Grant funding helps identify behavioral health issues at the youngest ages |

Grant funding helps identify behavioral health issues at the youngest ages

Emily Ndawula, a preschool teacher at UCHealth GrandKids Child Care Center, explains how to identify emotions, a universal strategy to promote social-emotional development and reduce challenging behavior.
UCHealth Grandkids Childcare Center/Courtesy

STEAMBOAT SPRINGS — When applying for one of the Community Health Benefit Fund’s 2020 grants aimed at addressing mental health needs in the Yampa Valley, Jessica Carroll, director of UCHealth GrandKids Child Care Center, was focused on stepping in as early as possible — and preventing behavioral health problems from the very beginning.

While the grant she received was modest at $8,000, Carroll has made those dollars go far in the community and created the potential for a lifelong positive impact for countless children.

The first step for Carroll was to bring in a professional instructor and the Prevent-Teach-Reinforce program.

The program and techniques focus on intensive early intervention for kids between the ages 2 and 5 who are exhibiting challenging behavior and not responding to typical disciplinary or support interventions, Carroll said.

She also reached out to other childcare centers and was able to include staff from Little Lambs Daycare and Discovery Learning Center in the training. Between the three centers and a few other community organizations, 17 people attended the initial training sessions.

Those 17 people can reach at least 50 children in the Yampa Valley and more as they receive ongoing support in the classroom.

According to the Children’s Defense Fund, “Studies reveal that those enrolled in high quality early childhood education programs are more likely to complete higher levels of education, have higher earnings, be in better health and be in stable relationships, and are less likely to commit a crime or be incarcerated.”

It’s typical for toddlers to do things like take a toy from another child or push them, Carroll said, but red flags come when it is really chronic, and the behavior is more severe — throwing chairs, biting, screaming, etc.

The technical definition of challenging behavior, in this context, is “any repeated pattern of behavior that interferes with learning or engagement in pro-social interactions with peers and adults.”

There are also kids — less noticed — who may be incredibly withdrawn, she said, and demonstrate “an inability to connect socially with peers.”

Other kids may run away frequently, which also presents serious safety issues.

Intervening before age 5, before the child goes to kindergarten, is key, Carroll said.

Research shows children with challenging behavior experience more peer rejection, unpleasant interactions with family members and teachers, predictable and consistent school failure, and a lack of community integration, according to Pyramid Plus: the Colorado Center for Social Emotional Competence and Inclusion.

When a child is identified for intervention, the model begins with a series of meetings. The family may or may not be involved, but will always be contacted for permission, Carroll said. The early steps include identifying the target behavior deemed the most unsafe, or detrimental, and “focus on one behavior at a time.”

The child is likely trying to fulfill a need, she said, so there is an investigation into why the behavior is occurring, and then strategies created to develop a replacement skill.

For example, if a child is running away during circle time, they may have a hard time with larger groups. A replacement skill could be the child asking for a break, Carroll said, and having a special place in the classroom they can be by themselves. If a child is biting to get away from other children, a replacement behavior might be asking to be left alone, she said.

“It’s not just that you’ve got to get rid of the behavior — you replace it with positive behavior that meets the same need,” Carroll added.

While the focus is to reach the kids most in need, Carroll emphasized the benefit to all kids under the Pyramid Model.

Under the model, all practices are evidence-based and provide “universal supports for all children to develop nurturing and responsive relationships (and) interact with high quality supportive classroom environments.” About 80% of the children experience “targeted emotional supports,” and about 2% to 5% of children receive “intensive individualized interventions.”

The curriculum is taught to the whole classroom, Carroll explained, in terms of creating an environment focused on things like building friendships and positive relationships and learning how to label emotions and self-regulate the more challenging emotions.

By learning to “calmly interact with teachers and peers,” Carroll said, “that’s what sets them up on a lifelong learning track.”

They also learn how to engage and initiate play and follow directions. Throughout the day, and working with families at home, they also emphasize sticking to a routine to “make sure it is predictable, and the kids know what to expect.”

According to The National Center for Effective Mental Health Consultation, children with a strong foundation of emotional literacy tolerate frustration better, get into fewer fights and engage in less self-destructive behavior. Research also shows they are are healthier, less lonely, less impulsive, more focused and have greater academic achievement.

After participating in several virtual training sessions, Carroll said the teachers who have begun implementing the approach at the three participating child care centers are already seeing positive changes in behavior.

And not only does the model help kids in terms of academic and social emotional readiness, but it benefits the teachers, she noted. A positive environment leads to less teacher burnout and better retention.

Carroll sees the work up to now as “just barely touching the surface.” She has plans to expand the training and continued classroom support and is “taking it on as a project for the long haul.”

To reach Kari Dequine Harden, call 970-871-4205, email or follow her on Twitter @kariharden.

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