Children's Mental Health
and School Readiness: What Can Be Done?
By Cari Michaels
How can children with mental health needs be better prepared to succeed
in school? Research offers much information about the prevalence
of mental illness in early years and the most successful interventions
to provide needed services and improve health outcomes.
The 1999 Mental Health: A Report of the Surgeon General1 defined
children’s mental health as, “the achievement of expected
developmental cognitive, social, and emotional milestones and by secure
attachments, satisfying social relationships, and effective coping
skills” (p. 123). Mental disorders were defined as, “serious
deviations from expected cognitive, social, and emotional development,” (p.
123). Early childhood mental health refers
to the social, emotional, and behavioral needs of children from birth
to age six.2 The terms “early childhood mental health” and “social
emotional development” have been used interchangeably to refer
to these needs.2,3 Although there is limited data,2 social, emotional,
and behavioral problems have been reported in 8%-11% of young children.4,5 In
Minnesota, 47,402 children (ages 0-18) have a developmental, behavioral,
or emotional issue that requires treatment or counseling.7 Social,
emotional, and behavioral problems may also be predictors for
later developmental difficulities.8
Despite a tendency to define school readiness specifically as age-appropriate
cognitive development, the National Educational Goals Panel (NEGP)
promotes a broad conceptualization of school readiness that included:
health and physical development, social and emotional development,
approaches to learning, language development, and cognitive development
and general knowledge.10 Research confirms that young children’s
social and emotional adjustment is related to early school success
as well as future success.8,11,12 Young children who exhibit
poor mental health are more likely to experience unfavorable educational
consequences such as:
- poor task performance
- less participation in classroom activities
- greater negativity about learning and school
- low peer acceptance and interaction
- less acceptance, instruction, and positive feedback from classroom
teachers, and
- increased grade retention in the early elementary years.8,12
Untreated mental health problems in childhood are likely to continue
into adolescence and young adulthood.11 These problems are likely
to worsen over time, creating significant and costly burdens for families,
schools, and society.13-17 The promotion of
good mental health during the first six years of life can help facilitate
the establishment of developmental competencies that will positively
contribute to children’s school readiness, as well as positive
lifelong development. Research has demonstrated that many changes
can be made to enhance school readiness for children:
Research - Policy-relevant research can not only discern
which aspects of early childhood intervention programs promote optimal
development8,11 but also shows that research is most likely to affect
policy if it addresses questions and organizes answers in ways that
policymakers can put directly into action.18 Research can serve
to explore and document the potential economic benefits of investing
in different early childhood intervention efforts.8
Families - Research has shown that if parents have access
to programs that promote positive parenting behavior during the early
childhood years, they can engage in supportive, enriching, and developmentally
appropriate caregiving.3 Families can be supported in taking
an active role in the care and treatment of their young children with
mental health problems and should be empowered as experts about their
children’s needs.11. Parents need greater access to leadership,
liaison, and mentoring activities related to children’s mental
health13. Mental health facilities can support family involvement
and eliminate barriers (e.g., transportation).13
Communities – Research has also indicated that the
presence of accessible screenings and assessments in child and health
care settings, along with appropriate services to respond to identified
needs, predict which children may require more intensive services later
on.14 High quality and culturally appropriate early childhood
education programs significantly contribute to a child’s mental
health.19 Program staff benefit from timely access to evidence-based
information on child mental health and disorders, staff training in
child mental health issues, and access to consultation and referral
sources.8,20
Society - Public awareness campaigns can help eliminatestigma
about mental illness and educate people about how to access high quality
mental health services for young children and families.11,13 Some
research has indicated that creating a statewide public-private health
infrastructure will address the fragmentation and lack of availability
of mental health services for many children.11,13 The
existence of a well-coordinated, accessible system of mental health
assessment and treatment can ensure that young children develop the
emotional and behavioral competencies they need to successfully transition
to school and accomplish later developmental milestones.
References
1 U.S. Department of Health and Human Services (1999). Mental health:
A report of the Surgeon General. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, Center for Mental Health Services, National Institute
of Health, National Institute of Mental Health.
2 Knitzer, J. (2000). Early childhood mental health services: A policy
and systems development perspective. In J. Schonkoff & S. Meisels
(Eds.), Handbook of early childhood intervention, 2nd ed. (pp.
416-438). New York, NY: Cambridge University Press.
3 Knitzer, J., & Lefkowitz, J. (2005, November). Resources
to promote social and emotional health and school readiness in young
children and families: A community guide. Retrieved February 9,
2006 from Columbia University Mailman School of Public Health, National
Center for Children in Poverty Web Site: http://www.nccp.org/pub_pew.html.
4 West, J., Denton, K., & Reaney, L. M. (2001). The kindergarten
year: Findings from the Early Childhood Longitudinal Study, Kindergarten
class of 1998-1999 (Publication No. NCES2001-023). Washington,
DC: U.S. Department of Education, National Center for Education Statistics. http://nces.ed.gov/pubs2001/2001023.pdf.
5 Kupersmidt, J. B., Bryant, D., & Wiloughby, M. T. (2000). Prevalence
of aggressive behaviors among preschoolers in Head Start and community
child care programs. Behavioral Disorders, 26(1), 42-52.
6 Lavigne, J. V., Gibbons, R. D., Christoffel, K. K., Arend, R., Rosenbaurm,
D., Binns, H. et al., (1996). Prevalence rates and correlates of psychiatric
disorders among preschool children. Journal of the American Academy
of Child and Adolescent Psychiatry, 35(2), 204-214.
7 Minnesota Department of Health Center for Health Statistics (2005). 2005
Minnesota County Health Tables (Section G: Minnesota children
with special health needs). Retrieved from http://www.health.state.mn.us/divs/chs/countytables/.
8 Raver, C. C., & Knitzer, J. (2002, July). Ready to enter:
What research tells policymakers about strategies to promote social
and emotional school readiness among three- and four-year-old children. Retrieved
January 19, 2006 from Columbia University Mailman School of Public
Health, National Center for Children in Poverty Web site: http://www.nccp.org/pub_pew02c.html.
9 Hyson, M. C. (1994). The emotional development of young children:
Building an emotion-centered curriculum. New York, NY: Teachers
College Press.
10 Child Trends (2001, October). School readiness: Helping communities
get children ready for school and schools ready for children (Research
Brief). Washington, DC: Child Trends. http://www.childtrends.org/Files/schoolreadiness.pdf
11 National Research Council and Institute of Medicine (2000). From
neurons to neighborhoods: The science of early childhood development. Committee
on Integrating the Science of Early Childhood Development. Jack
P. Shonkoff and Deborah A. Phillips, eds. Board on Children, Youth,
and Families, commission on Behavioral and Social Sciences and Education.
Washington, D.C.: National Academy Press.
12 Raver, C. C. (2002, December). Emotions matter: Making the case
for the role of young children’s emotional development for early
school readiness (Social Policy Report, Vo. 26, No. 3). Ann Arbor,
MI: Society for Research in Child Development.
13 Minnesota Mental Health Task Force (2002, August). Blueprint
for a children’s mental health system of care. Retrieved
January 9 from Minnesota Department of Human Services Web site: http://edocs.dhs.state.mn.us/lfserver/legacy/ms-2177-eng.
14 Jones, D., Dodge, K. A., Foster, E. M., Nix, R., & Conduct Problems
Prevention Research Group (2002). Early identification of children
at risk for costly mental health service use. Prevention Science,
3(4), 247-256.
15 Newacheck, P. W., Inkelas, M., & Kim, S. E. (2004). Health services
use and health care expenditures for children with disabilities. Pediatrics,
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16 Simpson, G. A., Bloom, B., Cohen, R. A., Blumberg, S., & Bourdon,
K. H. (2005). U.S. children with emotional and behavioral difficulties:
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(Advance Data from vital and health statistics No 360). Hyattsville,
MD: National Center for Health Statistics.
17 Witt, W. P., Kasper, J. D., & Riley, A. W. (2003). Mental health
services use among school-aged children with disabilities: The role
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care coordination. Health Services Research, 38(6), 1441-1466.
18 Huston, A. C. (2005). Connecting the science of child development
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19 Rand Corporation (2005). Proven benefits of early childhood
interventions (Rand Labor and Population Research Brief, RB-91450PNC).
Santa Monica, CA: Rand Corporation.
20 Knitzer, J., & Lefkowitz, J. (2006, January). Pathways to
early school success: Helping the most vulnerable infants, toddlers,
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University Mailman School of Public Health, National Center for Children
in Poverty Web site: http://nccp.org/publications/pdf/text_669.pdf
