Michigans Early Childhood Mental Health Services

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Michigans Early Childhood Mental Health Services

• Sheri Falvay, Michigan Department of Community
  Health, Mental Health Services to Children and
  Families

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Michigans Efforts to Support Early Childhood
Mental Health

• Intervention
• Prevention
• Promotion

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Promotion

• High quality training on social-emotional
  development
• For Child Care Providers and Parents
• MI4C/Child Care Resource and Referral
• Michigan State University and
• Child Care Expulsion Prevention
• All funded with Child Care Development Block
  Grant Dollars earmarked for 0-3 Quality.

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Promotion

• Collaboration agreement between MI4C, MSU-E and
  CCEP was developed.
• Agreed to use common Social and emotional
  definition across trainings
• Within the context of ones family, community
  and cultural background it is the childs
  developing capacity to
• Experience and regulate emotions,
• Form secure relationships and
• Explore and learn (adapted from 0-3)
• Agreed to create an expanded state level social
  and emotional training committee and to involve
  all early childhood partners, i.e. Part C, Head
  Start

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Promotion

• Will work on (7) training recommendations
• Use the same definition and source for the topic
  of temperament.
• Provide referral information for all three
  projects at trainings.
• Emphasize the importance of the caregivers
  emotional health.
• Emphasize the importance of nurturing, responsive
  caregiving and the importance of having a primary
  caregiver.
• Use a common source for social-emotional
  milestones.
• Emphasize the importance of true partnerships
  between parents and caregivers in promoting
  social-emotional health.

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Promotion

• 2. High quality training on social-emotional
  development
• For Front line staff (IMH, Mental Health
  consultants, Health workers, etc)
• Michigan Association for Infant Mental Health
  Endorsement

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• Michigan Association for Infant Mental Health
  Endorsement

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What is the Value of Endorsement?

• Provides a level of assurance to families,
  agencies and the public at large that the person
  delivering services meets professional standards.
• Provides a pathway for development in the infant
  and family field for the span of ones career.
• Provides a set of competencies to guide training,
  service and research.

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Development of a Professional System

• 1997, MI-AIMH designed a 4-level framework for an
  interdisciplinary professional development system
  to recognize competency
• Infant Family Associate Level One
• Infant Family Specialist Level Two
• Infant Mental Health Specialist Level Three
• Infant Mental Health Mentor Level Four

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Framework for Endorsement Component Parts

• MI-AIMH identified the following endorsement
  criteria to assure best practice outcomes for
  infants, toddlers families
• specific educational experiences
• work experiences with infant, toddlers families
• competency-based, in-service training experiences
  
• reflective supervision/consultation experiences

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Additional Criteria for Endorsement

• Infant Mental Health Code of Ethics
• Reference ratings from 3 professionals
• Successful completion of a 3-hour written exam
  for level 3 4 candidates
• Membership in an IMH professional organization

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Steps to Endorsement

• Inquiry
• Applications
• Portfolio preparation
• Documentation
• Endorsement

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How is MI Infusing Endorsement?

• DCH requiring Level II endorsement by 2009 for
  all home based staff working in early childhood
• DCH, early childhood mental health consultation
  program (CCEP) requires all staff to be endorsed
  at Level II.

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Michigans Efforts to Support Early Childhood
Mental Health

• Intervention
• Prevention
• Promotion

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Prevention

• Early Childhood Mental Health Consultation
• Child Care Expulsion Prevention
• Started in 1999, the Department of Human Services
  (DHS) made an interdepartmental agreement with
  the Michigan Department of Community Health, to
  establish one Child Care Expulsion Prevention
  (CCEP) project to support the mental health needs
  of young children in early care and education
  settings.
• Now- 16 project in 31 counties

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CCEPs Goal
To support families and child care providers in
successfully nurturing the social and emotional
development of infants, toddlers and young
children (0-5) who are in child care.
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The Cornerstones

• Programmatic and child-family centered
  consultation
• Skilled consultants
• Reflective supervision
• Technical assistance
• Evidence-based practice
• Collaboration

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Programmatic ConsultationWhat Do We Do?

• Intake
• Observation
• Standardized Social and Emotional Assessment of
  Programs
• Planning
• Coaching
• Build Relationships!

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CCEP Core Trainings

• New (3-hour) standardized modules
• Social and Emotional
• Development
• Challenging Behavior
• Conflict Resolution
• Caring for the Caregiver

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CCEP Child/Family Consultation
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Child-Family Centered Consultation

• Referral and Intake
• Observation and Assessment
• Meetings to Develop Positive Child Guidance Plans
  and Programmatic Plans to support child
• Support for the Family and Provider to Implement
  Plans
• Social-Emotional Trainings
• Referrals to Outside Services as Needed
• Follow-up Services (optional)

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Why are Children Referred?

• Children are referred for many reasons but most
  often for
• Aggression (25)
• For example, biting, hitting, swearing,
  destroying property
• Regulatory issues (27)
• For example, Child has difficulty adjusting to
  changes in routine, does not sleep or rest as
  needed, has toileting problems or feeding
  difficulties.
• Developmental concerns (23)
• For example, child is clingy, has problems
  focusing, does not listen to care provider or
  parent, impulsive, or has problems with play
  (initiating, maintaining)

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What Happens with Support?(2007 data)

• 83 of children referred to CCEP stayed in the
  program. 92 percent of these children had
  positive outcomes (17 moved or data was not
  completed for extenuating circumstances)
• 56 stayed in the same child care setting with
  positive results
• 23 transferred to a more appropriate child care
  setting with agreement from all involved
• 13 of children graduated on to Kindergarten
  successfully or with appropriate support services
• 4 of the children were expelled with no follow
  up
• Another 4 were expelled but received services at
  a new site from CCEP

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Skilled Consultants Reflective
Supervision

• Masters Degree in Mental Health Related Field
• Level II MI-AIMH Endorsement
• Twice Monthly Reflective Supervision

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State-Level Technical Assistance for
CCEP Projects and Others

• Quarterly meetings in two regional locations
• Monthly Training and Evaluation meetings for
  administrators of CCEP programs
• On-site visits
• Statewide and national training
• Uniform forms and materials
• Email group

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Evidence-Based Practice

• Devereux Early Childhood Assessment for Infants,
  Toddlers and Preschoolers
• Evaluation!
• Data collection (child, care provider, family,
  and CCEP process)
• Case Studies
• Control Sample

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Michigans Efforts to Support Early Childhood
Mental Health

• Intervention
• Prevention
• Promotion

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Intervention

• Home-based Services for infants-toddlers, young
  children (0-3, 4-7) and their parents
• Infant Mental Health Services
• Parent Education
• Other CMHSP Services (i.e. respite, case
  management services, etc.)

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What is Happening?

• Revised 0-3 and 4-7 access criteria
• Requirement of MIAIMH endorsement for staff
  working in early childhood services
• State level committee charged with researching
  social and emotional assessments to support
  eligibility(18 tools researched)
• DECA-I/T chosen for piloting
• Still researching an adult/child interaction tool

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What is the DECA-IT?

• The Devereux Early Childhood Assessment for
  Infants and Toddlers (DECA-IT) is a premier
  instrument for assessing protective factors and
  screening for potential risks for social and
  emotional development in very young children 4
  weeks to 36 months.

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What Protective Factors Does the DECA-IT Measure?

• The Infant Assessment measures
• Initiative and
• Attachment/Relationships
• The Toddler Assessment measures
• Initiative
• Attachment/Relationships and
• Self-Regulation

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What Ages Does it Cover?

• There are two assessments.
• The Infant assessment covers from 4 weeks up to
  18 months- It also has four scoring profiles
• 4 weeks to 3 months
• 3 months up to 6 months
• 6 months up to 9 months
• 9 months up to 18 months
• The Toddler assessment covers from 18 months to
  36 months- It has one scoring profile

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Is it a Viable Assessment?

• The DECA-IT meets or exceeds professional
  standards of quality in terms of
• Reliability
• Validity
• The DECA-It had a national standardization sample
  of 2,185 infants and toddlers from across the
  U.S.

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Efforts Towards Universal Use

• Part C piloted the use of the DECA-I/T in
  combination with developmental assessment
• Early Head Start has purchased kits for all sites
  with training to follow
• All CCEP sites use the DECA for 0-3 and the
  Preschool DECA

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For More Information

• Please Contact Sheri Falvay at
• Falvay_at_michigan.gov
• 517/241-5762
• For information on CCEP or the DECA-I/T contact
  Mary Mackrain at
• Mackrain_at_aol.com
• 248/594-3250