The role of infant and early childhood mental health consultation in reducing racial and gender relational and discipline disparities between Black and white preschoolers

Abstract

This study presents findings from an Infant and Early Childhood Mental Health Consultation (IECMHC) initiative in Arizona called Smart Support. The IECMHC used an early childhood mental health consultation model as an early childhood education intervention to address the needs of preschoolers with challenging behaviors. Disparities in teacher‐child relationships and discipline are some of the most persistent racial disparities impacting young Black children. The goal of IECMHC is to facilitate teachers' skills to respond to challenging child behavior and to shift teachers' internal representations of young children. This study is one of the first to link a statewide IECMHC intervention to the analysis of racial and gender teacher‐child relational and discipline disparities. Multilevel growth analyses examined whether child scores at baseline and growth over time differed as a function of child race and gender. At baseline, Black children, compared to white peers, and Black boys, compared to white boys, had higher teacher‐child conflict scores. These scores decreased more strongly over the course of IECMHC such that Black children's outcomes surpassed those of white peers by the end of consultation. A trend was also seen for the reduction of Black boys' preschool expulsion risk, although this trend was only marginally significant.

Reflective supervision and reflective practice in infant mental health: A scoping review of a diverse body of literature

“…Shivers et al. (2022) also measured expulsion risk and found that it decreased more strongly for Black boys than white boys over the course of a 12‐month IECMHC program. No papers reviewed included family outcomes as part of their design.…”

“…A small number of empirical papers published after 2020 address structural factors as they are encountered in IMH and IECMH work. One study reviewed (Shivers et al., 2022) explicitly addressed structural racial inequality. In their quantitative, longitudinal study, the authors examined whether IECMH consultation could impact early childhood teacher perceptions of the behavior of young Black boys, given the implicit biases which are thought to contribute to disciplinary disparities in educational settings for this population.…”

“…While the number of papers is relatively small, it indicates an increase in empirical research on this topic in recent years (see Champagne, 2015, for comparison), and represents a body of practitioner‐focused, applied research. Studies which used a quantitative design were predominantly cross‐sectional, although there were some longitudinal designs (e.g., Davis et al., 2021; Shivers et al., 2022), and one design with a comparison group (Spielberger et al., 2022). There are various qualitative research designs, including some with rigorous analysis.…”

“…Spielberger et al (2022) found no effect on teacher reports of child wellbeing or expulsion risk (on the Preschool Expulsion Rissk Measure) as a result of teacher engagement in an IECMH program. Shivers et al (2022) also measured expulsion risk and found that it decreased more strongly for Black boys than white boys over the course of a 12-month IECMHC program. No papers reviewed included family outcomes as part of their design.…”

Adverse childhood experiences as context for youth assessment and diagnosis

“…For example, anxiety might look different in African American children and be mistaken for problem behaviors. When these errors occur, children do not receive adequate care, and often mental or behavioral health symptoms get worse resulting in poor academic, social, and emotional outcomes, which means early intervention is imperative (Shivers et al., 2021). Researchers should further examine why African American children are disproportionately diagnosed with behavioral problems, as evidenced by the current and existing research on this topic.…”