CHOP Policy Lab (CHOP-PL) and Philadelphia Health Management Corporation (PHMC) are currently developing a system of services to enable a childcare center to be a fully inclusive center in a manner that is financially feasible. This planning and pilot project is funded by the William Penn Foundation. A single childcare center is currently serving as a model and participating during a pilot period. This childcare center is an urban-based center that enrolls a high percentage of low-income children. During this planning phase, those agencies who have the responsibility to provide training to the center including South East Regional Key and Early Childhood Mental Health consultation services and those agencies that have the responsibility to provide direct services to children and families including Infant and Toddler Early Intervention and Preschool Early Intervention and Community Behavioral health are a part of the planning process. Families of the centers are also key to the planning.
During the planning phase, Positive Behavioral Interventions and Supports (PBIS) was selected as an evidenced-based social-emotional curriculum for the center. PBIS has garnered support by state education officials. Additional planning tasks include identification of best practices for referral of children to more intense services; for working with staff across all of the agencies involved to better collaborate; for working with families as key partners in every step of the process; and for providing education and coaching for parents at the childcare center on ways to build social-emotional skills at home.
Once the system has been fully planned and the pilot has been implemented at a single child care center from September 2016 to June 2017, the model will serve as the basis for expansion to four new locations in from 2017 to 2019. Two additional childcare centers that have similar characteristics of the participating centers will serve as a controls for comparison during an evaluation of the model.
CHOP PL will partner with PHMC to refine the key elements of a fully inclusive childcare center. This sustainable model will leverage public childcare supports from Early Intervention (EI) and Community Behavioral Health (CBH). The aims are as follows: 1) Financial aid for implementation of social and emotional supports will be provided through state early childhood funds; 2) Improvement in childs emotional regulation and a decrease in challenging behaviors will be seen through the implementation of a center wide program; and 3) Greater collaboration among childcare center staff and EI and CBH will have a positive impact on children, families, and teachers.
There are four key implementation components. A social-emotional curriculum will be integrated in the childcare center. In the pilot center, Positive Behavior Intervention and Supports (PBIS) is going to be used as the curriculum and framework for services. Training will be provided through PHMC. Tier 2 services for children with greater behavioral challenges will be provided by EI and mental health service providers in the community. A parenting education program that mirrors the strategies being used in the classrooms will be identified and put into place. The childcare director and staff will be trained on how to link children with community resources, how to integrate parent education in the center, and how to build collaborative relationships among service providers. The new curriculum training will be provided through existing professional development and technical assistance providers in Pennsylvania. Best practice guidelines for linking with community services, parent education, and building collaborative relationships will be provided by CHOP during the pilot and then incorporated in each agencys training system.
PHMC and SERK have extensive experience providing training and early childhood mental health consultation to childcare providers in the Philadelphia region. CHOP PL has strong experience in the early childhood field and has recently lead the program evaluation of home visiting efforts in the state.
This commitment will begin during the second half of the pilot period. The pilot will impact approximately 36 teachers and childcare staff, 150 students, and 130 families. The next phase of the commitment will be to expand the model to four additional centers and to evaluate the success of the model.
During the third phase of the commitment period, a mixed methods evaluation will occur using center reported data, direct observations of fidelity of program implementation, and qualitative interviews of participants including center directors, teachers, and children. Evaluation aims will include the assessment of feasibility and success in initial implementation, fidelity to social-emotional curriculum, and parent education over time, decrease in the occurrence of children with behavior challenges, expulsions and suspension, family satisfaction and acceptance of program and financial burden on center. These evaluations will be compared with baselines determined by interviews with parents and teachers that are currently being conducted.
The advantage of a mixed methods approach is that it will document improvement in children as well as changes in teacher and family sense of confidence in nurturing social-emotional skills. It will also provide rich information about the process of implementation that will inform future expansion. It is anticipated that over the course of the commitment, centers could experience changes in state regulations and policies regarding expulsion or additional trainings that will impact them. These changes in factors outside the control of this commitment effort will be tracked.
Quarter 1 (December 2016-Feb 2017) Completion of the pilot phase (Pilot Childcare center). Given information from the first academic year of the Pilot Childcare Center, will refine the model and expanding it to two new centers (Centers A & B). The completion of the model from the pilot will include creation of preliminary draft of a manual and guidelines for implementation.
Quarter 2 (March May 2017) Initial training for Centers A & B will take place, which includes a dual facilitator model (external facilitator and internal facilitator), and implementation of a program that will provide didactic training in classroom modeling and coaching for center directors and staff.
Quarter 3 (June-August 2017) Training finalization of Childcare Centers A & B. Included in the training will be real time feedback to teachers by facilitators. Teachers will be given ways to facilitate PBIS implementation by learning from specific examples.
Quarter 4 (September-November 2017) Initial implementation in Childcare Centers A & B will coincide with the start of the 2017 school year. This will include on-site coaching via the dual facilitator as well as set up of the evaluation plan. Services for parents will also begin.
Quarter 5 (December-February 2018) Continued full implementation in Childcare Centers A & B with ongoing evaluation of the model.
Quarter 6 (March May 2018) Ongoing implementation and evaluation in Childcare Centers A & B.. Expansion to two new centers (Childcare centers C & D) will take place. Baseline metrics will be gathered for for Centers C & D through an initial evaluation.
Quarter 7 (June-August 2018) Training of Childcare Centers C & D continues. There will be real time feedback to teachers by facilitators for Childcare Centers C & D. Teachers will be given ways to facilitate PBIS implementation by learning from specific examples as well as insights from Centers A & B. Centers A & B will continue to implement the program..
Quarter 8 (September-November 2018) Centers C & D undergo initial implementation to coincide with the school year while Centers A & B continue with ongoing implementation. As with Centers A & B, there will be onsite coaching via the dual facilitator model.
Quarter 9 (December-February 2019) Ongoing implementation in Centers A & B and full implementation with onsite coaching and implementation support as needed for Centers C & D. Evaluation of Childcare Centers A & B and C & D.
Quarter 10 (March May 2019) Continued implementation in Childcare Centers C & D. Evaluation of Childcare Centers A & B and C & D.
Quarter 11 (June-August 2019) Ongoing Implementation in Childcare Centers C & D. Evaluation of Childcare Centers A & B and C & D.
Quarter 12 (September-November 2019) Ongoing implementation in Childcare Centers A & B and C & D. Evaluation of Childcare Centers A & B and C & D.
Metrics will first be gathered prior to implementation of model system to serve as a baseline. Metrics will be reported at each quarter.