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Family Care Treatment Program to the Rescue

Tuesday, May 10, 2011

The PSH Child Care Center is licensed through Kansas Department of Health and Environment to serve 55 children, ages 2 weeks thru 14 years of age. Children from the public are enrolled on a "first come, first serve basis."

"Seven years ago we began implementing evidence-based practices at the PSH Child Care Center," says Sharla Hopper, Director. Early on, the concepts of removing televisions from the classroom and expecting written lesson plans appeared overwhelming for staff. It appeared that no amount of research could convince twenty-five staff members that applying at least one planned activity would improve both their job performance and our services to children.

A year later, a new population of staff has been employed at the Center located on the PSH&TC campus. It was at this time that I received a phone call from a parent requesting services for her son with Autism. Mom explained that her son's current family childcare provider kept him in a playpen all day to keep him safe. I felt confident that with center-based, adult-tochild ratios and activities implemented using evidenced-based practices we could provide quality services. I quickly discovered that centerbased ratios and our then-current level of training were barely enough to keep this child safe. I immediately made a referral to the local educational cooperative and scheduled training workshops for staff with Child Care Resource and Referral.

In rural southeast Kansas, enrolling a child with Autism seemed to open a door for families of children with disabilities. Within a few months, 30% of our enrollment consisted of children with disabilities. We were faced with additional challenges. The current tuition fees did not cover the cost for additional trained staff at the level that was needed to provide quality services.Parents' work schedules required children to be in child care a minimum of 8 hours a day. Depending on the level of need, the local cooperative provided a maximum of three hours of educational supports daily. We had the challenge and the opportunity to provide quality care for the remaining five hours and we still needed additional training for reducing the children's negative behaviors.

I was energized when I was able to hire an employee with a bachelor of science degree in elementary education, thinking they had skills to manage children's behavior. After an increase in children's accidental injuries and a low score on a environmental rating scale, I realized I was wrong. Extremely discouraged, I began to question if it was realistic to believe that providing affordable, quality child care was possible.

The turning point came in October 2009. A few of our families received services from the Southeast Kansas Family Care Treatment Program and had success in reducing their children's negative behaviors. In addition, they personally trained PSH child care staff on their children's individual behavior plans. We were able to work together with the families to improve their children's behaviors in our setting.

I called Dr. Katie Hine, B.C.B.A., Coordinator of the Family Care Treatment Program, and begged for help. I asked her what works? How can I train staff to acquire the basic skills to provide quality services? The research project was born, Southeast Kansas Child Care Teacher Training Initiative.

Dr. Hine scheduled brainstorming sessions to identify a set of targeted skills that caregivers need to provide quality care. Together we began addressing teaching skills related to the development of positive adult-child interactions, such as, rotation of attention to all children in the area and providing descriptive praise for good behavior. We recorded how often staff demonstrated the identified skills. Staff names were not recorded and individual staff members were not identified.

Once those skills were identified, a centerwide Behavior Skills Training (BST) process was implemented that includes verbal instruction, modeling, rehearsal and feedback.

Overall Center performance was monitored with direct observation. The Director, Assistant Director and research personnel observed staff in the classrooms. In each 10-minute observation, five staff members were observed for 2 minutes each. We recorded either "Yes," targeted skill was demonstrated or "No", it was not demonstrated.

The Center Director and/or the Assistant Director conducted training sessions with all staff members in small groups every four weeks. Teaching skills were addressed one at a time. Using a data sheet that lists only the first skill, staff watched a 20-minute video, recorded data and discussed the results. Training videos featured the Center Director, Assistant Director or research personnel working with children in a classroom.

A graph of the previous week's data for the first skill was posted in the lobby of the Center each Monday. Criterion performance (80-100%) was highlighted. Mastery was a center-wide average of between 80-100% for 3 of 4 weeks. Training sessions with different videos were conducted every four weeks until criteria were met for each skill. Once mastery was demonstrated the entire process was repeated for each identified skill.

Averages of staff observations were recorded per week. During the course of this project a total of 31 staff participated. Twenty-two staff worked at the Center throughout the project. Ongoing training for newly hired employees is now provided weekly. New staff view video demonstrations on the currently identified skill. With the Director or Assistant Director, the new staff member will then record data on all seven skills during three observations of previously trained staff.

The procedures for training and monitoring staff performance have resulted in improved performance of target behaviors. Although more gradual, staff performance of untrained skills has also improved. Dr. Hine says, "The teachers have done an exceptional job of demonstrating skills that promote pro-social child performances."

Despite low wages and limited formal education, caregivers at PSH Child Care can now obtain the skills needed to serve as impromptu behavior specialists through the BST process. Prior to the research project, the primary source for staff training was workshops and lecture style college classes. It was clear to me that it was not enough to know the information; we needed a process for demonstrating mastery of a range of targeted skills. Given the impact teachers have on both children and parents, it is imperative that a training process is in place to prepare teachers for their role in early childhood education. In my experience, the BST process has demonstrated to be far more effective for caregivers to implement their skills.

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