Alabama

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Alabama Strategies
Child Social-Emotional Screening and Response and Case Management/Linking Families to Services

Alabama is one of only a few states that has a statewide Help Me Grow (HMG) initiative. HMG has a presence in 9 regions of the state covering all 67 counties. As a national model, HMG has been implemented in 30 states and 99 systems. Alabama’s HMG incorporates the four core components of the national model:

  • A central call line allows parents, health care providers, early childhood professionals and others to talk with a HMG specialist about a child’s needs and assist in connecting families to appropriate services (e.g., Part C Early Intervention, mental health care, parenting programs); 
  • Through outreach and training activities, HMG staff educate health care and other professionals about screening children for developmental and social-emotional concerns, and help link families to community services and supports;
  • HMG builds a network of services and organizations and keeps up-to-date information about local resources for children and their families; 
  • Using data concerning family needs and the outcomes of efforts to connect families to resources, HMG identifies gaps and barriers that result in families’ unmet needs; HMG works with its network to reduce these obstacles. 

While retaining the core elements, states also implement the model in different ways (e.g., the extent to which they emphasize social-emotional screening and their approach to monitoring children’s development). Alabama’s HMG places strong emphasis on social-emotional screening, recruiting families that face significant challenges, and engaging health and early care and education professionals and parents in screening children.

One way families reach AL HMG is by dialing toll-free or enrolling online at helpmegrowalabama.org to get connected with a HMG Care Coordinator who will help link families to a wide range of services to meet the needs of the whole family, including programs that provide health and mental health care, services that help address behavioral, communication, and other developmental concerns, and resources to meet basic needs. HMG has contracts with local agencies statewide to ensure that local connections with parents and providers can be made, as well as to keep information about local resources up to date.

While families can self-enroll in HMG, HMG conducts extensive outreach to providers serving families with young children about the importance of early detection, using a valid, reliable screening tool such as the ASQ-3 and ASQ:SE-2, and making sure they know that they can refer families they are working with to HMG for connection to resources when concerns are identified. Currently, concerns about a child’s behavior and development trigger the largest number of calls to HMG.

When a family or provider calls HMG, a care coordinator talks with the caller about their concerns and identifies appropriate programs in the community. Families may be referred to Early Intervention (EI), Home Visiting, a mental health provider or other programs as well as local organizations that might be able to help address basic family needs. Currently, the state has a shortage of evidence-based dyadic treatment providers, and efforts are underway to increase the number of trained providers. To accomplish this, the state has created First 5 Alabama, a member of the Alliance for the Advancement of Infant Mental Health, to increase the professional capacity of the state to address the infant and early childhood mental health needs being seen statewide. In addition, the state’s EI program has been working to increase its capacity to support very young children’s social-emotional needs by training EI providers to use the SEAM (Social-Emotional Assessment/Evaluation Measure) to assess and monitor infants and toddlers found in screenings to be at-risk of social-emotional problems, and parents’ strengths and needs. The EI program also uses training materials from The Pyramid Model to help providers equip families in responding effectively to very young children’s challenging behavior.

All families that call HMG are asked if they would like to participate in developmental and behavioral screening in order to monitor their child’s growth. Parents that agree receive screening tools, the ASQ (Ages and Stages) and the ASQ:SE-2 (Ages and Stages Social-Emotional), to complete and return to HMG who score the screener, discuss results with parents, and connect the families to services when concerns are identified. HMG uses the ASQ in both English and Spanish. In addition, HMG participates in Quality Improvement-Maintenance of Certification projects facilitated by the Alabama Child Health Improvement Alliance (ACHIA) and American Academy of Pediatrics-Alabama Chapter, which are focused on increasing the developmental screening rates through the ASQ-3 and ASQ:SE-2 among pediatricians statewide. 

Help Me Grow uses the ASQ Enterprise system for screening completion and gives free access to early care and education programs statewide. This system helps programs store screening results and follow-up decisions in child records; track when children need to be screened, access activities parents can try at home to promote child progress; access automatic scoring and screening selection to help eliminate scoring errors and provide more accurate referral information, and analyze both child and program level data and track trends across time. Currently, pediatric practices, home visiting, licensed center and family home providers, and all state Pre-K classrooms use this system.

HMG also trains providers in pediatric practices, home visiting, and early care and education professionals on the importance of developmental screening, how to use the ASQ-3 and ASQ:SE-2, and how to connect with HMG to assist families when concerns are identified. Training and support are usually delivered in-person with additional follow-up webinar calls to answer questions. In 2018, HMG served 1,380 families statewide, and helped facilitate 23,229 screens for children enrolled in HMG and partnering agencies.

Monitoring and evaluation

The ASQ Enterprise system for screening completion, used by early care and education programs, home-visitors, and pediatric practices, provides data on screening and follow-up actions across these settings. Alabama, like all affiliates of the National HMG Center collects data on its implementation of the four service components, including outreach to providers and families, the number of families served, follow-up methods after referrals to services, and whether needs were met with referrals. Affiliate data are used in an annual national report. 

Financing

Help Me Grow Alabama is funded by the Alabama Department of Early Childhood Education through the Preschool Development Grant, the Alabama Department of Human Resources through the Child Care and Development Fund, and the Alabama Department of Mental Health through a Project LAUNCH Grant from the Substance Abuse and Mental Health Services Association. In addition, Help Me Grow Alabama is supported by an AmeriCorps State Grant from the Corporation for National and Community Service provided by The Governor’s Office of Volunteer Services. 

Last updated October 2019

Special thanks to Katie Prince, Help Me Grow Alabama Director, Alabama Partnership for Children, for providing information for and reviewing this profile.

Social-Emotional Professional Development, Coaching, and Curricula in ECE Programs: Conscious Discipline

Since 2018, Alabama has been scaling up the use of Conscious Discipline (CD), an evidence-based social-emotional learning model for early care and education settings (ECE) in SAMHSA’s National Registry of Evidence-based Programs and Practices. Statewide implementation of CD began in the state’s public prekindergarten (First Class Pre-K program) and now reaches an increasing number of licensed child care settings, including Early Head Start-Child Care Partnership (EHS-CCP) programs. The state aims to expand CD to all public ECE settings for children birth to eight, including elementary school settings and all licensed child care providers.  

CD is a comprehensive, trauma-informed, and healing-centered self-regulation program, based on current brain research that integrates social emotional learning, school culture, and restorative discipline. The CD approach is an “adult first” model designed to develop awareness, shift mindsets, and build fundamental capacities and skills in teachers and school staff. CD’s model and professional development have a strong focus on helping adults become aware of and able to regulate their emotions so they can support young children’s social-emotional learning and development. CD aims to strengthen relationships among adults and children in the program and help children develop social-emotional skills that promote positive interactions and help them manage their emotions and conflicts that arise. 

Professional development provided by the model’s developer includes online courses, group training, and on-site one-on-one coaching. The program also offers add-on curricula for children ages birth to five and prekindergarten to second grade, as well as a parent education curriculum suitable for families in ECE programs birth to 8 that has been used in some Alabama licensed child care programs. In addition to the CD training for teachers, Alabama uses the Feeling Buddies and Baby Doll Circle Time curricular materials in some licensed child care and prekindergarten classrooms. Alabama is the first state in which CD has been implemented at a statewide scale.

The origin of the state’s current CD work can be traced to a yearlong grassroots effort in 2016, led by two state-level staff in the Alabama Department of Early Childhood Education (ADECE) trained in CD, who conducted a voluntary study using CD books with interested First Class Pre-K teachers. The popularity of CD, generated by the book study among participating teachers and through word of mouth, led to interest at the state level. In 2018, ADECE, which administers First Class Pre-K, supported statewide implementation in public prekindergarten classrooms. Other state agencies were also invited to participate in CD implementation, including the Alabama Department of Human Resources (DHR), which oversees child care subsidies and licensing, as well as the Alabama Department of Mental Health (DMH) and the Alabama State Department of Education (ALSDE), office of Special Education Programs.

The process by which CD was introduced to different settings varies across types of programs. The following sections will explore CD implementation in First Class Pre-K, licensed child care settings, and other programs.

First Class Pre-K

In January 2018, an initial week-long CD training institute was held with state-level leaders from the ADECE and the department’s prekindergarten classroom coaches. Following this institute, the implementation process for First Class Pre-K programs involved three strands.

The first strand included all teachers in First Class Pre-K and aimed to expose them to CD principles and approaches, and to support them in the beginning to implement CD in their classrooms. An initial one-day “Ignite and Excite” training at the state’s First Class Pre-K conference in January 2018 reached teachers from the state’s 936 public prekindergarten classrooms. Following the conference, two-day group trainings reached 1,452 prekindergarten teachers in year one. Master CD Instructors from the national CD office delivered the trainings, which focused on building the seven core CD powers and skills for regulating emotions and on positive school climate and relationships among adults and children, known as “the school family” in the CD model. In the second year, 2,300 prekindergarten lead and auxiliary teachers attended two, one-day trainings held on consecutive days, which built on the trainings delivered in the first year. The first day focused on conflict resolution and the second on addressing child aggression. Formatting the trainings as two one-day sessions helped address some of the challenges related to the need for substitute teachers and classroom coverage that teachers reported in the first year, as they could choose to attend just one session or attend on non-consecutive days in the different locations.

The year one group trainings helped to identify prekindergarten teachers to participate in the second strand of implementation, which involved in-depth training of Conscious Discipline Actions Teams (CDAT). A month-long CDAT screening process was conducted in all 936 public prekindergarten classrooms and involved the use of an observational rubric developed by the state CD program leads that identified promising CD classrooms. The rubric examined fidelity to the CD approach in classroom environments and teacher practices, with a focus on teacher responses to children’s behavior and their use of CD social-emotional teaching strategies. Following screening, progressing teachers from 76 prekindergarten classrooms, along with their program’s director or principal, were invited to a two-day CDAT training in June 2018 led by Master CD Instructors from the national CD office. The CDAT training explored CD in greater depth and addressed how to roll out the program and reach high fidelity in CD implementation.

The third strand involved intensive CD coaching, which was offered by Master CD Instructors from the CD national office, to 25 of the teachers, identified through additional screening, who were implementing CD purposely in the CDAT group. This group’s goal for 2018 was high fidelity implementation within one year, a process that typically takes three to five years. Master CD Instructors from the CD national office delivered coaching to sites in a series of intensive four-day sessions in August, September, and October 2018. The 25 teachers who achieved fidelity in the first year have become peer mentors for other teachers in their programs. In 2019, a new cohort of 25 teachers began the coaching process with the Master CD Instructors and, based on their initial progress, are expected to achieve fidelity within two to three years.

In addition to the initial weeklong training that Alabama’s own 60 prekindergarten classroom coaches received from Master Instructors from CD’s national office, the classroom coaches were invited to observe the Master CD Instructors’ coaching sessions, allowing them to coach additional classrooms on CD. Each First Class Pre-K classroom has a coach, and the aim is for these coaches to take over most of the CD training. Two state-level CD instructors, within ADECE, also provide support to classroom coaches and prekindergarten teachers as needed via phone calls, one-on-one in-person coaching, training, and email.

Licensed Child Care Settings

CD has been introduced in licensed child care settings through an interagency agreement between ADECE and DHR. CD training was delivered by Master Instructors from CD’s national office to 13 Early Head Start-Child Care Partnership (EHS-CCP) program coaches. Each EHS-CCP classroom has a coach, who shadowed a Master Instructor from the CD national office working with an EHS-CCP teacher in the classroom and who then participated in in-depth reflection sessions with the CD Master Instructor. The 13 EHS-CCP coaches are also supported through monthly meetings led by ADECE’s two state-level CD instructors to further reflect on their use of CD powers and skills. CD training is mandatory for the state’s 100 EHS-CCP providers. This more formal train-the-trainer model has produced wider adoption in EHS-CCP programs than in the prekindergarten classrooms, in which classroom coaches are not required to use CD with teachers.

In addition to the work with EHS-CCP programs, DHR’s interagency agreement with ADECE includes two types of CD support for licensed child care center and family child care providers: challenging behavior support and developing family engagement. DHR master’s-level education specialist coaches, who have been trained on CD by one of ADECE’s state-level CD instructors, deliver these supports at the request of child care programs. Challenging behavior support consists of six months of CD coaching work with child care teachers for a particular age group (either infant and toddler or preschool). Developing family engagement support also lasts for six months, and CD coaches work with child care providers onsite, who then work with parents, through individual conferences or group meetings. Both types of support can include the use of the CD parent curriculum. The six coaches offering challenging behavior support can support 100 classrooms a year, and the three coaches delivering family engagement support can support 60 programs. 

ADECE’s two state-level CD instructors are developing a nine-week series of 40 family videos covering the CD framework and strategies for parents of children in EHS-CCP programs. The aim is to support parents with specific CD-informed activities in the home for those who do not want their children to participate in the in-person instruction during the pandemic. The videos are being piloted with 56 EHS-CCP teachers, parents, and coaches, and will ultimately be available to the public on YouTube.

Financing

Funding for CD in Alabama was $2 million in the first year, $1 million in the second year, and $500,000 in the third year. Initial funding for CD in First Class Pre-K came from the federal Preschool Development Grant (PDG) while the federal PDG Birth through Five grant provides current funding. Funding for CD in EHS comes from braiding EHS-CCP partnership grant and federal Child Care and Development Fund (CCDF) quality improvement funds. CD in other licensed child care settings is also supported by CCDF. Because CD is trauma-informed, funding may also be available through the Coronavirus Aid, Relief, and Economic Security (CARES) Act to support ECE programs with children affected by the pandemic.

Monitoring and Evaluation

Alabama CD produced an annual report on implementation activities during 2018, including information on the content of the trainings delivered and coaches’ impressions of teachers’ progress. Teachers and administrators also complete CD self-assessment rubrics, which are used to monitor their implementation progress.

The University of Alabama is conducting a formal evaluation of CD in Alabama. Evaluation activities will include the collection of child outcome data from CDAT classrooms using child social-emotional, language, and both child and teacher executive function measures.  Researchers are working to develop a reliable CD observational fidelity measure, informed by the CDAT screening rubric. Data have also been collected on teacher cortisol levels, which will allow a comparison of stress levels among teachers implementing and not implementing CD.

Extensive research on CD shows it is associated with improved teachers’ and children’s social-emotional skills, decreased child aggression, and more positive teacher-child interactions. A recent study examining preschool teacher fidelity to CD found that among 45 teachers and 293 of their students, higher fidelity to CD was positively associated with children’s executive function and social skills development.

Special thanks to the following individuals for providing information for and reviewing this profile: in the Alabama Department of Early Childhood Education, ADECE Secretary Barbara Cooper, Ph.D., Joy Winchester, Director, Early Childhood Development and Professional Support, and Amy Brakenhoff, Conscious Discipline State Implementation Lead B-8; from Conscious Discipline, Becky Bailey, creator of Conscious Discipline, Jill Molli, Master Instructor, Nicole Mercer, Certified Instructor, and Lavonne Joseph, Project Coordinator.