Exploring the Use of Infant Mental Health Screening Tools at Arkansas Childcare Providers

1. Exploring the Use of Infant Mental Health Screening Tools at Arkansas Childcare Providers Neena Viel Children’s Behavioral Health Care Commission April 2014

2. Agenda • Project Overview • Methodology • Results • Limitations • Moving Forward

3. What is infant mental health? Screening tools can be used to determine deviation (Social-emotional or developmental) from the expected norms for the age, and the need for more extensive formal evaluation. It does not provide a diagnosis. Infant mental health can be characterized as the developing capacity of a child from birth to 5 years of age to form secure relationships; experience, manage, and express a range of emotions and explore the environment.

4. Arkansas • In 2012 there were 1057 victims of abuse or neglect aged 0-1 and another 2780 victims aged 2-5 in Arkansas. • Arkansas is among a group of states with 4-7 expulsions per 1,000 preschoolers, a rate about three times higher than the rate in Kindergarten through 12th grade. • Surveys of mental health providers reveal that most are not trained in evidence-based interventions for children 0-5. • 18% of Arkansas mothers have post-partum depression; 27% of mothers of pre-kindergarten reported depressive symptoms shown to negatively impact parenting.

5. In 2006, First Lady Ginger Beebe went on a listening tour to hear narratives from families with children involved in the mental health system. • DHS/DCCECE provides Conscious Discipline training to childcare providers several times a year. • In 2012, DHS/DCCECE conducted a pilot study with the Ages and Stages infant mental health tool. • In 2013, the Social Work Department at UALR conducted a social-emotional health survey with childcare providers. • Project PLAY is an ongoing service project serving childcare centers and teachers through partnerships and consultations. Where are we?

6. The Project

7. Methods

8. Results: Respondent Demographics • 469 respondents from75 Arkansas counties. • Average number of staff is 16. • Average number of children served is 85.

9. Training

10. Developmental Screenings

11. Social-Emotional Screening

12. ASQ reported as the most widely utilized screening tool: • 33.3% of all respondents who screen reported using the ASQ for developmental screening. • 45% of all respondents who screen reported using the ASQ for social-emotional screening. • Of the 31.8% of private centers that screen, 70% reported using the ASQ. • Of the 68.5% of federal centers that screen, 40% indicated they used the ASQ. • Of the 73.9% of state centers that screen, 35.2% reported using the ASQ. *Note: There are no standardized screening requirements in the private sector. There are social-emotional screening requirements for federal and state funded providers, and this may help account for the difference in screening percentages. Ages and Stages

13. Social-Emotional Screening Frequency

14. Referral Rates

17. Limitations The high number of average children served (85) may indicate that more center-based providers took the survey than home-based providers. A larger proportion of providers from higher populated counties completed the survey, meaning the data may not be representative of provider experiences in smaller, rural counties.

18. Moving Forward

19. Developing a toolkit for early childhood learning centers. This toolkit could include information about implementing social-emotional screenings and use of the ASQ. • Targeting private providers for social-emotional training. • Assessing gaps in service capacity following screenings and referrals. • Launching a campaign to educate providers and families on what infant mental health is, and how to better address it. Where to go from here?

20. Dr. Nicola Connors-Burrow, Associate Professor, UAMS “When children experience healthy social and emotional development, they are able to play, learn and face challenges successfully. It is critical that we focus on ways to identify and support young children at risk for early problems in their social and emotional development.”