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The purpose of this article is to provide a qualitative review of the published research on the Scales for Assessing Emotional Disturbance-3: Screener noting the psychometric properties and overall findings. Results from 10 studies were reviewed and summarized. Across the studies, internal consistency, test-retest reliability, and inter-rater agreement were satisfactory. Unidimensionality of the tests scores was supported, and several studies reported only trivial degrees of bias across racial/ethnic and linguistic backgrounds. Diagnostic utility was acceptable as were convergent relations with other measures of psychopathology. Social validity was also satisfactory. This review indicates that the psychometric properties of the scores from the Screener meet acceptable professional standards and supports its use in school-based programs to identify at-risk students.

Youth involved in residential care programs present with significant difficulties across behavioral and mental health domains. Although this is a group that is also at considerable risk for academic failure, very little research has been done to understand the academic functioning of this population. The current study sought to expand what is known about this population and examine factors that are predictive of their levels of academic functioning. Results from 208 youth indicated that at the time of entry into residential care youth were performing in low average ranges across academic areas. While several variables were identified as predictors for level of academic functioning (e.g., IQ, age at admission, race/ethnicity, special education identification, and gender), variables particularly relevant for youth in residential care programs (e.g., behavior, number of previous schools attended) did not serve as predictors. Implications for practice and future research are discussed. (Contains 2 tables.)

Strength-based assessment of behaviors in preschool children provides evidence of emotional and behavioral skills in children, rather than focusing primarily on weaknesses identified by deficit-based assessments. The Preschool Behavioral and Emotional Rating Scales (PreBERS) is a normative assessment of emotional and behavioral strengths in preschool children. The PreBERS has well-established reliability and validity for typically developing children as well as children with identified special education needs, but this has not yet been established for children in Head Start programs, who tend to be at high risk for development of emotional and behavioral concerns. This study explores the factorial validity of the PreBERS scores for a large sample of children participating in Head Start programs around the United States. Results not only confirm the fit of the four-factor model of the PreBERS for this population, but also demonstrate the application of a bifactor model to the structure of the PreBERS which, in turn, allows for the computation of model-based reliability estimates for the four subscales (Emotional Regulation, School Readiness, Social Confidence, Family Involvement) and overall strength index score. The implications suggest that the PreBERS items are reliable scores that can be used to identify behavioral strengths in preschool children in Head Start, and support planning of interventions to selectively address component skills to promote child social and academic success.

Often considered a "last resort placement," residential settings serve a broad range of children who present significant risks. While much is known about emotional and behavioral functioning, less is known about academic strengths and limitations. This study evaluated 127 children at intake into a residential care program to determine demographic, behavioral, mental health, and educational characteristics. Results indicated that children entering care present high levels of risk across domains. Primary risks were found on indicators of behavior (e.g., rule breaking, aggression), mental illness (e.g., disruptive behavior, anxiety), and academic performance (e.g., general knowledge, reading). Implications, limitations, and recommendations for future research are discussed. (Contains 3 tables.)

Background: Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with disabilities, one might expect that medical care usage is elevated and will continue to be a need when children return home or age out of the system. The purpose of this study was to evaluate if medical service utilization differed between youth with and without school-identified disabilities in care, and whether certain correlates (e.g., demographic characteristics and mental health functioning) would be associated with medical service use among youth with disabilities. Method: Hierarchical multiple regression models were used to explore the role of disability status in the utilization of medical services as well as to predict the effects of mental health functioning on utilization while controlling for other known factors. Results: Results indicated that medical service usage for youth with school identified disabilities was statistically higher than usage for peers without disabilities after accounting for other factors associated with utilization, and internalizing and externalizing behavior severity were significantly related to medical service utilization for youth with disabilities. Conclusions: As expected, the findings suggest that youth with disabilities use more medical services than peers without disabilities regardless of the presence of a physical health condition, but might be due to differences in the severity of the physical health conditions. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The article presents information on a study conducted to compare parent and family teacher ratings of perceptions of aftercare services for youth. Participants in the study included parents of youth undergoing treatment in a residential Treatment Family Home (TFH), and family teachers working at the TFH. The study concluded that large number of differences were identified between family teachers and parents, due to which treatment providers should increase communication between them.

While much is known about youth struggles after reintegration into the home and community settings following stays in out-of-home care, little is known about appropriate supports for aftercare, or parent (see Note ) and youth perceptions during this critical transition period. This study seeks to begin to address these questions through surveys evaluating youth ( n = 48) and parent ( n = 48) perceptions of (i) transition planning, family preparedness and aftercare; (ii) youth preparedness for the transition period across major life domains (e.g. education, health care, relationships); and (iii) the importance of specific aftercare supports and services. Results indicate differences between youth and parents on perceptions of need for continued supports, likelihood of participation in aftercare programs; and youth preparedness for success in relationships, family and independent living domains. In contrast, similarities were found on youth and parent ratings regarding the importance of specific services and supports, with both groups indicating supports in education as most important and supports in mental health as least. Study limitations, future research and implications are provided. [ABSTRACT FROM AUTHOR]

The Emotional and Behavioral Screener (EBS) is a universal screening instrument designed to identify students whose excessive problem behaviors put them at risk of the education disability category of emotional disturbance (ED). This article reports findings from three studies that address the reliability and validity of the EBS. Studies 1 and 2 examined the test–retest and inter-rater reliability of the EBS. Study 3 investigated the convergent validity of the EBS by comparing it to the Behavioral and Emotional Screening System. The results from these studies support the reliability and validity of the EBS as a universal screening instrument for identifying students who may be at risk of ED or those who may require a greater degree of monitoring, decision-making, formal assessment, or intervention to restore normal behavior functioning and prevent identification as ED. Implications, research limitations, and future research needs are discussed. [ABSTRACT FROM AUTHOR]

Youth in residential treatment settings often present with a complex combination of mental and physical health problems. Despite an emerging literature documenting significant associations between mental health and physical health, the relationship between these two areas of functioning has not been systematically examined in youth presenting to residential treatment. This study examines the association between youth psychopathology and physical health problems in a sample of 606 youth entering a large residential treatment program between 2003 and 2010. As a part of the intake process, youth psychopathology symptoms were assessed using the parent-report form of the Child Behavior Checklist, and youth physical health problems were assessed in a medical evaluation by a licensed child health professional. Results indicated that higher levels of youth psychopathology, particularly internalizing problems, were associated with greater risk for physical health problems and more prescription medications. Psychopathology comorbidity was also associated with physical health problems. These findings suggest an interplay between physical and mental health among youth entering residential treatment, highlighting the need for integrated assessment and intervention services that address psychological and medical needs within this population. [ABSTRACT FROM AUTHOR]

Research and evaluation of the wraparound process has typically focused on outcomes, service providers, and costs. While many of these studies describe a process that is consistent with the wraparound approach, few studies have reported attempts to monitor or measure the treatment fidelity of the wraparound process. The purpose of this study was to assess the fidelity of the wraparound process in a community-based system of care using the Wraparound Observation Form-Second Version. Results from 112 family planning meetings indicated some strengths and weaknesses within the current system. Families and professionals were frequently involved in the planning and implementation of the wraparound process. However, informal supports and natural family supports were not present in a majority of the meetings. Given the significant number of youth served in wraparound programs, the benefits of using the Wraparound Observation Form-Second Version as an instrument to monitor the fidelity of the wraparound approach should not be ignored. [ABSTRACT FROM AUTHOR]

The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of weight problems in 245 youth with learning disabilities or emotional disturbance at entrance to residential care. Youth intake files were examined to evaluate the association between youth demographic characteristics, medical conditions, prior placements and placement settings, medication usage, and internalizing and externalizing behavioral problems and clinical weight problems. Findings revealed that over one half of the youth were overweight or obese {50.6%), and weight problems were associated with gender, medical conditions, and age. Study limitations, future research efforts, and treatment implications are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Adolescents entering residential care have high rates of clinical weight problems; however, some aspects of the residential setting may be conducive to healthy weight management. This study aimed to examine the change in adolescent weight status from intake to discharge among a large sample of youth in a residential care program (N =1195). Although weight management was not a specific target of the program, adolescents were more likely to move to a healthier weight status than a less healthy one by the end of the placement. Adolescents who were obese at the time of intake (n =274) showed an average decrease of .21 zBMI units, and approximately a quarter of this group moved to a healthier weight category at discharge. These changes compare favorably to outcomes for existing treatments for adolescent weight problems and may represent clinically-meaningful improvements in weight status for many youth. Further, a decrease in psychotropic medication prescriptions was significantly associated with weight loss for adolescents who were overweight at intake. The implications of these findings, including the possible benefits of effective weight management in residential settings and the potential value of highly structured environments in promoting healthy weight among vulnerable adolescents, are discussed. [Copyright &y& Elsevier]

Abstract: Reintegrating into the home, school, and community settings following a stay in out-of-home care can present significant challenges to school-aged youths. During this transition, social, behavioral, and educational challenges can result in placement instability, academic failure, and ultimately school drop-out. This article describes a home and school-focused transition program, On the Way Home, which was designed to support youths, families, and schools during this critical reintegration period. The intervention model, preliminary data on program effects on youth placement and educational stability, and future research are discussed. [Copyright &y& Elsevier]

This study compares the On the Way Home (OTWH) aftercare program to traditional aftercare supports on placement and school stability for 82 youth (43 treatment, 39 control) with disabilities discharging from residential care. One-year-post-discharge results revealed that negative event occurrence (i.e., returning to care or discontinuing enrollment in the community school) was three to over five times less likely for OTWH youth compared to youth in the control condition.

Rising health care costs have led to an emphasis on identifying factors that contribute to medical service utilization. Previous research has suggested an association between youth psychopathology and service utilization; however, prospective studies among high-risk populations are needed. The current study examined youth psychopathology as a predictor of subsequent medical service utilization among a large sample (N = 536) of youth entering residential treatment. Youth psychopathology and medical status were assessed at intake, and medical service utilization was tracked across the duration of the residential placement. Results indicated that higher levels of psychopathology predicted greater youth medical service utilization, even after controlling for the presence of a diagnosed medical condition. Internalizing problems was a significant independent predictor of utilization, but externalizing problems was not. These findings highlight the association between mental health and medical service utilization and suggest that effective behavioral health services may be helpful in reducing costly medical service needs.

Objective: To examine the prevalence of physical health problems among youth entering residential treatment., Patients and Methods: The sample included 1744 youth (mean age: 14.6 ± 1.8 years) entering a large residential treatment program between 2000 and 2010. Youth received an intake medical evaluation, including a review of available records, detailed medical history, and physical examination. Medical conditions present at the time of the evaluation were recorded by the examining physician and later coded by the research team. Only diagnoses recognized by the International Classification of Diseases, 10th Revision, were included in the analyses. To maintain the focus on physical health problems, behavioral and emotional disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision were excluded. Obesity, acne, and allergies were also excluded., Results: Approximately one-third (33.7%) of youth had a physical health diagnosis at the time of intake. Asthma was the most prevalent condition diagnosed (15.3% of the sample). Girls were significantly more likely to have a diagnosis than were boys (37.1% vs 31.5%). Age was not associated with diagnostic status. Rates of physical health conditions differed significantly by ethnicity: black (36.4%) and white (35.4%) youth had the highest rates, and Hispanic youth (23.2%) had the lowest., Conclusions: Youth who enter residential treatment have high rates of physical health conditions. These problems could complicate mental health treatment and should be considered in multidisciplinary treatment planning.

While estimates suggest that 10% to 31% of children in residential care are identified as with a disability, little is known about their characteristics or functioning as compared to nondisabled peers. This study evaluated data of 123 children with (n=34) and without (n=89) disabilities in residential care to determine demographic, behavioral, mental health, and educational characteristics. Data included demographic, behavior checklist, and standardized mental health and academic measures. Results indicated that both groups presented elevated risks; however, scores for children with disabilities revealed even greater levels of need. Primary risks were found on indicators of behaviors (e.g., social functioning), mental illness (e.g., anxiety), and academic performance (e.g., general knowledge and reading). Implications, limitations, and recommendations for future research are discussed.

The push to rapidly implement the wraparound approach for families of children with serious emotional disturbance (SED) has resulted in a number of service models that may or may not be in accordance with its theoretical foundation. Given the number of wraparound programs being implemented nationwide, the need to develop instruments that can measure the fidelity of wraparound services in a reliable manner should not be ignored. The purpose of this study was to examine the interobserver agreement of the Wraparound Observation Form--Second Version (WOF-2), an observation system designed to assess the fidelity of wraparound services. Observations were conducted across 30 family planning meetings where wraparound services were provided. The mean percentage agreement across the 48 items was 96.7% (range 83.3-100%) and the average kappa statistic was 0.886 (range = 0.318-1.0). On the basis of these results, the WOF-2 appears to be a reliable instrument for assessing the delivery of wraparound services.