Kristina Chism's voice shook. She pressed her lips tightly together trying to stanch the tears welling up in her eyes.
Her two children, Kolton, 4, and Hunter, 2, had gone to the same Searcy day care since they were 6 weeks old, until Chism accepted a job last year as the office manager of a Cabot medical clinic.
She got a new day care. Kolton cried when being dropped off there every morning. Two months later, Chism got a phone call at work from the facility director telling her that Hunter had bitten another child and, as a result, both of her children were expelled.
"I was shaking and crying," Chism said.
Kolton didn't understand. Every time they passed his former day care, he would inquire about his former teacher.
"Mama found a better place," Chism would console him.
"They don't like us anymore?" Kolton would ask.
Expulsions of children up to 5 years old are traumatic, and the social and emotional effect can follow a child into adulthood, mental-health experts say.
Yet the nation's day-care and preschool students are expelled at a rate of 6.7 per 1,000 students, while kindergarten-through-12th-grade students are expelled at a rate of 2.1 per 1,000, according to research by the national Foundation for Child Development.
With the ceremonial rollout earlier this month of the BehaviorHelp Response System, Arkansas became the first in the nation to require all of its publicly funded child-care facilities to seek intervention from the state Department of Human Services before suspending or expelling a child.
"Arkansas is getting a lot of things right," said Patrick Fisher, public affairs specialist with the U.S. Department of Health and Human Services in Washington, D.C.
The state is featured prominently in federal literature and reports as a leader in combating the effect of expulsions on children up to 5 years old. Other states, like Colorado, have begun to address the issue by requiring social-emotional development training for child-care providers. In Ohio, legislators allocated millions in state funding for intervention programs.
"They [Arkansas] are approaching this issue from the two angles that we see as critical to addressing this issue: 1) developing and implementing policy, and 2) enhancing and expanding supports for early educators," Fisher said.
THE PYRAMID
The Arkansas Division of Childcare and Early Childhood Education team blitzed the state Sept. 15, holding public forums and distributing about 30,000 oversized white envelopes packed with information about the new system, handouts for parents, magnets and fliers explaining the resources available to child-care providers.
"All these resources are online," said Arlene Rose, assistant director for operations and program development with the state Division of Childcare and Early Childhood Education.
Rose and her team developed and implemented the BehaviorHelp system only a year and a half after getting a challenge from the U.S. departments of Health and Human Services and Education for states to reduce and "eventually eliminate" expulsions and suspensions in early-learning settings.
And they did it without any additional state funding.
Rose pulled together existing partners like Project PLAY; Arkansas State University in Jonesboro; early child-care professionals, including educators; the Arkansas Better Chance program leaders; and representatives from state departments such as education, licensing and disabilities. The group, which continues to meet biweekly, designed, implemented and staffed the program, which was officially implemented July 1.
One new staff member was hired specifically for the program. All other duties were handled by shifting existing resources.
"It is a huge project, but I tell you, the reception overall has been very positive," Rose said. "We know that there has been a need. Even prior to launch, I would hear providers talk about challenges that they've experienced with children. You know, they would be at their wits' end asking, 'What do we do?'"
Rose grinned widely as she leaned forward and tapped her finger on a glossy picture of a pyramid.
"It excites me," she said. "I just think, 'What can we do for those babies that's really going to help them be successful?' This is near and dear to my heart, it really is. I just believe that every child can be saved."
The pyramid is separated by colored stripes, beginning at the base with a yellow "Effective Workforce" and topping off with a red "Intensive Intervention."
The system kicks in when a child-care provider reports via the online BehaviorHelp system that a child in his care has reached a critical point and that intervention is needed.
Within 48 hours, a specialist from the Division of Childcare and Early Childhood Education contacts the provider to assess the problem and decide in which level of the pyramid it falls.
Sometimes the solution is simple, like a pamphlet or behavior-modification tip for the teacher.
In instances like Chism's where her son was biting another student, a BehaviorHelp specialist would tell the day care that biting is normal for toddlers and would offer steps to modify the child's actions, said Nicola Edge, a University of Arkansas for Medical Sciences associate professor in family and preventive medicine.
Edge is also director of UAMS Project PLAY, an early-childhood intervention program that began nearly 12 years ago as a series of pilots funded by the Human Services Department and is primarily staffed through community mental health centers.
"Biting is really normal. It's going to happen in day care centers," Edge said. "The specialists can say, 'Here's a little pamphlet that's going to tell you what to do when children bite. Here's a pamphlet you can talk through with parents and that will tell the parents how to respond. Check back with me in two weeks, and let's see if that met your needs.'"
If the problem falls in one of the middle levels of the pyramid, reinforcements are called.
ASU's childhood services team, for example, can visit the day care or preschool to observe the classroom, offer solutions, and follow up with the teacher and director to ensure long-term success.
Project PLAY is called when a problem rises to the top of the pyramid -- such as severe behavior issues or a child acting out sexually. Mental-health professionals go into the classrooms and partner with the teacher to develop strategies for the specific issues.
The licensed mental-health professionals can also work with an individual child in his setting instead of a therapist's couch. Counselors are trained by Project PLAY in the intricacies of the child-care world and how to work as a consultant rather than a therapist, Edge said.
"We can help the teachers notice all those things in their classroom that are promoting disruptive behavior that they don't want," Edge said. "We can also work with them on how you build nurturing relationships with children."
Even with all of the BehaviorHelp resources, the result may be that the child would be better served at another, more specialized child-care center.
"We don't come at it with rose-colored glasses thinking that every child is going to be successful within that setting," Rose said.
ABIYOYO
Lewis, a student in the 3- to 5-year-old class at the UAMS Kennedy Head Start, sprung up from the carpet, tugged at the waistband of his bluejeans then adjusted plastic-framed glasses higher on his nose.
He laughed as he jumped up and down, pointing at the book in teacher Cassandra Roy's hands.
"Abiyoyo!" he screamed.
Roy smiled then briefly glanced at Lewis' empty spot on the floor. Lewis quickly plopped back down.
As a magician in the story makes things disappear with his wand, Roy animates the story with hand motions and props. She pauses in her narration at different points to praise her students.
"I like it when you guys are listening! That tells me you're learning."
"You know what? I really like the way my boys and girls are sitting. You're sitting flat."
Roy used the drama of the story's disappearing possessions to prompt the children to identify emotions they might feel in the same circumstance.
"I would be so ..." Roy prompted.
"Sad!" a little girl in braids yelled.
From the back of the room, Allison Martin, the mental health and disabilities supervisor at UAMS Head Start, silently clapped her hands, jumped an inch off the floor and whispered, "She's doing it!"
"Project PLAY promotes social and emotional skills," Martin said. "Teachers are trained to give positive guidance, to teach the children feeling words. Instead of pointing out what children are doing wrong, they're reinforcing what they're doing right."
From birth to age 5 is when scientists say a child's brain is developing the fastest, and imparting social and emotional skills from the very beginning will pay enormous dividends later, Edge said.
"What we say to people is 'you can deal with it now -- while it's easy, behavior is easier to change, it's less costly, and it's less intensive, and a lot of time we can do it outside the therapy office -- or you can deal with it when they're 13 and in the juvenile justice system. And they've become our $2 million dollar baby,'" Edge said. "Because that's what untreated, mental-health concerns in a young child, lifetime costs is estimated at, $2 million for a child."
Research finds that children who are expelled and suspended "are as much as 10 times more likely to drop out of high school, experience academic failure and grade retention, hold negative school attitudes, and face incarceration than those who are not," said Fisher.
"This indicates that the effects of expulsion and suspension in the early years manifest long after children leave preschool," Fisher said. "Those consequences not only affect the lives of the thousands of children who are expelled or suspended, they also affect society more broadly."
Sufna John, an assistant professor in the UAMS Department of Psychiatry who sees patients at the UAMS Child Study Center, said expelled toddlers lose relationships with trusted adults and social interaction with peers in a structured and nurturing environment.
"Additionally, expulsion often results in increased stress for families as they seek to find replacement child care," John said.
The abrupt expulsion of Chism's two boys from day care sent her into a panic to find a new child-care center. Area facilities had lengthy waiting lists.
"My mother-in-law kept the boys until we found a new day care," Chism said. "It was hard being furious and upset while I was really trying hard to find another place. I am just lucky that I had my mother-in-law."
WHAT'S NEXT?
While Arkansas is leading the nation in its quest to eliminate early childhood expulsions and suspensions, leaders say the battle is far from won.
For starters, the requirement to contact the BehaviorHelp system before expulsion or suspension applies only to those centers that are funded through the state's annual $50.3 million child-care vouchers system, as well as the state's Arkansas Better Chance child-care programs.
Private day cares can utilize the BehaviorHelp system free of charge, but it is not a requirement.
Also, the state is responding to a problem that thus far has not been properly measured. There are no Arkansas-specific statistics on how many children up to 5 years old have been suspended or expelled.
"The short answer is that we don't have data because we didn't previously track this, but we have now started to do so and should have some data at some point in the near future," said Amy Webb, a spokesman for the Human Services Department.
Edge said Project PLAY only recently began tracking the racial divide in their cases. She added that those statistics are important in order to address racial and gender disparities.
"It's really embarrassing that we didn't know this information a few years ago," Edge said.
The educations and pay rates of child-care teachers also figure into the success of the intervention, program leaders say. In 2014, Arkansas overhauled its minimum licensing requirements for child-care facilities for the first time in 45 years.
The education requirements for a day-care director were upgraded, but the child-care teacher requirements remained the same -- a high-school diploma or a GED and 15 hours annually of continuing education.
"We frankly have some of the lowest requirements of any state as far as the education that is required to serve as a child-care provider," Edge said.
A child-care education is included in the BehaviorHelp program through five one-hour free online courses at naptimeacademy.com.
"Our ultimate goal is for every teacher to have a degree in the early childhood field," Rose said. "That would be optimal."
Webb said she doesn't foresee upgrading child-care teacher requirements in the near future.
"I do know we want to encourage them to get more training and have a more diverse training background so they get to these types of programs that address these more specific behavior issues," Webb said.
Also, the low pay -- at or just above the minimum wage of $8 an hour -- for the majority of Arkansas child-care teachers leads to high turnover and low staff morale, which is counterproductive to the program's mission, Edge said.
"A third of our child-care providers are what we call 'food insecure,' meaning they don't know how they're feeding their family this week. So they're walking into the classroom underpaid, underfed, stressed out," Edge said. "Where's the support and recognition of the importance of this work? Especially with what we now know about brain science and our understanding that these are the brain-building years.
"This is probably the most important job that exists in our society."
Chism said Arkansas took a step in the right direction with its new policy and program. Kolton and Hunter are doing well, and she is very happy with the new day care.
"The first thing they said to me was, 'We don't kick out toddlers for biting,'" Chism said. "It's hard to find a day care where you know your kids are loved. Kids are being penalized throughout the state for just being kids."
Metro on 09/25/2016