Date: 07/20/2015
Final
Presentation on Early Childhood Mental Health
EARLY CHILDHOOD AND SCHOOL READINESS
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01:37 PM -- Presentation on Early Childhood Mental Health
Senator Martinez Humenik thanked Senator Johnston for his time and invited the next presenters to begin their presentation. Jordana Ash, Office of Early Childhood, Department of Human Services (DHS), and Anna Primavera, Early Childhood Mental Health Specialist, Aurora Mental Health Center, came to the table to discuss early childhood mental health.
Ms. Ash provided background information about Office of Early Childhood and the Early Childhood Specialist program. She explained that the purpose of the office is to infuse mental health concepts across all of DHS and to bring the early childhood mental health perspective in the State Innovation Model (SIM), Help Me Grow program, and other statewide offices. She said that she also is charged with aligning the office's strategic plan with different systems to improve early childhood mental health and improve workforce capacity.
She said that Early Childhood Office uses General Fund dollars to support 17 full time mental health employees across the state to conduct prevention and improve mental health. She explained that these individuals work with childcare providers by observing classroom dynamics, working to implement best practices, and improving outcomes across the state. She told the commission that the 17 full time employees work with 40,000 early childhood care providers in the state, providing care for 148,000 children.
01:47 PM
Ms. Ash discussed tracking expulsion rates and the significance this has on economic indicators for the affected families. She said challenging behaviors in childcare facilities can be addressed with the mental health specialists that are working with facilities, children, and families to avoid expulsions. She explained that expulsion rates are also being addressed nationally. For example, in Washington, DC, expulsions from childcare facilities are now banned, and the new federal Head Start indicators ban expulsions for any participants.
Senator Merrifield asked Ms. Ash if the 17 mental health experts are employees of the state and where they are located within the state. Ms. Ash replied that the mental health experts are not employees of the state but are employees of local mental health centers. Ms. Ash stated that the 17 mental health experts are located across the state, although some serve areas as large as ten counties, while some serve only one county.
Representative Singer asked about the indicators used in the mental health survey described by Ms. Ash. She stated that the survey looks at indicators of staff affect, including whether the staff provide a positive atmosphere, are warm and welcoming, are assisting with problem solving instead of being punitive, and are punishing one child more harshly than other children for the same behavior. She explained that the scale also looks at relationships among multiple providers and how those may impact the social and emotional growth of the children in the facility.
Representative Singer noted that some of the indicators appear somewhat subjective and he expressed concerns about inter-rater reliability. Ms. Ash agreed with this concern and said that this measure was developed by Dr. Walter Gilliam of Harvard and Yale Universities. She said that Dr. Gilliam developed a tool as a way to understand some of these indicators and how they may result in a greater likelihood of expulsions for children. Representative Singer asked about whether or not there is more than one person looking at multiple centers. Ms. Ash replied that the DHS does not have the capacity to have more than one mental health specialist rate each center.
01:58 PM
Representative Wilson asked about capacity concerns and whether or not these 17 mental health specialists could actually rate all of the facilities in each area. Ms. Ash explained that this is a valid concern, and that the 17 mental health specialists do their best but are spread very thin. Representative Wilson also asked how the study may or may not address concerns that keeping a disruptive child in a childcare facility may have a negative impact on all of the other children in the facility. Ms. Ash replied that this is addressed on a case by case basis and the facility tries to address any underlying issues impacting the care. Ms. Ash replied that to her knowledge there is no study about the impact a disruptive child has on other children in the childcare facility.
Senator Kefalas asked if the Preschool Mental Health Climate Scale study will also look at early childhood trauma and stress and how it may contribute to classroom behavior. Ms. Ash replied that the study does not address individual child needs. Representative Young asked if manifestation discussions occur in the preschool setting.
02:08 PM
Senator Martinez Humenik expressed her concern about the lack of data available and her desire to know how the rating system works. She said this will allow state legislators to work with the early childhood care providers and bring forth meaningful legislation. Representative Singer also stated that he would like to see the report when it is available to help him better understand the issues. Senator Martinez Humenik asked when the study would be available and Ms. Ash replied that she hopes it will be public in the early fall.
Ms. Primavera told the commission about her work as an early childhood mental health consultant to at-risk youth in centers in Aurora. She said she also provides parenting programs, early childhood social skills programs, and works closely with the Office of Early Childhood in DHS to implement the Preschool Mental Health Climate scale, which helps enhance the programs. Ms. Primavera explained that she splits a full time position with another mental health specialist and that she has ten hours per week to visit ten classrooms. She explained that the climate scale is only used on children ages two to five. Ms. Primavera explained that another part of her job is to help retain child care center staff, and provide program- and child-specific consultation. Ms. Primavera stressed that relationships are crucial to the development and a success of a program, and that child care facilities can be very stressful environments for the teachers.
02:20 PM
Ms. Primavera noted that teachers tend not to praise behaviors that they want to see but instead only notice when students are acting out, so she works with teachers to support positive behaviors among children in their classroom. Ms. Primavera said that trauma, whether at home or in the community, has a big impact on early childhood mental health.
Senator Merrifield asked the presenters how the legislature can be more helpful in making them more effective at their jobs. Representative Singer asked about the Nurturing Parenting Program and the Incredible Years Program. Ms. Primavera stated that the Nurturing Parenting Program is a 14-week program that is geared toward violence prevention, and the Incredible Years is a parenting program that has been around for nearly 30 years and is geared toward parents who have children with conduct disorders. She said that it is offered as a prevention or intervention program.
Senator Marble asked what it means to have a child be disregulated. Ms. Primavera stated that disregulated means a child is displaying challenging behavior in the form of crying, physical violence, disassociation, and other behaviors. Ms. Ash added that it means that these children are not able to display their emotions in an age appropriate way.
Senator Martinez Humenik asked about required staff training and staff retention rates at child care facilities, and expressed her concern with the lack of consistency in the classroom due to teacher turnover and how this may impact the behavior of the children in that classroom.
02:30 PM
Ms. Primavera told the commission that a teacher in one of the child care facilities she visits consistently threatens to leave because of the behavior issues in the classroom. She said she believes that teachers can be retained when they are valued and develop strong relationships, and professionalizing childcare providers helps to address some concerns with retention but the salary scale has not yet caught up to help enhance this.
Senator Martinez Humenik expressed her desire to have this type of work attract young adults entering the workforce, but that it must first start paying a living wage of more than $9-$11 per hour. She stated that we need workable solutions and data that can help legislators address some of these concerns. She also expressed concern about behavioral disputes in child care classrooms. Ms. Primavera stated that she is not tracking any data about the outcomes of interventions in behavioral disputes. Senator Martinez Humenik thanked Ms. Ash and Ms. Primavera for their time.
02:40 PM
Senator Martinez Humenik stressed the importance of getting input from the experts in the audience to help the committee determine future topics for presentations and discussion.
The following people spoke during the public comment session:
02:41 PM -- Bruce Atchison, Director of Policy, Education Commission of the States, suggested that the commission focus on the disconnect between the birth to five years old and kindergarten to 3rd grade space. He stated that there are a lot of topics that could be addressed in regards to the kindergarten to 3rd grade continuum. He also stressed that transition is a key issue and that there are incredible disconnects during the transition from pre-kindergarten to kindergarten. Mr. Atchison answered questions from the commission.
02:48 PM -- Bill Jaeger, Vice President for Early Childhood Initiatives at the Colorado Children's Campaign, came to the table to speak. He stressed the importance of continuity of care for young children, and recommended the commission look into the "Cliff Effect" that occurs when someone receives a subsidy for child care in one county and then moves to a different county and is no longer eligible for the child care subsidy. He also suggested looking at issues of child care for families who are homeless, and explained that the profile of a person most likely to be in a shelter is a young woman with two children, at least one of whom is under the age of six. Mr. Jaeger answered questions from the commission.
02:57 PM
Senator Todd asked how we show value to the economic impact of investing in early childhood care, and urged the business community to become advocates for quality early childhood education. Mr. Atchison added that the Education Commission of the States is available to provide information to the commission regarding best practices in other states. He said that Colorado has come a long way in its work on early childhood care but there is still work to be done.