific populations is important. Campbell (1995) states that approximately 10-15% of
preschool children have mild to moderate behavior problems. Data about the prevalence of
externalizing behavioral problems in young children from impoverished backgrounds are limited.
Although Head Start scholars and practitioners have called for documentation of the prevalence
of externalizing behavior among participant children, such data are sparse.
There is a growing body of evidence on the prevalence of emotional problems in general
in the Head Start population. A national study of Head Start children revealed that 0.5% had
emotional or behavioral disabilities based on information received from programs (Piotrkowski,
Collins, Knitzer & Robinson, 1994). However, Forness and colleagues (1993) have posited that
Head Start children with emotional disturbance remain underidentified at a rate of perhaps 50%
of what the rate actually may be. Yoshikawa and Knitzer (1997) have pointed to underestimation
of the mental health needs of Head Start children as well, citing the discrepancy between Head
Start Program Information Reports (PIR’s) and empirical studies of this phenomenon. These
findings suggest that externalizing behavior problems, as one class of mental health difficulty,
are underidentified among Head Start children as well.
The Ecology of Externalizing Behavior
There are multiple risk and protective factors which influence the emergence of
externalizing behavior in young children. An ecological framework emphasizes the contribution
Externalizing Problems in Head Start Children
of the individual and the environment to developmental outcome. Preschool behavioral
difficulties have been found to be the result of a complex interplay of intrapersonal and
interpersonal factors, including gender (Campbell, 1990), difficult temperament (Sanson et al.,
1993), compromised cognitive development (McGee, Partridge, Williams & Silva, 1991), and
deficits in social cognition and relationships (Patterson, DeBaryshe & Ramsey, 1989).
In terms of gender, a preponderance of evidence exists which indicates that male children,
at least in middle childhood and adolescence, are more vulnerable to externalizing behavioral
symptoms (Kazdin, 1995). However, the literature is more inconsistent about gender differences
during the preschool period (Campbell, 1995). Difficult temperament is predictive of children’s
social and behavioral adjustment in preschool and beyond (Rubin, Coplan, Fox & Calkins, 1995;
Eisenberg & Fabes, 1992). Recent definitions for difficult temperament in children include
emotional lability, poor soothability, distractibility, and hyperactivity (Rothbart & Bates, 1998).
Cognitive and social competence are important protective factors which ward against
externalizing behavior by giving children psychological resources to manage stressful situations.
The resilience literature points to the protective influence of IQ on the development of
psychopathology (Masten, Garmezy, Tellegen, Pellegrini & Larsen, 1988). More specifically,
cognitive ability has been associated with fewer externalizing behavior problems in studies of
young children (e.g., McGee et al., 1991; Lyons-Ruth, Alpern & Repacholi, 1995). Similarly, the
capacity to understand social relationships and situations fosters children’s ability to inhibit
externalizing behavior (Dodge, 1993). Evidence on one aspect of social cognition - children’s
social problem solving - reveals that children who can solve social dilemmas in an appropriate
manner have better behavioral adjustment (Dubow, Tisak, Causey, Hryshko & Reid, 1991).
Externalizing Problems in Head Start Children
Many ecological issues influence the emergence of externalizing behavior in young
children. Individual characteristics of parents, such as psychological well-being, have been
found to be concurrently and prospectively related to child behavioral problems (Campbell,
1995).
A wealth of data exists which points to the relation between maternal depression,
quality of parenting, and child outcome (Lyons-Ruth et al., 1993; Zahn-Waxler, Iannotti,
Cummings & Denham, 1990). Some studies have documented the tendency of depressed parents
to inflate the level of their children’s behavior problems (Fergusson, Lynskey & Horwood, 1993;
Webster-Stratton & Hammond, 1988), while other research has suggested that depressed mothers
provide veridical appraisals of their children’s problems (Richters, 1992).
Family structure and processes have been associated with children’s behavior problems.
For example, single parent families are more likely to have children with externalizing behavior
problems than families with two parents (Weintraub & Gringlas, 1995). Conflict and
disorganization within families result in poor adjustment for children in these environments
(Meyers, Taylor, Alvy, Arrington & Richardson, 1992). Discord between marital partners
(Webster-Stratton, 1989) and coercive interactions between parents and children (Patterson et al.,
1992; Patterson, 1982) are among the factors which have been found to create family climates
which breed behavior problems.
Children’s experiences in the ecology of the school have a significant impact on their
psychological outcomes. Preschool programs, such as Head Start, serve as major socializing
agents for young children which can foment or inhibit the emergence of conduct problems in
children (Zigler, Taussig & Black,1992). Additionally, young children’s presentation of
behavioral difficulties has been found to vary across settings, such as the home, school and clinic
Externalizing Problems in Head Start Children
(Tynan & Nearing, 1994). This may be partially attributable to the documented disparity
between different reporters’ perception of behavior problems (e.g., teacher and parent)
(Achenbach, 1987).
In the larger ecology, poverty and its concomitants greatly contribute to the development
of behavioral difficulties in children. Children from disadvantaged neighborhoods report more
stress and as such are prone to exhibit higher rates of aggressive behaviors when compared to
their more economically advantaged counterparts (Eamon, 1994). The work of McLoyd (1990)
suggests that parental psychopathology is exacerbated by conditions of chronic poverty, which in
turn leads to increased psychopathology among children reared in poverty. These less than
optimal family environments, engendered by the circumstances of poverty, have been found to be
directly related to behavior problems in children (Raadal, Odont, Milgram, Cauce & Mncl, 1994;
McLoyd, 1990). Finally, children’s exposure to community violence has an association with
emotional problems in young children (Osofsky, 1995). The bulk of this research has focused on
psychological outcomes in the internalizing domain, such as Post-Traumatic Stress Disorder
(PTSD) as a consequence of community violence exposure.
Investigating Behavior Problems in Young Children
An abiding theme in the many recent empirical investigations of behavior problems in
children is the importance of assessing behavior problems from multi-modal, cross-contextual,
and developmental perspectives. Kazdin (1995) argues for a more refined empirical approach,
which includes assessing the diverse behaviors that fall within the rubric of conduct problems
and using multiple measurement modalities from various significant others. Emphasizing a
developmental perspective, Campbell (1995) urges consideration of the potential transient nature
Externalizing Problems in Head Start Children
of young children’s behavior problems and the environmental factors most likely to affect their
functioning (i.e., the family as the primary context for early childhood development). Given that
growing numbers of young children are spending time in preschool and child care settings, it has
become increasingly important to address their psychological functioning in these contexts as
well.
With these issues in the foreground, the current study was undertaken to contribute to the
literature on the mental health functioning of Head Start children. Specifically, its aim was to
inform Head Start program planning relevant to the needs of the growing numbers of participant
children with behavior problems. Thus, a major goal of the study was to explore the individual
and ecological factors related to behavior problems. Secondly, the study was designed to
investigate the problematic behaviors children exhibit in the classroom, from multiple
perspectives. A final goal was to examine the social competence of these children, based on
scholars’ call for an exploration of this phenomenon in Head Start children (e.g., Raver & Zigler,
1997).
Five research questions guided the design of this study. First, what proportion of our
sample of Head Start children was reported by parents to have behavior problems? It was
anticipated that the rate of behavior problems in our population would exceed the rate reported in
normative populations, and would be greater than the proportion which Head Start programs
identify in their Program Information Reports. The second question focused on what individual
characteristics were associated with externalizing behavior problems in this population of Head
Start children. Our hypotheses in this vein were that: 1) a greater number of male than female
children would be susceptible to behavioral problems; 2) children with more difficult
Externalizing Problems in Head Start Children
temperament (i.e. increased emotionality and activity, decreased attention and soothability)
would present more externalizing problems; and 3) children with lower cognitive ability (i.e.
poorer language skills) would have higher rates of externalizing problems.
Third, we sought to identify the ecological factors which were associated with higher
levels of externalizing problems. We hypothesized that children with higher levels of behavioral
problems would have increased exposure to: 1) parental psychopathology; 2) family conflict; and
3) community violence. A fourth question was whether children’s display of behavior problems
at home was reflected in their behavior at school. Our hypothesis relevant to this question was
that children who were identified as having high rates of behavioral problems at home (i.e., by
their parents) would exhibit high rates of similar behavioral problems at school. Finally, we
were interested in the question of how children’s social competence was related to their
externalizing behavior. More specifically, we wanted to explore the strategies children with
behavior problems used to solve social dilemmas. In addition, we hypothesized that children
with more prosocial skills would have lower levels of behavioral problems.
In sum, this study was implemented to expand upon the empirical evidence on young
children with externalizing disorders by investigating a poor, minority population from a withingroup perspective. Given the call to address mental health issues in Head Start, this research was
conducted to contribute to the Head Start literature specifically by examining the multiple
ecological factors which are associated with behavior problems in participant children.
Additionally, the study was designed to augment available research by employing a multi-modal
approach to explore child-specific and environmental factors related to externalizing behavior.
Externalizing Problems in Head Start Children
Method
This study was part of a larger project to design, implement, and evaluate an intervention
for Head Start children with behavior problems. The study described herein represents the preintervention component of the project. All children and their caregivers in the target settings
were initially interviewed (Phase 1). A subset of children, who were to comprise intervention
and comparison groups, participated in a second set of interviews, allowing for a more in-depth
analysis of the characteristics of children with behavioral problems (Phase 2). Following is a
description of the methods employed to gather these baseline data.
Participants. All the children registered to enter ten classrooms of a Head Start program
in a suburban county within the greater Washington, DC metropolitan area were initially
recruited to participate in the study. These ten classrooms were selected because they were in
two public elementary schools serving adjacent communities with similar characteristics. Other
Head Start classrooms in this area were dispersed throughout various other schools in dissimilar
communities. The schools were also selected because they contained the largest number of Head
Start children in the county.
A total of 155 children (81% of total population) received parental permission to
participate in the first phase of the project. Basically, the children were African-American (99%)
and lived in homes with incomes below the poverty line (100%). The average age of the children
was 4.1 years (SD=.35). Boys comprised 51% (n=79) of the sample, and girls 49% (n=76).
Children (88.4%) were overwhelmingly in the care of their mothers. Caregivers were
predominantly single (81.2%), high school graduates (74.2%), and unemployed (69.7%). The
average age of the children’s caregivers was 29.9 years (SD=9.1). Further demographic
Externalizing Problems in Head Start Children
information on the caregivers of these children is found in Table 1.
----------------------------------Insert Table 1 about here
----------------------------------For the second phase of the study, the Child Behavior Checklist (CBCL) was used to
identify specific sub-groups of children (see Measures section for a description of the CBCL). A
sub-group of children with behavior problems in the clinical or borderline range based on CBCL
T scores above 60 (i.e., externalizers) was selected based on parent report (n=42). This subgroup was similar demographically to the larger group of children.
Procedures. The data for the current study were collected at two different time points.
The first phase of the data collection occurred in the summer before the beginning of the Head
Start program year and included the entire sample (N=155). The second phase of data collection
occurred in the fall of the Head Start program year and only included a sub-group of the children
identified by their parents as having high levels of externalizing behavior. Following are the
procedures for each of the phases.
Phase 1. Initial assessment of the children and families was conducted in the homes of
study participants. Two interviewers completed each visit. While one researcher interviewed the
child, the other interviewed the parent. Every measure was read to the children and to the adults
to control for differential reading abilities. The home visits lasted about 90 minutes. Each parent
was paid $20 for study participation and each child was given a developmentally-appropriate gift.
Phase 2. The second data collection phase was completed in the school. Teachers
completed their questionnaires independently and were given a monetary contribution to their
Externalizing Problems in Head Start Children
classroom as an incentive. Children were individually interviewed at school using a
hypothetical-reflective social problem solving test in the second month of the academic year.
Each child was taken from the classroom to a private room by a trained interviewer. Behavioral
observations occurred in the classroom during this same time period. Observations were
conducted by trained observers in the classroom in five 1-minute intervals during unstructured
and structured activities interspersed throughout the Head Start day on three different occasions
(total of 15 minutes per child).
Measures and Assessment Protocols. A combination of parent-report, teacher-report,
independent observation, and child assessment was used for this study. The initial assessment of
the child included a cognitive evaluation and parent-report questionnaires on child behavior
problems, temperament, and exposure to violence. The parent assessment included self-report
questionnaires regarding parental psychopathology, family functioning, and social support. In
the second phase of the study, classroom behavior problems, social competence, and social skills
were assessed, as well as the parenting capacity of the caregivers of the children.
Parent Questionnaires:
Child Behavior. The Child Behavior Checklist (CBCL/4-18; Achenbach, 1991) was used
to assess children’s behavioral problems. This is a well established parent-report measure which
can be used with children from ages 4 through 18 years. It has been used with normative and
clinical samples, including children from minority and low-income backgrounds. Parents state
whether 112 behavioral problems apply to their children, using a 3-item response set (i.e., “not
true”, “sometimes or somewhat true”, and “very or often true”). Summary scores are derived for
the Internalizing behavioral domain (comprised of somatic, anxious-depressed, and withdrawn
Externalizing Problems in Head Start Children
subscales) and Externalizing behavioral domain (comprised of aggressive and delinquent
subscales). Sample items from the aggressive subscale are: “cruelty, bullying, or meanness to
others” and “destroys his/her own things”. Sample items from the delinquent subscale are:
“doesn’t seem to feel guilty after misbehaving” and “steals at home”. Clinical and borderline
cut-off scores have been derived for this measure, based on research with clinical and normative
samples. Raw scores are converted into T scores; a T score of 60-63 is in the borderline range,
and 64 or over is in the clinical range. Test-retest reliability ranges from 0.87 to 0.95.
Child Temperament. The Colorado Child Temperament Inventory (CCTI; Rowe &
Plomin, 1977) is a parent-report instrument used to identify temperament types for young
children. It is a 30-item questionnaire which yields the following subscales: emotionality;
activity; attention; soothability; shyness; and sociability. Rubin and colleagues (1995) have
created an emotion dysregulation variable using this measure by subtracting soothability from
emotionality, which will be used in this study. Internal reliability data garnered from this study
are as follows: emotionality - 0.67; activity - 0.44; attention - 0.28; soothability - 0.46; shyness 0.60; and sociability - 0.55.
Parental Psychopathology. The Brief Symptom Inventory (BSI; Derogatis & Spencer,
1982) was used to assess the mental health status of each parent. It is a 53-item self-report
questionnaire, which requires respondents to rate each symptom on a 5-point scale of distress
(from not at all to extremely) during the last week. There are nine primary symptom dimensions
for this scale, but only two of these were selected for this study based on their documented
association with child externalizing behaviors. These two subscales and their corresponding
internal reliability estimates from this study (presented first in parentheses) and from Boulet &
Externalizing Problems in Head Start Children
Boss (1991) are: 1) depression (0.86; 0.89); and 2) hostility (0.60; 0.78). The total symptom
score (i.e., global severity index) was also ascertained for this study, which had an alpha of 0.95.
Family Environment. The Family Environment Scale (FES; Moos & Moos, 1993) was
administered to measure the degree of commitment, openness, and disagreement among family
members. The short form of this self-report instrument, which contains 54 items, was used in
this study. Respondents state whether each statement is true or false for their family. Following
are the 6 subscales which comprise this measure with their corresponding alpha coefficients
based on data from the current study: conflict (0.63); cohesion (0.62); control (0.27);
expressiveness (0.43); organization (0.55); and religiosity (0.54). The overall alpha coefficient
for this version has been reported to be 0.65 (Green & Plank, 1994). It is a widely used
instrument which, although initially developed with a middle income sample, has been found to
be valid with higher risk populations (Moos & Moos, 1993).
Child Exposure to Violence. The Violence Exposure Scale for Children - preschool
version (VEX-P; Fox & Leavittt, 1995) was used to determine the level of violence to which
each child was exposed. Parents were asked to state whether their child had witnessed or
experienced 22 different types of violent events occurring at school, at home, and in the
neighborhood. This measure was designed for use with this population. Cronbach’s alpha was
0.72 for mild exposure items. Because there was so little variability for severe violence, alpha’s
could not be determined in this domain (Shahinfar, Fox, Leavitt & Richters, in press).
Family Background. A family information form was devised for this project to obtain
data on the families’ socioeconomic status, race/ethnicity, household composition, time child
spends with each parent, housing status, religion, and other background issues.
Externalizing Problems in Head Start Children
Child Assessments:
Behavior Problems. Because this was the central variable of interest in this study, three
strategies for obtaining these data were employed. First, the parents of the children were
interviewed regarding the existence of various behavior problems (see parent questionnaires).
Teachers rated the children on the presentation of a variety of behaviors. Finally, independent
observers recorded the frequency of children’s display of specific behaviors.
Teachers rated the classroom based behavior of the children identified by parents as
having high levels of externalizing problems, using the Preschool Behavior Questionnaire (Behar
& Stringfield, 1974). This 30-item measure contains 3 subscales: Hostile-Aggressive;
Hyperactive-Distractible; and Anxious-Fearful. The responses for this measure are: 1) does not
apply; 2) sometimes applies; and 3) frequently applies. The reported reliability for the overall
measures is 0.84, and subscale alphas are 0.81 (Hostile-Aggressive), 0.67 (HyperactiveDistractible), and 0.71 (Anxious-Fearful) (Behar, 1977).
The children with identified externalizing behavior problems were assessed by trained
observers. Training included practice coding of children’s behavior via observing videotapes and
children in classrooms. Researchers observed children during five one-minute intervals on three
different program days, during structured and unstructured activities (total of 15 minutes). The
frequency of children’s appropriate and inappropriate behavior was coded by objective observers.
The appropriate category included competent responses to environmental demands. These
events were also classified into one of the following categories: solitary play; group play;
dramatic play; rough-and-tumble play; and on-task behavior. The inappropriate category
included incompetent responses to environmental demands such as withdrawn behavior, negative
Externalizing Problems in Head Start Children
affect (i.e., sadness and anxiety), hyperactive-inattentive-impulsive behavior, aggressive-reactive
and aggressive-initiating behavior. For reliability purposes, a second researcher observed 29% of
the observations. Cohen’s kappas averaged 0.93 across all behaviors (SD=0.04; range 0.88-0.97)
and 0.92 for the appropriate/inappropriate distinction (SD=0.05; range 0.83-0.98).
Social Competence. Two types of data were collected which pertained to this variable.
Teachers responded to ten items adapted from the social competence subscale of the Preschool
Socioaffective Profile (LaFreniere, Dumas, Capuano, & Dubeau, 1992) for children in the high
and low externalizing sub-groups. Socially competent behaviors delineated included cooperating
with others, comforts or assists others, and takes pleasure in own accomplishments. Teachers
stated whether each behavior “does not apply”, “sometimes applies” or “frequently applies” to a
specific child. Scores for responses ranged from 0-2, with a total possible score for this subscale
of 20. Internal reliability for this subscale ranged from 0.79 to 0.91.
In addition, the Social Problem Solving Test - Revised (SPST-R; Rubin, 1988; Rubin &
Rose-Krasnor, 1986) was administered only to the sub-group of children with high rates of
parent-identified externalizing behavior problems. The SPST-R is an interview in which
children are asked to respond to eight stories, which are accompanied by pictures drawn on 8" by
10" cards, depicting hypothetical social situations. Specifically, they are asked what the central
character would do or say to resolve the given social problem, involving either object acquisition
or friendship initiation. Children are also asked what they would do if faced with the same
situation. Each response was coded for its category membership (i.e. prosocial, agonistic,
trade/bribe, inappropriate, authority intervention, and manipulate affect) and for its flexibility
(response differed in category from other responses). Incompetent social problem solving skills
Externalizing Problems in Head Start Children
were determined by the combined score for agonistic and inappropriate strategies. Competent
social problem solving skills were defined as the use of prosocial strategies and the receipt of a
high score (>2) on flexibility. One third of the children’s responses were coded by two
researchers, which yielded a kappa of 0.88.
Cognition. The Peabody Picture Vocabulary Test - Revised (PPVT-R; Dunn & Dunn,
1981) was administered to each child in the first phase of the study. The PPVT-R is a widely
used test of receptive vocabulary which is highly correlated with child cognitive functioning.
Children are shown a group of four pictures and are asked to point to the picture which
corresponds to the word given by the examiner. The measure can be used from the preschool
period to adulthood. A standard score is derived from the measure which is based on a large,
nationally representative sample.
Results
Following are the results from the two phases of the project. The first phase of the
project included all 155 children and parents in the study. Analysis of data collected during this
phase addresses the proportion of children with externalizing problems and the relations between
child externalizing behavior and child-specific and ecological factors. The second phase of the
project focused on a sub-group of children, with high rates of parent-identified behavioral
problems (n=42). Data analyses in this phase explores the social competence and classroom
behavior of the sub-group of children and the relations between these variables. Descriptive data
on the full sample and the externalizing sub-group are presented in Table 2.
----------------------------------Insert Table 2 about here
Externalizing Problems in Head Start Children
----------------------------------Phase 1. Prevalence and correlates of externalizing behavior in Head Start children
Based on the T scores of the parent-report of the CBCL, 23.7% of the children assessed
had externalizing behavior problems in the clinical (15.8%) or borderline (7.9%) range. An
examination of the externalizing subscales of the CBCL revealed that 9.7% of the children were
reported to have aggressive behavior and 11.0% delinquent behavior in the clinical or borderline
ranges. Further, 6.5% of the children were identified as having internalizing difficulties in the
clinical or borderline range.
Although there was no difference between the average CBCL externalizing behavior Tscores of boys and girls in this study, twice as many girls exhibited externalizing behavioral
problems as boys. Fifteen percent of boys and 32% of girls were reported by their parents to
have externalizing behavior problems in the clinical or borderline range. Chi square analysis
revealed a significant difference between the proportions of boys and girls with externalizing
behavior (X2(1)=5.8, p<.02) . This pattern persisted with specific types of externalizing behavior.
In regard to aggressive behavior, 14.4% of the girls but only 5.1% of the boys reached the
borderline or clinical range. Similarly, 14.4% of the girls were reported to have delinquent
behavior and 7.6% of the boys were. Graphic depictions of the proportion of girls and boys who
have borderline or clinical externalizing behavior problems are presented in Figures 1 and 2.
---------------------------------------Insert Figures 1&2 about here
Externalizing Problems in Head Start Children
---------------------------------------As portrayed in Table 3, externalizing behavior problems in children were significantly
associated with several child-specific variables. Externalizing problems were positively related
to internalizing symptoms, r(154)=.53, p<.001, and negative emotionality (temperament),
r(154)=.55, p<.001. Significant negative associations were found between externalizing
behavior and the temperament variables of attention, r(154)=-.23, p<.01, and soothability,
r(154)=-.17, p<.05. Externalizing behavior was significantly related to emotion dysregulation
(i.e., temperament variables of emotionality minus soothability), r(154)=.49, p<.001. Nonsignificant relations emerged between externalizing behavior and PPVT scores.
----------------------------------Insert Table 3 about here
----------------------------------Several ecological variables had significant associations with externalizing behavior in
children. Every symptom of parental psychopathology assessed was strongly associated with
child externalizing problems (for total BSI: r(154)=.42, p<.001). Although caregiver marital
status was not correlated with child externalizing problems (the majority of the sample was
single), the amount of time children spent with their biological mothers, fathers, or other
caregivers was. Higher rates of externalizing problems were associated with less time spent with
the child’s father, r(154)=.25, p<.01. Chi square analysis comparing children who were with
their fathers more than half the time and less than half the time revealed a significant difference
between the numbers of children with externalizing behavior in each group (X2 (1)=5.2; p=.02.
Children who spent less than half the time with their fathers were more likely to have
Externalizing Problems in Head Start Children
externalizing behavioral problems.
Family environment was also highly correlated with child externalizing problems. Child
behavior problems were positively related to family conflict, r(154)=.30, p<.01, and negatively
associated with family organization, r(154)=-.21, p<.01. Regarding larger ecological variables,
exposure to community violence was positively related to externalizing problems, r(154)=.25,
p<.01. Because of the gender findings in this study, correlations were conducted separately for
boys and girls; similar patterns of association were found for both groups. The correlations
between externalizing behavior and the ecological variables for the total sample are presented in
Table 4.
----------------------------------Insert Table 4 about here
----------------------------------Phase 2. Classroom behavior and social competence in Head Start children with high rates of
parent-identified externalizing behavior
Classroom behavior was assessed for the sub-group of children who were identified with
high levels of externalizing behavior problems. Teachers reported an average of 13 out of 30
possible classroom behavior problems overall. Following are the average levels of behavior
problems reported by teachers in each of the three categories: Anxious-Fearful M=2.6 (SD=3.1);
Hostile-Aggressive M=3.5 (SD=4.8); and Hyperactive-Distractible M=2.6 (SD=2.6). The mean
for teacher-rated social competence was 9.9 (SD=5.0) out of a possible total score of 20.
Descriptive data on behaviors in the classroom as observed by independent raters are
summarized in Table 5. Provided is the proportion of the 15-minute observation period in which
Externalizing Problems in Head Start Children
children were engaged in specific behaviors. Children with externalizing problems spent the
majority of the observed time displaying appropriate behavior. Most of the appropriate observed
behavior were when children were involved in on-task activities during structured and
unstructured times (e.g., attention at circle time, compliance with teacher, focused exploratory
play). They played in groups more than they did in a solitary manner. The majority of their
inappropriate behavior consisted of hyperactive-impulsive behaviors. These children did not
tend to exhibit aggressive behavior nor display negative affect.
----------------------------------Insert Table 5 about here
----------------------------------The relation between teacher-rated social competence and specific child variables was
explored. There was a significant relation between teacher ratings of social competence and
teacher ratings of three types of behavior problems: Hostile-Aggressive, r(40)= -.46, p<.01;
Anxious-Fearful, r(40)= -.44, p<.01; and Hyperactive-Distractible, r(40)= -.58, p<.001. In
contrast, a non-significant relation was found between teacher-rated social competence and social
problem-solving skills.
The relation between teacher-rated behavioral problems and the types of solution to
hypothetical social dilemmas which children selected was also explored for the group of children
with high levels of parent-identified externalizing behavior. Children rated as hostile-aggressive
by their teachers had less relevant social problem solving strategies, r(40)= -.34, p<.05. The
more anxious-fearful children were, the less likely they were to use relevant solutions, r (40) =
-.37, p<.05, flexible solutions, r(40)= -.39, p<.05, and prosocial solutions, r(40)=-.56, p<.01 to
Externalizing Problems in Head Start Children
solve social dilemmas. Children identified by teachers as having hyperactive-distractible
behaviors were less likely to provide prosocial solutions, r(40)= -.39, p<.05. The correlations
between teacher-rated behavior problems and social problem-solving skills are summarized in
Table 6.
----------------------------------Insert Table 6 about here
----------------------------------Further examination of the social problem solving skills of children with high levels of
externalizing problems revealed that they generated prosocial solutions to social dilemmas but
also relied on more problematic strategies. Following are the mean proportions of specific
strategies children utilized in their solutions to social dilemmas: prosocial strategies - 49%
(SD=0.23); authority intervention strategies - 8% (SD=0.14); agonistic strategies (e.g. hitting,
biting) - 19% (SD=0.23); manipulate affect strategies - 3% (SD=0.07); trade/bribe strategies - 1%
(SD=0.03); and inappropriate strategies - 21% (SD=0.27).
Discussion
There is a solid evidentiary base for the high rates of externalizing behavior problems
among children in poverty (Bolger et al., 1995). Consistent with this literature, the present study
documented that almost one quarter of Head Start children present with externalizing behavior
problems in a sample of children from low-income, minority backgrounds. In this Head Start
sample, a higher proportion of children was identified by their parents as having externalizing
behavior problems than in normative samples and in other Head Start samples (Sinclair, Del
Homme & Gonzalez, 1993; Lopez, Tarullo, Forness, & Boyce, 2000). However, the children in
Externalizing Problems in Head Start Children
such studies were identified by their teachers as having behavior problems, not by their parents as
occurred in the present study. In a study that included parent reports and observational data,
Webster-Stratton and Hammond (1998) documented rates similar to those found in the current
study. Kazdin (1995) has suggested that parent and teacher reports are distinct in perspective but
equally important for understanding child behavior problems. Parent-reports, in particular, have
been found to correlate with clinical judgments about externalizing problems.
Individual-Level Contributions: Gender, Temperament, and Cognition
The disparity between the proportion of boys and girls with externalizing behavior was
unanticipated. Reviews of the literature on gender differences and externalizing behavior during
the preschool period reveal inconsistent results (Campbell, 1995). A preponderance of evidence
suggests that boys are generally more likely to have externalizing behavioral problems during
childhood and adolescence. However, recent evidence indicates that externalizing behavior is
increasing among adolescent female populations (i.e., increase in arrest rates overall, and for
violent crimes and thefts, etc.) (Office of Juvenile Justice and Delinquency Prevention, 1998).
Typically, externalizing females have been understudied despite the data that when
compared to non-externalizing females, they are more likely to be psychiatrically impaired,
adolescent mothers, single parents, less competent mothers, and mothers of children who become
externalizers themselves (Tremblay, 1991). However, empirical attention to externalizing
females is increasing. For example, Keenan and Shaw (1997) have reviewed several major
studies which address young girls’ behavior problems, underscoring the different presentation
and trajectory of psychopathology found among females. One of the issues considered in this
review is that language serves as a protective factor for girls who are vulnerable to behavioral
Externalizing Problems in Head Start Children
problems. The girls in the current study had similarly impoverished language as the boys, which
may partially explain their high rates of behavior problems.
The higher rates of externalizing behavior problems in girls found in this study may be
also attributable to the demographic composition of the sample. For example, AfricanAmerican parents have been found to have higher expectations for their female children than
their male children. This is particularly salient among single, low-income mothers who expect
their female children to have more responsibility and maturity than their male counterparts
(Randolph, Koblinsky, Beemer, Roberts, & Letiecq, 2000; Randolph, 1995). It may also be that
boys and girls show the same levels of externalizing problems, but that mothers may view this
behavior as more normative in boys than in girls. Further, there is some evidence that adolescent
females from low-income families may have poorer outcomes than their male counterparts due to
their heightened reaction to family stress and interpersonal conflict (Luthar, 1999).
As expected, other child-specific characteristics were also associated with externalizing
behavior. Certain temperamental factors may render children more vulnerable to psychological
difficulties (Sarason et al., 1993). In the current study, the temperamental variables of negative
emotionality, attentional problems, and poor soothability were associated with behavior problems
reported by parents. This is consistent with a growing body of research which suggests that
children who are hypersensitive and easily emotionally aroused are more likely to demonstrate
problems of an externalizing nature (Rubin et al., 1995).
The relations between externalizing behaviors and attentional difficulties and
internalizing behavior were also anticipated. There is substantial evidence on children with
Attention Deficit Hyperactivity Disorder which supports the connection between distractibility
Externalizing Problems in Head Start Children
and behavior problems (Kazdin, 1995; Barkley, 1990). The relation between externalizing and
internalizing behaviors has been increasingly documented among low-income children. There is
substantial evidence pointing to the comorbidity between externalizing and internalizing
difficulties (see Zahn-Waxler, Klimes-Dougan & Slattery, in press; Zoccolillo, 1992). Although
the correlations in this study are partially attributable to response bias (i.e. same respondent is
reporting on temperament and both types of behavioral problems), they corroborate findings that
have been widely reported in the literature.
In contrast, cognitive competence (i.e. PPVT score) did not serve as a protective factor
for these Head Start children. This finding is inconsistent with the evidence that cognitive and
language ability in children are associated with better psychological adjustment (Olson et al.,
1990; Masten et al., 1988; Beitchman, Wilson, Brownlie, Walters, Inglis & Lance, 1996).
Perhaps in this sample, because cognition/language was universally low (i.e. mean PPVT score
of 62.7 for this sample, which is in the deficit range), it did not have the same buffering effect
which it does in normative populations. Additionally, because many of these children had not
experienced formal education, their scores on the PPVT may not have been an adequate
representation of their cognitive competence, but may have been a reflection of understimulation
in their environments.
Ecological Influences: The Role of the Family and Community
The current investigation corroborated findings of the influence of specific aspects of the
family ecology on child outcome in this sample of Head Start children. As expected, parental
psychopathology was strongly correlated with child adjustment and behavior. Such findings
must be considered seriously in the face of evidence pointing to the exacerbation of the effects of
Externalizing Problems in Head Start Children
poverty by parental psychopathology (McLoyd, 1998). There is a large corpus of literature which
documents the deleterious effects of maternal depression on child outcome, including social and
academic difficulties at school, and internalizing and externalizing behavior problems (see
Downey & Coyne, 1990 for a review). Recent research has underscored the synergistic impact
of maternal depression and poverty on child outcome (McLoyd, 1990; 1998). Another symptom
of parental psychopathology explored was hostility. The association between the maternal
symptom of hostility and externalizing behavior highlights the negative impact of parental
negative emotionality on child adjustment, particularly when poverty is a salient factor
(Ackerman, Izard, Schoff, Youngstrom & Kogos, 1999).
Similarly, family conflict and disorganization can be particularly damaging for poor,
minority children who need structure and stability to counter the effects of poverty on their
psychological well-being. One important family factor is underscored by the finding that
children who spend less time with their fathers have more externalizing problems. The role of
the father, whether living in the home or not, in diminishing behavioral problems in young
children has been documented in studies of parenting processes as well as intervention efficacy
(Black, Dubowtiz & Starr, 1999; Crockett, Eggebeen, & Hawkins, 1993; Webster-Stratton,
1989).
That exposure to community violence is related to externalizing problems in preschool
children is also a fairly far-reaching finding. Young children may have an early-onset trajectory
toward conduct disorder not only because of the family influences which have been documented
in many studies (e.g., Walker et al., 1998), but also due to the impact of factors within the larger
ecology such as community violence. Additional findings from this study in relation to violence
Externalizing Problems in Head Start Children
exposure are described elsewhere (Shahinfar, Fox, Leavitt, and Richters, in press). Other
investigations of the effects of violence exposure suggest that parents can buffer the effects of
community violence on child psychological adjustment as well (Richters & Martinez, 1993).
Behavior Problems in the Context of the Classroom
The classroom-focused examination of children with high levels of externalizing
difficulties yielded a mixture of anticipated and unanticipated findings. Overall, the data
confirmed the disparity found in previous studies between teachers and parents on their
perceptions of children’s behavior (e.g., Achenbach et al., 1987). Some studies indicate that
teachers are more likely to identify behavior problems in children than parents (Zimmerman et
al., 1995), whereas others report they are less likely to do so (Webster-Stratton & Hammond,
1998). In this study of Head Start children, parents identified a large group of children with
externalizing problems, and teachers did not concur with their perceptions. One potential reason
for this lack of congruence emanates from the evidence that mothers who are depressed perceive
their children as more problematic (Field, 1995). The difference in parent and teacher
instrumentation is also an issue. The CBCL delineates a much wider range of behaviors than the
PBQ does.
Additionally, Kazdin (1995) suggests that teachers are basing their assessments on peer
interactions and other factors distinct from those which parents consider in their evaluations of
child behavior. Finally, teachers in this Head Start system may experience fewer behavioral
challenges in their classroom due to the provision of the structure that children need to facilitate
the regulation of impulses and affect. Thus, it may be that the behavioral problems of these
children are more controlled in the classroom. Clearly the school environment is a necessary
Externalizing Problems in Head Start Children
venue for intervention with children who have behavioral problems, but it may not be sufficient.
Addressing the behavioral issues that arise in the home setting may be just as crucial for
children’s optimal development.
Independent observers discerned varying levels of specific behaviors in externalizing
children. These children were observed to be primarily appropriate in their behavior, a finding
which was counter to what was expected. What parents observed in the home was not congruent
with what was seen at school by teachers and independent observers, specifically in terms of
aggressive behavior. Again, the context of the Head Start environment may have provided
children with the structure, rules, and adult support which assisted them to refrain from
aggressive acts. Nevertheless, the children’s display of hyperactive and impulsive behavior
suggests that their capacity to self-regulate is still compromised. Early difficulties with selfregulation and control may portend later aggressive behavioral difficulties and other socially
incompetent behaviors(Campbell, 1995; Eisenberg & Fabes, 1992).
Social Competence and Externalizing Behavior
There was great variability in the level of social problem-solving skills that these children
displayed. Studies of normative populations report variability as well, but also report less
generation of incompetent problem-solving strategies (Rubin et al., 1991). Previous research
has also pointed to the higher levels of incompetent social problem solving strategies used by
aggressive children (Rubin et al., 1991). Because the children whose social problem solving
ability was evaluated in this study were in the externalizing group, their incompetence in solving
social dilemmas was not surprising. Similarly, the inverse relation found between competent
social problem-solving and teacher-rated behavioral problems was expected.
Externalizing Problems in Head Start Children
In contrast, significant relations were not found between social problem solving and
teacher rated social competence. As has been found in studies of social problem solving
interventions, children’s ability to solve hypothetical dilemmas does not necessarily translate into
behavioral competence in social situations (Shure & Spivak, 1980). Additionally, with the
advent of more sophisticated perspective-taking, preschool children are capable of fairly complex
prosocial behavior such as sharing, helping, and offering comfort (Eisenberg & Fabes, 1998).
The children in the current study demonstrated these qualities overall, but tended to have more
difficulty with the arguably more emotionally demanding tasks of negotiating social conflicts and
regulating negative behaviors.
Methodological Issues
Although this investigation has provided insight into the home and school factors related
to externalizing problems in Head Start children, there are limitations to this study which should
be acknowledged. First, the prevalence data offered by this study should be viewed with caution.
This was not an epidemiological study which was population based; the two Head Start centers
were not selected based on their representativeness. In addition, behavioral observations and
teacher reports were not obtained on the entire population of children (i.e. 155). Thus, some
modicum of response bias exists for the first part of the study, since the primary respondent was
the child’s parent. In the second phase of the study, the sub-sample was small, which has
implications for the adequacy of statistical power to conduct specific analyses. Behavioral
observations at baseline were also limited. Additionally, a measure of parenting capacity was not
included in the current study. Thus, it was not possible to address the mediating role of parenting
skill, style, and interaction with the child on the effect of environmental factors on child
Externalizing Problems in Head Start Children
outcomes. Finally, the influence of the classroom (e.g. teacher-child relationships, structure) on
the display of externalizing behaviors was not examined.
Future research should incorporate such a comprehensive, multi-modal approach into an
investigation of a group of Head Start children representing entire Head Start systems and
classrooms. A more in-depth examination of children’s behavioral problems in the home would
be beneficial for understanding the high numbers of behavioral problems identified by parents, as
well as for informing program development efforts which incorporate parents and children.
Moreover, an exploration of the unique needs and capacities of female children with behavioral
problems seems warranted. Observational data could be expanded to include teacher-child and
parent-child interactions which could be videotaped for later coding. Finally, a comparison of
children receiving and not receiving Head Start services would provide valuable information
about the contribution of the school environment to behavioral problems in young children.
Implications for Educational and Mental Health Intervention
There are multiple practice implications of this study. First, as advocated by Yoshikawa
and Knitzer (1997), Head start programs need to place more resources into meeting the mental
health needs of their populations. Given that one quarter of children in this study exhibited
externalizing behavior problems, interventions should be integrated into Head Start program
designs which specifically address this issue. This would be a boon to Head Start teachers, who
too often cite having to use precious classroom time for behavior management. Teachers need
additional preparation to assist them to understand the needs of these children, as well as to
increase their repertoire of effective responses to these behaviors in the classroom. Mental
health strategies should be designed to meet the needs of both genders. Although research and
Externalizing Problems in Head Start Children
intervention often target boys, the findings of this study point to the import of incorporating girls
into programmatic initiatives and of addressing their unique needs.
Prevention programs on all levels (Simeonsson, 1991) should be established with a goal
of assisting all Head Start children to behave optimally in the classroom. Models such as the
FAST Track program (Bierman, Coie, Dodge, Greenberg & McMahon, in press) and First Steps
to Success (Walker et al., 1998) are examples of school-based comprehensive interventions for
young children which have resulted in improved child and family outcomes. Such models can be
easily adapted for Head Start populations. This comprehensive, program-driven approach would
be more appropriate than the current practice in many Head Start programs to “parachute in”
part-time consultants to address the mental health needs of children.
Child-targeted interventions can be designed to address the emotional, social, and
behavioral needs of all Head Start children (see Forness, Serna, Kavale & Nielsen, 1998; Walker,
Colvin & Ramsey, 1995; Greenberg, Kusche, Cook & Quamma, 1995; Shure & Spivak, 1980).
Programs with the goal of promoting the social competence of young children, in areas such as
social problem solving skill and prosocial peer relationships can be adapted for Head Start
populations. Similarly, strategies to foster young children’s self-regulation and impulse control
can be incorporated into the Head Start curriculum. Finally, Head Start teachers can be taught to
use basic behavior management techniques to address the needs of children with an identified
externalizing problem.
Family support and parent education are crucial components of any intervention to
diminish behavior problems in children. The Partners Parent Program (Webster-Stratton &
Herbert, 1994) is an example of a parent-focused intervention that has documented effectiveness
Externalizing Problems in Head Start Children
with severely oppositional preschool children. Parents need to be informed about what is
normative in preschool children, and about the developmental and emotional underpinnings to
young children’s negative behavior. Providing parents with concrete strategies for managing
their children’s behavior also seems paramount. Learning from the structure and management
strategies offered in the classroom should assist them in socializing their children at home in a
more developmentally-appropriate manner.
Additionally, emphasis should also be placed on improving the parents’ psychological
well-being. There are multiple data sources which point to the strong relation between parent
and child psychological adjustment. Thus, linking parents with adult mental health providers,
assisting them to minimize the stress in their lives, and conducting activities for supporting their
mental health should be central to the parent programming. In line with this, family-centered
interventions which maximize family cohesion, mutual support, and emotional connections
would be beneficial to parents and children alike. Fatherhood programs, which have gained
some momentum in Head Start programs, should be widely implemented, with a goal of
enhancing the relationship (and thus increasing the amount of time spent) between fathers and
their preschool children.
Home visitation would seem to be an important service delivery strategy for Head Start
programs to maintain in order to address all of these family-centered issues. It is essential that
Head Start produces a cadre of home visitors who are trained to deliver family support services,
as well as to provide mental health intervention, specifically that which is prevention focused.
Finally, assisting parents to manage the impact of larger ecological stressors (e.g., violence,
poverty) on their families, as well as advocating with them for improving social conditions are
Externalizing Problems in Head Start Children
both central to Head Start’s family and community support and collaboration mission.
Conclusions
This study has expanded on previous research on behavior problems in preschoolers by
investigating a population of Head Start children using a multi-modal, multi-dimensional design.
The findings of the study offer empirical validation of the anecodotal reports of high rates of
problematic behaviors among Head Start children. In addition, the study offers insight into
child-specific and ecological factors which are associated with behavior problems in this
population. Such evidence allows for a consideration of strategies that go beyond managing the
“bad behavior” to those that focus on what may be at the core of children’s externalizing
difficulties, such as difficult temperament, parental psychopathology, and family stress.
Additionally, capitalizing on the prosocial capacities (e.g. social problem solving and positive
play behaviors) of preschool children seems an important target of intervention strategies. This
set of findings argues for a comprehensive approach to addressing Head Start children’s behavior
problems, in which teachers, parents, and mental health professionals work in an integrated way
to improve the functioning of the whole child - across developmental domains and across
settings.
References
Achenbach, T. (1991). Manual for the Child Behavior Checklist. Burlington, VT:
Externalizing Problems in Head Start Children
Department of Psychiatry, University of Vermont.
Achenbach, T., McConaughty, S. & Howell, C. (1987). Child/adolescent behavior and
emotional problems: Implications of cross-informant correlations for situational specificity.
Psychological Bulletin, 101, 213-232.
Ackerman, B., Izard, C., Schoff, K., Youngsrom, E. & Kogos, J. (1999). Contextual risk,
caregiver emotionality, and the problem behaviors of six- and seven-year-old children from
economically disadvantaged families. Child Development, 70(6), 1415-1427.
Barkley, R. (1990). Attention deficit hyperactivity disorder: A handbook for diagnosis
and treatment. New York: Guilford.
Behar, L. & Stringfield, S. (1974). A behavior rating scales for the preschool child.
Developmental Psychology, 10(5), 601-610.
Beitchman, J., Wilson, B., Brownlie, E., Walters, H., Inglis, A. & Lance, W. (1996).
Long-term consistency in speech/language profiles, 2: behavioral, emotional and social
outcomes. Journal of the Academy of Child and Adolescent Psychiatry, 35(6), 815-125.
Bierman, K., Coie, J., Dodge, K., Greenberg, M. & McMahon, R. (in press). A
developmental and clinical model for the prevention of conduct disorders: The FAST Track
Program. Development and Psychopathology.
Black, M., Dubowitz, H. & Starr. R. (1999). African-American fathers in low income,
urban families: Development, behavior, and home environment of their three year old children.
Child Development, 70(4), 967-978.
Bolger, K., Patterson, C., Thompson, W. & Kupersmidt, J. (1995). Psychosocial
adjustment among children experiencing persistent and intermittent family economic hardship.
Externalizing Problems in Head Start Children
Child Development, 66, 1107-1129.
Brandt, P. & Weinart, C. (1981). The PRQ: A social support measure. Nursing Research,
30(5), 277-280.
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature
and design. Cambridge, MA: Harvard University Press.
Campbell, S. (1995). Behavior problems in preschool children: A review of recent
research. Journal of Child Psychology and Psychiatry, 36(1), 113-149.
Campbell, S. (1990). Behavior problems in preschool children. New York: Guilford.
Campbell, S., March, C., Pierce, E., Ewing, L. & Szumowski, E. (1991). Hard to manage
preschool boys: Family context and the stability of externalizing behavior. Journal of Abnormal
Child Psychology, 19, 301-316.
Crockett, L., Eggebeen, D. & Hawkins, A. (1993). Fathers’ presence and young
children’s behavioral and cognitive adjustment. Journal of Family Issues, 14, 355-377.
Derogatis, L. & Spencer, P. Brief Symptom Inventory: Administration, scoring, and
procedures manual-I. Baltimore, MD: Clinical Psychometric Research.
Dodge, K. (1993). Social-cognitive mechanisms in the development of conduct disorder
and depression. Annual Review of Psychology, 44, 559-584.
Downey, G. & Coyne, J. (1990). Children of depressed parents: An integrative review.
Psychological Bulletin, 108(1), 50-76.
Dubow, E., Tisak, J., Causey, J., Hryshko, A. & Reid, G. (1991). A two-year longitudinal
study of stressful life events, social support, and social problem solving skills: Contributions to
children’s behavioral and academic adjustment. Child Development, 62, 583-599.
Externalizing Problems in Head Start Children
Dunn, L. & Dunn, P. (1981). Peabody Picture Vocabulary Test-Revised. Circle Pines,
MN: American Guidance Service.
Eamon, M. (1994). Poverty and placement outcomes in intensive family preservation
services. Child and Adolescent Social Work Journal, 11(5), 349-361.
Eisenberg, N. & Fabes, R. (1992). Emotion, regulation, and the development of social
competence. In M. Clark (Ed.), Emotion and Social Behavior: Review of Personality and Social
Psychology (volume 14) (pp.119-150). Newbury Park, CA: Sage.
Eisenberg, N. & Fabes, R. (1998). Prosocial development. In N. Eisenber (Eds), W.
Damon (Series Ed.), Handbook of child psychology: Vol.3. Social, emotional, and personality
development (5th ed., 701-778). New York: Wiley.
Farrington, D. (1991). Childhood aggression and adult violence: Early precursors and
later life outcomes. In D. Pepler & K. Rubin (Eds.), The Development and Treatment of
Childhood Aggression (pp. 5-29). Hillsdale, NJ: Erlbaum.
Fergusson, D., Lynskey, M. & Horwoood, L. (1993). The effect of maternal depression on
maternal ratings of child behavior. Journal of Abnormal Child Psychology, 21, 245-270.
Field, T. (1995). Psychologically depressed parents. In Bornstein, M. (Ed.), Handbook of
Parenting, 4, 85-99. Mahwah, NJ: Erlbaum.
Forness, S. & Finn, D. (1993). Screening children in Head Start for emotional or
behavioral disorders. Severe Behavior Disorders Monograph, 16, 6-14.
Forness, S., Serna, L., Kavale, K. & Nielsen, E. (1998). Mental Health and Head Start:
Teaching adaptive skills. Education and Treatment of Children, 21, 258-274.
Fox, N. & Leavitt, L. (1995). The Violence Exposure Questionnaire for Children
Externalizing Problems in Head Start Children
(Preschool Version). College Park, MD: University of Maryland.
Greenberg, M., Kusche, C., Cook, E. & Quamma, J. (1995). Promoting emotional
competence in school-aged children: The effects of the PATHS curriculum. Development and
Psychopathology, 7, 117-136.
Kazdin, A. (1995). Conduct disorders in childhood and adolescence. Thousand Oaks,
CA: Sage.
Keenan, K. & Shaw, D. (1997). Developmental and social influences on young girls’
behavioral and emotional problems. Psychological Bulletin, 121(1), 95-113.
LaFreniere, P., Dumas, J., Capuana, F. & Dubeau, D. (1992). Development and validation
of the preschool socioaffective profile. Psychological Assessment, 4, 242-250.
Leadbeater, B. & Bishop, S. (1994). Predictors of behavior problems in preschool
children of inner-city Afro-American and Puerto Rican adolescent mothers. Child Development,
65, 638-648.
Lopez, M., Tarullo, L., Forness, S. & Boyce, C. (2000). Head Start as a venue for early
identification and intervention in mental health: Implications for research and practice. Early
Education and Development.
Luthar, S. (1999). Poverty and children’s adjustment. In A. Kazdin (Ed.), Series on
Developmental Clinical Psychology and Psychiatry, 41. Thousand Oaks, CA: Sage.
Lyons-Ruth, K., Easterbrooks, M.., Davidson Cibelli, C. & Bronfman, E. (1995).
Predicting school-age externalizing symptoms from infancy: Contribution of disorganized
attachment strategies and mild mental lag. Presented at the biennial convention of the Society
for Research in Child Development, Indianapolis, IN.
Externalizing Problems in Head Start Children
Lyons-Ruth, K., Alpern, L. & Repacholi, B. (1993). Disorganized infant attachment
classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in
the preschool classroom. Child Development, 64, 572-585.
Masten, A., Garmezy, N., Tellegen, A., Pellegrini, D. & Larsen, A. (1988). Competence
and stress in school children: The moderating effects of individual and family qualities. Journal
of Child Psychology and Psychiatry, 29, 745-764.
McGee, R., Partridge, F., Williams, S. & Silva, P. (1991). A twelve-year follow-up of
preschool hyperactive children. Journal of the American Academy of Child and Adolescent
Psychiatry, 25, 573-586.
McLoyd, V. (1998). Socioeconomic disadvantage and child development. American
Psychologist, 53(2), 185-204.
McLoyd, V. (1990). The impact of economic hardship on black families and children:
Psychological distress, parenting, and socioemotional development. Child Development, 61,
311-346.
McLoyd, V. (1998). Socioeconomic disadvantage and child development. American
Psychologist, 53(2), 185-204.
Meyers, H., Taylor, S., Alvy, K., Arrington, A. & Richardson, M. (1992). Parental and
family predictors of behavior problems in inner-city black children. American Journal of
Community Psychology, 20(5), 557-576.
Moos, R. & Moos, L. (1981). Family Environment Scale. Palo Alto, CA: Consulting
Psychologists Press.
Office of Juvenile Justice and Delinquency Prevention (1998). Juvenile female offenders:
Externalizing Problems in Head Start Children
A status of the states report. Washington, DC: U.S. Department of Justice (available on the
World Wide Web: http://www.ojjdp.ncjrs.org/pubs/gender/.html).
Olson, S., Bates, J. & Bayles, K. (1990). Early antecedents of childhood impulsivity: The
role of parent-child interaction, cognitive competence, and temperament. Journal of Abnormal
Child Psychology, 18, 317-334.
Osofsky, J. (1995). The effects of exposure to violence on young children. American
Psychologist, 50(9), 782-788.
Patterson, G. (1982). Coercive family process: Volume 3. A social learning process.
Eugene, OR: Castalia Press.
Patterson, G., DeBaryshe, B. & Ramsey, E. (1989). A developmental perspective on
antisocial behavior. American Psychologist, 44, 329-335.
Patterson, G., Reid. J. & Dishion, T. (1992). Antisocial boys. Eugene, OR: Castalia Press.
Piotrkowski, C., Collins, R., Knitzer, J. & Robinson, R. (1994). Strengthening mental
health services in Head Start: A challenge for the 1990's. American Psychologist, 49(2), 133-139.
Raadal, M., Odont, Milgram, P., Cauce, A & Mncl, L. (1994). Behavior problems in five
to eleven year old children from low-income families. Journal of American Academy of Child
and Adolescent Psychiatry, 33(7), 1017-1025.
Randolph, S. (1995). African-American children in single-mother families. In B.
Dickerson (Ed.), African American Single Mothers. Thousand Oaks, CA: Sage.
Randolph, S., Koblinsky, S., Beemer, M., Roberts, D. & Letiecq, B. (2000). Behavior
problems of African American boys and girls attending Head Start programs in violent
neighborhoods. Early Education and Development.
Externalizing Problems in Head Start Children
Raver, C., Blackburn, E., Bancroft, M. & Torp, N. (1999). Relations between effective
emotional self-regulation, attentional control, and low-income preschoolers’ social competence
with peers. Early Education and Development, 10(3), 333-350.
Raver, C. & Zigler, E. (1997). Social competence: An untapped dimension of Head
Start’s success. Early Childhood Research Quarterly, 12, 363-385.
Richters, J. (1992). Depressed mothers as informants about their children: A critical
review of the evidence for distortion. Psychological Bulletin, 112(3), 485-499.
Richters, J. & Martinez, P. (1993). Violent communities, family choices, and children’s
changes: An algorithm for improving the odds. Development and Psychopathology, 5, 609-627.
Rothbart, M. & Bates, J. (1998). Temperament. In N. Eisenberg (Ed.), W. Damon
(Series Ed.), Handbook of Child Psychology: Vol.3. Social, emotional, and personality
development (5th ed., 105-176). New York: Wiley.
Rowe, P. & Plomin, R. (1977). Colorado Child Temperament Inventory. Denver, CO:
University of Colorado.
Rubin, K. (1988). Social Problem Solving Test - Revised. Waterloo, CA: University of
Waterloo.
Rubin, K., Bream, L. & Rose-Krasnor, L. (1991). Social problem solving and aggression
in childhood. In D. Pepler & K. Rubin (Eds.), The Development and Treatment of Childhood
Aggression (219-248). Hillsdale, NJ: Erlbaum.
Rubin, K., Coplan, R., Fox, N. & Calkins, S. (1995). Emotionality, emotion regulation,
and preschooler’s social adaptation. Development and Psychopathology, 7, 49-62.
Rubin, K. & Rose-Krasnor, L. (1986). Interpersonal problem-solving and social
Externalizing Problems in Head Start Children
competence in young children. In V. Van Hasselt & M. Hersen (Eds.), Handbook of social
development: A lifespan perspective (283-323). New York: Plenum.
Rutherford, R., Quinn, M. & Mathur, S. (1995). Effective strategies for teaching
appropriate behaviors to children with emotional/behavioral disorders. Reston, VA: Council for
Exceptional Children.
Sanson, A., Smart, D., Prior, M. & Oberklaid, F. (1993). Precursors of hyperactivity and
aggression. Journal of the American Academy of Child and Adolescent Psychiatry, 32(6), 12071216.
Shahinfar, A., Fox, N., Leavitt, L., & Richters, J. (in press). Preschool children’s
exposure to violence: Relations between parent and child perceptions of prevalence and behavior
problems. American Journal of Orthopsychiatry.
Shaw, D., Owens, E., Vondra, J., Keenan, K. & Winslow, E. (1996). Early risk factors
and pathways in the development of early disruptive behavior problems. Development and
Psychopathology, 8, 679-699.
Shure, M. & Spivak, G. (1980). Interpersonal problem-solving as a mediator of
behavioral adjustment in preschool and kindergarten children. Journal of Applied Developmental
Psychology, 1, 29-44.
Sinclair, E., DelHomme, M. & Gonzalez, M. (1993). Systematic screening for preschool
behavioral disorders. Journal of Behavioral Disorders, 18(3), 177-188.
Tremblay, P. (1991). Commentary - Aggression, prosocial behavior, and gender: Three
magic words, but no magic wand. In D. Pepler & K. Rubin (Eds.), The Development and
Treatment of Childhood Aggression (219-248). Hillsdale, NJ: Earlbaum.
Externalizing Problems in Head Start Children
Tremblay, R., Pihl, R. Vitaro, F. & Dobkin, P. (1994). Predicting early onset of male
antisocial behavior from preschool behavior. Archives of General Psychiatry, 51, 732-739.
Tynan, W. & Nearing, J. (1994). The diagnosis of attention deficit hyperactivity disorder
in young children. Infants and Young Children, 6(4), 13-20.
Walker, H., Colvin, G. & Ramsey, E. (1995). Antisocial behavior in school: Strategies
and best practices. Longmont, CO: Sopris West.
Walker, H., Kavanagh, K., Stiller, B., Golly, A., Severson, H. & Feil, E. (1998). First
Step to Success: An early intervention approach for preventing school antisocial behavior.
Journal of Emotional and Behavioral Disorders, 6(2), 66-80.
Webster-Stratton, C. (1989). The relationship of marital support, conflict, and divorce to
parent perceptions, behaviors, and childhood conduct problems. Journal of Marriage and the
Family, 51, 406-416.
Webster-Stratton, C. (1985). The effects of father involvement in parent training for
conduct problem children. Journal of Child Psychology and Psychiatry, 26, 801-810.
Webster-Stratton, C. & Hammond, M. (1998). Conduct problems and level of social
competence in Head Start children: Prevalence, pervasiveness, and associated risk factors.
Clinical Child and Family Psychology Review, 1(2), 101-123.
Webster-Stratton, C. & Hammond, M. (1988). Maternal depression and its relationship to
life stress, perceptions of child behavior problems, parenting behaviors, and child conduct
problems. Journal of Abnormal Child Psychology, 16, 299-315.
Webster-Stratton, C. & Herbert, M. (1994). Troubled families - problem children. New
York: Wiley.
Externalizing Problems in Head Start Children
Weintraub, M. & Gringlas, M. (1995). Single parenthood. In M. Bornstein (Ed.),
Handbook of parenting: Volume 3. Status and social conditions of parenting (65-87). Mahwah,
NJ: Lawrence Erlbaum.
Wilson, B. (1999). Entry behavior and emotion regulation abilities of developmentally
delayed boys. Developmental Psychology, 35, 214-222.
Yoshikawa, H. & Knitzer, J. (1997). Lessons from the field: Head Start mental health
strategies to meet changing needs. New York: National Center for Children in Poverty.
Zahn-Waxler, C., Iannotti, R., Cummings, E. & Denham, S. (1990). Antecedents of
problem behaviors in children of depressed mothers. Development and Psychopathology, 2, 271291.
Zahn-Waxler, C., Klimes-Dougan, B. & Slattery, M. (in press). Internalizing problems of
childhood and adolescence: Prospects, pitfalls, and progress in understanding the development of
anxiety and depression. In D. Cicchetti & A. Sroufe (Eds.), Millenium Special Issue on
Development and Psychopathology, Development and Psychopathology.
Zigler, E., Taussig, C. & Black, K. (1992). Early childhood intervention: A promising
preventative for juvenile delinquency. American Psychologist, 47, 997-1006.
Zimmerman, M., Salem, D. & Maton, K. (1995). Family structure and psychosocial
correlates among urban African-American adolescent males. Child Development, 66, 15981613.
Zocolillo, M. (1992). Co-occurrence of conduct disorder and its adult outcomes with
depressive and anxiety disorders: A review. Journal of the American Academy of Child and
Adolescent Psychiatry, 31, 547-556.
Externalizing Problems in Head Start Children
Externalizing Problems in Head Start Children
Figure Captions
Figure 1 - Proportion of Girls (n=76) with Externalizing Behavior in the Normal (68.4%; n=52),
Borderline (10.5%; n=8), and Clinical (21.1%; n=16) Ranges
Figure 2 - Proportion of Boys (n=79) with Externalizing Behavior in the Normal (84.8%; n=87),
Borderline(5.1%; n=4), and Clinical (10.1%; n=8) Ranges
Externalizing Problems in Head Start Children
Externalizing Problems in Head Start Children
Table 1
Sample Characteristics: Primary Caregiver of Child (n=155)
Externalizing Problems in Head Start Children
______________________________________________________________________________
Characteristic
Proportion
______________________________________________________________________________
Relationship to child
Biological Mother
88.4%
Biological Father
2.6%
Grandmother
6.5%
______________________________________________________________________________
Religion
Baptist
56.6%
Catholic
15.0%
None
10.4%
______________________________________________________________________________
Race/Ethnicity
African-American
98.8%
Asian
0.6%
Bi-racial
0.6%
______________________________________________________________________________
Highest grade completed
<High School
25.8%
High School/GED
51.6%
Some post high school
22.6%
______________________________________________________________________________
Employment status
Unemployed
69.7%
Part-time
15.5%
Full-time
14.8%
______________________________________________________________________________
Marital status
Single/separated
81.2%
Married to child’s parent
11.0%
Married to another
7.8%
______________________________________________________________________________
Table 2
Means and Standard Deviations for Child and Parent Characteristics for Total Sample (N=155)
and Externalizing Group (n=42)
Externalizing Problems in Head Start Children
_______________________________________________________________
Characteristic
Total Sample
Externalizing
M
SD
M
SD
_______________________________________________________________
CBCL Externalizing
10.9
6.4
20.5
3.8
CBCL Internalizing
4.5
0.4
7.6
5.0
CTI Emotionality
2.6
0.9
3.4
0.7
CTI Activity
4.1
0.7
4.1
0.7
CTI Attention
3.4
1.3
3.1
0.8
CTI Soothability
3.8
0.7
3.6
0.7
CTI Shyness
2.3
0.8
2.2
0.8
62.7
17.9
64.4
20.1
BSI Total
6.2
5.4
7.3
5.0
BSI Depression
0.4
0.7
0.6
0.6
BSI Hostility
0.4
0.5
0.8
0.7
BSI Symptom Distress
1.6
0.7
2.0
0.6
FES Conflict
2.8
1.9
3.6
2.1
FES Expressiveness
5.2
1.7
5.0
1.8
FES Cohesion
7.3
1.7
7.0
1.6
FES Organization
6.6
1.8
6.3
2.0
PPVT Receptive Vocabulary
VEX-P Violence Exposure
2.0
2.0
3.1
2.4
_______________________________________________________________
Table 3
Intercorrelations Between Child-Specific Variables and Externalizing Behavior (n=155)
Externalizing Problems in Head Start Children
______________________________________________________________________________
Variable
1
2
3
4
5
6
7
8
9
______________________________________________________________________________
1. Externalizing
1.00
2. Internalizing
.53***--
3. Emotionality
.55***.48
4. Activity
.08
-.13
--.06
--
5. Attention
-.23**-.14
-.21*
.08
--
6. Soothability
-.17* -.07
-.18*
.20*
.11
7. Shyness
-.13
8. Dysregulation
.28** .14
-.40** -.03
.49***.39** .82***-.16*
--.17*
--
-.21* -.71*** .20*
--
9. PPVT
.04
.01
.08
.20* -.01 -.09
-.06
.10 1.00
______________________________________________________________________________
* p<.05
** p<.01
***p<.001
Table 4
Intercorrelations Between Ecological Variables and Externalizing Behavior (n=155)
______________________________________________________________________________
Variable
1
2
3
4
5
6
7
8
9
10
______________________________________________________________________________
1. Externalizing
1.00
2. BSI Global Symptoms
3. BSI Depression
4. BSI Hostility
5. BSI Symptom Distress
6. FES Conflict
7. FES Expressiveness
8. FES Cohesion
9. FES Organization
.45*** .29** .50***.32*** .29** -.02
-.14
-.18*
.31**
--
.84***.68*** .57***.27** -.14
-.37** -.20*
.30**
--
-.41
.48** * .43** .20*
--
-.13
-.12
.13
.39** .28** -.10
-.23** -.31** .27**
--
-.28** -.14
.22** -.14
--
-.16
--
.21*
-.50***-.38** .23*
.32** .15
--
.12
.31** -.09
--
-.08
10. Violence Exposure
1.00
______________________________________________________________________________
*p<.05 **p<.01
Table 5
Means and Standard Deviations for Observed Behaviors Among Externalizing Group (n=42)
____________________________________________________________
Observed Behavior
M
SD
____________________________________________________________
Appropriate Behaviors
80.35
7.97
Solitary Play
4.17
4.37
Group Play
11.58
8.50
Dramatic Play
3.54
4.95
Rough-and-Tumble Play
1.10
2.76
On-Task Behavior
59.97
14.24
19.54
8.17
Hyperactive-Impulsive Behavior
13.44
7.53
Withdrawn Behavior
4.58
4.60
Aggressive-Initiating Behavior
0.81
0.93
Aggressive-Reactive Behavior
0.29
0.63
Inappropriate Behaviors
Negative Affect
0.42
1.37
____________________________________________________________
Table 6
Intercorrelations Between Social Problem Solving and Teacher Ratings of Behavior Problems
(n=40)
______________________________________________________________________________
Socially
Anxious
Hyperactive
Hostile
Social Problem Solving
Competent
Fearful
Distractible Aggressive
______________________________________________________________________________
Prosocial Strategies
.13
-.56**
-.36*
-.10
Agonistic Strategies
-.06
.03
.21
-.01
Trade/Bribe Strategies
-.08
.29
.06
-.03
Inappropriate Strategies
.32
.33
.24
-.22
Manipulate Affect Strategies -.18
.27
.17
.15
Authority Strategies
-.01
.44**
-.05
-.12
Flexibility
-.06
-.39*
-.24
-.28
Relevancy
-.08
-.37*
-.28
-.34*
______________________________________________________________________________
*p<.05 **p<.01
HEAD START AND MENTAL HEALTH:
A FERTILE FIELD FOR PRACTICE AND RESEARCH
Preface to the Special Issue
For over three decades, Head Start has been a national laboratory for inquiry into the
functioning and experiences of young children from low-income backgrounds (Zigler &
Valentine, 1997). Research involving Head Start children, families, and programs has become
one of the best exemplars of the use of applied developmental research for informing policy
(Zigler & Styfco, 1993). Although some scholars have criticized the use of this evidence as the
basis for our knowledge of minority child development (e.g., Washington & Oyemade, 1987),
Head Start research initiatives continue to be the primary source of data on the needs and
competencies of young children in impoverished minority families.
The proliferation of studies on Head Start children in the last few decades has generated a
large body of evidence on participant children’s cognitive and academic functioning, but
comparatively little on their social competence and mental health (Raver & Zigler, 1997;
Yoshikawa & Knitzer, 1997). Despite the identification of child social competence as the
overall goal of Head Start programs, and in spite of the regulatory mandate to address the mental
health needs of participant children (Head Start Program Final Rule, 1996), the mental health and
social competence of Head Start children remain underexplored.
Because of the documented association between low socioeconomic status and
psychological difficulties, the Head Start program presents the research community with a unique
opportunity to expand the knowledge base about the prevalence of mental health problems and
the factors that contribute to emotional functioning in this segment of the preschool population.
Although children’s mental health is receiving more attention from clinical and research
perspectives, there is still a paucity of data relevant to the mental health functioning of young
children from impoverished backgrounds, such as those in Head Start. This lack of knowledge in
the field as a whole presents a clear rationale for incorporating a mental health focus in empirical
investigations involving Head Start.
Another rationale for exploring mental health issues in Head Start emanates directly from
the experiences of participant children and teachers. In their investigation of the mental health
strategies employed in Head Start programs, Yoshikawa and Knitzer (1997) cite the increasing
levels of stress encountered by Head Start children in their home environments, and the mounting
reports by Head Start staff of escalating behavior problems in participant children. Both these
issues have led to a renewed emphasis on identifying and intervening with children with
psychological difficulties. Similarly, scholars and practitioners have called for an increase in
research investigating which mental health interventions are most effective for specific
populations and particular mental health issues (O’Brien, 1994).
The goal of this special issue is to present and integrate current knowledge about the
mental health needs of Head Start children. Accordingly, papers have been selected which
address historical and current trends in Head Start mental health services, the prevalence of
mental health problems in Head Start children, andchild-specific and environmental influences
on the psychological functioning of these children. Through this exploration of this specific
group of children, papers in this special issue contribute to the understanding of emotional
problems in young children as well as inform policy and programmatic initiatives designed to
address the mental health needs of children in the Head Start population.
Three papers in this issue approach the subject of mental health broadly, from programand system-level perspectives. First, Yoshikawa and Zigler explore the historical and future
landscape of mental health in Head Start. They consider some of the major challenges of
maintaining a focus on mental health in a 21st century Head Start program, including definitional
issues, program-level services, system level coordination, and macro-level policy factors. Lopez
and colleagues use program information reports (PIR’s) to provide national data on the numbers
of children identified with emotional problems in all Head Start programs. These data are
contextualized with a thoughtful discussion of prevalence evidence from other research
initiatives, including studies of individual programs and from other sources such as parents.
Lara, McCabe and Brooks-Gunn offer a qualitative exploration of the strategies employed by
Head Start staff in 5 different centers to deliver mental health services. They discuss the role of
management style in how teachers and other staff intervene with children and families who
present with emotional difficulties.
The remainder of the papers in this special issue examine the characteristics of participant
children and families relevant to their mental health. Fagan and Iglesias investigate an often
ignored area of research - the contribution of fathers to children’s developmental outcomes.
Specifically, they address the influence of father’s communication styles on children’s language
and behavioral competence. Koblinsky, Gordon and Anderson explore the functioning of Head
Start children experiencing homelessness. They compare the social skills and behavior problems
of homeless and housed children at two points during the Head Start year.
Two studies address individual and ecological influences on behavioral problems in Head
Start children. Randolph and colleagues investigate the role of gender and community violence
on the existence of behavioral problems in Head Start children. Jones Harden and colleagues
address several factors in their investigation of externalizing behaviors in Head Start children,
including individual characteristics such as gender, cognition, and temperament, and ecological
issues such as parental characteristics, family environment, and community violence. This study
explores the relation between parent-identified behavioral problems and children’s presentation
of socially competent or behavioral difficulties in the classroom.
This special issue is devoted to understanding mental health issues affecting children who
participate in Head Start, as well as exploring programs’ delivery of mental health services. The
papers individually and collectively amplify the magnitude of the gap between policy, practice,
and research in the mental health domain. Several specific directions for practice and research
have emerged from the analyses presented here.
Addressing infrastructure issues, Yoshikawa and Zigler call for increased program
incentives and enhanced training and technical assistance efforts in providing mental health
services through Head Start. Lara, McCabe and Brooks-Gunn highlight the importance of
infusing a mental health focus in staffing, supervision, and management strategies. Consistent
with the comprehensive program philosophy of Head Start, the paper by Jones Harden and
colleagues suggests that mental health services in Head Start should address the needs of children
and families, through classroom-based and home-based interventions at the preventive and
targeted levels. Fagan and Iglesias point to the importance of providing targeted support to
fathers in family-centered interventions. Finally, the papers by Koblinsky et al. and Randolph et
al. underscore that interventions must address the external stressors that impinge upon mental
health functioning, such as homelessness and community violence.
Research directions for Head Start and mental health have been described richly and
succinctly by Lopez, Tarullo, Forness and Boyce. They describe a new generation of
collaborative research which includes careful evaluation of sophisticated program designs.
Further, they delineate five key areas for future research: “1) population prevalence estimates and
developmental trajectories for young children’s mental health problems; 2) new measures and
methodologies for assessing developmental psychopathology; 3) cost-effective approaches to
early identification, prevention, and intervention; 4) improved understanding of mental health
service utilization patterns; and 5) better approaches to implementing high quality, communitybased systems of care”.
Given the ascendancy of interest in early intervention in current political, funding, and
research circles, the time is ripe for programmatic and empirical initiatives on mental health in
Head Start populations. The paradoxical situation in which Head Start scholars and practitioners
find themselves is one in which mental health services are mandated but do not yet receive the
national or individual program emphasis that they should. Resultant gaps in program and
research implementation around mental health issues create fertile soil for generating new
knowledge about the mental health functioning of children in poverty, as well as effective
intervention strategies to promote their optimal mental health. The authors, reviewers and
editorial board and staff who invested time and energy in this special issue hope that we have
contributed to moving the mental health of Head Start children to a place of prominence for
policy-makers, practitioners, and researchers.
Brenda Jones Harden
References
Campbell, S. (1995). Behavioral problems in preschool children: A review of recent
research. Journal of Child Psychology and Psychiatry, 36(1), 113-149.
Head Start Program Final Rule, 45 CFR § 1301 (1996).
O’Brien, James. (1994). Head Start and mental health (special issue). National Head Start
Bulletin, 49.
Raver, C. & Zigler, E. (1997). Social competence: An untapped dimension of Head
Start’s success. Early Childhood Research Quarterly, 12, 363-385.
Washington, V. & Oyemade, U. (1987). Project Head Start: Past, present and future
trends in the context of family needs. New York: Garland.
Yoshikawa, H. & Knitzer, J. (1997). Lesons from the field: Head Start mental health
strategies to meet changing needs. New York: National Center for Children in Poverty.
Zigler, E. & Styfco, S. (1993). Using research and theory to justify and inform Head Start
expansion. Society for Research in Child Development Social Policy Report, 7(2).
Zigler, E. & Valentine, J. (Eds.)(1997). Project Head Start: A legacy of the War on
Poverty (2nd edition). Alexandria, VA: National Head Start Association.