(PS4-B39) Outcomes of a Therapeutic Child Care Program

Adverse childhood experiences (ACE) refer to various adverse circumstances or events such as poverty, experiences of racism, and exposure to violence, abuse, and neglect. When experienced in childhood, those experiences can negatively affect developmental trajectories, increasing risk for physical and mental health problems throughout the lifespan (Felitti et al., 1998). The consequences of ACEs can manifest through behavioral issues in the early years of life, impairing children’s ability to participate successfully in social interactions such as attending a conventional childcare environment (Chu & Lieberman, 2010, Goodnight et al., 2012). Therapeutic Day Care (TCC) programs provide an environment in which the therapeutic interventions aimed at supporting child and family well-being are incorporated with an educational program (Kanine et al., 2015). TCC provides an opportunity for early intervention in children and families with exposure to ACEs in offering mental health support that addresses mental and behavioral issues resulting from ACEs while providing a safe, stable environment to prepare them for school entry. The present study investigated the effectiveness of a TCC program in reducing children’s internalizing and externalizing symptoms for children experiencing poverty who were enrolled in the program between 2018 and 2023. All participants’ (n = 239, M_age = 2.93) primary legal guardians fill out the Child Behavior Check List Ages 1 ½-5 (CBCL; Achenbach, 2009), an empirically based measure used to identify children's emotional and behavioral problems at intake and annually throughout the child’s participants in the program. To identify participants’ symptom changes, the current study examined CBCL T scores at three time points: intake, the first annual assessment (midpoint), and discharge. Multiple imputation was utilized to handle missing data (0% missing at intake, 70.28% missing at midpoint, 59.43% missing at discharge). At intake, mean T scores were in the clinically significant range for all CBCL subscales (T scores range = 62.52– 71.05) except for Somatization, which was in the at-risk range (T = 57.43). The highest mean T score among the sample was Aggressive Behavior  (T = 71.05). T tests were conducted to compare the mean T scores between intake, midpoint, and discharge. Results indicated a significant improvement in children's internalizing and externalizing symptoms between intake and discharge (t = 7.095, p < .001), and between the midpoint assessment and discharge from the program (t = 8.884, p < .001). There was not a significant difference in CBCL T scores between intake and the midpoint assessment. Results suggest children's externalizing and internalizing symptoms improve over the duration of their enrollment in TCC, supporting the effectiveness of the intervention..