Starting early

Why boosting mental health for the youngest children is attracting federal — and private — investment

John Hicks, co-facilitator of a parenting class called "The Incredible Years" listens as participants discuss setting rules for their kids.

At dinnertime on a Tuesday night, nine parents sat in a Commerce City preschool classroom discussing the difficulty of setting rules for their small children.

Some said they bark orders too often and are trying to cut back. One mom said she wished one blanket rule — “just love each other” — would cover it. But inevitably she finds a dozen more specific things to list off: Don’t bite, don’t hit and so on.

Over the next hour, the parents and two facilitators talked through more effective approaches, including giving kids fewer direct orders, defining “non-negotiables” and letting little things go.

The parenting class was part of a federally-funded initiative called Project LAUNCH that aims to help parents, preschool teachers, pediatricians and other adults in Adams County boost mental health in young children. It reflects growing national awareness that children stand a greater chance of succeeding in school and life if they get mental health support in their earliest years.

“We have so many kids with social and emotional needs,” said Lisa Jansen Thompson, executive director of the Early Childhood Partnership of Adams County. “It is just increasing.”

The Project LAUNCH work in Adams County is a five-year, $2.6 million effort funded by a federal grant program that pays for similar efforts in states and tribal areas across the country.

Getting kids reading well by the third grade used to be the “north star” for many early childhood advocates, Jansen Thompson said. But now, abundant data show the need to start earlier — well before kids enter school. That’s when key lifelong skills develop, such as the ability to form close relationships and manage strong emotions.

And if that development hits a roadblock, a new set of problems can crop up, like kids getting suspended in preschool or having pitched battles at home.

Competition was stiff for Colorado’s Project LAUNCH funding. Eleven communities submitted letters of interest within a 48-hour period. The Adams County proposal, which focuses on Spanish-speaking families in the southern portion of the county, ultimately won out.

But the story didn’t end there. The outsized interest in early childhood mental health — along with the success of an earlier Project LAUNCH site in Weld County — inspired a first-of-its-kind effort by eight private funders to replicate the program in four other Colorado communities.

That initiative — called LAUNCH Together — last fall awarded a total of $8 million to grantees in Denver, Pueblo, Jefferson County and, working as one team, Chaffee and Fremont counties. The private funders include seven foundations and one health care provider.

“We were not trying to prove that a privately funded model could do this better,” said Colleen Church, director of programs for the Caring for Colorado Foundation, one of the funders. “We were really building off what had worked.”

She said interest in early childhood mental health had been growing among funders for several years, elevating it to the level of traditional child health priorities such as ensuring kids have access to medical care and are fully immunized.

The funders hired a Denver-based organization called Early Milestones Colorado to lead the privately funded effort.

While the details differ in the five communities participating in Project LAUNCH and LAUNCH Together, the primary strategies are the same. They involve special training for preschool teachers, parents and the staff of home visiting programs, which send professionals to work with parents of babies or young children. The idea is to help the adults with whom children interact learn how to foster social and emotional skills in kids, and spot red flags that might require outside help.

There are also efforts to get new mothers screened for depression and to make sure children are routinely screened for developmental milestones at doctor check-ups — and if problems arise, give families quick access to mental health services.

Janine Pryor, coordinator of the Chaffee County Early Childhood Council, said because of the LAUNCH Together funding, “We’re sending people to trainings that no one here could ever afford.”

Leaders of the various LAUNCH efforts say their goal is not just to alter the experience that kids and families have now at preschools, doctor’s offices and in their homes, but to make systems-level shifts that ensure changes continue after the grant money runs out.

At the same time, they want to raise public awareness about the importance of early childhood mental health and reduce the stigma that so often accompanies it.

“We’re going to try in our region to really get the word out and develop messages that will resonate with everyone,” Pryor said.

early intervention

Meet Colorado’s resident expert on early childhood mental health

Jordana Ash, Colorado's director of early childhood mental health

Jordana Ash holds a job that doesn’t exist in most states.

She’s Colorado’s director of early childhood mental health — a position created three years ago within the state’s Office of Early Childhood. A local foundation paid Ash’s salary for 18 months and then the state took over.

The addition of a high-level state job dedicated to the mental health of young children was a win for advocates, coming at a time of growing awareness about the long-term impact of childhood trauma. Ash said her role helps infuse both the Office of Early Childhood, where her unit is housed, and other state agencies with programs and policies focusing on child mental health.

Before coming to the Office of Early Childhood, which is part of the Department of Human Services, Ash ran a mental health consultation program in Boulder for 13 years.

We sat down with Ash this week to discuss her background, the state’s work on early childhood mental health and her thoughts on the recent defeat of state legislation that would have limited early childhood suspensions and expulsions.

The interview has been edited for clarity and length.

What sparked your interest in early childhood mental health?
My first job out of graduate school was in Alameda County, California and I was a child welfare worker. I didn’t have a lot of life experience at that time. I didn’t have children of my own. I didn’t know a lot about child development. But what I could really do is listen to families. We met families at the hardest times.These were families whose children were removed for suspicion of abuse or neglect.

Everybody has a story and if you spend time listening, you will hear about their hopes for their child, things that bring them joy in parenting. To me, it’s about the stories and what parents do every day to try to do better for their kids.

Can you put into context Colorado’s work on early childhood mental health compared to work in other states?
Colorado is really in a unique position compared to other states. My position was created three years ago with philanthropic dollars (from the Denver-based Rose Community Foundation, which is also is a financial supporter of Chalkbeat) looking to get a position in state government completely focused on early childhood mental health.

There are very few states that have a position of leadership in state government with (early childhood mental health) being their primary focus. Minnesota has a similar position, Connecticut has a coordinator position. A couple of states are coming along. Other states have recognized that it’s a wise investment to have a position where you can really institutionalize some of those important changes and policies for statewide reach.

Can you talk about the major efforts your unit is working on now?
Our two main initiatives are the mental health (consultant) program and Colorado Project LAUNCH. (See this story for more about Project LAUNCH.)

We are (also) studying the effects of parent adversity on child well-being. We were (also) selected to receive three years of technical assistance on infant and early childhood mental health consultation. We’re hoping that helps us finalize our system of consultation in Colorado so we are a premier program that other states look to.

Last year, the state doubled the number of early childhood mental health consultants available to help child care providers and preschool teachers manage challenging behavior. How is it going?
Our state-funded program of 34 full-time positions is one of the largest (in the nation). We’re working really hard on developing Colorado’s system of mental health consultation so it’s consistent — for state-funded positions, for positions funded by philanthropy for programs that have their own hired consultants — so everyone is working toward the same standard of practice.

Can you share an anecdote about how mental health consultation works?

I can think of a situation where a consultant provided support for a cook at a child care center. Her child was enrolled in the program. This was a 3-year-old with a lot of challenging behaviors. At first, (the mother) was really nervous to talk to the consultant. She confused the role of the mental health consultant with something like social services and wondered if she was going to be judged or somehow scrutinized about her parenting. She had never had contact with any kind of mental health service before.

In getting to know the consultant not only did she find some new ways to interact with her child so that he could be more successful in the classroom and at home, but she also had her first experience with a mental health professional. It reduced the sense of stigma (around) getting mental health help.

She found that she could get a better position at the child care center because her child was successful in his classroom. She wasn’t having to take him home because of his problems.

What advice do you have for child care providers or early childhood teachers who are at their wits’ end over a child’s challenging behavior and haven’t accessed a consultant? Take a deep breath. We want to understand that that child is telling us something. We might not understand what that behavior means but it’s our responsibility as adults to help figure that out.

We really encourage providers to access a mental health consultant or other support right away when they’re starting to be puzzled or concerned about a child’s behavior. It’s much easier to intervene if you have new ideas sooner in the process.

The role of child care providers and teachers is critically important. So we are not in a position to judge or to evaluate what you’ve done. We’re in a position to partner with you and help you provide the best care you can.

To locate an early childhood mental health consultant, providers can call 303-866-4393.

What advice do you have for parents who know their child is acting up at preschool or child care and worry they could get counseled out or kicked out?
Reach out and connect directly with your child care program about the problem before you start feeling like your child may be at risk of being suspended or expelled. That partnership between parents and providers is the most powerful part of a solution.

I would also say you can talk to your child’s primary care physician as a start. Maybe there’s a developmental concern your physician can help figure out and that’s gonna be a really important piece of the puzzle.

Connecting with a mental health consultant in your area is a really good solution to start looking at the causes of those challenging behaviors and to start putting in place some interventions while other tests or other assessments are being done.

For help locating a mental health consultant, parents can visit: http://www.coloradoofficeofearlychildhood.com/ecmentalhealth

What are your thoughts on the bill killed during Colorado’s 2017 legislative session that would have limited suspensions and expulsions in preschool and kindergarten through second grade?

The fact that the bill made it as far as it did meant lots of people were invested, were having great conversations about this problem in a way we never (had) before. Stakeholders were for the first time …. considering issues of disproportionality and implicit bias in a way that was a first. We had never had that kind of visibility to the early childhood time period and this very complex issue that affects children’s trajectories way into their school years.

Would you like to see a similar bill pass next year?
As an office, we’d be super interested in whatever’s put forward.

Early education

Colorado gets good marks on preschool access for 3-year-olds, not so much on funding

PHOTO: Ann Schimke
Preschoolers play dress-up on a recent morning at Fairview Elementary in the Westminster school district.

While Colorado ranks near the back of the pack for state preschool funding, it gets relatively high marks for providing preschool access to the state’s 3-year-olds, according to a report released Wednesday by the National Institute for Early Education Research.

Colorado ranked 11th for 3-year-old access among 33 states offering preschool to 3-year-olds. The state-funded Colorado Preschool Program, which is for children with certain risk factors, served about 5,400 3-year-olds and about 15,700 4-year-olds last year.

PHOTO: NIEER
This chart shows the percentage of Colorado children served by state-funded preschool over time.
PHOTO: NIEER
This chart shows how Colorado’s per-pupil preschool funding has changed over time.

Colorado ranked 24th of 44 states for 4-year-old preschool access in the state-by-state report, slightly worse than last year. Seven states, including Colorado’s neighbors, Wyoming and Utah, don’t fund preschool at all.

Besides gauging preschool funding and access, the new report revealed that Colorado meets five of 10 benchmarks designed to judge preschool quality. Last year, the state met six of the benchmarks, but several benchmarks changed this year in what the research institute described as an effort to raise the bar.

State officials said that observers should take Colorado’s middling benchmark score with a grain of salt because while the state didn’t get credit for having certain standards enshrined in state policy, the standards are widely practiced by school districts that participate in the Colorado Preschool Program. One example is the benchmark that calls for vision, hearing and health screenings of preschoolers — Colorado didn’t check that box, but most districts conduct the screenings.

Two other benchmarks that Colorado doesn’t meet include a requirement for lead teachers to have a bachelor’s degree and assistant teachers to have a Child Development Associate credential.

Cathrine Floyd, program director for the Colorado Preschool Program and Results Matter Program at the Colorado Department of Education, said the degrees are highly encouraged by the state but not required. That’s because some state-funded preschool slots are offered at community-based preschools that would not be able to afford to pay teachers if they all had higher-level degrees, she said.

Among the five benchmarks Colorado meets on the revised list are two related to class size and staff-student ratio, one related to teacher training, one related to state early learning standards and one related to preschool curriculum.

Floyd and her colleagues described the annual report from the well-regarded National Institute for Early Education Research as a good starting point for conversation, but said the state’s annual Colorado Preschool Program report provides more detail and context about Colorado’s progress.