home > early childhood programs > EC Mental Health

Early Childhood Programs

early childhood Mental Health Consultation project


The ECMH Consultation Program is a child-specific consultative model which addresses the social-emotional development of young children within their early care and education (ECE) program. Services are provided at the request of the director or teacher and with the permission of the child’s parent or guardian. The program includes an array of customized services that are based on the Pyramid Model for Promoting the Social Emotional Competence of Young Children (Center on the Social-Emotional Foundations for Early Learning)

The Pyramid Model is designed to help organize a variety of evidence-based approaches, activities, and practices focused on young children’s healthy social and emotional development. Consultants work directly with the child’s teachers and parents to increase their capacity to understand and address the child’s developmental needs. Research supports ECMH Consultation as an effective approach to promoting social-emotional competence in young children. Children in classrooms that received consultation showed greater improvement in social-emotional development and decreased problem behaviors than children in comparison groups that received no consultation. There is also evidence that as a result of consultation teachers felt more competent and effective and that they were more attuned to the needs of children. Finally, programs were found to benefit from ECMHC by having lower staff turnover and fewer children expelled for behavior.

Early Childhood Mental Health (ECMH) Consultation is designed to assist early care and education programs in meeting the social and emotional needs of children who exhibit challenging behaviors in the classroom.

Project Goals:

  1. Reduce the number of children expelled from early care and education settings due to behavioral issues
  2. Increase understanding of social and emotional development and its impact on educational success
  3. Link and bridge systems and services on behalf of a child, family and program

What is Early Childhood Mental Health?

Why Do We Call It Mental Health?

Early childhood mental health is synonymous with healthy social and emotional development.  It is developing capacity of the child from birth to age 5 to:

  • form close and secure inter-personal relationships
  • experience, regulate and express emotions; and
  • explore the environment and learn in the context of family, community, and cultural expectations from young children. 

(Adapted from ZERO TO THREE: National Center for Infants, Toddlers & Families)

A child may benefit from ECMH services if he or she:

  • If his/her behavior is concerning to or difficult for caregivers.
  • displays very little emotion
  • shows no interest in sights, sounds or touch
  • rejects or avoids being touched or held
  • is unusually difficult to soothe or console
  • is unable to comfort or calm self
  • is extremely fearful or on-guard
  • does not turn to familiar adults for comfort

ECMH Consultation provides on-site support including observation, social and emotional and/or development screening, development of an individualized action plan, referral to additional community supports, and facility-wide professional development. These services are available to:

  • To all early learning programs participating in Keystone STARS
  • For children age birth to five
  • Free of charge to the early learning program

How can I access services?

Contact your Regional Key and ask to speak with an Early Childhood Mental Health Consultant, or contact Jennifer Murphy at jenmur@pakeys.org or 484-955-8264.  You can also complete and submit a Request for Service Form to your Regional Key.

Parent permission is necessary before the ECMH consultant will become involved. The ECMHC Parent/Facility Agreement Form is an agreement between the ECMH consultant, the parents, and the child care facility. 


Focus on ECMH Articles

For the complete list of articles visit PA Recovery and Resiliency


Infant Toddler Temperament Tool

The Infant Toddler Temperament Tool (IT3) was developed for the Center for Early Childhood Mental Health Consultation, an Innovation and Support Project funded by the Office of Head Start. The online version of the Infant Toddler Temperament Tool includes a short survey that allows parents and caregivers of infants and toddlers to recognize and explore their own temperament traits and those of a child for which they provide care. The IT3 generates results which support parents and caregivers in understanding how adult and child similarities and differences in temperament traits may affect “goodness of fit.” Along with these results, the IT3 generates simple best practice tips adults can use to foster the unique temperament of each child within their care. The paper versions can be found below.

Social and Emotional Tips for Parents and Providers provides a set of one-page posters that families and early learning practitioners can refer to during specific daily routines including: dressing, meal times, play time, resting and diapering. Putting these posters up around the house or classroom can serve as a reminder of what to say or do to nurture the social and emotional health of their infants every day. 

Screening in pennsylvania: ages & stages questionnaires

Importance of screening:

Screening young children is an effective, efficient way for professionals to catch problems and start treatment when it does the most good - during the crucial early years when the child's brain and body are developing so rapidly.

"Compensating for missed opportunities, such as the failure to detect early difficulties...often requires extensive intervention, if not heroic efforts, later in life." --From Neurons to Neighborhoods

Ages & Stages Questionnaire (ASQ) system has been chosen as the formal screening tool of the ECMH Consultation Project:

The tool is quick and easy to administer and score.  The ASQ was designed to be completed by parents.  Also this system is being used across various state and county programs, such as Early Care and Education, Early Head Start and Head Start, Early Intervention for developmental monitoring and OCYF.  It has strong technical qualities:

  • concurrent validity = 84% over all agreement - compared percentage of agreement between the results of parent-completed ASQ with the results of professionally administered standardized assessments
  • sensitivity*=72% overall agreement - ability to correctly identify those children with delays
  • specificity*=86% overall agreement - ability to correctly identify typically developing children

    *Given the complexity of measuring child development, the AAP considers high quality developmental screening tests to have sensitivity and specificity of 70-80%.

Ages & Stages Questionnaire (ASQ) System has two complementary components:

  1. Ages & Stages Questionnaires cover 5 developmental domains: communication, gross motor, fine motor, personal-social and problem solving
  2. Ages & Stages: Social Emotional focuses on social and emotional competence and the areas of: self-regulation, compliance, communication, adaptive functioning, autonomy, affect and interaction with people.

Results indicative of concern and referral for more intensive evaluation:

Cut off score vary depending on the age of the child and are included on each questionnaire. A low score on the ASQ indicates a concern, while a high score on the ASQ:SE is indicative of concern.

A concerning score does not necessarily mean that a child has a diagnosable condition, but may suggest the potential for something to develop if prevention/early intervention services do not occur within the context of caregiver/child relationship.

Referrals are most often made to:

Early Intervention - CONNECT Helpline 1-800-692-7288, a county CASSP coordinator, a behavioral health provider, or a pediatrician.

Information about Early Intervention for Families
Information about Early Intervention for Practitioners

Additional Resources



Questions regarding the use of the ASQ in Pennsylvania can be directed to Jennifer Murphy, ECMH Coordinator at 484-955-8264 or jenmur@pakeys.org

To make a referral to ECMHC contact Jennifer Murphy, ECMH Coordinator at 484-955-8264 or jenmur@pakeys.org.  

Questions about Pennsylvania's Early Childhood Mental Health Initiative can be directed to Jennifer Murphy at 484-955-8264 or jenmur@pakeys.org 


copyright © 2009 PA Keys