Why Teachers Should Care about Flint

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Maybe you’re not so interested in lead exposure in children.

I have to admit I wasn’t, even though I’d known for a long time that it’s an important risk factor for challenging behavior. We’d written about it in Challenging Behavior in Young Children, but somehow it seemed less sexy to me than other risk factors like temperament or media violence.

But now that I’ve actually spent some time learning about what happened in Flint, I’ve become obsessed.

I notice all the tiny places where the paint is chipped or peeling in my house, which was built long before lead paint was banned.

I remember how we lived in this house with our 4-year-old daughter while our painter meticulously sanded each wall, creating clouds of dust that were certainly heavily contaminated with lead.

I recollect that the city only recently replaced the old lead water line connecting us to the central water supply.

I can picture my children and grandchildren playing with our wonderful old Fisher Price toys whose colorful plastic—unbeknownst to us—was filled with lead.

Fortunately, my family is all right. But a great many other people aren’t as lucky, so I think you should know the story of lead and how it affects us all.

 The story of lead

Once upon a time—when cars ran on leaded gasoline, buildings were covered with lead-based paint, and water came into our homes, schools, and work places through lead pipes—the air and water were filled with lead. But about 40 years ago, people began to understand that lead wasn’t very good for our health, and governments passed some laws to remedy the situation.

In 1975, we started phasing out leaded gasoline, and in 1978, we banned lead-based paint. By 2006, the average level of lead in children’s blood had fallen dramatically.

Since we thought we’d solved the lead problem, our political will—and funding—for getting rid of lead evaporated. In 2012, the Centers for Disease Control and Prevention (CDC) saw its budget for the prevention of lead poisoning chopped from $30 million to $2 million.

We were wrong        

But it turns out we were wrong. The lead from our years of using leaded gas is still resting comfortably in our soil, especially in the inner cities. Old lead paint remains on the walls and woodwork of 24 million apartments and houses where 4 million children live. And as schools in Newark, Camden, Ithaca, Baltimore, Los Angeles, Washington, DC, and too many other cities have found, lead is often still in our plumbing.

In the meantime the World Health Organization (WHO) has determined that no level of lead is really safe, especially for children 5 years and younger. As they play, they’re much more likely to mouth or swallow its miniscule particles in dust, and their rapidly developing brains and bodies absorb a far greater percentage of it than adults’ do.

Children of color and children living in poverty are particularly vulnerable because they’re apt to live in older lead-filled neighborhoods in buildings in poor condition, and they may not be able to access or afford the nutritious food—high in calcium, iron, and vitamin C—that can slow down lead absorption. Even upper- and middle-class children whose families are renovating an older dwelling may be at risk.

What does lead do?

What does lead do when it enters the body? First of all, it affects the brain by damaging the developing prefrontal cortex—the thinking, planning, decision-making part of the brain—along with the white matter that enables cells in the brain and nervous system to communicate effectively.

As a result, children exposed to lead may lose several IQ points and suffer from impaired executive function (that is, they may have trouble with emotional regulation, impulse control, verbal reasoning, and mental flexibility). They are also at increased risk for learning disabilities, ADHD, aggressive behavior, and arrests for violent crime in adulthood.

Lead exposure also hurts school achievement, including readiness for kindergarten and reading. A large study in Chicago found that 75 percent of third graders had such poisonously high blood lead levels that they were likely to fail grade 3 and score badly on standardized tests—enough to make a difference between passing and failing. Not surprisingly, the greatest impact was on non-Hispanic African Americans, followed by Hispanics.

Lead can also affect the rest of the body—the cardiovascular, immune, hormone, and gastrointestinal systems—and is linked to anemia, hypertension, and kidney problems.

In case you were wondering, these effects are irreversible.

We could actually prevent future generations from being poisoned by lead if only we had the desire and the money. The amounts involved are gigantic, but so are the returns. One study estimated that for every dollar spent we’d gain $221 by increasing productivity and tax revenues and reducing spending on health care, special education, and crime. We might even close the achievement gap.

What can we do?

Mona Hanna-Attisha, the pediatrician who first alerted the government to the high lead levels in Flint’s children, has called for funding for evidence-based interventions such as mother-infant support, literacy programs, universal preschool, school health services, nutrition programs, primary medical care, and mental health care.

These programs are vital, but ordinary teachers and administrators can also help to protect children from lead’s poisonous effects. You can:

  • Ask your administration to test the school’s water. If your school or daycare center was built before 1986, find out if filters have been installed on every water fountain and faucet and if those fountains and taps are flushed every day. They should run for 30 seconds to 2 minutes. (Collect the water and give it to your plants.) Alert families to the dangers of lead and encourage them to test, filter, and flush their faucets at home.
  • Use only cold water for drinking, cooking, and preparing formula.
  • Suggest that parents have their children’s blood lead level tested, or arrange to have testing at school, as the city of Newark has just done. Testing is mandatory in some states, including New York, Massachusetts, and Rhode Island, and Medicaid requires testing for children at 1 and 2 years. But children in old low-income neighborhoods should be tested later as well. Those with high lead levels may be eligible for early intervention and special education services under the “Other Health Impairment” category of IDEA.
  • Provide meals and snacks that are rich in calcium, iron, and vitamin C. Avoid fatty foods, which aid absorption.
  • Be sure that children wash their hands and faces often, and wash toys regularly, especially outdoor toys.
  • To reduce lead-filled dust, have everyone take off their shoes before entering classrooms. Regularly wet-mop floors and entrances, and wet-wipe windows, taking extra care with sills and wells. Thoroughly clean mops and sponges.
  • Don’t let children play in bare soil. Instead plant grass or cover the ground with grass seed, mulch, sod, or wood chips.

Flint did one thing that’s positive: It put the problem of lead exposure front and center. Let’s keep it that way. —Judy Sklar Rasminsky


Social and Emotional Learning: A Great Investment

International Year of the Child (IYC) - 1979

United Nations International Year of the Child

 

If you know anything about the value of high-quality early childhood education, you know that the Perry Preschool Project provided a very substantial return on the money invested in it.

To be exact, society had reaped $7 in benefits for every dollar spent by the time the 3- and 4-year-olds enrolled in the program reached the age of 27. More of them had graduated from high school, and they earned more money, owned more homes and cars, and had fewer arrests than their peers who’d acted as controls. (When they turned 40, the gains had climbed to $16 per dollar invested.)

Big payback for SEL

Columbia University researchers have just discovered another big winner. Their cost-benefit analysis of six social and emotional learning programs, The Economic Value of Social and Emotional Learning, shows that SEL delivers $11 in benefits for every dollar invested.

Although the programs they studied (Second Step, Responsive Classroom, 4Rs, Positive Action, Life Skills Training, and Social and Emotional Training) have different goals and approaches and target children of different ages and levels of risk, all of them bring benefits that greatly exceed their price tag. The children in these programs experienced significant:

  • Reductions in aggression, violence, substance abuse, and delinquency
  • Declines in depression and anxiety
  • Increases in grades, attendance, and performance on core academic subjects

213 studies can’t be wrong

A recent meta-analysis of 213 universal school-based SEL programs documented the same extraordinary results, but without examining costs. These interventions:

  • Enhanced social and emotional skills like recognizing emotions, empathy, managing stress, problem-solving, and decision-making
  • Promoted positive attitudes and social behaviors
  • Decreased behavior problems and emotional distress
  • Improved academic performance

The researchers found that SEL programs help all children, and regular classroom teachers can teach them, but this shouldn’t be an ad hoc affair. The most effective learning takes place when teachers use evidence-based programs and implement them faithfully.

An effective program includes four practices known by the acronym SAFE:

  • Sequenced—a step-by-step training approach
  • Active—active forms of learning like role-play and rehearsal
  • Focus—time spent on developing personal or social skills
  • Explicit—learning goals directed at specific social and emotional skills, rather than general ones

Head Start agrees

With such remarkable outcomes, it’s no wonder that Head Start is considering introducing SEL programs on a large scale. After testing PATHS, the Incredible Years, and a one-year version of Tools of the Mind, they found there are different ways to boost children’s social and emotional development, provided they’re evidence-based and include high-quality teacher training and coaching.

Challenging behavior and SEL

Children with challenging behavior may have trouble in the social and emotional realm. Because they’re frequently rejected by their classmates, they have few opportunities to learn and practice social and emotional skills. In fact, they may hang out with others like themselves, reinforcing their antisocial tendencies.

When you proactively teach SEL to the whole class, no one is singled out or stigmatized, and everyone learns the same concepts and vocabulary, making the skills easier to model, practice, use, and reinforce, and you can integrate them into the curriculum and everyday activities.

Clearly, social and emotional skills can be taught, and they’re worth every penny.

Here are some guides to SEL programs:

What do you think?

A nationally representative survey showed that most teachers believe social and emotional learning is important. What do you think? Are you using a social and emotional learning program in your classroom? Does it help you address behavior problems? We’d love to know your views.


“Children with Challenging Behavior” Is Back

Photo by Ryan Tauss

Photo by Ryan Tauss

We’re back! We’ve been away far too long, working on other projects. Barbara has been traveling, giving keynotes and workshops in New York City, Rhode Island, Connecticut, Dallas, Pennsylvania, New Brunswick, and—lucky Barbara—in Auckland, New Zealand. Where is she going next? Check out her upcoming gigs here.

Barbara also presented a webinar called “Out of Control Children: A Team Approach for Early Educators and Families” for Early Childhood Investigations. If you weren’t one of the more than 4000 people who signed up, you can access the webinar here.

Miss Night’s marvelous musings

Now that we’re blogging again, we’ll share some of the exciting new research and strategies we discovered while we were writing.

First of all, we want to alert you to two powerful blog posts published this winter. You may have seen at least one of them because it went viral, so far receiving more than 2 million views, 1000 comments, 100 requests to share it in school and agency newsletters, and 6 translations. The author is Amy Murray, better known as Miss Night, who in real life is the director of early childhood education at the Calgary French & International School in Calgary, Alberta, Canada.

Her post, “Dear Parent: About THAT kid…,” appeared on November 10, 2014. It begins:

“Dear Parent:

“I know. You’re worried. Every day, your child comes home with a story about THAT kid. The one who is always hitting shoving pinching scratching maybe even biting other children. The one who always has to hold my hand in the hallway. The one who has a special spot at the carpet, and sometimes sits on a chair rather than the floor. The one who had to leave the block centre because blocks are not for throwing. The one who climbed over the playground fence right exactly as I was telling her to stop. The one who poured his neighbour’s milk onto the floor in a fit of anger. On purpose. While I was watching. And then, when I asked him to clean it up, emptied the ENTIRE paper towel dispenser. On purpose. While I was watching. The one who dropped the REAL ACTUAL F-word in gym class.”

To read the rest, click here:

Inspired by Miss Night

The second powerful post comes from a parent—one who identified herself as “that” parent. Using her own experience in British Columbia as a springboard, Karen Copeland created a blog and founded a group called Champions for Community Mental Wellness, whose mission is to educate others about the challenges faced by the families of children with mental health problems.

On November 15, 2014, Copeland posted her reaction to Miss Night’s blog, calling it “I Am ‘that’ parent.” It begins:

Dear professionals: You know me, I am the one who asks questions. The one who seems like she is always asking for information. The one who makes suggestions on the IEP, or seems to go on and on and on about the concerns she has about her son. The one who will turn a 15 minute scheduled meeting into 45 minutes. The one who does not hesitate to let you know when things are not going well for her child. The one who can get emotional and (unintentionally) make everyone feel yucky. The one who requests documentation and wants to look at her child’s file. The one who says she wants goals to be more specific. The one who just doesn’t seem to go away and leave you alone to do your job. The one who keeps her own file.”

To see more, click here.

What do you think of these posts? Do they resonate with you? What have you learned from them? Have parents ever asked you questions like these? How do you reply? What would you like to say?


When Is It Bullying?

girl crying

Photo by D. Sharon Pruitt

Note: This is the second in a series on bullying.  

These days most of us think we know all about bullying. But the truth is that almost any attempt to define it stirs up mass confusion and controversy.

The 49 states with anti-bullying legislation have created at least 10 different definitions. The academics define bullying as a stronger person deliberately and repeatedly harming a weaker person. And for kids and many adults, bullying is simply mean behavior.

What’s in a Name?

So does a definition matter? Well, it matters for researchers because they can’t measure bullying and figure out how to stop it if they don’t know what they’re counting.

And it matters for teachers because they can’t intervene appropriately if they don’t recognize bullying when they see it.

At this point you may ask, shouldn’t I intervene whenever I see a mean or harmful act, whether it’s bullying or not? The answer is a resounding YES! However, if you’re really dealing with bullying, an intervention for ordinary aggression—physical or relational, direct or indirect—probably won’t work in the long run, even if it stops the bullying at that moment.

Although aggression and bullying are closely related, the academic definition points to differences that make bullying a serious form of abuse. All of those involved—the child who bullies, the target of the bullying, and even the bystanders, who may experience anxiety, fear, guilt, depression, and trauma—suffer long-lasting effects.

Children who are targeted can’t shake off the bullying because it happens again and again. They can’t avoid or escape it because their aggressors are bigger, stronger, smarter, more popular, or more influential with their peers. Children who bully aren’t just angry or after someone’s lunch money. Their behavior is intentional—they know exactly what they’re doing—and their goal is to show their power by hurting and tormenting their targets, chosen because they are weak, different, or lack social status. Over time, targets become more and more frightened and isolated and less and less able to defend themselves.

What Does Bullying Look Like?

Aggression takes place in the open—the aggressor will knock over whomever gets in the way of something he wants, even if a teacher is standing right there. But bullying usually goes on behind teachers’ backs in unstructured settings such as bathrooms, corridors, and schoolyards, and children don’t often report it. As a result, you probably won’t know about it, and it may be difficult to identify. Besides, it doesn’t always look the way you expect it to.

Other factors can also affect your reaction to bullying:

  • Your own childhood encounters with bullying may influence your attitudes and responses
  • Children who are targeted may be as unappealing to you as they are to the children who bully them
  • If you don’t know what to do, you may be tempted to excuse the behavior or turn away

The experts list these signs to look out for when you suspect a child is being targeted. He or she:

  • Takes little interest in school activities and grades
  • Feels anxious
  • Has low self-esteem or feelings of helplessness
  • Suffers from frequent headaches or stomachaches
  • Loses things, needs money, or is hungry
  • Has injuries or damaged clothing, books, etc.
  • Seems unhappy and isolated
  • Suddenly loses friends or avoids social situations

When Does Teasing Become Bullying?

It is especially challenging to find the blurry line where teasing leaves off and bullying begins. Children know they’ve crossed it “when a joke isn’t funny any more,” but in practice they may be as confused as you are.

Teasing between friends is fun and affectionate, helps to resolve conflict, and enforces social norms. But when it exhibits the qualities of bullying—a power imbalance, an intention to harm, and repetition—it is indeed bullying.

The child being teased provides one clue to the distinction. If he or she doesn’t laugh or smile and is repeatedly hurt or upset, the teaser has probably crossed the line. Boys may not show their hurt feelings, so if you’re in doubt ask them privately how they feel. But because they might try to save face and not answer honestly, it is probably a good idea to talk to with the teasing child anyway.

The subject matter offers another clue. If the teasing is about a child’s appearance, the intention is almost certainly hostile. And if the teaser uses an aggressive or nasty tone, that’s probably bullying as well, and it’s time to intervene.

In fact, if you suspect any kind of bullying, even if you don’t see it yourself, it’s important to step in at once. Listen to—and believe—every child who reports it, and pay attention to your instincts. It’s better to overreact than to underreact. If children are ever going to ask for your help, they need to trust you, believe that you trust them, and have confidence that you’ll act.

In our next post we’ll discuss the children who bully, the targets of bullying, and why bystanders find it so hard to intervene. Later in this series we’ll cover what adults need to do.

In the meantime let us know what you think. Have you found it hard to identify bullying? How do you tell the difference between teasing and bullying? Have you been aware of how your own past experience and attitudes influence your response?


Anxiety: A Signal of Challenging Behavior

Challenging and aggressive behavior often seems to come out of nowhere, but the truth is that if you look carefully you can see it on the horizon–in the guise of anxiety.

Anxiety in a child is a kind of early warning system that something is amiss, whether it’s the result of being left out of a group, stress at home, exposure to violence, even autistic spectrum disorder.

It’s hard to notice in a busy classroom because it’s internal; it doesn’t usually show much, and it doesn’t affect anyone but the child himself. But anxiety interferes with a child’s ability to learn and interact with his peers, and it can easily escalate to agitation and aggression if it isn’t addressed. We will certainly notice it then.

Become Sherlock Holmes

To see anxiety, you have to become a detective. To begin with, you must build a close relationship with every child and get to know all the children well–their temperaments, developmental levels, play skills, families, and cultures; what frustrates and frightens them; what makes them happy, mad, or sad.

You also have to learn to read the subtle physiological and behavioral clues the children display as they try to cope with their anxiety. For example:

  • Physiology. Tears, frequent urination, clenched teeth, blushing, pallor, rigidity, rapid breathing, sweating, fidgeting, vomiting, squeaky voice
  • Behavior. Downcast eyes, withdrawing, hair twirling, thumb-sucking, sucking hair or clothes, biting fingernails, hoarding, clinging, whining, being noisy or quiet, screaming, masturbating, smirking, giggling, crying

Figuring out what the child is thinking and feeling will help, too.

  • Thoughts. No one loves me; no one wants me; I’m no good; I don’t like it here; I don’t have any friends; no one will come to get me; I can’t do it; I’m bad; I want my mommy
  • Feelings. Distressed, troubled, afraid, nervous, excited, expectant, sad, irritable, grouchy, mad, insecure, frustrated, worried, confused, panicky

Reach Out

When a child’s characteristic clues appear, it’s time to connect–to smile, to sit nearby, to offer your help, to ask open-ended questions.

Pay special attention to your body language, facial expression, and tone of voice, which all convey far more than your words. You’ll want to do whatever works for a particular child.

This tiny intervention delivered at just the right moment will save you tons of time and trouble later, and protect the child from learning that challenging behavior is the best way to solve problems.

PS. Many of these ideas come from the WEVAS program created by Neil Butchard and Robert Spencler. For more information go to www.wevas.net


Fighting Violence with Early Childhood Education

This summer two horrific mass shootings shocked the country.

The first, in July, took place at the midnight opening of “The Dark Knight Rises”  in Aurora, CO, just down the road from Littleton, a town that’s still reeling from the Columbine massacre. The shooter, James Holmes, killed 12 and wounded 58.

The second attack, by an unrelated assailant, Wade M. Page, occurred in August at the Sikh Temple of Wisconsin, near Milwaukee. Six died and three were injured.

This fall, two school shooters joined this nefarious company. A 15-year-old was charged with assault and attempted murder in Perry Hall, MD; and a 14-year-old shot into the ceiling of a packed classroom in Normal, IL. Thankfully, no one was hurt.

Child with American flag and gun inTexas

A child with an American flag and a gun in Texas in the 1920s. Photo by Harry Walker, courtesy of Special Collections, University of Houston Libraries. UH Digital Library

Risk Factors

We know very little about these shooters, and we certainly don’t know what caused these attacks. But we do know some of the factors that increase the risk of violent and aggressive behavior, and we also know that risk factors are cumulative—one plus one equals more than two. They can easily become overwhelming.

In young children, these risks work to produce challenging behavior, and when that behavior continues into kindergarten and beyond it becomes harder and harder to change.

Children with behavior problems are frequently rejected by their peers, and as a result they’re deprived of opportunities to develop and practice the social and emotional skills they need for self-esteem and success.

Their behavior also creates problems in school, where teachers all too often make the situation worse by teaching them less and punishing them more.

No wonder children with challenging behavior develop into teens who drop out of school and turn to delinquency, gangs, drugs, and mental illness. As adults they’re more likely to commit violent crimes.

White Power

Even knowing nothing about his childhood, we can guess about how risk factors led one of these shooters down a dangerous path. The Milwaukee gunman was immersed in the neo-Nazi culture of racial hatred and its white-power music, “hatecore.” The songs he played on his guitar and bass were intended to incite violence and strengthen commitment to his cause.

To heighten the risk, he—and all of the other assailants, including the teens—had ready access to guns.

A Different Life?

But maybe once upon a time they were young children with challenging behavior. If they’d had strong relationships with their teachers and effective teaching, they might have turned out differently.

The police are lobbying for high quality early childhood education because research shows that it prevents crime.

What do you think? What causes violent behavior? Is it guns? Violent media? Poverty? Genes? And what can we do about it? Can high quality early childhood education prevent crime and violence?


Six Tips for Preventing Challenging Behavior

Maybe it’s one of your nightmares about the beginning of the school year: There’s a child with challenging behavior in your class, and you don’t know what to do.

Like many teachers, you probably had very little training in this subject. But believe it or not, you can help this child to behave appropriately and at the same time create a classroom that’s pleasant, relaxed, and conducive to learning.

Prevention is the best intervention. Here are some tips on how to do it.

1. Know the children well. If a child with challenging behavior can’t function, she may distract or frighten the other children, destroy their work, even hurt them. She will monopolize your time, deplete your resources, and keep you from teaching. But when the environment meets her physical, cognitive, emotional, and social needs, she feels capable of success and needs challenging behavior less.

By anticipating when she’ll have trouble, preventing the situation from occurring, and reminding her of what to do instead of waiting for her to make a mistake, you can construct a new pattern: She will feel good about herself and yearn to have that feeling again.

You may have to change your teaching style to meet her needs, but you will have more to give to all the children.

2. Make your classroom a community. The social context of the classroom has an enormous impact on the way children behave. Although you can’t see or touch it, the social context—which grows out of our words, actions, and body language—is everywhere, telling us what attitudes and behaviors are expected, accepted, and valued.

While young children are learning self-control, they rely on the external environment to help them. Teachers can support them by developing caring, responsive relationships and surrounding them with a positive, prosocial, predictable social context.

When children participate in structured cooperative activities or work together toward a common goal, they have a better chance to feel included. Class meetings; music, dance, and drama activities; cooking, murals, noncompetitive games, large construction projects; and reading aloud to the whole group every day foster unity, shared interests, prosocial behavior, and cooperative social interaction.

3. Watch your (body) language.  Remember that you’re always a role model. When you smile and show your affection and enthusiasm, the children notice, and you set a positive tone for the whole class.

Eliminate no, don’t, and stop from your vocabulary. “Stop running!” opens the door for trouble: Should they hop, skip, jump? Instead use positive, direct language that tells them what to do. “Please walk in the hallway,” stated clearly, calmly, and respectfully, informs them of the expected behavior.

Avoid why, too. Andrew may not know why he spit, and if you ask, he’s likely to fabricate a reason. He may even believe that an explanation will make the behavior acceptable. But unacceptable behavior is always unacceptable, and why puts some children on the defensive, making it harder for them to regain control.

Saying “please” and “thank you,” expressing your feelings, being sensitive to others’ feelings, and offering and accepting help all show that you respect and value the children—and demonstrate how they can respect and value each other.

4. Help the children create rules, which teach expectations and set boundaries for behavior. Three to 5 are enough—it’s easier to remember them when there aren’t too many. They should be clear, explicit, stated in the positive, general enough to cover almost any situation, and important enough so that there will be no exceptions.

Begin with the primary need of everyone in the room—to be safe. Children and teachers have proposed:

  • Respect yourself / Take care of yourself / Be safe
  • Respect others / Take care of others / Be kind
  • Respect the environment / Take care of the environment / Be gentle

The children will understand, respect, and follow the rules more readily if they create them themselves, with your support and guidance. Explain that rules enable people to treat one another fairly, kindly, and respectfully. This is a difficult concept, so work on it over time, including lots of examples and discussion so that the children come to a common understanding of what the rules mean. For instance, “respect others” may mean “listen when other people are talking” and “use an inside voice in the hallway.”

Post the rules with illustrations by the children and give each child a copy to take home. Throughout the year, use natural opportunities and activities to reinforce them. Children tend to forget, and practice helps them to remember.

5. Provide choice. When children can make their own decisions, they don’t need inappropriate ways to seek power and independence. Give them opportunities to succeed and to feel comfortable trying, and supervise closely so that you can reduce or add choices or teach new skills as circumstances require.

Even when you have a great circle or meeting time with lots of variety—sitting, standing, jumping, singing—give the children the choice to leave and return so that they don’t learn to rely on inappropriate behavior to meet their needs. Be sure to create a procedure for leaving and returning.

6. Teach social and emotional skills proactively and on a regular basis. They help children to make friends, regulate their emotions, gain self-esteem, resolve conflicts, and perform better at school.

Adults model, teach, and reinforce social and emotional skills, but because children imitate those most like themselves, they increasingly learn these skills through interaction with their peers.

Children with challenging behavior have great difficulty in the social and emotional realm. Often rejected by their classmates, they have few chances to learn and practice these skills, so it’s a good idea to teach social and emotional skills to the whole group. All of the children benefit; no one is singled out or stigmatized; and everyone learns the same concepts and vocabulary, making the skills easier to model and use.

Reinforce them in real-life interactions by staying closely attuned and coaching, prompting, and cueing to ensure children get the desired results.