Connecting the Dots in Cleveland County, NC: A Healthy Tomorrows project

Without treatment, early childhood behavioral problems persist and worsen with time, increasing the likelihood of difficulties in school. Out-of-home child care presents an opportunity to prevent minor social and emotional issues from developing into serious mental health problems. This community-based project links child care providers with primary health care providers and pediatric mental health specialists using the existing relationship between the Cleveland County NC Health Department and child care providers as facilitated by the local child care health consultant (CCHC). It operates on four levels: Level I - CCHC consults in and assesses child care and Head Start classrooms, training child care providers and Head Start teachers to promote desired behaviors and respond appropriately to challenging behaviors. Level II - Screening is implemented by teachers and parents, with guidance and support from the CCHC. Level III - Children screening positively are referred by the CCHC to their primary health care provider for further evaluation and treatment. Level IV: Children in need of mental health services are referred to a pediatric mental health professional by the primary care provider. Screening results from fall 2006: Of 526 children screened, 136 (26%) had an identified issue. Of these, 57 (42%) needed behavioral intervention, 33 (24%) needed speech/language assessment only, and 46 (34%) did not require either type of referral. A slightly higher percentage of child care center children needed behavioral referral and the reverse was true for speech/language referral. Aggregate results of referrals, follow-ups, and outcomes will be available for presentation.