universal screening for social-emotional and behavioral difficulties

Universal Screening Universal Screening for Social-Emotional and for Social-Emotional and

Behavioral DifficultiesBehavioral DifficultiesDelaware PBS ProjectDelaware PBS Project

April 23, 2008April 23, 2008Kathleen MinkeKathleen Minke

Workshop OverviewWorkshop Overview Background/Rationale for universal Background/Rationale for universal

screeningscreening

Methods for your considerationMethods for your consideration

Linking identified students to Linking identified students to servicesservices

What Is Universal Screening?What Is Universal Screening? Purpose:Purpose: to identify youth who have to identify youth who have

high risk for developing behavioral or high risk for developing behavioral or mental health problemsmental health problems

Conducted on a Conducted on a schoolwideschoolwide basis basis Typically involves Typically involves several levelsseveral levels of of

assessment to avoid over- or under-assessment to avoid over- or under-identification of studentsidentification of students

Universal Screening for What?Universal Screening for What? Behavior problems?Behavior problems?

Social-emotional problems?Social-emotional problems?

Mental illness? Mental health?Mental illness? Mental health?

Why Should Schools Be Why Should Schools Be Concerned With This?Concerned With This?

Fits with the three-tiered modelFits with the three-tiered model

Fits with RTIFits with RTI

Why Should Schools Be Why Should Schools Be Concerned With This?Concerned With This?

Children with better social-emotional Children with better social-emotional and behavioral skills do better and behavioral skills do better academicallyacademically

Children’s academic and social Children’s academic and social competencies influence each othercompetencies influence each other– When you improve children’s social When you improve children’s social

competence you also make it more likely competence you also make it more likely that they will improve academically that they will improve academically

Students are more likely to use Students are more likely to use services that are offered at schoolservices that are offered at school

Do Students Need Support?Do Students Need Support? 2005: Around 2.2 million adolescents (12-2005: Around 2.2 million adolescents (12-

17) reported a major depressive episode; 17) reported a major depressive episode; nearly 60% received no treatmentnearly 60% received no treatment

Students with significant social-emotional Students with significant social-emotional and behavioral needs drop out at a rate and behavioral needs drop out at a rate twice that of other studentstwice that of other students

In a given year, around 20% of children In a given year, around 20% of children and adolescents experience symptoms of and adolescents experience symptoms of mental health problemsmental health problems

Facts about Delaware’s YouthFacts about Delaware’s Youth 16.6% carried a weapon in the prior 16.6% carried a weapon in the prior

month; 5.4% carried a gunmonth; 5.4% carried a gun 4.6% did not go to school because 4.6% did not go to school because

they felt unsafethey felt unsafe 6.2% were threatened or injured on 6.2% were threatened or injured on

school grounds in prior 12 monthsschool grounds in prior 12 months 7.1% attempted suicide; 12.7% 7.1% attempted suicide; 12.7%

seriously considered suicideseriously considered suicide

The Good News…The Good News…Prevention WorksPrevention Works

Greenberg et al. (2003):Greenberg et al. (2003): Programs that developed students’ skills Programs that developed students’ skills

and promoted positive school climates and promoted positive school climates demonstrated improved interpersonal demonstrated improved interpersonal relationships, improved academic relationships, improved academic achievement, and reductions in problem achievement, and reductions in problem behaviors (e.g., truancy, substance use, behaviors (e.g., truancy, substance use, violence) among students violence) among students (Catalono et al, 2002)(Catalono et al, 2002)

Primary prevention programs in school Primary prevention programs in school settings can enhance interpersonal settings can enhance interpersonal competencies and prevent externalizing competencies and prevent externalizing and internalizing problems and internalizing problems (Durlak & Wells, (Durlak & Wells, 1997)1997)

““There is a solid and growing empirical There is a solid and growing empirical base indicating that well-designed, base indicating that well-designed, well-implemented, school-based well-implemented, school-based prevention and youth development prevention and youth development programming can positively influence programming can positively influence a diverse array of social, health, and a diverse array of social, health, and academic outcomes.”academic outcomes.”Greenberg et al. (2003)Greenberg et al. (2003)

Is My School Ready to Do This?Is My School Ready to Do This? The school faculty and staff are committed The school faculty and staff are committed

to improving social-emotional and to improving social-emotional and behavioral health among students.behavioral health among students.

The school and district are committed to The school and district are committed to “following the data.”“following the data.”

Faculty understand and accept that Faculty understand and accept that current referral and support structures in current referral and support structures in the school may need to change.the school may need to change.

The community supports screening for The community supports screening for social-emotional and behavioral concerns.social-emotional and behavioral concerns.

Is My School Ready to Do This?Is My School Ready to Do This? The schoolwide program is working well The schoolwide program is working well

for 80-85% of students.for 80-85% of students.

The targeted program is working well and The targeted program is working well and the problem-solving process at this level is the problem-solving process at this level is not overwhelmed.not overwhelmed.

In-school resources are available to In-school resources are available to provide interventions.provide interventions.

Effective connections have been Effective connections have been established with community support established with community support services.services.

Academic and Behavioral Systems Work TogetherAcademic and Behavioral Systems Work Together

•Effective academic support•Teaching social skills• Character development•Teaching school-wide expectations•Active supervision in common areas•Positive reinforcement (tangible and intangible) for all•Firm fair, corrective discipline•Family-school collaboration efforts•Effective classroom management

•More detailed social skills training and support•Self-management programs•School-based adult mentors (check-in)•Increased academic support & practice•Alternatives to school suspension

•Intensive academic support•School based adult mentors•Intensive social skills training•Individualized function based behavior support plans•Parent training and collaboration•Multi-agency collaboration (wrap around)•Alternatives to suspension and expulsion

Intensive Interventions •Individual Students•Assessment-based, function based•Intense, durable proceduresTargeted Interventions•Some students (at-risk)•Function-based•Skill development and/or relationship development•Individual or group•High efficiency•Rapid responseSchool-wide Interventions•All settings, all students•Preventive, proactiveAll interventions are based on function and progress monitoring data

10-15%

5-10%

Multiple Gating ProceduresMultiple Gating Procedures Gate 1: cast a wide netGate 1: cast a wide net

– Teacher report or nominationTeacher report or nomination– Brief parent reportBrief parent report– Brief self-reportBrief self-report

Remember that measurement Remember that measurement class?class?

True PositivesTrue Positives

Identified as at risk Identified as at risk who actually arewho actually are

at riskat risk

False PositivesFalse Positives

Identified as at risk Identified as at risk but who are but who are not at risknot at risk

False NegativesFalse Negatives

Identified as not at Identified as not at risk but who are risk but who are actually at riskactually at risk

True NegativesTrue Negatives

Identified as not at Identified as not at risk who are actually risk who are actually

not at risknot at risk

Remember that measurement Remember that measurement class?class?

Sensitivity:Sensitivity:– Of those Of those actuallyactually at risk, what at risk, what

proportion is identified?proportion is identified? Specificity:Specificity:

– Of those Of those actually notactually not at risk, what at risk, what proportion is identified?proportion is identified?

Positive predictive valuePositive predictive value– Of those Of those identifiedidentified as at risk, what as at risk, what

proportion is correctly identified?proportion is correctly identified?



Gate 2: refine the “catch”Gate 2: refine the “catch”– Ratings and/or rankingsRatings and/or rankings



Gate 2: refine the “catch”Gate 2: refine the “catch”– Ratings and/or rankingsRatings and/or rankings

Gate 3: identify those most at riskGate 3: identify those most at risk– Observations, interviews, other assessmentsObservations, interviews, other assessments

Then What?Then What? Individualized planningIndividualized planning

InterventionIntervention

Progress monitoringProgress monitoring

Fading of interventionFading of intervention

Universal = All?Universal = All? All kindergartnersAll kindergartners

All transfers into schoolAll transfers into school

All students during transition year to All students during transition year to middle school or high schoolmiddle school or high school

When to Screen?When to Screen? If using parent report, at beginning If using parent report, at beginning

of school year is okof school year is ok

If using teacher report, wait at least If using teacher report, wait at least two monthstwo months

Self-report?Self-report?

What about Informed Consent?What about Informed Consent? Passive vs. active consentPassive vs. active consent

The trade-offThe trade-off

What About Informed Consent?What About Informed Consent?Hatch Amendment (1974)Hatch Amendment (1974) No student shall be required, as part of any applicable program, to No student shall be required, as part of any applicable program, to

submit to a survey, analysis, or evaluation that reveals submit to a survey, analysis, or evaluation that reveals information concerning—information concerning—

(1) political affiliations;(1) political affiliations; (2) mental and psychological problems potentially embarrassing to (2) mental and psychological problems potentially embarrassing to

the student or his family;the student or his family; (3) sex behavior and attitudes;(3) sex behavior and attitudes; (4) illegal, anti-social, self-incriminating and demeaning behavior;(4) illegal, anti-social, self-incriminating and demeaning behavior; (5) critical appraisals of other individuals with whom respondents (5) critical appraisals of other individuals with whom respondents

have close family relationships;have close family relationships; (6) legally recognized privileged or analogous relationships, such (6) legally recognized privileged or analogous relationships, such

as those of lawyers, physicians, and ministers; oras those of lawyers, physicians, and ministers; or (7) income (other than that required by law to determine eligibility (7) income (other than that required by law to determine eligibility

for participation in a program or for receiving financial assistance for participation in a program or for receiving financial assistance under such program),under such program),

without the prior consent of the student (if the student is an adult without the prior consent of the student (if the student is an adult or emancipated minor), or in the case of an unemancipated minor, or emancipated minor), or in the case of an unemancipated minor, without the prior written consent of the parent.without the prior written consent of the parent.

What About Informed Consent?What About Informed Consent? Broad interpretations of the Hatch Broad interpretations of the Hatch

Amendment (1974); parents seek to Amendment (1974); parents seek to restrict activities related to:restrict activities related to:– Values clarification; moral dilemmasValues clarification; moral dilemmas– Religious and moral standardsReligious and moral standards– Death education; Sex educationDeath education; Sex education– Drug and alcohol useDrug and alcohol use– Nuclear policy and globalismNuclear policy and globalism– Witchcraft, occult, supernaturalWitchcraft, occult, supernatural– EvolutionEvolution

What About Informed Consent?What About Informed Consent? “ “Psychological and psychiatric Psychological and psychiatric

treatment that is designed to affect treatment that is designed to affect behavioral, emotional, or attitudinal behavioral, emotional, or attitudinal characteristics of an individual or characteristics of an individual or designed to elicit information about designed to elicit information about attitudes, habits, traits, opinions, attitudes, habits, traits, opinions, beliefs or feelings of an individual or beliefs or feelings of an individual or group.”group.”

What about Informed Consent?What about Informed Consent? Passive consent probably ok for teacher Passive consent probably ok for teacher

nominations or rankings at Gate 1 and 2; nominations or rankings at Gate 1 and 2; obtain active consent for Gate 3obtain active consent for Gate 3

Almost always obtain active consent when Almost always obtain active consent when student or parent report is usedstudent or parent report is used

Get consent and screen when parents are Get consent and screen when parents are physically present at schoolphysically present at school

Don’t forget the lawyers….Don’t forget the lawyers….

Assessing Technical AdequacyAssessing Technical Adequacy Just because it is published…Just because it is published…

School or district level evaluation…School or district level evaluation…

Except for a few statistics,Except for a few statistics, everything I learned in graduate everything I learned in graduate

school turned out to be wrong.school turned out to be wrong.- Jack Bardon - Jack Bardon

StatisticsStatistics

Please remember to Please remember to answer in the form answer in the form of a question…or of a question…or whatever….whatever….

And, as always, no And, as always, no wagering. wagering.

Variance is a measure of

a. the amount of spread in a set of scores.b. the most frequently occurring score.c. the average score.d. the difficulty level of scores.

The statistic that tells you the strength and direction of the relationship between two variables.

True or false:If you know that there is an r of .85 between measures of these two variables, you can state with confidence that parent involvement in schooling results in students’ high grades.

Which of the following is a more impressive result in a study?A. “the correlation between the variables was significant at the .0001 level.”B. “An effect size of 1.2 was observed in favor of the experimental group.”

A self-concept scale was A self-concept scale was normed in 1968 on 200 children normed in 1968 on 200 children who lived near a university in who lived near a university in Colorado. Name at least 3 Colorado. Name at least 3 problems with using this problems with using this measure in Delaware.measure in Delaware.

A T score has a mean of _____ and a SD of _____ .a. 50; 10b. 50; 50c. 100; 15d. 0; 2

Cronbach’s coefficient alpha is a measure ofa. construct validity.b. internal consistency reliability.c. discriminant validity.d. test‑retest reliability.

True or False: A low test-rest reliability coefficient always means that the test is poorly constructed.

__________ validity is the extent to which the items in a measure represent the domain being assessed.A. ConstructB. FaceC. ContentD. Concurrent

Technical Adequacy SummaryTechnical Adequacy Summary Representative normsRepresentative norms Internal consistency reliabilityInternal consistency reliability Test-retest reliabilityTest-retest reliability Inter-rater reliabilityInter-rater reliability Predictive validityPredictive validity Concurrent validityConcurrent validity Construct validityConstruct validity Content validityContent validity

Additional Factors to ConsiderAdditional Factors to Consider AcceptabilityAcceptability AppropriatenessAppropriateness FeasibilityFeasibility AdaptabilityAdaptability UtilityUtility

See Glover and Albers (2007)See Glover and Albers (2007)

UtilityUtility Are the outcomes useful for guiding Are the outcomes useful for guiding

intervention?intervention?

Does this process improve student Does this process improve student outcomes?outcomes?

CautionsCautions Build support for the programBuild support for the program

– Provide clearly written, family-friendly Provide clearly written, family-friendly information that outlines the benefits of information that outlines the benefits of screeningscreening

– Provide prompt answers and additional Provide prompt answers and additional information to any parent expressing information to any parent expressing concernconcern

– Provide information about screening Provide information about screening outcomes (and effectiveness of outcomes (and effectiveness of programming)programming)

CautionsCautions Gain student assentGain student assent

– Even when parents have provided Even when parents have provided permission, students must have the permission, students must have the freedom to opt out without penaltyfreedom to opt out without penalty

– Provide student-friendly information Provide student-friendly information about the screeningabout the screening

– Encourage family decision-makingEncourage family decision-making

CautionsCautions Protect student and family privacyProtect student and family privacy

– Educate teachers about confidentialityEducate teachers about confidentiality– Guard against labelingGuard against labeling

Screening must lead to effective Screening must lead to effective intervention!intervention!

Some ExamplesSome Examples Published methodsPublished methods

– SSBD SSBD – BASC-2/BESSBASC-2/BESS

Build-Your-Own-ScreeningBuild-Your-Own-Screening– NominationNomination– Delaware Behavior ChecklistDelaware Behavior Checklist– Parent or Youth Self-ReportParent or Youth Self-Report

Systematic Screening for Behavior Systematic Screening for Behavior Disorders (SSBD)Disorders (SSBD)

Walker and Severson (1992)Walker and Severson (1992) Published by Sopris WestPublished by Sopris West Cost: $120 (plus $14 per pack of Cost: $120 (plus $14 per pack of

forms)forms) K-6K-6 Identifies externalizing and Identifies externalizing and

internalizing disordersinternalizing disorders


Based on teacher judgment which is Based on teacher judgment which is reliable and valid but underutilizedreliable and valid but underutilized

Simple procedures at Gates 1 and 2 that:Simple procedures at Gates 1 and 2 that:– Take full advantage of teachers’ Take full advantage of teachers’

judgmentsjudgments– Require attention to the full range of Require attention to the full range of

potentially problematic behaviors potentially problematic behaviors (internalizing and externalizing)(internalizing and externalizing)

– Require systematic attention to all Require systematic attention to all students in a classstudents in a class


Procedures at Gate 3 that:Procedures at Gate 3 that:– Address the two major adjustment Address the two major adjustment

areas for childrenareas for childrenTeacher-related classroom adjustmentTeacher-related classroom adjustmentPeer-related social adjustmentPeer-related social adjustment


Don’t conduct screening until at least Don’t conduct screening until at least one month into school year; end of one month into school year; end of October preferredOctober preferred

Don’t rank any student that the Don’t rank any student that the teacher has known for less than one teacher has known for less than one monthmonth

Screen again in February to pick up Screen again in February to pick up new students, missed students, and new students, missed students, and those whose behavior has changedthose whose behavior has changed


Gate 1 – Step 1:Gate 1 – Step 1:– Study definitions and examples of Study definitions and examples of

externalizing and internalizing behavior externalizing and internalizing behavior problemsproblems

Gate 1 – Step 2:Gate 1 – Step 2:– Using class roster, select 10 students for Using class roster, select 10 students for

EACH of the externalizing and EACH of the externalizing and internalizing groupsinternalizing groups

Gate 1 – Step 3:Gate 1 – Step 3:– Rank order students in each group from Rank order students in each group from

most to least according to degree of most to least according to degree of externalizing or internalizing behaviorexternalizing or internalizing behavior


Gate 2Gate 2– Working only with the top three Working only with the top three

students from each liststudents from each list– Complete two rating scales on all Complete two rating scales on all

six childrensix children


Gate 2:Gate 2:– Critical Events IndexCritical Events Index

Steals, trantrums, damages property, etc.Steals, trantrums, damages property, etc.– Combined Frequency IndexCombined Frequency Index

5 point Likert scale (never to frequently)5 point Likert scale (never to frequently)12 adaptive (e.g., considerate of others’ 12 adaptive (e.g., considerate of others’

feelings, cooperates)feelings, cooperates)12 maladaptive (e.g., behaves 12 maladaptive (e.g., behaves

inappropriately when corrected, manipulates inappropriately when corrected, manipulates others to get his/her own way)others to get his/her own way)


Gates 1 and 2 are designed to be Gates 1 and 2 are designed to be completed in a single one hour completed in a single one hour faculty meeting.faculty meeting.– Allows oral review of definitionsAllows oral review of definitions– Allows questions to be answeredAllows questions to be answered

When students are selected for When students are selected for Gate 3, probably seek permission Gate 3, probably seek permission to continueto continue


Decision rules to pass to Gate 3Decision rules to pass to Gate 3– For each “externalizing” child:For each “externalizing” child:

If CEI ≥ 5, child passes to Gate 3If CEI ≥ 5, child passes to Gate 3If CEI is < 5 but >0, check CFIIf CEI is < 5 but >0, check CFI

– If adaptive score is > 30, stop.If adaptive score is > 30, stop.– If adaptive score is ≤ 30, examine If adaptive score is ≤ 30, examine

maladaptive score.maladaptive score.

– If maladaptive score is < 35, stop.If maladaptive score is < 35, stop.– If maladaptive score is ≥ 35, child passes If maladaptive score is ≥ 35, child passes

to Gate 3. to Gate 3.


Gate 3 – systematic observationGate 3 – systematic observation– Classroom and playgroundClassroom and playground

Two observations in each settingTwo observations in each settingAt least 15 minutes per observationAt least 15 minutes per observationIncludes observation of normative Includes observation of normative

peer (optional)peer (optional)– Conducted by a trained observer Conducted by a trained observer

other than the child’s classroom other than the child’s classroom teacherteacher


Academic Engaged Time (AET)Academic Engaged Time (AET)– Attending to materials and taskAttending to materials and task– Making appropriate responsesMaking appropriate responses– Asking for assistance appropriatelyAsking for assistance appropriately

– Duration recordingDuration recording


Peer Social Behavior ObservationPeer Social Behavior Observation– Social engagementSocial engagement– ParticipationParticipation– Parallel playParallel play– AloneAlone– (No Code)(No Code)

– Interval recordingInterval recording


Decision criteria for Gate 3:Decision criteria for Gate 3:– Internalizers:Internalizers:

AET ≤ 45% ORAET ≤ 45% OR% Alone + % Parallel Play% Alone + % Parallel Play

– 40% or more (Grades 1-3)40% or more (Grades 1-3)– 35% or more (Grades 4-6)35% or more (Grades 4-6)

– Externalizers:Externalizers:AET ≤ 35% ORAET ≤ 35% ORTotal Negative behavior ≥ 12%Total Negative behavior ≥ 12%


Around 17% of students Around 17% of students nominated as externalizing pass nominated as externalizing pass Gates 2 and 3 (0% of controls)Gates 2 and 3 (0% of controls)

Around 11% of students Around 11% of students nominated as internalizing pass nominated as internalizing pass Gates 2 and 3 (0.5% of controls)Gates 2 and 3 (0.5% of controls)


Technical dataTechnical data– Gate 1: Test-retest (one month) Gate 1: Test-retest (one month)

averages .88 for externalizing averages .88 for externalizing and .74 for internalizingand .74 for internalizing

– Gate 2: CEI r = .81; CFI r = .90 Gate 2: CEI r = .81; CFI r = .90 (adaptive); .87 (maladaptive)(adaptive); .87 (maladaptive)

– Gate 3: About 90% of students Gate 3: About 90% of students correctly classified as externalizing, correctly classified as externalizing, internalizing, or controlinternalizing, or control


Technical dataTechnical data– Large normative sample (Large normative sample (4,463 4,463

students at Stage II and 1,275 students students at Stage II and 1,275 students at Stage III)at Stage III)

– From 8 states with west over-From 8 states with west over-represented represented

– Predictive validity could be higher (52% Predictive validity could be higher (52% of internalizers and 69% of externalizers of internalizers and 69% of externalizers were ranked in top 3 the following year)were ranked in top 3 the following year)

Jefferson Parish Public SchoolsScreening 2007-2008Students # %

Total # screened 16,634 38% of JPPSS students

Total # nominated 3,521 21.2% of all students screened

Average # nominated per school

6622%

Range: 5.1% - 36.8%

Total # “AT-RISK” 129936.9% of

nominated / 7.8% of total population

Average # “AT-RISK” per school 25

8.0%Range: 2.0% -

21.7%Morgan-D’atrio, et al. (2008)

Jefferson Parish Public SchoolsScreening 2007-2008

% “AT-RISK” by Gender:

71.7%*Male

28.3%*Female

% “AT-RISK” by SSBD Dimension:

66.6%*Externalizing

33.4%*Internalizing

% “AT-RISK” by Race:

60.6%*African Americ

an

29.3%*

White

6.2%*Hispani

c

3.9%*

Other

*(N = 1,299) Morgan-D’atrio, et al. (2008)


Conclusions:Conclusions:– Worth consideringWorth considering– Use caution with normsUse caution with norms– Conduct local evaluationConduct local evaluation

BASC-2 Behavioral and Emotional BASC-2 Behavioral and Emotional Screening System (BESS)Screening System (BESS)

Purpose:Purpose:– To provide a standardized, efficient, and To provide a standardized, efficient, and

effective way to identify behavioral and effective way to identify behavioral and emotional strengths and weaknesses in emotional strengths and weaknesses in children and adolescents from PK-high children and adolescents from PK-high school.school.

– Intended for prevention and early Intended for prevention and early interventionintervention

BASC-2/BESSBASC-2/BESS Kamphaus and Reynolds (2007)Kamphaus and Reynolds (2007) Published by Pearson Published by Pearson Cost: $60 (manual); $589 (scoring Cost: $60 (manual); $589 (scoring

software); $98 (pack of 100 forms)software); $98 (pack of 100 forms) Preschool (age 3) to Grade 12; separate Preschool (age 3) to Grade 12; separate

forms depending on age and informantforms depending on age and informant Teacher, parent, self-report forms Teacher, parent, self-report forms

(beginning grade 3)(beginning grade 3) Global score to indicate risk for problemsGlobal score to indicate risk for problems

BASC-2/BESSBASC-2/BESS Designed for use in a multiple gating Designed for use in a multiple gating

procedureprocedure Parent and student forms are Parent and student forms are

available in Spanishavailable in Spanish Reading levels at about 6Reading levels at about 6thth grade for grade for

parents and 2parents and 2ndnd grade for students grade for students Includes a validity check for Includes a validity check for

respondentsrespondents Software available for easy scoringSoftware available for easy scoring

BASC-2/BESSBASC-2/BESS Similar proceduresSimilar procedures

– Conduct assessment using teachers as Conduct assessment using teachers as informants only after at least one month informants only after at least one month of daily contactof daily contact

– Ask parent who is most familiar with the Ask parent who is most familiar with the childchild

– Self report beginning in grade 3Self report beginning in grade 3

– Active parental consent for parent and Active parental consent for parent and self-report versions; teacher version?self-report versions; teacher version?

BASC-2/BESSBASC-2/BESS Who to screen?Who to screen?

– Transitional yearsTransitional years– New studentsNew students– Schools with high numbers of behavioral Schools with high numbers of behavioral

problems (for prevention at early problems (for prevention at early grades)grades)

BASC-2/BESSBASC-2/BESS Gate 1: BESS administrationGate 1: BESS administration

– 25-30 items (depending on form)25-30 items (depending on form)– 4 point Likert scale4 point Likert scale

Never, sometimes, often almost alwaysNever, sometimes, often almost always– About 5-10 minutes to administerAbout 5-10 minutes to administer

– Scan or hand-key formsScan or hand-key forms– ASSIST SoftwareASSIST Software

BASC-2/BESSBASC-2/BESS Total Score for each studentTotal Score for each student

– T score in one of three categoriesT score in one of three categoriesNormal risk (T ≤ 60)Normal risk (T ≤ 60)Elevated risk (T = 61 to 70)Elevated risk (T = 61 to 70)Extremely elevated risk (T ≥ 71)Extremely elevated risk (T ≥ 71)

– User can set level of risk for moving to User can set level of risk for moving to next gatenext gate

BASC-2/BESSBASC-2/BESS Gate 2: Administer BASC-2 for all Gate 2: Administer BASC-2 for all

those identified as falling above those identified as falling above accepted level of riskaccepted level of risk

All those above pre-determined All those above pre-determined elevation levels for internalizing, elevation levels for internalizing, externalizing, total problems, etc. externalizing, total problems, etc.

Further evaluation And/or Intervention

BASC-2/BESSBASC-2/BESS Gate 3: “comprehensive diagnostic Gate 3: “comprehensive diagnostic

assessment” leading to placement assessment” leading to placement decision or differential diagnosis.decision or differential diagnosis.

BASC-2/BESSBASC-2/BESS Technical dataTechnical data

– Nationally representative sample Nationally representative sample (matched to US population for race, (matched to US population for race, region, and SES) of 12,350region, and SES) of 12,350

– High levels of reliability:High levels of reliability:Test-retest (interval not Test-retest (interval not

reported): .80-.91reported): .80-.91Internal consistency: .90-.96Internal consistency: .90-.96Inter-rater: .71-.83Inter-rater: .71-.83

BASC-2/BESSBASC-2/BESS Technical dataTechnical data

– Good positive predictive values for total Good positive predictive values for total problems (.73-.82) and externalizing problems (.73-.82) and externalizing (.61-.76)(.61-.76)

– Low levels for internalizing at preschool Low levels for internalizing at preschool age (.30-.47)age (.30-.47)

– Moderate levels for internalizing at Moderate levels for internalizing at child/adolescent (above .5) child/adolescent (above .5)

BASC-2/BESSBASC-2/BESS Conclusions:Conclusions:

– Excellent national norms, co-normed Excellent national norms, co-normed with instrument already in use in many with instrument already in use in many placesplaces

– Too soon to tell if predictive validity Too soon to tell if predictive validity estimates will hold upestimates will hold up

– Expense of scoring software a drawbackExpense of scoring software a drawback– Offers flexibility in setting levels of riskOffers flexibility in setting levels of risk– Allows large scale, district wide data Allows large scale, district wide data

collection and reportingcollection and reporting– Not good for progress monitoringNot good for progress monitoring

Build-Your-Own-ScreeningBuild-Your-Own-Screening Simple nomination and individualized Simple nomination and individualized

follow-upfollow-up– Clearly define “at risk” for purposes of Clearly define “at risk” for purposes of

nominationnomination– Teachers nominate X students meeting the Teachers nominate X students meeting the

definition (Gate 1)definition (Gate 1)– Select a more detailed rating scale for Select a more detailed rating scale for

nominated students that matches the nominated students that matches the definition; set criterion for risk (Gate 2)definition; set criterion for risk (Gate 2)

– Observations & interviews as needed to Observations & interviews as needed to determine intervention steps (Gate 3)determine intervention steps (Gate 3)

Build-Your-Own-ScreeningBuild-Your-Own-Screening Delaware Behavior ChecklistDelaware Behavior Checklist

– Brief (20 items) rating of all students in Brief (20 items) rating of all students in classroomclassroom

– 3 point Likert scale (not a problem, 3 point Likert scale (not a problem, sometimes a problem, often a problem)sometimes a problem, often a problem)

– Produces 5 scale scores and a total:Produces 5 scale scores and a total:AggressionAggressionClassroom disruptionClassroom disruptionDepression/anxietyDepression/anxietyPeer relationsPeer relationsAcademic problemsAcademic problems

Build-Your-Own-ScreeningBuild-Your-Own-Screening Delaware Behavior ChecklistDelaware Behavior Checklist

– Currently, norms for Christina School Currently, norms for Christina School District onlyDistrict only

– Use as Gate 1 screening; follow up those Use as Gate 1 screening; follow up those scoring 1.5 standard deviations above scoring 1.5 standard deviations above the mean for either total or individual the mean for either total or individual scale scoresscale scores

– Gates 2 and 3 as aboveGates 2 and 3 as above

Build-Your-Own-ScreeningBuild-Your-Own-Screening Parent report at Gate 1Parent report at Gate 1

– Pediatric Symptom Checklist-17 (Pediatric Symptom Checklist-17 (Jellinek, Jellinek, Murphy, & Burns, 1986Murphy, & Burns, 1986))

Ages 6-12Ages 6-1217 items17 items3 point Likert scale (never, sometimes, 3 point Likert scale (never, sometimes,

often)often)Yields internalizing, externalizing, and total Yields internalizing, externalizing, and total

scoresscoresAvailable on line: Available on line:

http://ocs.ccri.ws/psc-17.asphttp://ocs.ccri.ws/psc-17.asp

Build-Your-Own-ScreeningBuild-Your-Own-Screening Youth self-report at Gate 1Youth self-report at Gate 1

– Use active consentUse active consent– Broad-band measures:Broad-band measures:

BASC-2 Self-reportBASC-2 Self-reportYouth Self Report (Achenbach scales)Youth Self Report (Achenbach scales)

– Narrow-band measures:Narrow-band measures:Multi-dimensional Anxiety ScaleMulti-dimensional Anxiety ScaleReynolds Adolescent Depression ScaleReynolds Adolescent Depression ScaleChildren’s Depression InventoryChildren’s Depression InventoryPersonal Experiences Screening Personal Experiences Screening

Questionnaire (substance use)Questionnaire (substance use)

No matter what the method…No matter what the method… Consider issues of consentConsider issues of consent

Make sure students identified as high Make sure students identified as high risk receive interventionrisk receive intervention

Conduct program evaluationConduct program evaluation– See www.casel.org/assessmentSee www.casel.org/assessment

Linking to InterventionLinking to Intervention Use what you haveUse what you have

Monitor what you doMonitor what you do

Tools for progress monitoring: Tools for progress monitoring:

http://www.jimwrightonline.com/http://www.jimwrightonline.com/php/tbrc/tbrc.phpphp/tbrc/tbrc.php

Linking to InterventionLinking to Intervention Use what you haveUse what you have

Monitor what you doMonitor what you do

Refer as neededRefer as needed

Linking to InterventionLinking to InterventionKeys to making a “good” referral:Keys to making a “good” referral:

Involve family early and oftenInvolve family early and often– Describe what has been learnedDescribe what has been learned– ASK family for their views and ideas about ASK family for their views and ideas about

what, if anything, should be donewhat, if anything, should be done Brainstorm options whenever possibleBrainstorm options whenever possible

– More than one agency?More than one agency?– Community resources?Community resources?

Assist the family with the appointmentAssist the family with the appointment– Call while they are with youCall while they are with you– Follow upFollow up

Read more about it….Read more about it….

Questions or support?Questions or support?– http://www.udel.edu/cds/pbs/http://www.udel.edu/cds/pbs/– [email protected]@udel.edu

http://www.udel.edu/cds/pbs/

mailto:[email protected]

universal screening for social-emotional and behavioral difficulties

Documents