Promoting the Social, Emotional and Behavioral Development of Young Children Barbara J. Smith, Ph.D. University of Colorado Denver Alaska Statewide Special Education Conference February 18, 2009 Anchorage, AK

Campbell (1995) estimated that approximately 10-15% of all typically developing preschool children have chronic mild to moderate levels of behavior problems. Children who are poor are much more likely to develop behavior problems with prevalence rates that approach 30% (Qi & Kaiser, 2003). Center for Evidence Based Practice: Young Children with Challenging Behavior

The proportion of preschool children meeting the criteria for the clinical diagnosis of ODD (Oppositional Defiant Disorder) ranges from 7% to 25% of children in the United States, depending on the population surveyed ( Webster-Stratton, 1997). ( Webster-Stratton, 1997). Center for Evidence Based Practice: Young Children with Challenging Behavior

Children who are identified as hard to manage at ages 3 and 4 have a high probability (50:50) of continuing to have difficulties into adolescence (Campbell & Ewing, 1990; Egeland et al., 1990; Fischer, Rolf, Hasazi, & Cummings, 1984). Center for Evidence Based Practice: Young Children with Challenging Behavior

Early Predictors Temperamental Difficulties Early Aggression Language Difficulties Noncompliance Center for Evidence Based Practice: Young Children with Challenging Behavior

The correlation between preschool-age aggression and aggression at age 10 is higher than that for IQ. (Kazdin, 1995) Center for Evidence Based Practice: Young Children with Challenging Behavior

Early appearing aggressive behaviors are the best predictor of juvenile gang membership and violence. (Reid, 1993) Center for Evidence Based Practice: Young Children with Challenging Behavior

When aggressive and antisocial behavior has persisted to age 9, further intervention has a poor chance of success. (Dodge, 1993) Center for Evidence Based Practice: Young Children with Challenging Behavior

Preschool children are three times more likely to be “expelled” then children in grades K-12 (Gilliam, 2005)

Young Children with Challenging Behavior:  Are rejected by peers  Receive less positive feedback  Do worse in school  Are less likely to be successful in kindergarten Center for Evidence Based Practice: Young Children with Challenging Behavior

Social Competence “Emotional well-being and social competence provide a strong foundation for emerging cognitive abilities, and together they are the bricks and mortar that comprise the foundation of human development.” (National Scientific Council on the Developing Child, 2007)

Part C and 619 Child Outcomes Percent of children who demonstrate improved: ◦Positive social emotional skills (including positive social relationships) ◦Acquisition and use of knowledge and skills (including early language/ communication [and early literacy]) ◦Use of appropriate behaviors to meet their needs

Key Social and Emotional Skills Children Need as They Enter School Key Skills ◦ Confidence ◦ Capacity to develop good relationships with peers ◦ Concentration and persistence on challenging tasks ◦ Ability to effectively communicate emotions ◦ Ability to listen to instructions and be attentive When children don’t have these skills, they often exhibit challenging behaviors

The Center on the Social and Emotional Foundations for Early Learning (CSEFEL)

v The Technical Assistance Center on Social Emotional Intervention (TACSEI)

The Pyramid Model: Effective Practices to Promote Social Emotional Competence and Prevent and Address Young Children’s Challenging Behavior

Pyramid Model Universal Promotion Secondary Prevention Tertiary Intervention

Nurturing and Responsive Relationships Foundation of the pyramid: for ALL children Essential to healthy social development Includes relationships with children, families and team members

High Quality Environments Inclusive early care and education environments: for ALL children Supportive home environments

Supportive Home Environments Supporting families and other caregivers to promote development within natural routines and community settings Providing families and other caregivers with information, support, and new skills

Targeted Social Emotional Supports Explicit instruction and support for learning social skills Self-regulation, expressing and understanding emotions, developing social relationships

Individualized Intensive Interventions Family-centered, comprehensive interventions Assessment-based Skill-building Team based PBS

Pyramid Foundation=Effective Workforce Training and technical assistance Coaching Ongoing professional development Fidelity of implementation Policies, resources and procedures

Evaluation/Data Collection Implementation Coaching Teaching Pyramid Observation Tool Program Program Incidents (calls to families, dismissals, transfer, requests for assistance, family conferences) Behavior Incidents Child Social Skills Rating System or other measure (social skills; problem behavior)

Outcomes Associated with Adopting the Pyramid Model Program-Wide Improved staff confidence in supporting children with challenges Active instruction of social emotional competence Elimination of time-out as a practice Development of a process for addressing the needs of children with the most problem behaviors Enhancement of partnerships with families

Outcomes Associated with Adopting the Pyramid Model Program-Wide Increased use of comprehensive strategies and team planning Capacity to support all children rather than asking children to leave Internal capacity to deal with problem behaviors Reallocation of mental health dollars to focus more on prevention Reduced staff attrition, increase staff job satisfaction Improvement in overall program quality

CSEFEL  National Center focused on promoting the social emotional development and school readiness of young children birth to age 5.  Jointly funded by the Office of Head Start and the Child Care Bureau, under the auspices of the Administration on Children, Youth and Families at the U.S. Department of Health and Human Services.

Resources Research syntheses in usable formats: what works briefs, etc. Practice resources and materials Training modules Planning strategies for adopting the Pyramid Model and Practices Webinars, voice over power points Video/DVDs

Pyramid Training Modules  Suggested Agenda  List of Materials Needed, including Video Clips  Trainer Scripts  Trainer PowerPoint Slides  Participant Handouts

CSEFEL - What Works Briefs

On Monday When it Rained Glad Monster Sad Monster Hands Are Not for Hitting Practical Ideas - Book Nooks

TACSEI  National TA center funded by OSEP, US Dept. of Education  To identify, disseminate and promote the implementation of evidence-based practices to improve the social, emotional, and behavioral functioning of young children with or at risk for delays or disabilities ages birth through age 5.

Providing Evidence-Based Models Implementation and evaluation of the use of the Pyramid Model with children with or at risk for delays or disabilities Analysis of implementation and sustainability factors Implementation guidance Support for selected states in the implementation, sustainability, and scale-up of models

Consultant Bank Bank of consultants organized by expertise Web-based process of matching request to consultant Accountability procedures

Primary Partners

v Lessons Learned Thus Far State-wide Pyramid Implementation Initiatives

State Implementation CSEFEL State Partnerships CO, MD, IA, NE, NC, VT, HI, TN TACSEI State Partnerships (to be selected in 2009 through an application process)

Implementation Purpose and Model Purpose: PD system to support adoption and sustainability of Pyramid Model and practices Model of state-wide implementation based on literature and experience re: how to: Disseminate info on what works to program level staff and families Support adoption of what works Support sustained use over time of what works

Implementation Strategies Literature and experience indicates the following strategies: State level collaborative planning and support State-wide trainers Community/program level coaches Demonstration sites

State Level Planning and Support State level collaborative planning team Planful group decision making processes that promote shared ownership and limits feelings of “winners and losers” Written, shared: vision, language, agendas, meeting summaries, action plans Shared decision making Ground rules for conducting meetings and decision making See for some exampleswww.vanderbilt.edu/csefel

Trainers and Coaches State wide Pyramid Model Trainers Trained to train on Pyramid and practices Trained on effective training techniques coaches Pyramid Model Coaches Trained on Pyramid Model and practices Trained on effective training practices Trained on effective coaching strategies

Demonstration Sites Demonstration sites High quality setting, committed leadership, enthusiastic about the Pyramid Model and being a demonstration site Supported in implementation and sustainability of Pyramid Model and practices Supported in data collection to ensure fidelity of implementation and positive outcomes Supported as a site that stakeholders can visit to see the Pyramid in action!

Lessons Learned So Far Programs and families like the Pyramid Model and practices Programs and coaches can implement the model and practices to fidelity Programs report improved outcomes

Lessons Learned So Far It takes time, time, time, time Time for training Time for providers to be coached Time for coaches to coach Time for program planning Time for data collection Time for helping families implement the practices

What Do We Mean by Implementation? A specified set of activities designed to put into practice an activity or program of known dimensions. Processes are purposeful and defined in sufficient detail such that independent observers can detect the presence and strength of these “specified activities”

Insufficient Methods Implementation by laws/ compliance by itself does not work Implementation by “following the money” by itself does not work Implementation without changing supporting roles and functions does not work Fixsen, Naoom, Blase, Friedman, Wallace, 2005

Insufficient Methods Diffusion/dissemination of information by itself does not lead to successful implementation Training alone, no matter how well done, does not lead to successful implementation Fixsen, Naoom, Blase, Friedman, Wallace, 2005

OUTCOMES (% of Participants who Demonstrate Knowledge, Demonstrate new Skills in a Training Setting, and Use new Skills in the Classroom) TRAINING COMPONENTS Knowledge Skill Demonstration Use in the Classroom Theory and Discussion 10% 5%0%..+Demonstratio n in Training 30% 20% 0% …+ Practice & Feedback in Training 60% 5% …+ Coaching in Classroom 95% Joyce and Showers, 2002

“What” AND “How” To successfully implement and sustain the use of the Pyramid Model you need to understand: The intervention framework (What - the Pyramid Model) AND Effective implementation and sustainability frameworks (How)

Population of ConcernIntervention (the WHAT) Strategies Intervention Outcomes Children Birth through 5 with or at risk for delays or disabilities including children with challenging behavior Competent use of the “Pyramid Model” framework and intervention strategies over time and across staff Improved social and emotional competence, behavior & relationships among children, their families & other caregivers TACSEI Logic Model for Implementation & Sustainability TACSEI and the TA Center for State Implementation and Scaling Up of Evidence-Based Practices

Population of ConcernIntervention (the WHAT) Strategies Intervention Outcomes Children Birth through 5 with or at risk for delays or disabilities including children with challenging behavior Competent use of the “Teaching Pyramid” framework and intervention strategies over time and across staff Improved social and emotional competence, behavior & relationships among children, their families & other caregivers TACSEI and the TA Center for State Implementation and Scaling Up of Evidence-Based Practices How? TACSEI Logic Model for Implementation & Sustainability

Population of ConcernIntervention Strategies Intervention Outcomes Children Birth through 5 with or at risk for delays or disabilities including children with challenging behavior Competent use of the “Teaching Pyramid” framework and intervention strategies over time and across staff Improved social and emotional competence, behavior & relationships among children, their families & other caregivers Populations of ConcernImplementation & Sustainability Strategies Implementation & Sustainability Outcomes Adults: Caregivers, early childhood service providers, family members, early interventionists, child care staff, preschool teachers Science-Based Strategies: Skill-based Training Competent Coaching and Support Collection and use of fidelity and outcome data Development of facilitative administrative practices and policies within the organization to support implementation Competent use of the Teaching Pyramid framework and intervention strategies over time and across staff. TACSEI and the TA Center for State Implementation and Scaling Up of Evidence-Based Practices TACSEI Logic Model for Implementation & Sustainability

Population of ConcernIntervention StrategiesIntervention Outcomes Children Birth through 5 with or at risk for delays or disabilities including children with challenging behavior Competent use of the “Teaching Pyramid” framework and intervention strategies over time and across staff Improved social and emotional competence, behavior & relationships among children, their families & other caregivers Populations of ConcernImplementation & Sustainability Strategies Implementation & Sustainability Outcomes Adults: Caregivers, early childhood service providers, family members, early interventionists, child care staff, preschool teachers Science-Based Strategies: Skill-based Training Competent Coaching and Support Collection and use of fidelity and outcome data Development of facilitative administrative practices and policies within the organization to support implementation Competent use of the Teaching Pyramid framework and intervention strategies over time and across staff. TACSEI and the TA Center for State Implementation and Scaling Up of Evidence-Based Practices TACSEI Logic Model for Implementation and Sustainability How?

Population of ConcernIntervention StrategiesIntervention Outcomes Children Birth through 5 with or at risk for delays or disabilities including children with challenging behavior Competent use of the “Pyramid Model” framework and intervention strategies over time and across staff Improved social and emotional competence, behavior & relationships among children, their families & other caregivers Populations of ConcernImplementation & Sustainability Strategies Implementation & Sustainability Outcomes Adults: Caregivers, early childhood service providers, family members, early interventionists, child care staff, preschool teachers Science-Based Strategies Skill-based Training Competent Coaching Collection and use of fidelity and outcome measures and data Development of facilitative administrative practices to support implementation Competent use of the Pyramid Model framework to problem-solve, plan system change and competently use the intervention strategies over time and across staff Formal Implementation Teams at State, regional, and agency levels Collaborative planning, advocacy, and execution to advocate for, install, monitor, and support the use of Science-Based Implementation & Sustainability Strategies focused on the Pyramid Model content Competent, Sustainable state, regional and agency infrastructure to support the development and use of Science-Based Implementation & Sustainability Strategies TACSEI Logic Model for Implementation & Sustainability TACSEI and the TA Center for State Implementation and Scaling Up of Evidence-Based Practices

There are evidence-based practices that are effective in changing the developmental trajectory of children with or at risk for social, emotional and behavioral concerns…the problem is not what to do, but rests in ensuring access to intervention and support