An important goal of early childhood education is teaching emotional self-regulation within the context of a safe, stable, nurturing environment. Expulsion of young children ignores underlying emotional and behavioral concerns, disproportionately affects children of color (Black or Hispanic), males, children with disabilities, and socioeconomically disadvantaged populations, and has long-term consequences on educational and life success. Addressing implicit bias and providing child mental health consultation (psychologists, social workers, developmental behavioral pediatricians, child psychiatrists, and child neurologists) to child care providers can prevent expulsion. Pediatricians and other providers within the medical home play an important part in preventing expulsion. However, pediatricians need more training in early childhood mental health and in understanding how systemic racism and implicit bias lead to preschool expulsion in children of color. By identifying children at risk for expulsion because of poverty, racial discrimination, toxic stress, insecure attachment, or history of trauma, the pediatrician can connect families with community resources that may ameliorate these effects. Pediatricians can provide information on social-emotional development in early childhood, promote positive parent-child relationships, and model and discuss age-appropriate and developmentally appropriate behavior management. Pediatricians can also guide parents toward high-quality child care programs that use mental health consultation and developmentally appropriate activities, both of which lessen the chance of child expulsion. Furthermore, behavioral health providers integrated into the medical home can provide consultation to child care providers on managing patients. These recommendations are consistent with our knowledge of early child brain development and support the current tenets of the American Academy of Pediatrics regarding the pediatrician's role in building resilience and buffering toxic stress to promote optimal child development.

中文翻译：

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解决早期教育和儿童保育驱逐问题。

幼儿教育的一个重要目标是在安全、稳定、培育的环境中教授情绪自我调节。驱逐幼儿忽视了潜在的情感和行为问题，不成比例地影响有色人种儿童（黑人或西班牙裔）、男性、残疾儿童和社会经济弱势群体，并对教育和生活成功产生长期影响。解决隐性偏见并向儿童保育提供者提供儿童心理健康咨询（心理学家、社会工作者、发育行为儿科医生、儿童精神病学家和儿童神经学家）可以防止被开除。儿科医生和医疗之家内的其他提供者在防止驱逐方面发挥着重要作用。然而，儿科医生需要在儿童早期心理健康方面进行更多培训，并了解系统性种族主义和隐性偏见如何导致有色人种儿童被学前开除。通过识别因贫困、种族歧视、有毒压力、不安全依恋或创伤史而面临被驱逐风险的儿童，儿科医生可以将家庭与可能改善这些影响的社区资源联系起来。儿科医生可以提供有关幼儿期社会情感发展的信息，促进积极的亲子关系，并建模和讨论适合年龄和发育的行为管理。儿科医生还可以指导父母开展高质量的儿童保育计划，利用心理健康咨询和适合发育的活动，这两者都可以减少儿童被驱逐的机会。此外，融入医疗之家的行为健康提供者可以向儿童保育提供者提供有关管理患者的咨询。这些建议与我们对早期儿童大脑发育的了解一致，并支持美国儿科学会关于儿科医生在增强复原力和缓冲毒性压力以促进最佳儿童发育方面的作用的当前原则。