(see Poster Gallery) Examining Growth in Trauma-Informed Attitudes across Interdisciplinary Early Childhood Providers Using Piecewise Multilevel Modeling: Outcomes from a Trauma-Informed Training

Background: Addressing the constellation of risks associated with early childhood adversity requires professionals from a range of systems, including health, early intervention, and education systems. Yet often there remain gaps in knowledge or responses to early childhood trauma and mental health needs among professionals serving young children. It is not clear whether trauma-informed trainings are associated with increases in trauma-informed knowledge and confidence across early childhood professionals.

The Child Adult Relationship Enhancement (CARE) training was adapted from Parent-Child Intervention Therapy as a way to support skill development for non-clinical professionals and caregivers that interact with a specific child. The current study examines the extent to which a half-day CARE training supports enhanced awareness and confidence among providers serving trauma-impacted young children and families. Specifically, we examined whether CARE training was associated with significant increases in trauma-informed (TI) attitudes from pre-training to a 2-month follow-up.

Methods: Providers (n=106) were recruited to take part in the training and study from a range of settings in a Mountain West state, and included 27.4% child care workers, 25.5% early childhood educators, 19.8% early intervention professionals, 8.5% mental health professionals, and 18.8% other professionals, including medical professionals. Trainings were conducted in pairs by licensed mental health professionals in summer and fall of 2021. Participants completed surveys of TI attitudes at three points: baseline (pre-training), 2-weeks post-training (post-training) and 2-months follow-up (follow-up). Growth modeling analyses were run in HLM software to chart participant within person change in trauma-informed outcomes over time. Model fit testing provided support for piecewise growth modeling, which models the training period (pre-training to post-training) and follow-up period (post-training to 2-month follow-up) as distinct processes of change, over linear growth modeling, which models a single process of change from baseline to 2-month follow-up.

Results:

The results indicate a similar pattern of change for total TI attitudes, and four out of the 5 TI attitude subscales, with significant changes from baseline to 2-week post-training scores and no significant difference in scores from post-training to the 2-month follow-up. For example, there were significance increase in total TI attitudes from baseline to post-training (coefficient.= .25, p < .001) and no differences in total TI attitudes from post-training to the 2-month follow-up (coefficient = -.02, p = .243). Variance components indicate significant within-person differences in rates of change in TI attitudes on baseline TI outcome scores and rates of change for the majority of TI subscales and overall TI scores.

Conclusions:

The findings of this study suggest that a brief (half day) training can have lasting effects on aspects of early childhood providers’ TI attitudes, particularly related to knowledge of trauma and responses to trauma. Future research should examine the extent to which shared trauma-informed language and knowledge as a result of a training can improve cross-provider collaboration in state-wide early childhood systems. Social workers are often positioned in interdisciplinary settings and are uniquely poised to provide trauma-informed trainings and facilitate such interprofessional connection and collaboration.