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Improving Outcomes for Children in the Child Welfare System: Infant and Early Childhood Mental Health Consultation is Key

January 27, 2025

Since 2020, BUILD Initiative has explored how the child welfare and early childhood systems – including all child-and-family serving systems -- can align and work together to achieve better outcomes for children and families. According to Dr. Cynthia Tate, who leads the project, several states are developing promising programs, policies, and strategies that can provide inspiration for other states.

One goal of BUILD’s six-part webinar series, Moving Away from Family Separation: Cross-Systems Strategies to Support Young Children and Families at Risk of Child Welfare Involvement, is to highlight successful state strategies. Sponsored by the PN-3 Capacity-Building Hub at BUILD, the series will cover several strategies, including those that focus on infants and toddlers, who are removed from their homes at more than double the rate of children ages 4 to 17. This is the second blog based on the first webinar in the series, presented in October 2024, entitled Two Systems, One Vision: Quality Early Care and Education for Children in Foster Care.

Children involved in the child welfare system must receive high-quality, trauma-informed early childhood education (ECE) if they are to have the best outcomes. Arkansas is one state that is working toward that end. An October 2024 webinar sponsored by the PN-3 Capacity-Building Hub at BUILD, entitled, Two Systems, One Vision: Quality Early Care and Education for Children in Foster Care, focused on the state’s efforts to ensure young children in the child welfare system get the support they need to thrive. Nikki Edge, PhD, from the University of Arkansas for Medical Sciences, presented on the high risk for poor behavior and learning outcomes children in foster care experience because of trauma and separation from primary caregivers. In addition, she discussed the need to reduce expulsion through Infant and Early Childhood Mental Health Consultation (IEMHC). Nikki’s presentation built on information presented in the same webinar by Sheila Smith, Ph.D., National Center for Children in Poverty, and Todd Grindal, Ed.D, SRI International, on the “learn, innovate, and improve” model they are using to understand the barriers to and facilitators of access to high-quality early childhood programs and help the workforce care for children who demonstrate signs of trauma.

Nikki and her colleagues have found that IECMHC may be able to be utilized to support children in foster care as effectively as other children that are also at risk for expulsion, and it may be an important service to improve outcomes for children in foster care. She said they are “very encouraged by the data that says we’re able to effectively support children whose relationships have been disrupted and who are especially in need of warm and supportive early care and education experiences.”

Despite the literature on the positive impact of preschool, the disparities in the expulsion data (there is a higher impact on boys, especially boys of color), and federal guidance encouraging states to act on this issue, Nikki noted that it persists, leaving many children unable to experience the benefits of high-quality early care and education.

Children who have experienced trauma are at higher risk for delays in social and emotional development as well as for early emerging mental health concerns like post-traumatic stress disorder. Sometimes these concerns manifest in challenging behaviors in the classroom that are difficult for teachers to manage. Not surprisingly, research suggests that young children who’ve experienced trauma are at increased risk for expulsion from early care and education settings. When these factors combine with the fact that children in foster care are less likely to experience high-quality early care and education, it follows that these children will experience some unique risk factors for expulsion.

Studies have confirmed that Infant and Early Childhood Mental Health Consultation is associated with decreased likelihood of expulsion, along with improved teacher/child interactions and reductions in challenging classroom behaviors. But we know that childhood trauma is not always part of the background and training of early childhood staff. Nikki pointed out that many teachers and directors “haven’t yet connected the dots between children’s experiences of trauma and some of the behaviors or challenges they are seeing in the classroom. Having more information can help them see the behaviors through a different lens and give them a broader array of responses or just increase their empathy or willingness to work through challenging times.”

IECMHC in the Classroom 
Nicki discussed the following ways a specially trained mental health professional can pair with directors, teachers, and parents to build their capacity to support children in the classroom:

  1. Respond to behavior in ways that’s safe and avoid re-traumatization, i.e., focusing on de-escalation and helping teachers keep their cool.
  2. Work on techniques to build and strengthen relationships between teachers and children, and creating emotional and physical safety in classrooms, e.g., supporting children with strategies to help make their worlds more predictable and consistent and helping them know what’s coming next in the classroom so that they can transition through each set of activities more smoothly.
  3. Help teachers equip children with skills for self-regulation. Trauma, by definition, means that we have experienced events that have overwhelmed our capacity to cope. So, it’s important to help children build coping skills, understand how to identify their emotions, and learn how to calm down from big feelings.
  4. Build social skills. Some children may not have had great models for conflict resolution and for problem solving for friendship skills.
  5. Support the well-being of ECE program staff. Working with children in foster care can be emotionally challenging for some teachers. It involves trying to rebuild their empathy, to work through challenging behaviors.
  6. Be mindful of the emotional load of these cases on teachers and give them a safe place to work through issues. Some teachers have difficulty understanding the mission of the child welfare system to reunite families whenever safely possible. Or they may feel anger toward a parent where there was maltreatment, carry a lot of worry for a child who may be about to transition out of their program.
  7. Make room for different perspectives to be shared, including the child, whose voice is often left out, the parent and the teacher. They all have their own experience of the situation.Cross-Systems Alignment is Crucial  
    Collaboration and effective communication between those working in the ECE and child welfare systems is essential to meeting the needs of children and families. Those serving children in foster care need to know the history of the children that they’re serving, or if reunification is nearing, if the case is coming to adoption, or if changes in visitation schedules and/or court appointments will lead to daily disruptions in the life of the child and in the program. Nikki discussed a communications toolkit created with the support of Arkansas’s child welfare and early education agencies that ECE and child welfare teams can use when they’re working together to meet the needs of a child in foster care. One of the most important elements of the toolkit is the simplest – just a letter from these agency leaders saying, “We support the sharing of information in the best interest of the child.” The toolkit provides tips for the kinds of questions that are appropriate for ECE providers to ask, ways to share their updates with the court and with case workers, and ideas for how to support children who are leaving a program.Other States Can Use These Findings 
    The work of Nikki and her colleagues has shown the potential of IECMHC as a support for children in foster care and those that are also at risk for expulsion. State leaders can now use these findings to support children in their states whose relationships have been disrupted and who are most in need of high-quality, trauma-informed early care and education experiences.For more information on the cross-systems collaboration between the child welfare and early childhood systems, check out the resource collection on BUILD’s website. It includes recent reports and articles as well as recording and archived materials from BUILD’s webinars.

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