Zero to Three challenging behavior and

Topics: Child development, Psychology, Childhood Pages: 8 (6642 words) Published: December 7, 2014
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Challenging Behavior and
Expulsion From Child Care
The Role of Mental Health Consultation
deBorah f. perry
Courtney holland
Georgetown University

nikki darling-kuria
CKD Communications, LLC
Martinsburg, West Virginia

sarah nadiv
University of Maryland


here is strong evidence that social and emotional skills
are as critical to school adjustment as are competencies
in language and academic readiness skills. When
kindergarten teachers report that children are not
entering school ready to learn, they are most often
referring to deficits in social and emotional skills. Left
untreated, early behavioral problems can develop into
more serious mental health conditions that can effect learning and achievement (Joseph & Strain, 2003; Raver & knitzer, 2002; wentzel & Asher, 1995). In fact, roughly half of all children with problem behaviors in kindergarten are placed in special education by the 4th grade. Research has shown that social and behavioral competence in young children more accurately predict their academic performance in 1st grade than do their cognitive skills and family backgrounds (Fox & Smith, 2007). The prevalence rates for young children

with challenging behavior ranges from 10%
to 30% (Fox & Smith 2007). Campbell (1995)
estimated that approximately 10–15% of all
typically developing preschool children have
chronic mild to moderate levels of behavior problems. Emotional and behavioral problems of children are typically divided
into two general categories: externalizing
and internalizing problems. Externalizing
problems involve aggressive, defiant, and
noncompliant behaviors. The most common externalizing emotional and behavioral problems are attention deficit hyperactivity
disorder (ADHD), oppositional defiant disorder, and conduct disorder. Internalizing problems include withdrawal, depression,
and anxiety. The most common internalizing
4 Z e ro to thre e No v e m b e r 20 1 1

problems are separation anxiety disorder,
generalized anxiety disorder, and depressive
disorders. In addition, very young children
commonly exhibit problems that do not fall
within either of these general diagnostic categories, for example, sleeping problems, eating problems, and toilet-training–related problems. Many of these are best diagnosed using the Diagnostic Classification 0–3r (ZERO TO

THREE, 2005). The most common specific
challenging behaviors in children less than
5 years old are aggression, noncompliance,
defiance, tantrums, and destruction of property (Strain & Timm, 2001). When challenging behaviors in young
children are not addressed early, emotional
and behavior problems in preschool and
kindergarten children are often stable over

time. young children with challenging
behavior are more likely to experience early
and persistent peer rejection, frequent

Preschool children are being expelled
from child care programs at an
astonishing rate, often because of
challenging behaviors such as aggression, tantrums, and noncompliance. Teachers say they need more training in how to manage these behaviors in child care settings. Early childhood
mental health consultation (ECMHC)
has been shown to build provider’s
capacity to better cope with challenging behavior. This article describes the lessons learned from interviews
about 20 children receiving ECMHC
who nonetheless exited their child
care settings because of behavioral
concerns. The authors outline the common characteristics of children at risk for expulsion, as well as the common characteristics of programs that may exacerbate challenging behaviors. A discussion of how ECMHC can help reduce the risk for expulsion is

included along with a detailed list of
specific strategies consultants recommended for use with teachers.

punitive contacts with teachers, unpleasant
family interaction...

References: (2008). The evidence base for mental health
consultation in early childhood settings:
Campbell, S. B. (1995). Behavior problems in
preschool children: A Review of Recent
Cohen, E., & Kaufmann, R. (2000). Early childhood
mental health consultation
Donohue, P., Falk, B., & Provet, A. G. (2000).
& Strain, P. (2003). The teaching pyramid:
A model for supporting social competence
Fox, L., & Smith, B. J. (2007). Issue Brief: Promoting
social, emotional and behavioral outcomes of
Gilliam, W. S. (2005). Prekindergarteners left behind:
Expulsion rates in state prekindergarten programs.
Johnston, K., & Brinamen, C. (2006). Mental
health consultation in child care: Transforming
Perry, D. F., & Kaufmann, R. K. (2009). Integrating
early childhood mental health consultation with
Raver, C., & Knitzer, J. (2002). Ready to enter:
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