Early Childhood Mental Health Consultation: Results of a Statewide Random-Controlled Evaluation

Abstract Objective Despite recent federal recommendations calling for increased funding for early childhood mental health consultation (ECMHC) as a means to reduce preschool expulsions, no random-controlled evaluations of this form of intervention have been reported in the scientific literature. This study is the first attempt to isolate the effects of ECMHC for enhancing classroom quality, reducing teacher-rated behavior problems, and reducing the likelihood of expulsion in targeted children in early childhood classrooms. Method The sample consisted of 176 target children (ages 3-4) and 88 preschool classrooms and teachers, randomly assigned to receive ECMHC through Connecticut’s statewide Early Childhood Consultation Partnership (ECCP) or waitlist control group. Prior to randomization, teachers selected two target children in each classroom whose behaviors most prompted the request for ECCP. Evaluation measures were collected at both pretreatment and posttreatment, assessing child behavior and social skills, and overall quality of the child care environment. Hierarchical linear modeling was used to evaluate the effectiveness of ECCP and to account for the nested structure of the study design. Results Children who received ECCP had significantly lower ratings of hyperactivity, restlessness, externalizing behaviors, problem behaviors, and total problems compared to children in the control group even after controlling for gender and pretest scores. No effects were found on likelihood of expulsion and quality of child care environment. Conclusion ECCP resulted in significant decreases across several domains of teacher-rated externalizing and problem behaviors and is a viable and potentially cost-effective means for infusing mental health services into early childhood settings. Clinical and policy implications for ECMHC are discussed.