Impact

Impact

Our goal is promoting children’s social and emotional development by empowering the adults in their lives with the knowledge and resources they need to create nurturing, supportive relationships and environments. We also aim to reduce suspension, expulsion, and exclusionary discipline practices so that every child has access to quality care and education and every provider feels supported in providing that care. By supporting providers and caregivers, we hope to create equitable, sustainable systems of care for Maryland children. Central to these goals is data-based decision making. At a state level, we regularly monitor the following metrics and report them annually.

  • Fidelity of implementation and intervention — Are our programs running the way we intend?
  • Program outcomes for children, families, and the workforce — Are our programs making a difference?
  • Program reach — Who are we serving? Who are we not serving?

Fidelity

Data collection tools

  • Teaching Pyramid Observation Tool (TPOT) for Preschool Classrooms – The TPOT is a tool that measures the fidelity of implementation of Pyramid Model practices in the preschool classroom (ages 2-5), based on observation by a trained observer and an interview with the teacher. The TPOT contains three types of items organized under three subscales: Pyramid Model Teaching Practices, Red Flags, and Challenging Behavior.
  • Teaching Pyramid Infant-Toddler Observation Scale (TPITOS) – The TPITOS is a tool that measures the fidelity of implementation of Pyramid Model practices in infant and toddler classrooms (ages birth-3), based on observation by a trained observer and an interview with the teacher.
  • Classroom coaching logs – Pyramid Model program coaches can collect data on the types of coaching strategies that are used with early childhood providers, including observation, modeling, and reflective conversations.

  • Early Intervention Pyramid Practice Fidelity Instrument (EIPPFI) – The EIPPFI is used to assess the implementation of Pyramid Model practices by early interventionists in the coaching of family caregivers. EIPPFI practices are aligned with the Division for Early Childhood Recommended Practices and the Principles of Early Intervention. EIPPFI organizes practices within six practice categories: (1) Building Partnerships with Families; (2) Social Emotional Development; (3) Family-centered Coaching; (4) Dyadic Relationships; (5) Children with Challenging Behavior; and (6) Social Emotional Assessment.

Annually since 2019, the Pyramid Model State Leadership Team (SLT) has been collectively self-assessing its progress toward high-fidelity implementation of Pyramid Model practices in the areas of: the State Leadership Team, family engagement, implementation and demonstration programs/sites, professional development, and evaluation/data-based decision making. The Benchmarks of Quality are grounded in implementation science and monitor progress toward stages of implementation: planning/installation, implementation, scale-up, and sustainability. As displayed in the graph below, the percentage of indicators in place and emerging have been rising for the past 5 years. Our SLT has also infused equity into relevant BOQ items, and we regularly reflect on how far we have come and how we can improve in serving our communities equitably.

State Leadership Team Benchmarks of Quality

Reach

The Pyramid Model started with just a few county-wide demonstration sites. Today, every county has some level of Pyramid Model implementation, with trainers and coaches serving all jurisdictions. Take a look at our FY23 training numbers at a glance.

4,335

Pyramid Model and related trainings completed

573

Part C Early Intervention trainings completed

47

Positive Solutions for Families facilitators trained

230

Positive Solutions for Families participants

27

Practice Based Coaching trainees

27

ASQ-3 and ASQ-SE assessors certified

29

TPOT and TPITOS assessors certified

The number of accepted cases has increased slightly in the past fiscal year but is still well below the pre-pandemic number

Child Care Centers & Family Child Care Programs pie chart

Maryland Map with Program Logos

Infant and Early Childhood Mental Health Consultation (IECMHC) has 10 funded programs that provide services to all 24 jurisdictions. In FY 22-23, IECMHC programs accepted 402 cases from 242 early learning programs. While the number of accepted cases has increased slightly over the past 3 years, it is still well below the number of pre-pandemic cases.

In 2023, the PIEC team completed an Equity mapping report to identify where IECMH consultation services were delivered across all of Maryland in the context of where child care programs and families in need were from July 3, 2017, through December 31, 2020. Our intention with this report was to prompt discussions about equity in Maryland’s IECMH consultation services and inform decisions about programmatic changes wherever needed. Whether you are an IECMH consultant, program director, researcher, or policymaker, we encourage you to use this report, along with your own experiences and expertise, to promote meaningful advances towards an equitable IECMH consultation services network.

The report includes an interactive dashboard. Our statewide maps and interactive dashboard can be useful tools for Maryland IECMH consultation program staff, funders, legislators and community leaders to identify where else IECMH consultation services could have been provided in the context of racial/ethnic, socio-economic factors, and type of child care available. Furthermore, these maps can help initiate and facilitate collective discussions that explore the potential reasons behind IECMH consultation service gaps – like funding, community outreach efforts, delivery of IECMH consultation, and cultural/linguistic appropriateness.

Outcomes

Commonly used measures:

This checklist can be used by site directors and their program coaches/consultants to collect data about responses to behavioral concerns.

View Suspension, Expulsion & Exclusionary Practices Checklist

The Behavior Incident Report is a form used by teachers to record serious behavior incidents, including the behavior, the context in which it happened, the response, and needed follow-up. The BIRS is a mechanism for gathering and summarizing this information to inform decision-making and alert programs of possible equity issues by calculating disproportionality related to race, gender, IEP status, and dual-language learners.

Download BIR form and BIRS Excel system from NCPMI

The ASQ:SE2 is a screening tool that measures social-emotional development of children ages 2-60 months. It helps identify areas in which a child is on track and where they may need additional support.

The DECA is a behavior rating scale that is completed by parents and/or caregivers or teachers, and it measures child protective factors central to social-emotional health and resilience.

Pyramid Model

We are actively collecting baseline and follow-up data on TPOT, TPITOS, BOQ, and Suspension, Expulsion, and Exclusionary Discipline Practices for our 5 Pyramid Model implementation sites. Stay tuned for more information on what we are learning from our sites!

DECA-teacher graph

Outcomes Monitoring System (PIDS)

Pyramid Model Implementation Data SystemWe collect data from early childhood programs that implement the Pyramid Model and/or Infant and Early Childhood Mental Health Consultation by utilizing Outcomes Monitoring Systems. We are currently in the process of transitioning our current OMS for both Pyramid Model and IECMHC to the Pyramid Model Implementation Data System (PIDS). Program coaches, consultants, and providers can enter child, classroom, and program-level data into PIDS and produce reports on the ASQ: SE, BIRS, BOQ, TPOT, TPITOS, and classroom coaching logs. The PIDS allows state, local, and program leaders to remain informed about progress toward Pyramid Model implementation, monitor the effectiveness of classroom-level and child-level strategies for supporting social-emotional development, and monitoring program coach activities such as trainings and classroom coaching.

Stay tuned for PIDS training and support resources!

Enter PIDS data system

  • Rakap, S., & Balikci, S. (2024). Enhancing Preschool Teachers’ Use of Pyramid Model Practices Through Coaching Intervention. Journal of Behavioral Education, 1-27. https://link.springer.com/article/10.1007/s10864-024-09551-x.
  • Schoch, A.D., & Gal-Szabo, D. (2023). Advancing racial equity in early childhood through Infant and Early Childhood Mental Health Consultation. Child Trends. https://doi.org/10.56417/9248r9864l
  • Shivers, E. M., Farago, F., & Gal‐Szabo, D. E. (2022). The role of infant and early childhood mental health consultation in reducing racial and gender relational and discipline disparities between Black and white preschoolers. Psychology in the Schools, 59(10), 1965-1983. https://doi.org/10.1002/pits.22573
  • Silver, H. C., Davis Schoch, A. E., Loomis, A. M., Park, C. E., & Zinsser, K. M. (2023). Updating the evidence: A systematic review of a decade of Infant and Early Childhood Mental Health Consultation (IECMHC) research. Infant Mental Health Journal, 44(1), 5-26. https://doi.org/10.1002/imhj.22033
  • Trivedi, P. A., deMonsabert, J., & Horen, N. M. (2021). Infant and early childhood mental health consultation: Overview of research, best practices, and examples. SRI International. https://childcareta.acf.hhs.gov/sites/default/files/pdgb5_iecmhc_rtpbrief_acc.pdf