UMMS Affiliation

Department of Family Medicine and Community Health; Department of Psychiatry

Publication Date


Document Type



Interpersonal Relations; Child Behavior; Social Behavior; Child, Preschool; Child Day Care Centers


Education | Mental and Social Health | Psychiatric and Mental Health | Psychiatry and Psychology


The Together for Kids (TFK) project, now beginning its third implementation year, grew out of two years of work of over 30 childcare, health care, child welfare and social service agencies concerned about early childhood mental health issues. These concerned constituents, like others across the country, were responding to an increase in the incidence of young children exhibiting challenging behaviors that were resulting in disrupted early childhood classrooms and children being expelled from programs (Grannan et al, 1999; Swanson, 2001). Locally, there was also a concern about the growing number of public school special education students with diagnoses of emotional impairment/behaviorally disordered in the early grades.

The importance of addressing the needs of these children at an early stage has been emphasized by a broad array of mental health and childcare professionals. Without appropriate services, these children end up with impaired ability to interact appropriately with family and peers; create family stress; become stigmatized as problem children; fail to develop school readiness skills and behaviors; cause disruptions to other children’s learning, socialization and safety; and contribute to burn out and turnover of preschool teachers (Grannan et al 1999; Shonkoff & Phillips, 2000).

The TFK Coalition collected information from the research literature and from local day care centers about the extent of children at risk in the Worcester area. They found that 3.1% of children in four local day care centers, enrolling over 300 preschool children, were so disruptive they were expelled or would have been if the parents did not voluntarily withdraw them, with an additional 14% identified as at risk of expulsion. Based on this information, the TFK Coalition developed an intervention model that focused specifically on challenging behaviors of preschool children (ages 3 and up) enrolled in childcare centers. The first year of the project was used as a Pilot year to implement the mental health consultation model in two preschool in Worcester and a Head Start Program in South County. Results of the evaluation of this Pilot phase were encouraging and supported the initiation of an implementation phase in Year Two. This implementation phase involved providing the mental health consultation model in two additional centers that served as comparison centers during the Pilot phase. These two sites were brought on as New Intervention Sites in January 2004.

This report focuses on the evaluation of the implementation phase, including the original Pilot Sites, the South County Sites and the two New Intervention Sites, as well as summarizing the findings from both of the years of intervention.


Hennigan, L., Upshur, C. & Wenz-Gross, M. (December, 2004). “Second year report: Together for Kids, a project of Community Healthlink, Inc.” Worcester: Health Foundation of Central Massachusetts. Link to report on HFCM website

Journal/Book/Conference Title

Health Foundation of Central Massachusetts