Preschoolers are being expelled at alarmingly high rates--almost three times the rate of children in K-12 schools, according to the Yale Child Study Center's recent report, Prekindergartners Left Behind.

But there's good news: When child care workers have access to mental health experts, the expulsion rate is cut in half.

The Early Esteem program of Foothill Family Service (FFS) in Pasadena, for example, provides free counseling services for lower-income families of children under five, and "ends up covering all the bases in these children's lives," says FFS therapy intern Laura Rios. FFS provides counseling at its offices, but also visits children's homes and child care centers; working with parents, staff, and children to encourage positive changes.

The results are dramatic: At least four-fifths of the children they work with show improvement.

Support for parents

Families come to FFS through child care recommendations, fliers, and word of mouth. Therapists meet with the family and observe the child at preschool, "then we develop a plan together," says therapist Marlen Jimenez.

Valerie Butts found FFS when she and her husband were going through a divorce. Her three-year-old son "was having problems because he wasn't seeing his dad" and was acting very angry with his mother.

Butts says FFS taught her a number of ways to redirect her son's anger. "If he's throwing a fit because he can't get his way, I might say 'come over here and help me cook dinner.' Also when he's angry, I would take out a picture of his dad and tell him that his dad loves him, and he would carry it around."

FFS has "made a major difference," Butts says. "It's helped me learn how to understand what he's going through."

Advice for child care

FFS provides similar coaching to child care staff. "Right now I'm working with a child, Matthew (not his real name)," says Jiminez, "who was just annoying. I think the teacher was frustrated because she was doing what she could to help him make friends, and it wasn't working. He was very imaginative, but people would try to join in and he would get angry." The teacher learned how to show Matthew how to include others. She could say something like, "Matthew, that sounds like a really fun game. Maybe Anita would like to play too."

Help on wheels

FFS has also outfitted two vans for therapy sessions. "We put in carpets and a portable table and benches," says Pat Kocsis, clinical coordinator for Early Esteem. "We take parents and children into the van and do assessments and play therapy."

"One family lived in a small garage," Jimenez recalls, "Four kids under six. They had no way to make it into the office. And we would all go into the van. Their child, Tim, was having problems with aggression." Jimenez noticed that when Tim and his sister would "fight over a toy, the parents would give the toy to one and give the other something else." This often continued the conflict. Jimenez helped the mother "teach them to how to brainstorm (a solution), like each one gets the ball for a few minutes."

Recovery from trauma

Besides basic behavioral problems, FFS works with children who have endured severe trauma. Debra Zabel says her three-year-old granddaughter survived years of abuse and neglect by her mother. Zabel noticed that "she was doing sexual acts with her dolls and I was not sure if that was done to her or if she just watched it. She had a lot of other problems--night terrors--she used to be up two or three times a night.

"The therapist suggested with the sleep thing that I turn the TV off and have a night light and massage her to help her go back to sleep. She does sleep through the night now. For any kids that have gone through something like this, (this program) is really important. It not only helps the kids, it helps the parents. As a matter of fact, we adopted her last week!"

Why early intervention

Intervention for young children is essential because

• Behavioral problems dealt with at an early age are less likely to show up in a more extreme form later. "If we put more money at the beginning, then we're going to be spending less later on," for example, in the juvenile justice system, says Kocsis.

• Some problems, such as speech impediments or autism, can be treated more effectively if caught early.

• And, says Kocsis, "the earlier you can get to the family, the more effective (it is). Parents of kids this age haven't built up a lot of resentment for the child, whereas with a child who is ten, there's a lot of resentment there."

Resources lacking

Although programs like Early Esteem make a big difference, the preschool expulsion rate reflects some underlying problems--problems that make it difficult for preschool programs to do as well as they would like in supporting healthy emotional development, says Niki Harmon, child development coordinator at Pasadena City College.

For example, in many preschool programs, "there are not enough teachers for the students." And even when the state subsidizes preschool programs, each preschool student receives less than half the funding that K-12 students receive. In addition, says Harmon, not enough teachers are trained to work with children with special needs.

"We don't have the funding for a full-time person that would help us with the emotional needs or behavior of children," says Maria Nila, a child care provider at Hill Grove Children's Center. "So Foothill has been instrumental to us."

Foothill Family Service: 626-564-1613

Early Esteem in numbers

• Started with First 5 grant in May 2001.

• In the first three years
  • helped 545 children and their families
  • trained 1,688 child care providers
    
• Funded by First 5, Medi-Cal (billed for eligible children), and private donations (Other possible funding sources for such programs: child abuse prevention funds and mental health funds from Prop. 63)

• At least 80% of the children showed improvement on tests that measured how well they functioned in general, how well they functioned in child care, and how much their behavior improved as reported by their parents.