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Primary Project

Program Description

Primary Project (formerly the Primary Mental Health Project) is a school-based prevention and intervention program designed to enhance learning, build social skills, and address school adjustment through the early detection of social, emotional, or behavioral difficulties exhibited by children in pre–K through third grade.

Primary Project is intended for children who exhibit mild-to-moderate difficulties (e.g., withdrawal, mild acting out, and learning difficulties). It is not intended for children with more severe symptoms. The core components of Primary Project programs are their 1) focus on young children (preschool – third grade); 2) early, systematic screening of all children and selection for appropriate services; 3) use of paraprofessionals to provide direct services; 4) use of school-based, mental health professionals to provide clinical supervision; 5) ongoing program evaluation; and 6) integration into the school continuum of care and support for students.

First, children are screened using systematic procedures, behavior-rating scales, and direct observations. Children determined to be at risk for school adjustment problems are referred to sessions with a trained paraprofessional, or child associate. Weekly sessions take place in a designated playroom in the school, over 12-15 weeks for 30-40 minutes.  Child associates use developmentally appropriate child-led play techniques to help students express their feelings, build confidence, and develop social skills.

For children in pre–K, the sessions progress through multiple stages. First, children are observed once or twice in the classroom by the child associate. Next, the children participate in 12 to 16, 20-30-minute individual play sessions. Students then move into play pairs or small groups of three children, for between four to six play sessions. Finally, children prepare for the end of the program with support from the child associate during classroom sessions.

Program Snapshot
Evidence Ratings
Internalizing Problems
Social Competence
Disruptive Behavior Disorders and Symptoms
Cognitive Functioning
Attention Disorders and Symptoms
Program Contact
Children’s Institute, University of Rochester


Dissemination/Implementation Contact
Lynn Smith, LMSW


Program Type
Mental health promotion


0-5 (Early childhood)
6-12 (Childhood)

Geographic Locations
Rural and/or frontier

School / Classroom

Black or African American
Hispanic or Latino

Implementation materials available
Dissemination materials available