Surveys suggest that between 4.3% and 11.5% of children living in the United States have a serious emotional disturbance (SED). SED is defined in the Federal Register, and federal block grants are allocated to states based on the prevalence of SED. Accurate measurement of SED is critical, yet surveys have used different methodologies and instrumentation to obtain prevalence estimates. Two expert panels were convened by the Substance Abuse and Mental Health Services Administration (SAMHSA) in the fall of 2014 to discuss the current state of the field in operationalizing and measuring SED. The aims of this article are to (a) provide an update on SED prevalence rates from survey research, (b) summarize key discussion points that emerged during the SAMHSA expert panel meetings, and (c) make specific recommendations for next steps in measuring the prevalence of SED. Issues addressed in this article are important not only for federal allocation of service dollars to meet the needs of children with SED, but also for broader mental health surveillance efforts within the context of large national research surveys.
We report results of an exploratory validation study of the Student Risk Screening Scale–Internalizing and Externalizing (SRSS-IE) applied with the first sample of middle and high school students from nine middle and three high schools from three states. The Student Risk Screening Scale (SRSS) was modified to broaden the scope of this user-friendly systematic screening tool to detect secondary-age students with internalizing behavior patterns. Building on initial evidence establishing reliability and validity of the SRSS-IE at the middle school level, we used classical test theory to explore reliability of SRSS-IE spring screening scores for use with sixth- through 12th-grade students. Specifically, we analyzed item-level data, internal consistency estimates, and factor structure using exploratory factor analysis. Results suggested five of the seven proposed items be retained, yielding the SRSS-IE12. Peer rejection (one of the originally developed items by Drummond) loaded on the internalizing construct, providing preliminary evidence suggesting two factors: SRSS-E7 (the original tool) and SRSS-I6 for use with secondary students, with peer rejection loading on both subscales but only added once when formulating the total score (SRSS-IE12). We present limitations and direction for future inquiry.
Anxiety disorders are commonly occurring among children and are associated with increased risk for poor educational outcomes. However, little is known about the specific supports and accommodations provided to anxious children in schools. This study examines reports of school functioning and school-based supports and accommodations among a sample of 51 anxious youth and their mothers seeking treatment at an outpatient clinic. Children and their mothers reported significant anxiety-related impairment in school functioning, particularly for older children. Children identified as needing special education and related services (through Individualized Education Program [IEP] and 504 plans) more often received anxiety-related supports and accommodations at school than their peers who did not receive IEP/504 services. However, these accommodations were not always well matched to child needs and, in some cases, might facilitate avoidance of anxiety. Results suggest that some children with anxiety disorders receive supports in schools that may be inconsistent with evidence-based clinical practices. School-based mental health providers can be in an important position to facilitate coordinated care for youth with anxiety disorders.
Community-based systems of care (SOC) provide a range of services to students with significant emotional and behavioral difficulties and their families. However, little is known about the educational characteristics and functioning of students at enrollment in SOC. The purpose of this study was to replicate and extend previous research by examining the educational characteristics and predictors of school functioning for students referred to SOC using a large and diverse national data source. Participants were 5,628 students ages 6 to 18 years who were enrolled in community-based SOC across 45 U.S. states, districts, and territories. Students’ grades, discipline, and attendance (as reported by caregivers) were used as indicators of school functioning, and students’ demographic characteristics, referral source, and emotional/behavioral functioning were used to predict functioning in school, including the testing of interaction effects. Findings revealed that, although many students earned average grades, a large portion of students had significant discipline and attendance problems. Results of the ordinal regression analyses indicated that most demographic variables and measures of clinical functioning significantly predicted students’ grades, attendance, and discipline, and that age and special education status represented a significant interaction. Findings provide insight into the educational functioning of students at enrollment in community-based SOC and have implications for research and practice.
Maladaptive adolescent behavior patterns often create escalating conflict with adults and peers, leading to poor long-term social trajectories. To address this, school-based behavior management often consists of contingent reinforcement for appropriate behavior, behavior reduction procedures, and placement in self-contained or alternative settings. Yet, these commonplace practices may not foster the self-regulation processes necessary to override the habitual and negative response sequences that prohibit independent and sustained positive social functioning. As such, we developed I Control, a curriculum to teach middle school students with significant behavior problems how to engage in appropriate social self-regulation. Pre–post pilot data analyses using Mplus from 152 students in 14 schools/17 classrooms indicated that students taught I Control evidenced more positive scores than controls on teacher-reported contextualized executive function, externalizing behavior problems, and general problem behavior, and student-reported emotional control, social problem solving, and externalizing and internalizing behavior problems. Also, students who were taught the curriculum had greater curricular knowledge than control students. These positive findings indicate that I Control warrants more extensive investigation.
The School Refusal Assessment Scale (SRAS) was developed to identify four factors that might maintain a youth’s school attendance problem (SAP), and thus be targeted for treatment. There is still limited support for the four-factor model inherent to the SRAS and its revision (SRAS-R). Recent studies indicate problems with the wording of eight items added to the SRAS to form the SRAS-R. We examined the factorial validity of an adapted item set comprising 16 of the 24 SRAS-R items and eight items developed for this study. The eight items paralleled the content of the SRAS-R items being replaced but were less complex and ambiguous. Data were gathered from 199 youth with a SAP and 131 parents. Confirmatory factor analysis (CFA) of the adapted item set supported a four-factor model. Internal consistency reliability of the subscales was higher than it is commonly reported in SRAS-R studies. Concurrent validity was supported by associations between the four factors and measures of internalizing or externalizing behavior. The adapted SRAS-R may help professionals reliably assess the relative strength of factors maintaining SAPs. This is one of the few studies conducted independent of the instrument’s developer and in a school culture different from that where the instrument is usually tested.
Providing students who are involved in the juvenile justice system with an appropriate education has the potential to improve their academic, behavior, and post-school outcomes. Giving these students access to quality teachers is an important and necessary component of the educational process. The purposes of this study were to identify the initial reasons juvenile justice teachers entered their profession, examine the relationship between those reasons and their job satisfaction, and explore how teacher demographics influenced their profession selection. In total, 486 (n = 486) juvenile justice teachers across three states participated in the study. Results suggest that a majority of the teachers entered the field for both personal reasons and better employment opportunities, with the latter being more important to them. In addition, where teachers work influences how satisfied they are with their job. Teachers in short-term facilities were more satisfied as compared with those in long-term facilities. Findings are discussed in relationship to recruiting and retaining juvenile justice teachers.
Research has consistently demonstrated that students with emotional and behavioral disorders (EBD) are at risk for academic underachievement. Despite the persistent and strong association between academic problems and EBD, there remains a dearth of information on the process for developing intensive academic interventions for students with EBD. The intent of the present article is to describe and review an experimental approach for developing intensive and individualized academic interventions that provide a potentially valuable method for informing the development of academic interventions. Specifically, brief experimental analyses of academic behavior allow for the comparison of two or more interventions over a relatively short period of time. These formal comparisons provide essential information on which particular practice or set of strategies produce improved responding for the student on the particular skill of interest. The authors contextualize the brief experimental analysis methods within the data-based individualization (DBI) approach advanced by the National Center on Intensive Intervention (NCII) before reviewing recent research on the approach. Results are used to make recommendations for subsequent research and practice.
We present a dynamic systems perspective for the intensification of interventions for students with emotional and behavioral disorders (EBD). With this framework, we suggest behavior involves the contributions of multiple factors and reflects the interplay between the characteristics of the student and the ecologies in which he or she is embedded. Building from a discussion of the application of dynamic systems theory to ecological intervention, we propose four types of data are needed to guide intervention intensification: universal/probabilistic knowledge and strategies, implementation science practice elements, person-oriented developmental analysis, and person-in-context interactional analyses. We discuss practice implications and propose two types of specialists: intervention specialists who provide direct services and have expertise adapting interventions across the academic, behavioral, and social domains and intervention specialist coordinators who direct intervention intensification activities across service sectors and design and monitor long-term intervention plans focused on developmentally relevant outcomes. Finally, we consider implications for research and professional development.
Children receiving services for severe emotional and behavioral difficulties are less likely to have parents who are involved in their education and support services. Peer-to-peer family support programs are one approach to increasing the self-efficacy and empowerment of parents’ engagement in the treatment of a child’s mental health conditions. Furthermore, programs providing parental support may reduce the strain and negative consequences caregivers may experience due to the stress of caring for a child with emotional and behavioral needs. Although much is known about the relation between caregivers’ strain and children’s use of mental health services, less is known about caregiver strain and parents’ participation in family support programs. This study evaluated whether caregiver strain predicted parents’ (N = 52) participation in a phone-based, peer-to-peer support intervention. Results of the regression analysis indicated that highly strained parents participated in four to seven more phone conversations over the course of intervention, which occurred across the academic year. Therefore, findings have implications for the school and mental health providers aiming to increase the involvement of parents of children with emotional and behavioral disorders.
This study examined whether physiological and behavioral indicators of emotion dysregulation assessed over the course of multisystemic therapy (MST) were related to treatment response. Participants were 180 ethnically diverse adolescents (n = 120 males), ranging in age from 12 to 17 years. Treatment response was assessed through therapist report and official arrest records. Changes in cortisol reactivity and changes in scores on a Behavioral Dysregulation subscale of the Child Behavior Checklist were used as indicators of emotion dysregulation. Hierarchical linear modeling analyses examined whether a less favorable treatment response was associated with cortisol reactivity measures collected (a) early in treatment and (b) over the course of treatment as well as with behavioral reports of emotion dysregulation reported (c) early in treatment and (d) over the course of treatment. Sex was explored as a moderator of these associations. Results indicated that both cortisol and behavioral indices of emotion dysregulation early in treatment and over the course of therapy predicted treatment responsiveness. This relationship was moderated by sex: Girls were more likely to evidence a pattern of increasing emotion regulation prior to successful therapy response. The results lend further support to the notion of incorporating emotion regulation techniques into treatment protocols for delinquent behavior.
The present study assessed the potential of a health behavior model used to explain adherence to treatment for chronic illnesses, the Integrative Behavioral Prediction Model (IBPM), to better understand therapy engagement (e.g., low participation) for child therapy in community-based service settings. Qualitative interview methods were used to assess the fit of the IBPM to therapy engagement. Caregivers of children (n = 17) who had successfully completed therapy, were at risk of dropping out, or terminated prematurely at a community mental health clinic were interviewed. Clinic therapists and administrative staff were also interviewed (n = 8). From the perspective of caregivers, therapists, and administrative staff, most IBPM elements—cognitions, intentions, and environmental/contextual factors—appear to be relevant to therapy engagement. Other factors, such as personal and psychological barriers (e.g., poor fit with therapist), not found in the IBPM also may influence therapy engagement. It appears that the core elements of the IBPM may translate to child therapy, though future research is needed to evaluate the generalizability of the study findings. Thus, health behavior models (e.g., IBPM) may improve our understanding of factors contributing to poor therapy engagement for children receiving psychosocial therapy in community-based service settings.
Group homes are a frequently used but controversial treatment setting for youth with mental health problems. Within the relatively sparse literature on group homes, there is some evidence that some models of treatment may be associated with more positive outcomes for youth. This article explores this possibility by examining differences across time for youth served in group homes utilizing the Teaching Family Model (TFM) and geographically proximate homes using more eclectic approaches. Data come from a longitudinal quasi-experimental study that included 554 youth. Results suggest that youth showed, on average, significant and rapid improvement during initial months in a group home. Improvement did not differ for TFM and non-TFM homes during this initial period. Post-discharge results, though, show that TFM was associated with continued improvement after discharge and significantly better outcomes by 8 months post-discharge. Results also discuss youth-level factors that may influence outcomes as well as need for additional work to more fully understand processes and practices that are key for maximizing and maintaining youths’ positive outcomes during and after group home placements.
The prevalence of psychotropic medication use among students with emotional and behavioral challenges continues to increase as intensive behavioral interventions are designed and evaluated in schools. There is general consensus among clinical professionals that psychotropic medications are not "silver bullets" but should be expected to improve mental health outcomes and enhance the effects of academic and behavioral interventions. Thus, they should be used to supplement, not replace, classroom-based strategies. Unfortunately, effective collaboration between clinical and educational professionals to evaluate medication effects is rare. As a result, psychopharmacological and behavioral interventions often occur simultaneously but are implemented and monitored independently by separate teams of professionals. In the present article, we make a case that a better understanding of behavioral mechanisms of psychotropic drug effects has the potential to improve the integration and evaluation of psychotropic and intensive behavioral interventions for students with emotional and behavioral challenges in schools. First, we review behavior-analytic approaches to intensive intervention models and current use patterns in psychotropic medications for students with emotional and behavioral challenges. Second, we review potential behavioral mechanisms of drug action as a framework for integrating the two treatment models. Third, we discuss implications of this integrated framework for practitioners when implementing and evaluating intensive, integrated interventions in schools.
Youth in foster care often experience many negative outcomes. Fortunately, the empirical examination of potential protective factors is beginning to grow. The aim of this study was to investigate the influence that a warm relationship with one’s caregiver has on the well-established association between trauma symptoms and youth reports of internalizing and externalizing behaviors. Mediation and moderation analyses were conducted to explore the impact of this protective factor on this association. A warm relationship with a caregiver was a significant moderator of trauma and youth report of internalizing behaviors. Implications for practice and policy are discussed.
Positive behavioral interventions and supports (PBIS) and school mental health (SMH) are prominent initiatives in the United States to improve student behavior and promote mental health and wellness, led by education and mental health systems, respectively. Unfortunately, PBIS and SMH often operate separately in districts and schools, resulting in a number of missed opportunities for interconnecting programs and services and increasing their depth and quality within multi-tiered frameworks of prevention, support, and intervention. The current article details a necessary first step in the process of improved interconnection of these two frameworks by describing the development of a process and tool for schools/districts to assess readiness for connecting PBIS and SMH through a blended system. Relevant literature, pilot data, and methodology are discussed, in addition to psychometric properties of the survey and future applications of this instrument for practice, research, and policy.
Sixteen general and special education teachers were randomly assigned to one of four teams that were to make manifestation determinations using two different "hidden profiles" case studies based on students with an emotional behavioral disability. One case study was constructed to support a decision of the behavior not being a manifestation of the disability and the other case study was constructed to support a conclusion that the behavior of concern was a manifestation of the disability. To fully understand the student and behavior of concern, team members were required to actively share and discuss all of the relevant information they possessed. Both the teams working with profiles supporting the manifestation of the disability reached that conclusion; however, the two teams working with profiles that supported a non-manifestation of disability conclusion reached different conclusions, one declaring the behavior to be a non-manifestation and the other declaring it to be a manifestation of the disability. Overall, participants found the manifestation determination process to be an effective way to discuss student behavior, but special and general educators approached the determination process differently. Discussion of the manifestation determination review (MDR) process is presented along with implications for practice, limitations, and future research.
This exploratory longitudinal study examined behavioral outcomes and parenting stress among families with children adopted from foster care, taking into account environmental and biological risk factors. Child internalizing and externalizing problems and parenting stress were assessed in 82 adopted children and their families at 2 months post-placement, 12 months post-placement, and then yearly until 5 years post-placement. A history of abuse/neglect predicted significantly higher externalizing and internalizing problems at a borderline level of statistical significance. In the initial stages after placement, externalizing problems were significantly higher among children who were 4 years or older at placement versus those who were younger than 4, although differences were no longer significant 5 years post-placement. Statistical trends in parenting stress reflected reduced stress in the first 12 months followed by a plateau for parents who adopted older children and greater stress for parents who adopted younger children. Familiar limitations for observational cohort data apply. Nonetheless, the availability of longitudinal follow-up on a sizable sample of children adopted from foster care adds insight to the psychological dynamics for adoptive families and suggests that families of children adopted from the foster care system may have unique needs for ongoing support around behavioral issues.
Using an integrated administrative data set, out-of-home residential placements (i.e., child welfare, juvenile justice, mental health) were examined in a sample of early adolescents in a large urban school district. Out-of-home placements were tracked across Grades 7 to 9 in a population of 58,000 youth. This included 10,911 students identified for special education (7,028 with learning disabilities, 1,247 with serious emotional disturbance, 1,245 with intellectual disabilities, 804 with speech and language impairments, and 587 with other disabilities). Students who received special education were twice as likely to experience out-of-home placements. The rates and types of out-of-home placements were differentially related to specific special education classifications. In particular, youth with serious emotional disturbance were more likely to experience out-of-home placements and to be involved in multiple sectors. Findings are discussed in relation to the development of intensive emotional and behavioral interventions for early adolescents who receive special education services.
For decades, research has shown that function-based support is effective in reducing the frequency and severity of problematic student behaviors. One way for schools and districts to implement these supports effectively is by building local capacity to intervene with function-based interventions at the first signs of persistent problem behavior (i.e., when less intensive supports have proven ineffective), rather than waiting until problem behavior becomes more severe. In the present pilot study, a 6-hr comprehensive training package was used to train elementary- and middle school professionals to conduct "basic" (as opposed to "complex") functional behavioral assessment (FBA) and lead school-based teams in basic function-based behavior support methods and procedures. Findings indicate that the training was effective in increasing (a) participant knowledge related to function-based behavior support and (b) reported use of function-based supports by participating school-based professionals. In addition, school personnel rated the training materials and methods as acceptable and feasible for use in typical school contexts and provided descriptive data related to perceived enablers and barriers to implementing function-based support in schools. Limitations, practical implications, and future research needs are discussed.
In this article, we provided descriptive and methodological illustrations of how to conduct systematic behavior screenings at the middle and high school levels to detect students with intensive intervention needs using one systematic screening tool: the Student Risk Screening Scale. We discussed the importance of systematic screening and presented data from secondary schools conducting systematic screenings to illustrate the proportion of students with these intensive needs. Results suggested 5.49% of the more than 10,000 students placed into the high-risk category, with results varying across states and school levels (middle vs. high school). Then, we offered recommendations for using systematic screening data to address the needs of middle- and high-school students including the use of research-based, intensive supports within tiered systems of support. We discussed challenges of conducting screenings in secondary school settings and addressed limitations and future directions for subsequent inquiry.
Although attention-deficit/hyperactivity disorder (ADHD) is prevalent among adolescents in outpatient behavioral care, one of the few evidence-based treatment options, stimulant medication, is significantly underutilized. The Medication Integration Protocol (MIP) is a family-based intervention designed to help behavior therapists assume a lead role in educating clients about ADHD in adolescents, promoting family-centered decisions about medication initiation, and integrating medication management activities within behavioral treatment planning. This pilot study evaluated treatment fidelity and medication utilization for inner-city teens receiving MIP (n = 14) compared with a matched Historical Control (HC) group (n = 21) in a community clinic. Observational analyses revealed that in comparison with HC, MIP demonstrated basic protocol fidelity with regard to adherence to the MIP protocol, therapeutic alliance with the adolescent, and clinical focus on ADHD in session. MIP showed greater psychiatric evaluation completion and ADHD medication initiation than HC. Next steps in the ongoing development of MIP are outlined.
Affect dysregulation (AD) is characterized by heightened reactivity to strong emotions, difficulty calming down when upset, and mood instability. This phenomenon has not been widely examined in older foster youth, yet it may be an avenue to improve behavior and functioning in young adulthood. This study examines two dimensions of AD—affect skills deficits and affect instability—in a sample of 17-year-old foster youth, assessing the relationship of each dimension to risk factors and behavioral health service use at age 17, and as predictors of functional outcomes at age 19. We found that the level of AD among older foster youth was similar to a clinical sample and was associated with a history of physical abuse, depression, attention deficit hyperactivity disorder, and disruptive behavioral disorders. Higher levels of affect skills deficits were associated with use of intensive types of services such as psychiatric hospitalization, residential treatment, and psychiatric medications but affect instability was not. Higher levels of affect skills deficits were negatively related to graduating from high school and positively related to being arrested. AD, especially affect skills deficits, are a promising target for inclusion in interventions to support older foster youth with mental health problems.
This study examined the relation between family functioning and classroom problem behavior of children with emotional and behavioral disorders receiving special educational support. To this end, the Teachers’ Report Form and the Family Questionnaire were completed for 84 children (M age of 9.8 years) 2 times with a time lag of 11 months. Cross-lagged path analyses showed that internalizing and externalizing problem behavior in the classroom were stable over time, just as poor family functioning. Continuity of (a) poor communication, (b) discordant partner relationship, and (c) lack of social support were strongly associated with future total problem behavior in the classroom. Furthermore, parental responsiveness to a child’s needs was associated with lower future total problem behavior. A direct association was also found between externalizing behavior in the classroom and future poor family functioning. Implications of these findings for future research and practice are discussed.
To measure parents’ representations of their child’s mental health problems, the validity of the Parents’ Illness Perception Questionnaire–Children’s Mental Health (PIPQ-CMH), a modified version of The Illness Perception Questionnaire–Revised, was established to explore the link between parents’ representations and (a) child problem severity, (b) parental adjustment, and (c) treatment acceptability. Parents (N = 487) of 4- to 15-year-old children (68% boys) from five children’s mental health centers across Southwestern Ontario, Canada completed the PIPQ-CMH along with additional measures to assess validity. The Brief Child and Family Phone Interview was used to assess problem severity, the Depression and Anxiety Stress Scale was used to assess parental adjustment, and an adapted version of the Treatment Acceptability Questionnaire was used to assess the acceptability of five types of psychological treatment. Confirmatory factor analysis demonstrated that the PIPQ-CMH was a reasonable fit to the data. Cronbach’s alpha and test–retest reliabilities were above .70. Significant relationships were found between parents’ perceptions (e.g., timeline, controllability, consequences, illness coherence, emotional representations) and child problem severity, parental adjustment, and treatment acceptability. Preliminary construct validity exists for the PIPQ-CMH as a measure of parents’ representations of child mental health problems. This measure should help to inform the impact of parent representations on the treatment process.
This study examined caregiver strain in families who initiated mental health services for their child. Predictors of strain and the bidirectional relation between strain and child symptoms were examined. Participants included 218 children aged 4 to 13 with disruptive behavior problems and their caregivers, plus 96 psychotherapists, recruited from six publicly funded clinics. Child disruptive behavior severity and caregiver strain were assessed at baseline, 4, and 8 months. Multilevel models were used to examine predictors of reduced caregiver strain, and autoregressive cross-lagged models were used to examine the bidirectional relations between change in caregiver strain and behavior problems over time. There were small to medium decreases in caregiver strain over the 8 months after the initiation of mental health services, but few factors predicted change other than initial behavior problem severity. Whereas more severe initial child symptoms predicted greater reductions in caregiver strain, greater child symptom severity sustained at 4 months predicted lesser improvements in caregiver strain. Simultaneously, greater caregiver strain predicted less improvement in child symptom severity, suggesting that child symptom severity and caregiver strain affect each other over time. These results suggest that attending to both child and caregiver factors may be important in maintaining improvements after initiating usual care.
The purpose of this study was to determine the benefits of a multiple family group (MFG) service delivery model compared with services as usual (SAU) in improving the functioning of youth with oppositional defiant/conduct disorder in families residing in socioeconomically disadvantaged communities. Participants included 320 youth aged 7 to 11 and their families who were referred to participating outpatient clinics. Participants were assigned to the MFG or the SAU condition, with parent report of child oppositional behavior, social competence, and level of youth impairment as primary outcomes at post-treatment. Family engagement to MFG was measured by attendance to each group session. Caregivers of youth in the MFG service delivery model condition reported significant improvement in youth oppositional behavior and social competence compared with youth in the SAU condition. Impairment improved over time for both groups with no difference between treatment conditions. The MFG led to greater percentage of youth with clinically significant improvements in oppositional behavior. Attendance to the MFG was high, given the high-risk nature of the study population. The MFG service delivery model offers an efficient and engaging format to implement evidence-based approaches to improving functioning of youth with oppositional defiant and/or conduct disorder in families from socioeconomically disadvantaged communities.
This study is part of a larger randomized efficacy trial examining the impact of Behavioral, Emotional, and Social Training: Competent Learners Achieving School Success (BEST in CLASS), a Tier 2 intervention that targets the prevention of emotional/behavioral disorders in young, high risk children. In this investigation, we examined teachers’ implementation and maintenance of instructional practices in early childhood classrooms and the corollary relationships between teacher implementation of the specific instructional practices associated with BEST in CLASS and child engagement and problem behaviors. Fifty-three teachers (26 in treatment and 27 in comparison) and 130 preschool-aged children (66 in treatment and 64 in comparison) participated. Findings indicated that teachers’ who received training and coaching in the BEST in CLASS intervention increased their use of specific instructional practices in comparison with teachers in the control condition. In addition, children whose teachers’ received the BEST in CLASS intervention demonstrated increased engagement and a decrease in problem behaviors in comparison with those children who were in the control group. Positive teacher–child interactions increased and negative teacher–child interactions decreased in the intervention group in comparison with the control group. Results are discussed in relation to measuring teachers’ implementation of instructional practices and implementation science.
Adolescents constitute a large proportion of youth in foster care, but few foster care models specifically concentrate on their developmental or treatment needs. This study examined outcomes for an agency-developed, theoretically based treatment foster care (TFC) model using de-identified administrative data from 612 youth discharged from care over a 3-year period using a structural equation modeling path analysis. Results indicate that youth enrolled in Pressley Ridge Treatment Foster Care (PR-TFC) improve in functioning from entry to discharge and that, overall, youth in PR-TFC treatment typically improve in day-to-day functioning as they age, and youth who enter the PR-TFC homes at an older age generally function better at discharge than younger youth who stayed comparable amounts of time. Additional results indicate that older youth, youth with a greater number of clinical diagnoses, youth with a lower pre-test Child and Adolescent Functional Assessment Scale (CAFAS) score, and youth of color spent more time in care, while older youth, youth with fewer clinical diagnoses, youth with lower pre-test CAFAS scores, and European American youth had lower post-test CAFAS scores, indicating better functioning at discharge. This article also provides an example of how administrative data can be used to develop practice-based evidence for a treatment model.
A mixed methods approach was used to identify problem situations in peer and school contexts experienced by urban middle school students with high incidence disabilities that may impact their emotional and behavioral adjustment. A survey and semi-structured interview were conducted with a predominantly African American sample (95%) of 74 adolescents (61% boys) with high incidence disabilities (71% with learning disabilities, 15% with intellectual disabilities, and 14% with emotional or behavioral disorders). Focus groups were conducted with 35 school staff members. Based on the survey data, 14 peer and school problem situations were rated as frequently occurring and difficult to cope with. Data from the student interviews and focus groups revealed five themes of problem situations, including three in peer (i.e., peer influence, provocation, and teasing) and two in school (i.e., academic challenges and student–teacher relationships) contexts. These findings have important implications for school-based interventions focused on reducing risk for emotional and behavioral adjustment problems.
Over 15 years after passage of legislation requiring the use of functional behavioral assessment (FBA) to inform the development of positive behavior support plans (BSPs) in special education, schools are still struggling to implement BSPs based on FBA and the function of behavior. A primary concern is that school teams regularly fail to use function of behavior to generate behavioral interventions, even after completing an FBA and receiving training. The current study evaluated outcomes of an efficient 60-min training that taught explicit strategies for using function of behavior and FBA information to identify function-based intervention through modeling, guided practice, and feedback using student vignettes for escape-maintained and attention-maintained behaviors. The training yielded significant, positive results in participants’ ability to identify function-based interventions on behavioral vignettes. Future research and next steps are suggested for expanding the training to address the challenge of extending the science of FBA to guide the implementation of effective behavioral interventions in schools.
Youth treated in a residential treatment center (RTC) receive an array of services to address their mental health and behavioral issues, including psychotherapy and medication. Prior studies have shown that youth continue to receive a considerable number of services after discharge from a RTC. This study describes the characteristics of children and youth served in Florida’s Medicaid-funded residential treatment facilities, examines whether family involvement in treatment is associated with discharge to a family-like setting, and assesses continuity of treatment after discharge. Data for this study were obtained from the SIPP Provider Monthly Report Database from January 2005 through December 2011. These data contain information on family involvement during treatment. Post-discharge data were from Medicaid enrollment/claims files and Prepaid Mental Health Plan encounters. Results of this study suggest that family contacts for interventions and treatment planning are associated with a greater likelihood of discharge to a family-like setting. Among youth discharged to a family-like setting, family involvement during treatment was associated with receiving follow-up outpatient care. Results support the continued emphasis on including family members in the treatment of youth with mental health needs to ensure better outcomes and continuity of treatment.
Moving evidence-based practices for classroom behavior management into real-world settings is a high priority for education and public health. This article describes the development and use of a model of training and support for the Good Behavior Game (GBG), one of the few preventive interventions shown to have positive outcomes for elementary schoolchildren lasting through to young adulthood, ages 19–21, including reductions in the use of drugs and alcohol, school-based mental health services, and suicide ideation and attempts. We first describe the conceptual framework guiding the development of the model of training and support. Data on implementation of the model, from an ongoing trial of GBG being conducted in partnership with the Houston Independent School District, are then presented. We end with a discussion of the lessons learned and the implications for the next stage of research and practice.
Directed consultation is presented as a professional development framework to guide and support teachers in the implementation of evidence-based interventions that involve contextual and process-oriented approaches designed to be incorporated into daily classroom management. This approach consists of four components: pre-intervention observations and interviews with school professionals, professional development workshops, online training modules, and team- and individual-level implementation meetings. In the current study, directed consultation was used to train sixth-grade teachers to use the Supporting Early Adolescent Learning and Social Support (SEALS) program, a multicomponent intervention model, to promote productive and supportive classroom contexts during the transition to middle school. The current report involved classroom observations in 14 schools (7 interventions, 7 controls) as part of a broader cluster-randomized control trial. A total of 144 classrooms were observed in late fall of the sixth grade during ongoing professional development training activities and again in the spring at the completion of the SEALS training. As compared with control classrooms, teachers in intervention classrooms used more positive feedback and less negative feedback and redirection. Furthermore, teachers in intervention classrooms provided more effective use of classroom structure, feedback to students, behavior management, communication with students, groups and social dynamics, and motivation strategies. Results are discussed in terms of implications for professional development activities aimed at enhancing classroom management.
Even with the use of effective universal classroom management practices, some students will need additional behavioral supports. However, to translate implementation of new strategies into the classroom, professional development programs need to be adaptive to the complexities teachers face in providing instruction and managing classroom behaviors among diverse learners. Teachers also need support to successfully implement universal practices as well as to develop and enact plans for supporting students with disruptive behavior. This article describes a universal classroom management program that embeds coaching within the model. The coach supported teachers both in implementing universal strategies and in developing and implementing behavior support plans for students with disruptive behavior. The study evaluates the effectiveness of the behavior support plans and the types of coaching activities used to support these plans. Findings indicated that during meetings with teachers, coaches spent time action planning and providing performance feedback to teachers on their implementation of the behavior support plans. In addition, teachers reduced their rate of reprimands with the targeted at-risk students. Students receiving behavioral supports demonstrated decreased rates of disruptive behavior, increased prosocial behavior, and a trend toward improved on-task behavior. In comparison, a matched sample of students with disruptive behaviors did not demonstrate improved outcomes. Implications for practice are discussed.
Although numerous studies address the efficacy of school-based interventions, fewer focus on how to support sustainability of interventions from the perspective of participants. To address this research gap, we use the Practical, Robust Implementation and Sustainability Model to examine how the characteristics of an evidence-based program interact with those of participants (i.e., students, parents, educators) to influence program implementation and continuation. Specifically, we consider lessons learned in one site of the national effectiveness study of First Step to Success which sustained implementation in a majority of participating schools after the study ceased. First, we analyze implementation fidelity and its effects on students’ behavioral and academic outcome data. Then, we analyze focus group and interview data collected from participants 2 years after initial implementation to consider contextual factors associated with continued program success, including (a) the nature of the intervention, (b) the external environment, (c) implementation and sustainability infrastructure, and (d) participant characteristics.
Peer problems are common among children with emotional and behavioral disorders (EBD). However, the extent to which children’s peer functioning varies across settings is unknown, as is the incremental power of peer functioning in different settings in predicting subsequent psychopathology. Participants were 57 children with Attention-Deficit/Hyperactivity Disorder (ADHD) who had peer sociometric nominations collected in general education classrooms and a Summer Treatment Program (STP) with all-EBD peers. Significant, small-to-medium correlations existed between nomination rates across settings. Lower rates of STP positive nominations and higher rates of STP negative nominations (but not classroom nominations) predicted exacerbated self-reported depression and antisocial behavior 1 year later. Lower rates of STP positive nominations, but higher rates of classroom positive nominations, predicted increased self-reported depression 2 years later. For children with high rates of classroom positive nominations, higher rates of STP positive nominations predicted reduced parent-reported internalizing behavior 1 year later. For children with low rates of classroom negative nominations, higher rates of STP negative nominations predicted increased teacher-reported externalizing behavior 1 year later and self-reported depression 2 years later. Results suggest that sociometric nominations collected within an EBD peer group may have stronger predictive power for later adjustment than nominations collected in a mainstream classroom.
Teachers and students in 54 elementary school classrooms (first, third, and fifth grades) participated in a multi-method longitudinal study of classroom social dynamics. At each of three assessments within a single school year, observers rated teacher–student interaction quality, students completed sociometric assessments and reported on their sense of peer community and school bonding/motivation for schooling, and teachers rated students’ social behavior. Teachers also completed end-of-year ratings of their strategies and beliefs regarding the management of classroom social dynamics. Multilevel models indicated that teachers’ efforts to mitigate status extremes and support isolated students were associated with more positive patterns of within-year change in students’ sense of peer community, responsive teacher–student interactions predicted positive changes in school bonding/motivation, and teacher-rated efforts to manage aggression and promote prosocial behavior among aggressive students predicted within-year declines in peer-nominated aggression. Teacher attunement to classroom friendship and victimization patterns, when combined with responsive teaching, was associated with more positive changes in school bonding/motivation. Teachers rated children’s aggressive/mean behaviors as being more important for their teaching than social status or friendship dynamics and were more likely to believe that children should solve the latter issues on their own.
The present study investigated hypotheses focusing on the relationship between youths with disruptive behavior disorders (DBDs) and caregiver strain. Furthermore, analyses explored whether the relationship between youths with DBDs and caregiver strain depended on the amount of service use in three separate settings (outpatient, school-based, and inpatient). Participants were high-risk youths from the Patterns of Care study who were randomly sampled from one of five public sectors of care. Findings supported hypotheses linking caregiver strain to individuals caring for youths meeting diagnosis for DBDs. Furthermore, the relationship between youths with DBDs and caregiver strain varied depending on the amount of inpatient service use, but the relationship did not differ across levels of outpatient and school-based counseling service use. These findings suggest the importance of addressing caregiver strain when developing treatment plans for youths with DBDs.
This pilot feasibility study provided a preliminary test of a community-partnered intervention that targeted engaging parents and improving parent functioning. This intervention was combined with the Cognitive-Behavioral Intervention for Trauma in Schools (CBITS), allowing for a comparison of the CBITS-as-usual (CBITS) with the CBITS-plus-family treatment component (CBITS + Family). This study used a quasi-experimental design, capitalizing on ongoing CBITS implementation within a school system. A total of 19 parent–student dyads participated in CBITS groups and 21 parent–student dyads participated in CBITS + Family groups. Parents and students under both conditions completed pre- and posttreatment measures. Participants were from low-income, predominantly Latino families. Children were 59% female with an average age of 11.83 years. Parents who received the family treatment component reported higher satisfaction and attended a greater proportion of sessions than parents who received CBITS. In addition, parents who received the family treatment component reported improvements in primary control coping, secondary control coping, family loyalty and closeness, as well as decreases in involuntary engagement and family passive appraisal. Parents who received the family component also showed more warmth, monitoring, and less inconsistency at post-intervention. Results suggest that the family component may contribute to improved parent functioning that could benefit children in the long term.
Given the emphasis on promoting self-determination in the field of special education and the corresponding use of scales to measure self-determination in research and practice, it is important to examine whether widely used self-determination assessments measure the same constructs among and between students from different disability categories. This study examined the equivalence of measurement and structural parameters of The Arc’s Self-Determination Scale (SDS) across groups of students with emotional and behavioral disorders (EBD) or learning disabilities (LD), using a two-group confirmatory factor analysis (CFA). The results indicated that four essential elements of self-determined behavior that form the structure of the SDS (i.e., autonomy, self-regulation, psychological empowerment, and self-realization) are invariant across the two groups. In addition, students with EBD indicated lower levels of autonomy compared with those with LD. Implications and future directions for research and practice are discussed.
The measurement of treatment integrity is critical to evaluate the efficacy and effectiveness of evidence-based programs (EBPs) designed to improve the developmental outcomes of young children at risk of emotional/behavioral disorders. Unfortunately, the science of treatment integrity measurement lags behind the development and evaluation of EBP for young, high-risk children. This article describes the development and preliminary psychometric properties of the BEST in CLASS Adherence and Competence Scale (BiCACS), designed to measure the adherence and competence of delivery of the BEST in CLASS prevention program. Independent observers coded videotaped (n = 116) and live (n = 289) observations of teachers delivering the BEST in CLASS program. The BiCACS showed good interrater reliability and analyses provided some support for the validity of the measure. Implications for future research and integrity measurement work are discussed.
In addition to complex behavioral and emotional issues, youth presenting to residential care tend to have higher rates of physical health conditions than those in the general population. Although a strong body of research has found a relationship between physical and mental health, the influence of health status on youth residential care outcomes has not been explored. This study examined the impact of poor physical health on mental health treatment outcomes in a sample of 1,735 youth entering residential care from 2000 to 2010. At intake, youth received medical evaluations identifying physical health conditions, medication prescriptions, and anthropometric measurements. Residential care outcomes were measured by changes in 1-year National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children–IV mental health diagnoses and discharge setting. Rates of school dropout and placement stability were also examined 6 months after discharge. Results suggest that factors related to poor physical health, specifically nonpsychotropic medication prescriptions, are associated with suboptimal mental health outcomes at 1 year, discharge, and follow-up from residential care. These findings indicate that physical health issues adversely impact residential care outcomes, suggesting these youth may require specialized services, such as integrated treatment planning, to achieve optimal treatment outcomes.
The current pilot study demonstrates the potential of adding simple and efficient bully prevention strategies to already established School-Wide Positive Behavior Interventions and Supports. The self-report surveys of third-, fourth-, and fifth-grade students from three elementary schools evaluated the relationship between the implementation of Bully Prevention in Positive Behavior Support and attitudes related to bullying, harassment, and school safety. Results indicated significant improvements in 12 of the 13 dependent variables after the intervention was implemented. Student perceptions of assertiveness, bystander support, and use of a "stop" signal were particularly altered. Considerable methodological limitations are described along with potential implications for practice and recommendations for future research.
Continuity and change in children’s involvement in bullying was examined across the transition to middle school in relation to externalizing and internalizing behavior problems in fifth grade and peer affiliations in fifth and sixth grades. The sample consisted of 533 students (223 boys, 310 girls) with 72% European American, 25% African American, and 3% Other. Although externalizing and internalizing behavior problems in fifth grade were related to bullying involvement in sixth grade, the prediction of stability and desistance in bullying and victimization status was enhanced by information about students’ peer group trajectories. Furthermore, peer group trajectories uniquely explained the emergence of bullying and victimization in middle school.
The federal definition of emotional disturbance (ED) includes a social maladjustment (SM) exclusion clause that stipulates that students are not eligible for special education services if they are determined to be "socially maladjusted" and not also meeting criteria for ED. This clause has long been criticized for being ambiguous and confusing. Although the clause is not defined in federal regulations, it remains in each new reauthorization of the Individuals With Disabilities Education Act (most recent, Individuals With Disabilities Education Improvement Act [IDEIA], 2004). This study provides an updated review of state practices regarding the use and interpretation of the clause, which has not been conducted since 1994. We examined state definitions, clarifications to terminology, and assessment recommendations to determine whether inconsistencies continue to exist across states. We present the results of a national survey that examined state and local school professionals’ reported practices regarding the exclusion and compared it with the policy of the state in which each respondent resides. Results indicated that states are moving toward the adoption of the federal definition of ED, which includes the clause. This is the case even though state regulations, and staff-reported use and knowledge of the clause continue to be inconsistent across states.
Given theoretical and empirical support for the importance of peer play within the preschool classroom to early learning, the present study tested the hypothesis that associations between teacher-reported problem behavior and academic skills were mediated by difficulties in peer play (disruptive and disconnected play), for a representative sample (N = 507 children across 46 classrooms) enrolled in a large urban Head Start program. The study also tested whether mediation was moderated by child sex (e.g., whether the mechanism through which problem behavior was associated with learning differed for boys and girls) controlling for the multilevel nature of these data. Findings from structural equation models provided evidence for partial mediation, whereby associations between internalizing behavior and academic skills were partially explained through their effects on disconnected play; however, mediation was present for girls only. Implications for theory, research, and practice are discussed as they support low-income children’s social and academic development through the context of peer play.
To support students’ academic, behavioral, and social needs, many schools have adopted multitiered models of prevention. Because Tier 3 interventions are costly in terms of time and resources, schools must find efficient and effective Tier 2 interventions prior to providing such intense supports. In this article, we review the literature base on Tier 2 interventions conducted within the context of multitiered prevention models evidencing a Tier 1 behavioral plan. Article selection and coding procedures are described and results are presented. Finally, we summarize our findings of four research questions, reflect on limitations, and offer suggestions for future inquiry.
There is a high degree of comorbidity between anxiety and depressive disorders among treatment-seeking adolescents. Comorbid youth often present with greater diagnostic severity, worse social functioning, and more severe anxiety and depressive symptoms, compared with anxiety-disordered youth without depression. However, the degree to which these populations may differ in underlying affect and emotion regulation (ER) is largely unknown. This study compared 44 anxiety-disordered adolescents (ages 12-18 years) with a comorbid depressive disorder (ANX + DEP) and 32 anxiety-disordered adolescents without a comorbid depressive disorder (ANX) on several clinical and emotion-related variables. Results indicated that ANX + DEP adolescents were assigned higher clinician-rated diagnostic severity ratings, and reported greater functional impairment and more severe social anxiety and depressive symptoms, compared with ANX adolescents. In addition, ANX + DEP adolescents demonstrated higher levels of negative affect, lower levels of positive affect, and poorer self-reported and parent-reported ER. Implications for assessment and treatment, as well as directions for future research, are discussed.
Internalizing behaviors are directed inward toward the child and are frequently overlooked in classrooms compared with externalizing behaviors. When internalizing behaviors are identified, cognitive-behavioral interventions (CBIs) are typically the intervention of choice; however, CBIs are time-consuming and require considerable skill and experience for successful implementation. An efficient and time-effective targeted intervention for children with internalizing behavior problems is needed. Check In/Check Out (CICO) has been shown to be an effective targeted intervention for children with externalizing behavior problems, but this intervention has not been implemented directly targeting children with internalizing behavior patterns. The purpose of the present study was to evaluate CICO as a targeted intervention for children with internalizing behavior problems. Four elementary school students with internalizing behavior problems received a CICO intervention. Results showed that ratings of prosocial replacement behaviors increased as a result of the CICO intervention, and students’ levels of internalizing behaviors decreased.
Previous research documents that street-involved youth experience rates of trauma and posttraumatic stress disorder (PTSD) that are significantly higher than their housed counterparts. Trauma and PTSD are of particular concern for homeless youth as they can negatively affect youths’ ability to function adaptively and to transition off the streets. This mixed-methods study investigates the intricacies of trauma experienced by homeless youth across three U.S. cities. Qualitative interviews were conducted with a sample of 145 homeless youth in Los Angeles (n = 50), Denver (n = 50), and Austin (n = 45) to explore youths’ perspectives on the definition of trauma and the contexts associated with victimization. Quantitative standardized assessments investigated youths’ trauma experiences before and after becoming homeless. Trauma screening identified high rates of trauma incidents (78%), with 28% of participants meeting criteria for PTSD. Participants reported various traumatic experiences that occurred before leaving home and while on the streets, and high rates of polyvictimization. Qualitative themes describe particular people and places most vulnerable on the streets. Implications for services to prevent and treat trauma among homeless youth are discussed.
Children with emotional and behavioral disorders (E/BD) struggle to achieve social and academic outcomes. Many studies have demonstrated self-management interventions to be effective at reducing problem behavior and increasing positive social and academic behaviors. Functional behavior assessment (FBA) information may be used in designing effective self-management interventions. The purpose of this study was to link self-management procedures to hypothesized behavior function in three children with E/BD. Results demonstrated that self-monitoring (SM) alone could be enhanced using information derived from FBA and that consequences delivered by teachers were less effective than a self-management treatment package.
The aim of this study was to analyze the prevalence of mental health disorders in children living in residential care and their use of therapeutic services, including the relationship between these factors and social-family and intervention process variables, as well as the relationship among the disorders identified by professionals and the detection of disorders by means of a screening instrument. We studied a sample from the Autonomous Community of Extremadura in Spain made up of 264 children ages 6 to 18 years. Data collected from residential care workers on the children’s characteristics and the existence of disorders and possible treatments were used, as well as the Child Behavioral Checklist as a screening instrument. In addition, the case social workers provided information on social-family and intervention process variables. Results show that 26% of the children in residential care were receiving or had received treatment for mental health disorders. Seventeen percent of the total presented mental disability, and in half of these cases, they were also being treated for mental disorder. The screening test, however, detected that cases with clinical range accounted for 44% of the children and that there was considerable bias in relation to referrals for treatment.
A multiple baseline across participants design was used to examine the functional relation between the Self-Determined Learning Model of Instruction (SDLMI) intervention and the on- and off-task behaviors of high school students with emotional and behavioral disorders (EBD). The results showed that all four students significantly increased on-task behaviors and decreased off-task behaviors and all four participants maintained the increase of on-task behaviors and the decrease of off-task behaviors after the intervention was withdrawn. All four students made progress toward their goal of implementing on-task behavior in the classroom and generalized on-task behavior to a second general education classroom. The study provides evidence of effective self-determination instruction that supports students to improve their behavior in a general education classroom. Implications for practice and future research are provided.
The authors examined the role of early adverse experiences, mental health problems, and disabilities in the prediction of juvenile delinquency and recidivism, using a matched-control group design. The delinquent group comprised 99,602 youth, born between 1981 and 1988, whose cases had been processed by the South Carolina Department of Juvenile Justice. Records of 99,602 controls, matched by age, race, and gender were drawn from the records of the South Carolina Department of Education. Data on Child Protective Services, foster care, mental health referrals, and diagnoses as well as information about eligibility for free/reduced-price lunch were obtained from the South Carolina Budget and Control Board, Office of Research and Statistics. Logistic regression analyses showed that parental maltreatment and foster care made unique contributions to the prediction of membership in a delinquent sample. Presence of a public school classification of learning disability or emotional/behavioral disorder was also predictive of delinquent outcomes. A prearrest Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis relating to aggressive behavior (e.g., conduct disorder) was the strongest predictor of delinquency. Analyses conducted on the delinquent sample to predict recidivism showed a similar pattern, with an early mental health diagnosis of an aggressive disorder the strongest predictor of recidivism.
Youth with disabilities are disproportionately represented in juvenile justice populations and their education-related outcomes and rates of high school graduation are poor. This study examined academic characteristics of youth with and without disabilities (N = 4,066) and reports on the education-related outcomes of these youth 3 years after release from juvenile justice facilities in Florida. During commitment, youth with disabilities earned high school credits and grade point averages on par with their peers without disabilities. The number of credits earned during commitment improved the likelihood that youth returned to school after release. However, only 44% of the school-age cohort returned to school after release. Students with emotional/behavioral disorders (EBD) and learning disabilities (LD) returned to school at higher rates but did not maintain gains made during commitment as they earned significantly fewer high school diplomas after return to school. Implications for transition practice are discussed.
The overall aim of this multi-informant study was to examine pre–post treatment changes, and maintenance at 3-year follow-up, for multiple dimensions of the family context, for a modular intervention that has previously demonstrated significant clinical improvements in child behavior and maintenance of these effects. Family outcomes included parenting practices (i.e., positive parenting, harsh/inconsistent parenting, psychological/physical aggression), parent functioning (i.e., symptoms of psychopathology, self-efficacy), and family functioning (i.e., family adaptability/cohesion, social support, negative life events). The sample comprised 139 families with children ages 6 to11 who participated in a modular treatment protocol for early-onset oppositional-defiant disorder or conduct disorder that has already been associated with improved child behavior outcomes, delivered in a nonrandomized comparison of research clinic and community settings. Improvement from pre- to post-treatment included indicators of maternal psychological distress and negative parenting practices (e.g., corporal punishment, inconsistent discipline, psychological aggression). Psychological aggression significantly increased following treatment termination; corporal punishment continued to decrease during the 3-year follow-up period. Results are discussed in the context of treatment effects in the broader family context and potential needs for continued intervention research and development.
The purpose of the current study is to contribute to the knowledge base on the use of family education and support (FES) services by examining the longitudinal trajectories of FES receipt and multiple domains of child and family functioning. Using an extant data set of more than 9,000 youth and their caregivers, results indicate that families who received FES on entry into services had greater caregiver strain, and their children experienced greater emotional challenges than families who did not receive FES services. Furthermore, for families who received FES, the longitudinal results revealed an immediate effect of seeking additional services, decreasing caregiver strain 6 months after receipt of FES services, and improving child emotional functioning 6 to 18 months after initial receipt of FES services. The complex, lagged effects in the results are discussed in the context of the theorized cyclical course of family stress as exemplified by the Double ABCX model of adjustment and adaptation. Implications for future research of FES services are discussed, especially the need to develop a functional logic model and an operational definition of FES and its components.
Reading deficits among students with emotional and behavioral disorders (E/BD) are well documented. One approach to addressing these deficits has been providing students with intensive and explicit reading instruction. In this study, 31 students with E/BD and reading deficits in self-contained settings were provided with 8 weeks of Corrective Reading plus Language! instruction following a 4-week baseline phase with Language! instruction only. Standardized Reading Fluency, Comprehension, Word Attack, and Letter-Word Identification subtests and general reading achievement results yielded statistically significant reading growth. Weekly oral reading fluency rates grew at a rate of 1.592 words per week during the baseline phase and 3.563 words per week during the intervention phase. Reading achievement gains were consistent across settings (self-contained classrooms and self-contained schools) and the Corrective Reading intervention was perceived as effective and beneficial to teachers and students. Limitations addressed include brief duration of intervention and relatively small sample size. Increasing the length of the intervention and number of participants are presented as future directions for research.
Trajectories of depressive symptoms were compared between European American and African American boys and girls from ages 8 to 14 in a longitudinal sample of 130 children born to adolescent mothers. Mixed-effects regression modeling was used to analyze individual and group differences in level of depressive symptoms and their changes over time. Time-varying predictors included rigid parenting attitudes, maternal depression, and maternal educational attainment. African American boys reported more symptoms of depression at age 8 than African American girls or European American boys or girls. Symptoms of depression increased over time only for European American girls. Rigid parenting attitudes, but not maternal depression or maternal educational attainment, were associated with children’s depressive symptoms. Results substantiate the importance of differentiating groups by gender and race in conceptual models of depression.
The current study examined the incremental utility of rating scales, a structured diagnostic interview, and multiple informants in a comprehensive assessment of attention-deficit/hyperactivity disorder (ADHD). The sample included 185 children with ADHD (Mage = 9.22, SD = 0.95) and 82 children without ADHD (Mage = 9.24, SD = 0.88). Logistic regressions were used to examine the incremental contribution of each method within an assessment of ADHD. Results indicated that information collected from a structured diagnostic interview was unable to significantly improve a prediction model including parent and teacher ratings (Block 2 = 0.91, = .64). Teacher ratings on symptom-based scales resulted in significant model improvement beyond parent ratings alone (Block 2 = 48.47, < .001). Exploratory analyses indicated that using behavioral rating scales correctly classified all participants by diagnosis. Clinical implications are highlighted, and future research directions are discussed.