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Resource Details

Initiative Name: 

Pennsylvania Embeds Early Childhood Mental Health Consultation into QRIS




Social and Emotional Health, Developmental Screening, Child Care, Early Intervention, Quality Improvement

Source Of Information: 

ZERO TO THREE Policy Center state updates



Year Started: 


Administered By: 

Pennsylvania Office of Child Development and Early Learning


Pennsylvania is leading the way among states by embedding early childhood mental health consultation (ECMHC) into its state’s early education Quality Rating and Improvement System (QRIS). In 2006, Pennsylvania developed the Early Childhood Mental Health Consultation (ECMHC) program, which began as a pilot to provide support to the early care and education workforce as they strived to understand and meet the social and emotional needs of infants and toddlers, especially those exhibiting challenging behaviors. Since its inception, the project has expanded its reach and has progressed into a statewide program funded by the Pennsylvania Office of Child Development and Early Learning with clinical support from the Office of Mental Health and Substance Abuse Services. All state-registered or certified early care and education facilities enrolled in Keystone STARS, Pennsylvania’s quality rating and improvement system, are eligible to participate in ECMHC. The program approach is to develop stronger socio-emotional foundations for children by supporting caregivers. The overall goal is to reduce the number of instances where children are removed from child care settings due to behavioral issues.

The program uses the Pyramid Model for Promoting the Social Emotional Competence of Young Children (Center on the Social-Emotional Foundations for Early Learning). In this child-centered model, early care and education practitioners work together with parents to refer children into the program. Once referred, the practitioners as well as the parents/guardians complete a social-emotional screening using the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) which informs next steps that might be taken, including but not limited to on-site coaching, professional development sessions or resources, or potential referrals to other community services. Masters-level professionals in mental health, child development, and early education then work as consultants in partnership with early childhood practitioners and parents to help improve outcomes for children externalizing behavior concerns, such as aggression and self-regulation.

The program’s 2011-2012 evaluation showed that the Early Childhood Mental Health Consultants provided 11,685 direct service hours to early care and education practitioners, and delivered 335 hours of targeted social and emotional professional development. Outcomes achieved include reducing the number of children expelled from child care due to behavioral issues (in the population referred), increasing early care and education practitioners’ understanding of social and emotional development and its impact on educational success, and linking and bridging systems of services.

For more information on the program, visit:,,,, and/or

Updated December 2013


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