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As we have learned throughout this course series, when possible, early care and education (ECE) providers should avoid involuntary external transitions.  External transitions should be avoided whenever possible due to the impact on children, families, staff and the child care center.

You can take steps to prevent challenging behavior from happening in the first place. These steps can lead to a reduction in external transitions. The third and final module of the series uses examples and ideas to explain how to work with children showing challenging behavior.

Sometimes, external transitions are unavoidable, for instance, when a parent’s job changes.  In some cases, external transition may be in the child’s best interest. For example, a child with significant behavior issues may require a program that has a lower teacher ratio or is closer to mental health support specialists.

For such cases, we discuss resources that may help reduce negative outcomes.

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Early Care and Education (ECE) professionals are extremely important in a center’s ability to provide quality care to children. The relationships that ECE professionals build with children are instrumental in a child’s healthy social-emotional development. These relationships help build trust and the foundation for positive attachments which are important for building connections throughout life.

Even though the research shows how important it is to hire and retain ECE professionals who provide quality care for children, there is a lot of teacher and director turnover. Nationally, it is estimated turnover ranges from 25 to 40 percent. A lack of professional support and training may be adding  to the problem.

To be able to teach and care for children in a way that supports social, emotional, physical, and neurological growth while addressing challenging behavior, ECE professionals need training and ongoing support. When teachers in the classroom do not have the tools they need to work with children experiencing behavior problems, it can lead to a larger number of center-initiated transitions. Without training, resources, and professional support, it is harder to prevent challenging behaviors from happening in the first place. Without training, resources, and professional support, It is also harder to take steps to address challenging behaviors when they do happen. Zwolak’s (2017) research points out ways that the number of center-initiated external transitions may go down when opportunities for high-quality professional development for ECE professionals goes up.  The state of Kentucky has a support network in place for child care providers and this network has a history of making quality professional development available at little or no cost to providers. 

Implicit bias refers to the thoughts that influence our understanding of people and situations and how we react emotionally and physically to those situations.  Everyone experiences implicit bias in decision-making.  Implicit bias is tricky because it happens without our knowledge.

When people act on implicit bias, they do not understand that they are acting on thoughts that exist deep in their brains—the thoughts are unconscious. The way we think and act (biases) may include positive and negative perceptions about what is being observed. Perceptions shape individual decisions and actions.

Sometimes the way a person reacts to situations due to implicit bias does not match the person’s values or the way they think about themselves.  Implicit biases are different from conscious beliefs and attitudes because they live in the part of the brain of which we may not be aware. Prejudice and racism are very different from implicit bias because people usually know how they feel and think about prejudice and racism.

People can become more aware of their own prejudices, i.e. differences, racism, etc., by thinking about, talking about, and learning about their own feelings. Implicit bias is different because it cannot be discovered through reflection and introspection. Implicit biases are formed through life experiences and can be shaped by other people and the media.

People start to connect thoughts with experiences throughout their lives beginning in early childhood. These connected thoughts and experiences create the implicit biases, which are common for topics like race, ethnicity, age, appearance, or another characteristic.  Implicit bias theory suggests the patterns we learn that connect our thoughts with situations do not always match the values we think we have or the values we would teach another person.

There may be a connection between implicit bias and the data that shows children of certain genders or races experience center-initiated external transitions more often. More research is needed to say that implicit bias plays a role in the decisions to suspend or expel a child. The National Association for the Education of Young Children (NAEYC) has conducted research into the ways implicit bias might influence interactions in ECE classrooms.

• The data suggests implicit bias may play a role in the behavior teachers and staff expect from children and how negative they label a particular behavior to be.
• ECE staff of any race tend to watch African American children, especially boys, more closely when they expect to see challenging behavior.
• White ECE teachers may have lower behavioral expectations for African American children and may see the behaviors as typical of African American children. 
• African American teachers may have higher behavior expectation standards for African American children than White teachers.

The NAEYC research appears to support the fact that implicit biases, though unconscious, are learned behaviors. The NAEYC research also suggests it may be possible to unlearn implicit biases and reduce or eliminate their impact on one’s own behavior.

In one study, when teachers were given information about a child’s stressful home life, they tended to respond differently to that child, with some racial differences noted.  Teachers of the same race as the child showed increased empathy. Teachers of a different race than the child tended to consider the child’s behavior as worse. Teachers of a different race were also more likely to see the situation as unable to be fixed.

New research suggests implicit bias has an impact on the way teachers manage challenging behaviors in ECE classrooms. New research also suggests implicit bias could play a role in center-initiated external transitions.

While the research shows implicit bias cannot be changed through reflection or introspection, the research also shows there may be a way to change the actions taken because of implicit bias. Research suggests that implicit bias may be able to be changed by providing additional professional development and training.

National and state statistics on the number of children being served by child care show that parents may or may not have access to a wide variety of ECE options from which to choose when looking for child care.

Consider:

• 6.2% (estimated as 276,000) of children under age five live in Kentucky.
• National data shows that “61% of all United States children are in care outside of the home for 40 or more hours per week while their parents or primary caregivers are at work” (Zwolak, 2017).
• About 59% of Kentuckians ages 16 and older describe themselves as employed either full or part-time (U.S. Census Bureau, 2018).
• Broad estimates of four-year-olds from low-income households being served in Kentucky’s public preschools range from approximately 20 – 30% (Kentucky Youth Advocates, 2014). 
• An estimated 70 – 80% of four-year-old children are served at home or in privately owned and operated child care programs.

The Center for American Progress reports that potentially 50-60% of Kentucky’s children under age five live in child care deserts. A child care desert is any census area with more than 50 children under age 5 that contains either no child care providers or more than three times as many children as licensed child care slots.

• Child Care Aware of Kentucky offers services to help people interested in starting a child care business – giving priority to areas considered child care deserts.
• Child Care Aware of Kentucky offers services to increase access to quality child care through technical assistance, training, and scholarships for people interested in starting a child care and those who are current owners.

Data on how often children move from one child care setting to another is limited. Currently, in Kentucky there is no way of tracking the number of times a child moves from one child care setting to another, unless a parent self-reports the data. There is no requirement that privately owned and operated child care programs keep track of the number of times a child is suspended or expelled from a program.

In public preschool data, some external transitions are recorded in suspension and expulsion data.  Available statistics suggest:

• Male children are more likely to experience one or more out-of-school suspensions when compared to female children.
• African American male children are more likely to experience one or more out-of-school suspensions than other children. 
• African American female children appear more likely to experience suspension or expulsion more often than one would expect based on estimated populations. 

National public preschool data tells us:

• 41% of the children are White and about 28% of these children experienced one or more out-of-school suspensions. 
• 19% of the children attending public preschool are African American and yet 47% of all preschool out-of-school suspensions are African American children. 
• About 20% of the public preschool population are African American girls but of all female children who experience out-of-school suspension, about 54% are African American females. 
• This data shows us that African American children tend to be suspended more often than their White peers.

There is no public data in Kentucky which exclusively shows the number of preschool out-of-school suspensions by race; however, Kentucky’s Preschool – 12^th grade data shows similar patterns as what is reported nationally.

• 12% of the state’s students were involved in reported behavior incidents.
• Males comprised 72% of both in-school and out-of-school suspensions.
• 77% of the total student population are White children and 61% of the time White males were suspended.
• 11% of the total student population are African American children and 29% of the time African American males were suspended. 

The difference between the percentage of suspensions of White children compared with the total White student population and the percentage of suspensions of African American students compared with the total African American student population suggests African American students may be more likely to be disciplined with suspension than their White peers.

National and state statistics seem to show disciplinary disproportionality which describes circumstances when larger numbers of students from certain racial/ethnic groups are subjected to office discipline referrals, suspensions, school arrests, and expulsion. Additionally, national and state data seem to show that African American children may be suspended or expelled more often than their White peers which means they are more likely to experience center-initiated moves.

As described in the first module of this series, the more often a child moves to a new child care setting, the greater the chance they will move again in the future. The greater the number of moves a child experiences, the greater the chance that they will be impacted negatively by the moves. Additionally, moving more often makes it harder to benefit from the stable learning environments and relationships needed to grow to one’s full potential. This is important to think about when making decisions on whether to move children to a new center—especially when the data seems to show that racial bias may be a factor.

Video Credit: PBS Newshour

• Nationally, 31% of eligible children ages 3 – 5 have access to Head Start and 7% of eligible children under age three have access to Early Head Start programs. 
• In Kentucky, 42% of eligible children ages 3-5 years have access to Head Start and 7% of eligible children under age three have access to Early Head Start programs.

Continuity of care in early care and education (ECE) happens when children experience the same type of care over a long period of time. It can be challenging for families to control continuity of care in the early care and education settings they choose for their children. When families have less opportunity to choose an early care and education program that matches their philosophy and needs, children may be impacted more negatively by an external transition. When there are fewer options for quality ECE programs in a community, center-based external transitions become even more difficult for families.

Consider the following examples:

• Living in an area with a low number of ECE programs from which to choose.
• Significant differences in the ways care is provided by each ECE program.

Public preschools that are owned and operated by the public school district and Head Start programs are the organized regulated ECE programs which have operated for the longest time. These two program types also have the most similar programming.

The number of spaces available for children in public preschools and Head Start programs may be limited by location and eligibility guidelines. The children and families served by public preschools and Head Start programs must meet state or federal guidelines.

Kentucky’s public preschool programs must serve four-year-old children from families meeting low-income guidelines, children ages three and four who are identified by school districts as having a disability who have an associated Individualized Educational Plan (IEP). 

• Approximately 90% (159) of Kentucky’s 176 school districts offer public preschool programs.
• Less than half of the public preschool programs provide a full-day experience.

If there are open slots above and beyond those filled by children meeting the eligibility requirements, the school district can choose to serve additional four-year-olds that are paid for by the family.

• In 2017, approximately 61 of Kentucky’s 176 school districts offered some type of tuition-based public preschool services in addition to those served based on eligibility requirements.
• Choosing to serve tuition-paying children can help increase the number of children who have access to a quality Early Care and Education program.   

When leaders at a child care setting decide that a child must move, it is often because of behavior problems.

Challenging behavior in children usually tells a story about something the child has experienced.

Children who have experienced trauma are more likely to have challenging behavior.

Children experiencing ACES may be more likely to move because of a choice made by the leaders of a child care setting. See the examples in the handout below.

Children experiencing ACES need a routine stable environment to heal.

Moving children who have experienced trauma does NOT:

• Teach the child or family the skills to work through the challenging behavior. 

• Heal the trauma the child is experiencing.

• Lead to long-term changes in the child’s behavior.

Children who move from one child care setting to another because of behavior are at greater risk for:

• Additional moves in the future.
• Suspension and expulsion in grades K-12.
• Dropping out of school.
• Being involved with the criminal justice system.

It is estimated 35 million children in the United States have experienced one or more ACES. 

Significant trauma, like ACES, can have life-long implications.

For children experiencing ACES, moving to a new child care setting because of challenging behavior is a missed opportunity for healing and growth.

Child care providers who continue to care for children while working on challenging behavior can:

• Provide critical intervention services within their everyday programming.
• Be the stable environment the child needs to heal.
• Be the stable educational environment that helps a child catch up to developmental milestones.
• Help decrease the long-term impact of ACES for young children. 
• Work with families to make appropriate referrals for Early Intervention Services when needed.

Without intervention, children experiencing trauma (like ACES) may show worse or more frequent challenging behaviors and a pattern is created.  

• A child experiences trauma and reacts with challenging behaviors.
• They are moved to a new child care setting.
• The behavior gets worse.
• They are moved again.
• The behavior continues to get worse.

Each move leads to less stability, less bonding within relationships, and more challenging behavior.

All of these experiences making it harder for a child to heal from the trauma.

Moving again and again makes the problem worse.

Continuity of care in early care and education happens when children experience the same type of quality child care over a long period of time.

Continuity of care includes:

• The same routines that a child knows are going to happen (a daily schedule)

• Familiar expectations (rules, people, places)

• Familiar curriculum, teaching and learning practices, etc.

Experiencing meaningful relationships and quality education, which follows the Kentucky Early Learning Standards, are important for healthy social, emotional, physical, and educational growth.

When children stay in the same child care setting for long periods of time:

• They learn how to develop healthy relationships with other children and adults.
• They are more likely to be successful in school and later in life.

Moving from one child care setting to another interrupts familiar routines and meaningful relationships.

Meaningful relationships are safe and healthy relationships that form between children and adults when they spend time together during routine activities.

When caregivers change often it is hard for children to form meaningful relationships.

External transitions can add harm by interrupting the ability for the child to form the meaningful attachments to both peers and adults which are necessary for healthy emotional and social development.

• External transitions, including suspensions and expulsions, are harmful to children because they increase the chance for another move in the future.
  • As we discussed earlier in the course, negative behaviors tend to increase when a child moves to a new child care setting.
  • When children experience multiple external transitions, negative behaviors continue to build on the previous negative behaviors.
  • The caregivers and peers in the new child care setting may have a difficult time adjusting to the increased negative behavior because it takes time to form meaningful relationships in the new child care setting.

Every time a child transitions to a new child care setting, they must adjust to new rules, roles, routines, children, and adults. 

External transitions may lead to a regression in skills and or development.

When people of any age start a new project or activity their skills and abilities go down. 

• When children are placed in new situations, they show less ability to complete the same tasks they can complete in familiar situations.

• Regression is a natural part of adjusting to change.

• When a child experiences multiple external transitions, they may not be able to make up for the regression.

• Children who experience multiple external transitions may be older when reaching the same developmental milestones as children who do not experience as many changes.

• It’s important to realize how big the impact of changing child care is on children, consider this example:

Most children will not grow at the same rate as their peers without stability and consistent care. 

You will need to watch the video in its entirety before moving to the next topic.

ACEs can be harmful to children’s:

• Social/emotional development
• Behavioral development
• Brain development
• Nervous system development

ACEs can have a serious long-term impact on a child’s:

• Mental functioning
• Physical functioning
• Social functioning

ACEs can include many types of difficult or traumatic experiences that happen to the child or that the child watches happen. If you haven’t already, download the Adverse Childhood Experiences Examples handout below.

ACEs are trauma that a child can experience themselves or observe happening to others, for example:

Research tells us that experiencing even one ACE can impact a child’s health.

Experiencing the same ACE over and over again causes even greater harm.

Traumatic experience like ACEs impact more than behavior; they cause changes in a child’s nervous system and brain.

New research shows the brain and the body’s immune system are connected.

The connection between the brain and the immune system explains how stress can cause physical problems with health and disease.

Children who experience many incidents of trauma over time may live shorter lives.

Long term exposure

Problems related to repeated and long-term Adverse Childhood Event (ACE) exposure include:

• Less ability to react in ways that match the situation.
• Less ability to learn, remember, and problem-solve.
• Less ability to cope with stress, which can result in more fighting, arguing, defiance, or disengagement.
• Less social and emotional skills which are needed to grow and keep important relationships with peers and adults.
• More stress hormones in the body and a more difficult time settling down after experiencing stress.
• The body living in a constant state of perceived danger that increases heart rate, blood pressure, breathing patterns, and muscle tension.

Research shows that children experiencing negative impacts of ACE exposure are at greater risk for:

• Teen pregnancy
• Drug and alcohol abuse
• Smoking
• Depression and other mental health disorders
• Heart and liver disease
• Risky sexual behavior
• Sexually transmitted diseases
• Dangerous behavior
• Suicide

Research shows many ways in which Adverse Childhood Experiences (ACEs) change children’s brain development and functioning. 

When people experience stress, their bodies release chemicals and hormones.

Experiencing stress again and again causes the body to release the chemicals/hormones all the time.

When this happens during a developmental period the body learns to behave like they are experiencing stress all the time.

Over time releasing the chemicals and hormones changes how the body’s genes work.

The body stops behaving the way it does for most people and starts behaving differently.

When children experience ACEs, the genes that help the body learn to handle stress change:

• When a child’s body is acting like it is in danger, the child is more likely to over-react.
• The body starts to think the person is always in danger.
• The person acts like they are in danger (even when they aren’t).
• When the child over-reacts in a classroom, that looks like challenging behavior.

When the body reacts to stress again and again, the person has an increased risk for cancer, heart disease, depression, and more. 

When a child is exposed to ACEs over and over again for a long time, it can impact the brain.

The release of chemicals and hormones changes the size and shape of different parts of the brain including:

• The hippocampus, which helps balance emotions, stores memories and manages stress. 
• The prefrontal cortex, which is responsible for decision-making and impulse control. 
• The amygdala, which is associated with the ability to process fear.
• Brain cells – some brain cells will get swollen or inflamed and some will age faster.

Children experiencing ACEs are at-risk for over-reacting to stress when they are adults.

The brain doesn’t develop new connections in the same way as people who have not experienced ACEs.       

Children experiencing ACEs have a harder time building brain connections through everyday learning, play, and other life functions. 

Children experiencing ACEs have a more difficult time with tasks like:

• Memory
• Understanding new information
• Deciding what is important
• Deciding what can be ignored
• Deciding what steps to take when dealing with tasks and information

When these parts of the brain change, they may never recover.