About Infant and Early Childhood Mental Health Consultation

Infant and early childhood mental health consultation (IECMHC) is an intervention where clinicians work with teaching and administrative staff in early learning settings. This professional support builds capacity in adults who work with children to create environments supporting healthy development and address children's social-emotional and behavioral concerns.

The ECIN model of this intervention includes:

Schoolwide Supports

Ongoing training and professional development for staff to help them learn more about adverse childhood experiences (ACEs) and trauma-sensitive school practices.

Consulting with school leaders, including principals about school climate initiatives.

Classroom teacher consultations

Weekly meetings or activities with teachers about Tier 1 classroom practices and social-emotional learning.

Small group discussions about trauma-sensitive classroom practices.

Well-being check-ins or workshops for teachers.

Individual student consultations

Weekly meetings with teachers about interventions and supports for children with social, emotional, and behavioral challenges.

The ECIN model of IECMHC was created through a partnership between MedStar Health, an academic medical center, and AppleTree Early Learning, an innovative public charter school network in the District of Columbia that was founded in 1996. The mode builds upon past IECMHC work but difference in key ways:

Uses data to drive decisions about consultation service delivery targets and duration

Provides more specific content and structured sharing processes than previous models

Enhances formal meetings with teachers and key school staff

Implements continuous improvement through classroom observations and additional data sources

How IECMHC Is Making A Difference

Classrooms with 20+ weeks of IECMHC showed marked improvements in positive behavior reinforcement, classroom interactions, activity transitions, and staff cooperation.

Children in IECMHC schools demonstrated measurable advantages over peers in non-participating schools, including better classroom behavior, fewer social-emotional challenges, and higher academic achievement in math, literacy, and writing.

Our classroom observation tool - Preschool Observation of Social-emotional Teaching (POST) measures teachers' social-emotional practices during IECMHC. Research confirms POST has high reliability and strong validity when compared with the established CLASS measure.

Our Early Childhood Consultative Alliance Questionnaire (ECCAQ) tool assesses the critical consultant-teacher relationship in both teacher and consultant versions. ECCAQ shows good reliability and preliminary validity, correlating with teacher openness and teacher-student relationship quality.

future plans

Building Evidence for Wider Implementation

IECMHC offers a cost-effective and accessible alternative to individual therapy services by building capacity in teachers who work with children daily. This approach can positively influence all children in classrooms during consultation and future student cohorts through enhanced teacher skills.

Before ECIN's pilot, minimal research existed on IECMHC's impact in PreK 3-4 settings within public and charter schools. The pilot addressed critical gaps in understanding both consultation content and delivery processes in these environments.

Despite increasing adoption, many early learning settings still lack access to IECMHC services. Additional implementation across diverse settings would provide crucial empirical support for broader inclusion in early childhood mental health systems.

Research continues to evolve regarding IECMHC outcomes, change mechanisms, and optimal conditions for success. Further evaluation is essential to understand how this model produces positive outcomes for children, families, educators, and learning programs in various contexts.

ECIN also sponsors a certificate program in infant and early childhood mental health consultation for current and prospective IECMH consultants. The certificate program aims to support the IECMHC workforce by providing training in foundational aspects of IECMH consultation.

Early Childhood Mental Health Consultation