TA Consultation and Coaching: Infant Early Childhood Mental Health (IECMH) Consultation
Category
Early Care and Education
Child's Age
0-1 years, 1-2 years, 2-3 years, 3-4 years, 4-5 years
Participant
ECE Owner/Operator, ECE Teachers
Languages
English
Brief Description
Infant Early Childhood Mental Health (IECMH) Consultation is a non-clinical TA-consultation and coaching service designed for Early Childhood Education professionals. An IECMH Consultant collaborates with ECE professionals to support and sustain the healthy social and emotional development of all infants and young children. Technical Assistance is the provision of targeted and customized supports by a professional(s) with subject matter and adult learning knowledge and skills to develop or strengthen processes, knowledge application, or implementation of services by recipients. Consultation is a collaborative, problem-solving process between an external consultant with specific expertise and adult learning knowledge and skills and an individual or group from one program or organization. Consultation facilitates the assessment and resolution of an issue-specific concern—a program-/organizational-, staff-, or child-/family-related issue—or addresses a specific topic. Coaching is a relationship-based process led by an expert with specialized and adult learning knowledge and skills, who often serves in a different professional role than the recipient(s). Coaching is designed to build capacity for specific professional dispositions, skills, and behaviors and is focused on goal-setting and achievement for an individual or group.
Expected Impact
- Trends toward internal locus of control as reported by teachers
- Reduction in child’s hyperactivity, restlessness, externalizing behaviors, problem behaviors, and other social-emotional challenges
- Significant improvements in child’s social and emotional skills
- Increase in positive classroom behavior
Core Components for Model Fidelity
- Consultants: IECMH Consultants focus on building the capacity of the adults in children’s lives to understand young children’s social emotional development. Their work promotes nurturing relationships and supportive environments for children in child care. The level of support provided by the Consultant is based on community need and the credentials of the consultant, but will not include clinical diagnosis or intervention. IECMH Consultants must commit to, and be held accountable for, all National Competencies.
- IECMH Services: In their role as a TA/Consultant, the IECMH Consultant may engage in any of the following, based on their level of credentialing and expertise:
- Providing group or individual consultation with ECE professionals working with young children.
- The consultation cycle includes initial contact, discussion of needs, provision of an effective practice assessment, discussion of findings from initial assessment, development of a quality improvement plan with measurable results that will culminate in a post-assessment.
- Educators indicate an agreement to and participation in guided action plan.
- Supporting administrators in policy development and implementation
- Referral consultation to provide support and referrals to additional clinical or non-clinical services, as needed
- Providing reflective practices to early childhood professionals (direct service, managers and/or leaders)
- Providing group or individual consultation with ECE professionals working with young children.
- Services: TAs are encouraged to engage in the following cycle of activities with participating providers:
- Preparation - the initial set of activities that technical assistance providers use to prepare staff to engage in planning for technical assistance. Practices include needs assessment, practitioner decision making, visioning, readiness for change, and organizational capacity.
- Plan - the written documentation of professional development activities and sequence that a technical assistance provider facilitates with their learner. This would include an action plan for program administration and plans to support classroom personnel. Practices include objectives and goals, intervention practices, fit assessment, theory of change, TA resources, and practitioner roles and responsibilities.
- Implementation – the provision of technical assistance, including technical assistance provider credibility, professional development, coaching & mentoring, consultation, and provider support/feedback.
- Evaluation - the practices used by technical assistance providers to understand what changes have been made as a result of their work. Evaluation supports understanding if goals have been achieved and if plans were implemented with fidelity. Practices include process evaluation, outcome evaluation, fidelity of use of intervention practices, fidelity of use of technical assistance practices, and lessons learned.
- Sustainability – the plan of activities to maintain changes once formal technical assistance activities have been completed. Practices include capacity-sustaining activities, continuous quality improvement, ongoing technical assistance provider support and follow-up activities.
Core components based on research of technical assistance models & frameworks: https://ecpcta.org/wp-content/uploads/sites/2810/2019/11/Final-Combined-TA.pdf
Languages Materials are Available in
English
Delivery Mode
In-person consultation and coaching, prefered, but hybrid options are a reasonable response to environmental factors.
Dosage
Consultation: Dosage may vary greatly, with minimum of two contacts with professional or classroom. If engaging with a single professional/classroom on a regular basis, TAs, may transition the relationship to a coaching relationship.
Coaching: relationship building, observation, and feedback over a series of encounters in duration of 6–12 months typically.
Ideally, consultation evolves into coaching or be continued support after a coaching relationship and cycle has been completed.
Infrastructure for Implementation
Materials: Knowledge and Skills - an understanding of best practice as considered by a specific standard of quality. Tools for guided self-reflection for practitioners on current classroom or organizational practices. Resources and training for practitioners.
Space: As needed for group or one-on-one reflection and training
Staffing Requirements
Requirements:
- Complete all Center of Excellence for Infant and Early Childhood Mental Health Consultation's Foundational Modules online, The Mental Health Consultation Tool.
- All Consultation is based on the tenets of reflective practice and all IECMH Consultants must receive reflective supervision specific to IECMH Consultation from someone trained to provide reflective supervision and receiving it themselves. The Workforce Development section of the IECMHC Toolbox offers more information on supervision and oversight of IECMH consultants in the field.
- Minimum of a bachelor's degree in related field or with relevant coursework.
- Specialized knowledge in early childhood development, the effects of stress and trauma on families, the importance of attachment for young children, and the impacts of mental health of adults in parenting and caregiving roles on brain development and child outcomes.
- At least 2 years’ experience in or supporting early care & education setting(s).
Recommendations:
- At least two years’ experience in an area related to IECMH or early childhood service systems.
- North Carolina Infant and Early Childhood Mental Health Association Endorsement: Infant Mental Health Endorsement® Category Infant Family Specialist or higher, Early Childhood Mental Health Endorsement® Category Early Childhood Family Specialist or higher. Available to many sectors of the multidisciplinary workforce, that recognizes a professional’s ability to promote, prevent, treat, or provide leadership in the infant mental health field.
- Eligible to be endorsed within one year of hire.
- Early Educator Certification at Level 11 (or higher) or Technical Assistance Endorsement. If no Certification or Endorsement, minimum requirement "The Art and Science of TA" CEU or Practice-Based Coaching Training.
Training for Model Fidelity
Utilize the IECMHC Workforce tools to ensure IECMHC role is adequately supported, and all recommended training and coursework (below) is obtained.
- IECMHC Training Qualifications Grid
- Training Workforce Development Activities that Prepare and Support IECMH Consultants
- National Competencies: Center of Excellence for Infant and Early Childhood Mental Health Consultation Competencies
- Intended to facilitate national consensus on the practice of IECMHC and how it differs from related early childhood services, this document articulates the specific role of the MHC, the knowledge required to perform the role, and the tasks that define IECMHC.
Contact Information
Kelsey Smith: kelsey.smith@ncimha.org
Cost Estimates
Varies based on local staffing costs.
Purpose Service Code (PSC)
3105 - Accessing Professional Certification and Course Work
3104 - NC Child Care Resource and Referral Services
3125 - Quality Child Care
Program Identifier (PID)
TA Consultation and Coaching: Infant Early Childhood Mental Health Consultation
Minimal Outputs for NCPC Reporting
FY 24-25:
- Number of child care facilities receiving TA
Minimal Outcomes for NCPC Reporting
FY 24-25:
- Improved teacher/child interaction
Minimal Measures for NCPC Reporting
FY 24-25:
- TPITOS AND/OR TPOT
NCPC Evidence Categorization
Evidence Based- Two randomized controlled trials and a quasi-experimental study.
Research Summary
The studies mentioned here include two randomized controlled trials and a quasi-experimental study. Gilliam et al. (2016)1 completed the first RCT of early childhood mental health consultation. They found that intervention children had significantly less hyperactivity, restlessness, externalizing behaviors, problem behaviors, and overall fewer problems than control children. No significant results were found for likelihood of expulsion or quality of the childcare environment. The intervention may have been too short to create any lasting change in classroom quality. In 2021, Reyes and Gilliam2 conducted the second RCT and found that children in the intervention classrooms showed significant improvement in their social and emotional skills. Significant results were found for the subscales of Initiative, Attachment, and Behavioral Concerns on the DECA-P2 when scores were compared between control and intervention group’s post-treatment evaluations. Both target and random peers were reported to be more self-initiated. There were promising trends noted by the authors for reduced problem behaviors. Intervention teachers had a non-significant trend towards an internal locus of control, but they also reported fewer progressive practices. There were no significant effects found for likelihood of expulsion and mental health climate of the classrooms’ teachers. Lastly, Mathis et al. (2022)3 conducted a quasi-experimental waitlist control evaluation and found that intervention children had more positive classroom behavior, less social-emotional challenges, and achieved higher scores in math, literacy, and writing when assessed at the end of the school year.
- ^ See Gilliam et al. (2016). 176 children, aged 3-4, and their teachers were randomly assigned to early childhood mental health consultation or the waitlist control group. Two children were identified in each classroom, to focus the intervention on, due to their behaviors. Participants were located in community-based childcare centers, Head Start centers, or public schools. The intervention lasted 3 months. Measures used included: CLASS, the Social Skills Rating System, Conner’s Teacher Rating Scale-Revised Long Form, Preschool Expulsion Risk Measure (author created). All behavior reports were collected pre- and post-intervention. They found that intervention children had significantly less hyperactivity, restlessness, externalizing behaviors, problem behaviors, and overall fewer problems than control children. No significant results were found for likelihood of expulsion or quality of the childcare environment. The intervention may have been too short to create any lasting change in classroom quality. The results were Limited by reliance upon teacher-ratings of behavior.
- ^ See Reyes & Gilliam (2021). Conducted as a randomized controlled trail where classrooms were either assigned to receive ECMHC or to the waitlist-control group. Intervention evaluations were completed pre- and post-treatment, which included 6 consultation visits. There were 51 classrooms that included 57 preschool teachers and 190 preschool students (ages 3-5). The classrooms were located in 24 different Ohio counties. Measures included: the CHILD tool, The Center of Epidemiological Survey Depression Scale-10, the Framing Challenging Behaviors Questionnaire, the Conners Early Childhood Behavior-Teacher/Child care Provider Short Form, the Preschool Expulsion Risk Measure, the Devereux Early Childhood Assessment for Preschoolers, Second Edition, and the Preschool Learning Behaviors Scale.
- ^ See Mathis et al. (2022). Conducted as a quasi-experimental waitlist control evaluation of a school-based model of ECMHC. The consultants followed the framework developed by Georgetown University for school-based mental health consultation. Population included 15 intervention classrooms and 5 comparison, 282 intervention children and 108 comparison. The children were 3-4 years old and a majority were Black and were considered “at risk for academic failure” (meaning they receive TANF or SNAP benefits, are homeless, or are a part of the foster care system). No significant differences found between intervention and control classrooms for demographics. Other differences in the baseline measures were controlled for in the primary analyses. Measures included observation, teacher ratings, and direct assessment. Assessments used were the Positive Behavior Rating Scale, the Social Emotional Screener, and Every Child Ready assessments for math, literacy & language, and letters & writing.
Researched Population
Research on TA- Consultation and Coaching samples early childhood education professionals, including teachers, administrators, and owners/operators.
Clearinghouse and Compendium References
Gilliam, W. S., Maupin, A. N., & Reyes, C. R. (2016). Early childhood mental health consultation: Results of a statewide random-controlled evaluation. Journal of the American Academy of Child & Adolescent Psychiatry, 55(9), 754-761. https://doi.org/10.1016/j.jaac.2016.06.006
Mathis, E., Hartz, K., Berkowitz, M., Carlson, A., Kimport, R., Brown, C., ... & Domitrovich, C. E. (2022). Using Early Childhood Mental Health Consultation to Facilitate the Social Emotional Competence and School Readiness of Preschool Children in Marginalized Communities. School Mental Health, 1-16.
Reyes, C. R., & Gilliam, W. S. (2021). Addressing challenging behaviors in challenging environments: Findings from Ohio's early childhood mental health consultation system. Development and Psychopathology, 1-13. https://doi.org/10.1017/S0954579420001790
Center of Excellence for Infant and Early Childhood Mental Health Consultation (2021). Annotated Bibliography: The Evidence Base for Infant and Early Childhood Mental Health Consultation (IECMHC). http://www.iecmhc.org/documents/CoE-Annotated-Bibliography.pdf
- Before considering this activity please contact Healthy Social Behaviors Specialists to determine if resources are available in your area.
- TAs, also known as IECMH Consultants, should not engage in clinical diagnosis or intervention as part of this Smart Solution. Psychological and Mental Health Services can be provided by a licensed clinical provider with referral from the TA.
- Additional Resources
- Evaluation of the Illinois Model of Infant and Early Childhood Mental Health Consultation Pilot
- Alliance Addressing Suspension and Expulsion in Early Childhood Education Settings: An Infant and Early Childhood Mental Health-Informed Approach
- Early Childhood Mental Health Consultation: Policies and Practices to Foster the Social-Emotional Development of Young Children
- Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant and Early Childhood Mental Health® (Endorsement or IECMH-E®)
- Highly recommended by NCPC
- NCIMHA Endorsement Overview
- Two Endorsement categories depending on scope of practice
- Infant Mental Health Endorsement®: For professionals working with or on behalf of children birth to 3.
- Early Childhood Mental Health Endorsement®: For professionals working with or on behalf of children 3 to 6.
- Supports professionals in identifying and developing the knowledge and skills necessary to provide services that are high quality, culturally informed, reflective, and relationship based.
- Endorsement offers career paths that focus on principles, best practice skills, and reflective work experiences that lead to increased confidence and credibility.
- No additional training is required for Endorsement.
- Many applicants may find that many of their onboarding, in service, conference, discipline specific certification, and NCIMHA sponsored trainings can be utilized to complete an Endorsement application.
- NCIMHA Competency Guidelines® & Crosswalks: NCIMHA provides multiple crosswalks connecting the Competency Guidelines to well-recognized training curricula for professionals seeking Endorsement. Below are a few of these crosswalks that are particularly salient to the Smart Start Network as the curricula are included in Smart Solutions. Please view the associated Smart Solutions entries as well as NCIMHA's website for additional information about these curricula and other opportunities.
- The Center of Excellence (CoE) for IECMHC
- Provides professional development through virtual trainings for mental health consultants.
- Serves as a clearinghouse for IECMHC resources.
- Provides programmatic support (webinars, presentations, and technical assistance) to local stakeholders with an IECMHC program.
- Infant and Early Childhood Mental Consultation Foundational Modules
- 8 modules that correspond to the 8 areas in the National competencies for IECMHC.
Local Partnerships Currently Implementing
Local Partnerships in purple have adopted TA Consultation and Coaching: Infant Early Childhood Mental Health (IECMH) Consultation. Local Partnership contact information can be found here.