One State’s Systems Change Efforts to Reduce Child Care Expulsion

Abstract

This article describes the efforts funded by the state of Colorado to address unacceptably high rates of expulsion from child care. Based on the results of a 2006 survey, the state of Colorado launched two complementary policy initiatives in 2009 to impact expulsion rates and to improve the use of evidence-based practices related to challenging behavior. The primary policy initiative involved the funding of a center to develop model sites, a state-level planning team, ongoing practitioner training, and certification of coaches and trainers all built around the Pyramid Model. The secondary initiative involved expanding the number of early childhood mental health consultants and modifying their reimbursement/payment formula such that direct preventative work with adult providers, consistent with the Pyramid Model, was reimbursable. A follow-up survey in 2011 showed a dramatic reduction in expulsion rates and a corollary increase in providers’ teaching of prosocial skills to children with challenging behavior.

Keywords

behavior classroom evidence-based practices scaling up prevention policy issues expulsion

Research has shown that challenging behaviors occur in 10% to 30% of preschool-age children (Fox & Smith, 2007; Lavigne et al., 1996; Powell, Dunlap, & Fox, 2006; Strain, Cooke, & Apolloni, 1976; Webster-Stratton & Hammond, 1998). Challenging behaviors have been defined as “any repeated pattern of behavior, or perception of behavior, that interferes with or is at risk of interfering with optimal learning or engagement in prosocial interaction with peers and adults” (Smith & Fox, 2003, p. 5). Children who engage in challenging behaviors are often labeled the “most troubling” and experience peer rejection, frequent school failure, and difficulty interacting with family members and teachers (Coie & Dodge, 1998; Patterson, 1986; Patterson & Fleishman, 1979; Strain, 1984; Strain, Steele, Ellis, & Timm, 1982; U.S. General Accounting Office, 2001).

It is essential for children with challenging behaviors to receive effective early intervention services (Dunlap et al., 2006; Lipsey & Derzon, 1998; Patterson & Fleishman, 1979). However, the research is clear that those children who most need access to high quality programs are the least likely to attend and most likely to be expelled due to behavioral concerns (Barnett & Yarosz, 2007; Gilliam & Shahar, 2006). In fact, research has shown that the prekindergarten expulsion rate is 3.2 times the rate for K-12 students; with some states’ rates as much as 14.22 times higher than the K-12 rate (Gilliam, 2005). Without effective early services for children with challenging behaviors, the prognosis is disheartening. Untreated challenging behaviors result in the need for more costly intervention and treatments, such as more restrictive placements, and an increased likelihood of requiring special education services later in life (Carta et al., 1994; Dodge, 1993; Palfrey, Singer, Walker, & Butler, 1987; Reid, 1993).

In 2006, the Colorado legislature funded a study of expulsion in child care programs. The study found that 10 out of every 1,000 children below the age of 6 were removed from licensed and legally exempt child care programs, a rate that is three times higher than the national rate of K-12 removals (Gilliam, 2005). Furthermore, it was found that practitioners were largely using ineffective strategies to address challenging behaviors that were the stated reasons for removal (Hoover, Kubicek, Rosenberg, Zundel, & Rosenberg, 2012). For example, practitioners reported the extensive use of such non-evidence-based strategies as (a) talking to children about their behavior, (b) holding them, (c) calling parents to take them home, and (d) removal from the setting. This research created multiple recommendations to improve access to high quality early care and education environments and reduce the number of removals through the use of evidence-based promotion, prevention, and intervention efforts for young children. These recommendations culminated in the 2009 funding of Pyramid Plus: The Colorado Center for Social Emotional Competence and Inclusion, as well as increased state funding for early childhood mental health specialists and altered reimbursement such that these specialists could be reimbursed for working directly with early care and education providers.

Both Pyramid Plus and the expanded early childhood mental health initiative focused on expanding the skills of early care and education providers to address challenging behavior by coaching on evidence-based practices, particularly those embodied in the Pyramid Model for Promoting Social Emotional Competence in Infants and Young children. The Pyramid Model is a set of evidence-based practices developed and disseminated by two national technical assistance (TA) centers, the Center for the Social Emotional Foundations of Early Learning (CSEFEL) and the Technical Assistance Center for Social Emotional Interventions (TACSEI).

Description of Pyramid Plus Initiative

In recent years, the early childhood/early intervention field has begun to recognize the importance of bringing evidence-based practices to scale on a statewide basis. Although the importance of such initiatives is without question, there are as of yet little if any data on how to bring interventions to scale, and, when brought to scale whether these practices result in concurrent changes in broad, statewide outcome indicators such as statewide expulsion rates. Moreover, when interventions are brought to scale on a statewide basis, what is the control condition? Is it another state or multiple data points prior to beginning a broad policy initiative? In the present initiative, four broad and interrelated strategies were used to facilitate statewide change. First, a multi-agency, statewide team met monthly to create a professional development infrastructure to enable practitioners to access training and coaching, to build a career ladder related to the high fidelity implementation of Pyramid practices, and to seek funding opportunities for expansion. Second, four demonstration sites were established statewide to showcase Pyramid practices. After 3 years, the number of sites implementing the Pyramid was increased in each subsequent year. Third, the Pyramid Plus Center trained and certified both coaches and trainers in the model during intensive, 1-year professional development programs. These individuals, including the early childhood mental health specialists, then assumed key implementation roles in their communities. Fourth, a variety of data systems were installed such that changes in child behavior could be tracked, practitioners’ use of Pyramid tactics could be regularly assessed, and coaches and trainers could demonstrate that their efforts produced changes in adult behavior. Each of these four strategies is expanded upon below.

The multi-agency statewide team was populated with members holding financial and policy decision power in education, child care, Head Start, mental health, higher education, and other related agencies. Over the course of the 3 years (2009–2011) between surveys, the team accomplished the following:

Created a career ladder linked directly to Pyramid Model practices,

Funded the wide-scale expansion of demonstration sites,

Integrated Pyramid content into the early care quality rating protocol, and

Merged fiscal resources for coordinated training across agencies.

The four demonstration sites signed annual memoranda of understanding with the Pyramid Plus Center that required them to reach and maintain high fidelity use of Pyramid practice, host tours for area providers, maintain a leadership team, and use data to make program decisions. Key outcomes from the demonstration sites across the 2009 to 2011 period included (a) all classrooms at all sites reached the goal of 80% fidelity based upon external observers’ use of the Teaching Pyramid Observation Tool (TPOT) to assess adherence to the model; (b) from fall to spring each year, the sites demonstrated a 60% to 75% reduction in the percent of children scoring “at risk” on the Ages and Stages Social Emotional scale; and (c) all sites showed substantial positive change in their scores on the program-level benchmarks of quality, the Pyramid tool for assessing program-wide adoption of the model.

The Pyramid Plus Center also launched an intensive program to certify trainers and coaches in the Pyramid Model. Over the 2009 to 2011 period, 30 trainers were certified and 20 coaches were certified. Of particular significance to the survey outcomes, it should be noted that to be certified, a coach’s coachee had to demonstrate fidelity of implementation on the TPOT, and selected children of that coach had to make behavioral improvement on the Ages and Stages Questionnaire: Social/Emotional (ASQ:SE).

Finally, multiple data systems were installed to aid in decision making and accountability. For example, the state team organized its monthly meetings according to a detailed action plan. As items on the plan were achieved, new ones were added. The state team was also provided with fidelity and child outcome data from demonstration sites, and sites met with the team to communicate successes and challenges and to problem-solve solutions that could only occur at the state level. TPOT data at the demonstration sites were used to drive professional development activities around specific coach–coachee dyads and to organize more global initiatives when common concerns were revealed. Demonstration site teams regularly reviewed TPOT data to achieve and maintain compliance with memorandum of understanding (MOU) fidelity requirements. The ASQ:SE was administered to all children at each site in the fall and spring of each year. These data had two purposes. First, the results were used to identify children at risk of social/emotional difficulties and quickly target support. Second, data were used to judge the impact of program attendance on children shown to be at risk. Annually, data were generated showing the percent of children scoring in the risk range across fall/spring assessment times. These data were provided to the state team and center funders.

Evaluation of Pyramid Plus Specific to Expulsion Rates

Research to answer questions related to public policy and systems change is often descriptive or correlational. That is, one describes current policy or systems or attributes of policies or systems in relation to important societal outcomes. For example, warning labeling on tobacco products and imposing ID restrictions on sales are often associated with reductions in smoking. Similarly, safe sex practice information distributed in high-risk communities is often associated with reductions in sexually transmitted diseases. Using the same policy research logic, this investigation was aimed to assess changes in provider practices and expulsion rates following on the heels of these major state initiatives.

The 2011 survey was developed using the 2006 survey items, which reflected questions asked in a widely cited national survey (Gilliam, 2005) regarding preschool expulsions and challenging behavior. Several original questions from the 2006 survey were modified for this study to further ensure usable responses. The 2011 survey also included additional questions that examined the participant’s program accreditation, quality ratings, and program policies.

A link to 2011: Early Care and Education Administrator/Director Survey was sent by email or postcard to child care administrators and directors based on a list supplied by Qualistar Colorado, the state’s program for quality ratings and the portal for the 2006 survey as well. This list contained names, addresses, and some email addresses for administrators and directors from licensed center-based and family child care homes. Overall, there was a response rate of 17.9% with 4,153 administrators and directors receiving the link, and 741 usable surveys completed. In 2006, the response rate was 17% with 6,216 surveys mailed and 1,075 respondents.

Program Demographics

Type of setting

Of the 741 respondents, 344 identified as licensed centers, 323 family child care homes, and 22 as Head Start. There were 50 respondents who did not identify as any of these three types of settings. Respondents also could select multiple descriptors for their setting, and a duplicated response count indicated the following:

Licensed center based: 344

Family child care homes: 323

Non-profit: 173

For-profit: 101

Faith-based: 78

Head Start: 22

Legally exempt from licensing: 3

The setting type was very similar across the 2011 and 2006 data sets.

Respondents for the 2011 survey indicated that the average number of paid direct service staff/teachers employed within each setting was 7.71 with a range of 0 (i.e., respondent was the only employee) to 250. Over the past 12 months, participants’ programs had staff turnover with an average loss of 7.57% of staff members (range 0%–100%).

Program funding

In both 2006 and 2011, respondents indicated that parent tuition constituted the vast majority of their program’s funding.

Quality rating

In 2011, 19.3% of programs reported having a Qualistar rating. This rating examines the quality of child care programs in Colorado on a provisional- to four-star scale. Of the programs that received a Qualistar rating, scores were as follows:

0.8% received provisional rating,

4.2% received a star 1 rating,

20.0% received a star 2 rating,

47.5% received a star 3 rating, and

27.5% received a star 4 rating.

Respondents Demographics

Role

Respondents were asked to identify their role within their program. The majority of respondents identified as either an administrator/director (50%) or an owner (47.1%). Other respondents identified as a teacher/provider (1.4%), principal (0.9%), or other (0.6%).

Years of experience and levels of education

Respondents were asked to report information about their years of experience and level of education. The majority of respondents had more than 10 years of experience, which was similar to the results in 2006. Specifically, in 2011, the average amount of time that respondents held their current leadership role was 10.10 years with a range of 1 to 40 years. The majority of respondents in both surveys held an associate’s degree or higher, with most respondents holding a bachelor’s degree.

Only the 2011 survey asked respondents who held an associate degree or higher to report on their college major. One third of respondents indicated holding a degree in early childhood education. Nearly half reported holding a degree in something other than the below listed majors. The most common “other” responses were categorized as a business-related field (e.g., administration, business management, accounting), education (e.g., special education, secondary education, general education), and psychology and related services (i.e., social work, occupational therapy, speech and language therapy).

Respondents were asked to indicate whether they held any endorsements, credentials, certifications, or licenses in early care and education in Colorado. Nearly half of respondents reported having no endorsements, credentials, certifications, or licenses. Many respondents indicated that they had an endorsement, credential, certification, or license that was not listed. The most common of these included (ranked from most to least):

Director qualified,

Early childhood education,

Elementary education,

Colorado-level credential (i.e., most had a Level 4 credential), or

CDA Child Development Association National Credential.

Children With Challenging Behaviors

In 2011, the number of children identified with challenging behaviors enrolled in respondents’ facilities/programs below the age of 6 totaled 2,665 children (9.8% of the children served) and, in 2006, these numbers totaled 5,086 children (11.2% of the children served). Furthermore, respondents reported that their programs served an average of 4.77 children below the age of 6 with challenging behaviors within the past 12 months (range of 0–70).

Respondents were also asked about the impact of children’s challenging behaviors on their staff’s well-being. In 2011, 69.9% of respondents reported that some, many, or all of their staff felt that challenging behaviors had a negative impact on their well-being, the well-being of others, or the program’s functioning. In contrast, in 2006, 53.5% of respondents reported that some, many, or all of their staff felt that challenging behaviors had a negative impact on their well-being, the well-being of others, or the program’s functioning. Both in 2011 and 2006, respondents indicated that the following behaviors had the most negative impact on staff:

Hurts self or others;

Disrespectful, defiant; and

Irritable, mad, easily frustrated.

Strategies Used to Address Challenging Behaviors

In 2011, 95.7% of respondents reported being somewhat or very confident in their staff’s ability to address challenging behaviors in the children they serve. However, when asked to describe how their staff most often addressed challenging behaviors, the most commonly mentioned strategies were often reactive rather than preventive strategies. For example, common responses were general talk (25%), timeout (16%), and redirection (16%). Preventive strategies were the least common including praise for appropriate behavior (3%) and modifying the environment (2%). Yet, there was a large increase (15-fold) from 2006 to 2011 in the percentage of staff using “teaching appropriate behaviors” as a strategy to address challenging behaviors.

Rate of Removal of Children From Programs

The rate of removal decreased substantially from 2006 to 2011. Specifically, in 2011, 119 children below the age of 6 were removed from an early care and education setting for challenging behaviors, which is a rate of four per 1,000 children. In contrast, in 2006, this rate was 10 per 1,000 with 453 children below the age of 6 being removed from early care and education settings. In 2011, the vast majority of respondents (84.1%) reported removing no children due to challenging behaviors.

Similar to the permanent removal data, 91.0% of participants reported that no children were temporarily removed from their program due to challenging behaviors. Respondents in 2011 also reported that 70.9% had a written policy regarding removal of a child from their facility/program (no similar question was asked in 2006).

Summary

The survey results indicate large changes in the rates that young children with challenging behavior are removed from child care as well as large changes in how child care professionals respond to challenging behavior. Use of teaching strategies that promote positive social and emotional development is essential to prevention of challenging behavior and prevention of expulsion from child care (Dunlap et al., 2006). Although causal inference related to the state’s complementary initiatives of (a) increasing the number of providers offering mental health consultation to child care and (b) equipping these providers and practitioners statewide with access to Pyramid Model practices cannot be made, this interpretation problem is found in all wide-scale policy analyses. We believe these data are particularly relevant and timely in light of the recent federal spotlight on expulsions at the early childhood level (U.S. Department of Health and Human Services & U.S. Department of Education, 2015). How agencies and practitioners respond to the call for reducing expulsions is critical, especially in light of the victim-blaming history often associated with children who engage in behaviors that are disturbing to others. In addressing this issue, more than three decades ago the preeminent child psychologist Nicholas Hobbs (1982) asserted the following: “The way one defines a problem will determine in large measure the strategies used to solve it” (p. 182). In the Colorado case, “the problem” was seen not to reside in the behavior repertoire of preschoolers but rather in the skills of providers to competently and confidently prevent and address challenging behavior. At the risk of stating the obvious, expulsion is an act engaged in by adults. This is not to discount in any way the seriousness of some young children’s behavior, but rather to assert a logical order of events with systemic changes in practitioner behaviors leading to changes in child behaviors and to practitioners engaging in less expulsion behaviors.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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