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In this last lesson, The Pyramid Models for Program Development and Individualized Interventions are explored.  Pyramid models provide a framework for developing and implementing comprehensive, systemic prevention and intervention policies and practices.  They ensure that evidence-based quality foundations for environments, instructional practices, training, professional development, and center-wide practices are in place in ECE programs.  They incorporate increasingly focused levels of support to children experiencing behavior challenges.  All parts of pyramid models are important foundations for ensuring that programs are equipped to prevent and intervene with challenging behaviors, which may reduce or eliminate external transitions.  They will also provide critical support to children who are experiencing ACES, while potentially mitigating long-term impact of those traumatic experiences in children’s lives.

While ensuring comprehensive policies and health, safety, and quality teaching practices are in place and supported by strong professional development and ongoing training are important foundations for all ECE programs that will reduce challenging behaviors in children, positive social, emotional, and behavioral support and intervention plans are also necessary to serve the increasingly diverse and at-risk populations of children in our nation’s child care systems.  Behavioral supports and intervention plans should include evidence-based philosophies, standards, and practices that are implemented consistently and with fidelity throughout child care centers.  Center directors should be aware of local resources such as ECE coaches who can assist with identifying staff training resources, ECE behavior and mental health who can assist with targeted support and intervention services for children whose behaviors do not respond to center-wide systems.  Coaches and their multi-disciplinary networks of other ECE specialists can assist in determining children’s needs and obtaining additional assistance.  They can assist with either providing or connecting directors to consultants who can assist with developing individualized behavior intervention plans and strategies to help teachers meet children’s social, emotional, and behavioral needs and connect families with supports to help them address issues beyond the child care center.  Consultants can provide helpful assistance to staff who may need assistance with understanding and responding to children with behavior issues and those experiencing ACES and traumatic stressors.  Consultants can also assist with identifying staff training needs in factors that may be impacting the current situation such as implicit bias, culturally competent practices, reflective teaching, or other issues.

Consultants from outside agencies equipped to provide support can be helpful in working with families and helping them connect with resources they may need to cope with stressors and other factors influencing children’s social, emotional, and behavioral needs in the home that may contribute to challenges in ECE settings.

Proactive efforts such as universal developmental and behavioral screenings can help to identify children who need additional assistance in developing skills necessary to learn and grow in the ECE environment as well as those who may need additional behavioral support.  Early identification and intervention can prevent behaviors from escalating and could reduce the need for more intensive intervention.  Tracking data on teacher requests for assistance with children demonstrating challenging behaviors can assist ECE directors in identifying staff in need of additional training and help to monitor referrals and external transitions for the purpose of reducing them and analyzing them for potential bias in practices (“Developmental and Behavioral Screenings,” 2016).

Investment in a skilled staff of teachers and other adults through quality professional development and training is crucial.  ECE professionals must be appropriately trained in all aspects of a program’s policies, philosophies and practices and must have a solid understanding of child development and early learning.  ECE professionals must be equipped with skills to:

• Understand all aspects of healthy and safe quality programs and value continuous improvement efforts through self-assessment of environments and practices and working collaboratively with technical assistance resources
• Manage challenging behaviors in children using developmentally appropriate practices
• Promote children’s social-emotional development and form nurturing relationships
• Identify children needing additional support and work cooperatively with external resources such as protective services, mental health providers, respite workers, early intervention specialists and other supports a child may require
• Have a strong understanding of culture, diversity, implicit bias, ACES, protective factors, and trauma-informed care
• Understand and utilize center policies and programs implementing positive social/emotional and behavioral supports.

Developing and maintaining high-quality ECE programs requires creating and maintaining healthy and safe spaces, implementing quality programs and practices that address children’s cognitive, learning, social/emotional, developmental, and behavioral skill development needs.

Developing a comprehensive set of policies aligned with any existing federal or state requirements and guidelines with the purpose of reducing or eliminating center-initiated external transitions is an important first step toward eliminating external transitions.  Evidence-based policies should support all aspects of a center’s programs and practices and increase overall effectiveness.  To increase the likelihood of success, it is recommended that policies include provisions to address the multiple factors influencing the center as a whole, the children in its charge, the adults working in the center, partnerships with parents, and utilization of external supports as needed with the aim of maintaining comprehensive quality services to children.  Policies should ensure a developmentally appropriate, evidence-based program that also helps staff to appropriately respond to challenging behavior, to teach children appropriate replacement behaviors, to assist parents with supporting consistent behavior intervention between home and program, and to reduce external transitions (Gilliam & Shahar, 2006).

Early childhood positive behavior support strategies are important in ECE environments and may help to address the fact that children engaging in challenging behaviors may be more at-risk for external transition.  Gilliam & Shabar (2006) reported that “expulsion rates are higher for preschool age children than they are for school-age children.”  This research indicated that common challenging behaviors in the ECE setting such as biting, tantrums, non-compliance, and physical aggression are not likely to decrease over time without intervention and teaching of appropriate behaviors.  It is recommended that center policies include practices for addressing behavior in developmentally appropriate ways and specify a protocol for working with external supports to prevent external transition.

It is recommended that programs consider center-initiated external transition as the last resort “where there is a serious safety concern that cannot be reduced or eliminated with reasonable modifications” (“Spotlighting Progress in Policy and Supports,” 2016).  Policies should include provisions for monitoring external transition to ensure that practices in the center do not disproportionately impact any racial, ethnic, or minority group.

Adopting a comprehensive prevention and intervention approach increases the likelihood that the multiple factors underlying challenging behavior will be addressed and provides support to child care providers to equip them and their staff with necessary philosophies and skills to promote long-term success.  Such a comprehensive approach may ultimately reduce or eliminate center-initiated external transitions.  Comprehensive approaches involve policy development, quality programs, professional development, and positive social/emotional and behavioral .

Preventing center-initiated external transition requires a comprehensive approach in developing and implementing policies, quality programs, prevention efforts, and intervention strategies.  While center-initiated external transitions are not generally not recommended, it is recognized such transitions may occur.  Providing parents with support through that process may reduce negative impacts.  All center staff, children, and families can benefit from a creating and maintaining high-quality ECE environments with comprehensive policies, practices, and positive behavior supports and intervention plans.  When needed supportive external transition plans can be developed to assist children and their families with meeting children’s needs.  Such practices will support all aspects of children’s learning and developmental needs while teaching important social, emotional, and behavioral skills, which may also reduce center-initiated external transitions.

As previously noted, ECE centers are uniquely positioned to provide a stabilizing situation in the lives of young children experiencing ACES.  As such, they are also positioned to provide vital intervention services to children in crisis situations.  Externally transitioning children experiencing ACES who also have challenging behaviors results in a missed opportunity to support them and potentially mitigate the devastating impacts of traumatic experiences.  Consequently, center-initiated external transition represents a lost opportunity to provide services that can potentially mitigate the impact of ACES for young children.  Without intervention, these at-risk children may demonstrate increasingly challenging behaviors and successive incidents of external transition without services.  Adopting a comprehensive prevention and intervention approach may reduce the impact of ACES and the risk for future external transitions.

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