Center of Excellence for Infant and Early Childhood Mental Health Consultation, part of Georgetown University’s Thrive Center

Using/adapting Evidence-Based Practices

little girl and mom on bench

The important trend toward evidence-based practices (EBP’s) in early childhood mental health is aimed at designing and delivering mental health interventions that successfully attain the intended outcomes for young children and families. There is an expanding evidence base that ECMHC is an effective strategy for promoting social and emotional health, preventing the onset of behavioral issues, and addressing challenging behaviors in young children in early childhood settings. The research also indicates positive benefits to families and ECE providers (Brennan et al, 2008; Perry et al, 2006; Perry et al, 2010). Including evidence based practices as part of consultation and intervention has many challenges, including how to include and sufficiently address the application of these practices when working with culturally and linguistically diverse children and families (Isaacs et al, 2005).

According to Samuels et al, (2009) in the publication Toolkit for Modifying Evidence-Based Practice to Increase Cultural Competence, it is important to consider how to make the most of evidence-based practices to address social-emotional and mental health concerns of culturally and linguistically diverse communities. They suggest that existing practices can be made more culturally competent through:

  • Cultural Accommodation – modifying the way a practice is delivered so that it can be utilized with a particular culture or community (e.g., translating forms, using interpreters).
  • Cultural Adaptation – reviewing and changing the structure of a program or practice to more appropriately fit the needs and preferences of a particular cultural group or community

In the accompanying toolkit, Schudrich (2010) provides a checklist and workbook to guide the selection and modification process. Some examples of both accommodating and adapting evidence-based practices, might include making an evidence-based intervention such as The Incredible Years(opens in a new tab) or a parenting program accessible and meaningful for new immigrant children and families.

According to a recent “think tank” report by Finello, et al (2010), there are a number of EBP’s for use with preschool age children, but a more limited number designed for children under age three. More efforts must be made to evaluate promising practices that have potential to become research validated EBPs. In addition, research-based methodologies need to be examined and selected in the context of cultural values and other social factors, such as class, race, ethnicity, and community To this end, several important questions must be addressed when considering culturally competent, evidence-based practices in early childhood mental health promotion, prevention, and intervention:

  • What evidence based practices already exist that have been shown to be effective with young children and families from diverse communities?
  • What are the criteria and process for selecting and deciding to implement an evidence-based practice?
  • How will the selected evidence-base practice fit within the ECE program service model?
  • Do the ECE program, the staff, and the mental health consultant have the training, experience, and capacity to implement and evaluate the impact of the evidence-based practice?
  • What adaptations to the selected evidence-based practices must be made to meet the needs of the diverse children, families, and communities while maintaining fidelity and effectiveness of the intervention?

The responses to these questions are critical to implementing evidence-based practices in ECE settings. Early childhood mental health consultants can facilitate the process by:

  • Being knowledgeable about the mental health concerns of the young children, families, and diverse communities served by the ECE program.
  • Being familiar with evidence-based practices and interventions for young children and their families.
  • Reviewing lists of various interventions found in data bases at the National Registry of Evidence-based Programs and Practices, Substance Abuse and Mental Health Services Administration website at The U.S. Department of Health and Human Services Administration on Children, Youth, and Families, RAND’s Promising Practices Network.
  • Keeping current through professional journals such as Early Childhood Services: An Interdisciplinary Journal of Effectiveness, Clinical Child Psychology and Psychiatry(opens in a new tab), Child Development(opens in a new tab), Journal of Early Childhood and Infant Psychology.

(Adapted from Finello, et al (2010), Samuels, et al (2009), and Schudrich (2010))