What could they do about Tommy? The 4-year-old was the terror of the preschool class where his mother dropped him off each morning. At unexpected times he would erupt into temper tantrums, strike other children and disrupt the class with his uncontrollable behavior. His teacher had 10 other children to watch, often without help, and Tommy (not his real name) was in danger of being expelled. His mother, a single working parent, felt lucky to have found the subsidized preschool, and had no backup plan if Tommy lost his place.

Time to call Nanny 911? No, San Francisco has something better Parents Place, an agency founded in 1981 that offers free or affordable help to parents with almost any kind of problem involving their children. For Tommy's case, the solution came from the Early Childhood Mental Health Program (ECMH), a division of Parents Place that sends consultants to child care centers and preschools that serve low-income families.

A consultant trained in child behavior was dispatched to Tommy's preschool, where she observed him throughout the day, met with his teacher and got to know his mother. Unlike the Fox TV show with its quick-fix approach, the process took several months. But in the end, Tommy became manageable and was allowed to stay.

"Our consultant, through her observations, noticed that most of this behavior was happening between the structured time going into unstructured time from story time to outside, or from an activity that was very teacher-directed to free play," recalls Laurel Kloomok, the ECMH director. "The classroom for 3-year-olds had a lot more structure. He was used to having more planned activity. ... What the mother told the consultant what she hadn't told the school was that her husband had left. It was very disruptive, lots of anger and fighting as they were splitting up. ... It wasn't very predictable about where the boy was going after school, and there were questions about where his father was; there was lots of fear and grieving."

Working as a team, the three adults developed a plan to deal with the triggers that affected Tommy's behavior. "The mom was going to tell her son and the teacher every day what was going to happen after school," says Kloomok. "And the teacher did this with the whole class. ... Before every change of activity, she would engage this little 4-year-old as her helper. It took a while and he still had some trouble with transition, but he came to rely on his teacher for that kind of support, and everybody in the class benefited from being a little more structured."

Kloomok, a tall, slender, former New Yorker who radiates calmness, says the solution "wouldn't have happened on its own because there wasn't set-aside time to concentrate on an individual child."

Parents Place is a division of Jewish Family and Children's Services of San Francisco, Marin and Sonoma counties and the Peninsula. The ECMH, geared for children age 2 to 6, sends consultants each week to about 24 centers in The City and a total of 65 in the Bay Area. "We always work first with the directors to find out what they want," says Kloomok. "We explain our services in detail. If the director wants to go forward with us because it's voluntary - we come out and we talk to the staff, and then we engage the director and the teacher to identify where we can start. It's free for them: it's all funded. ... Very few places say they don't need our help."

The money comes from a variety of public and private sources. With its practical, hands-on approach, the program has grown rapidly since it began in 1996. "Our work is not about the curriculum or the academics, it's about supporting the social and emotional health of young children," she emphasizes.

She deplores the recent trend to try to teach children to read before they enter kindergarten. She attributes it the Bush administration's "No Child Left Behind" plan and pressure from parents who have "high expectations about getting into the right college and the right high school and the right kindergarten, and to do that, you have to have good grades. It's an upward mobility shift."

Instead of teaching reading and math, she says, preschools should concentrate on "helping young children and their families with promoting their social and emotional well-being, because it's the foundation of all later success getting along with each other, getting along with adults, developing relationships with a variety of people, resolving conflicts, learning to share, learning to focus, exploring interests."

On the other extreme, some child centers use television as a pacifier. "I don't think there's any room for television in preschool or child care," says Kloomok. "I don't want to blame preschools or preschool teachers because they're challenged: they're on the bottom of the salary ladder, their job is very difficult in that they're often undereducated and don't have any real support, supervision or mentoring. We want to raise the overall quality of the child care center ... and to intervene early with children who are at risk."

For those rare times when a child is expelled, Parents Place doesn't abandon the case, but works with the family to find another placement. The child might need therapy, special education or a small, highly structured environment.

Grownups Acting Like Kids

Sometimes, says Kloomok, the problem isn't the children. "A director might be concerned about a classroom where all the teachers are fighting, and there's such conflict that they're not paying any attention to the kids." One such case involved a center in which an African-American woman and a Filipina were placed in the same class.

"They had a food fight once in front of all the kids, they were so mad at each other. The director (a Latina from Guatemala) didn't know how to intervene: she was horrified. Individually they were good teachers, they had been at the center a while, but hadn't worked together that much."

Many centers would have chosen the easy way out by moving one of the teachers to another classroom. "But that has ramifications, because some of the children are attached to those teachers," points out Kloomok. The consultant assigned to the case quickly pinpointed the problem: the teachers at the center never had meetings. So the consultant arranged for the embattled pair to meet with her once a week, sometimes including the center's director.

"Over a period of time we geared a lot of the conversation to their culture, and their parenting techniques and their teaching techniques. We helped them develop a relationship that was based on understanding each other's culture and heritage and their hopes for the classroom," says Kloomok. "In each other's eyes they were only angry and frustrated. There was some conflict about discipline who was in charge of what child. ... We started planning around what is discipline, and having them identify their primary kids that were under their care. ... This way they developed more skill about working together as co-teachers. It was much deeper skill-building than just shifting them."

After three or four months, they became a good team in the classroom. Then all the teachers started having regular staff meetings once a month.

Other Programs

The Early Childhood Mental Health Program is but a small part of the Parent Place's activities. Headquartered at the corner of Scott and Sutter streets, Parents Place has spinoff sites in Palo Alto, San Rafael and Santa Rosa.

Based in an attractive, modern three-story building that resembles an oversized Cape Cod house, Parents Place has four rooms on the ground floor that are open to the public. The whimsically decorated, neatly kept play room is filled with blocks, toys and games. It is designed for children and parents to play together, as opposed to a drop-off center. The family room, lined with comfortable chairs and couches, has a one-way mirror looking into the play room so that children who have difficulty in socializing with others can be observed by their parents while the children interact with therapists.

A smaller room contains bulletin boards where nannies seeking work, and families looking for nannies, can leave notes for each other. Parents Place doesn't do specific referrals, but offers a class on "How to Find a Nanny." Another small room, the parenting resource library, has a collection of books and videos related to parenting. Parents may come and sit and read, or for $15 a year, borrow the materials to take home.

Parents Place has a wide range of classes and services, including therapists, play therapists, parent educators and referrals to other agencies. It provides private parent consultation on a sliding-scale fee, and doesn't turn anyone away, regardless of ability to pay.

"Parents always come to us if they don't know where to go," says Kloomok. "They can call here and make an appointment to assess their needs. They shouldn't hesitate to call us for anything, even if they think their question or concern is silly or outrageous. If it's about parenting, it's our job to help them."

Parents Place is located at 1710 Scott Street. Hours are Monday-Thursday 8:30 a.m.-6:30 p.m. and Friday 8:30-5. It is closed most Jewish and federal holidays. The phone number not listed in the San Francisco telephone directory is (415) 359-2454. For more information, visit the Web site at www.parentsplaceonline.org.