Journal of Emotional and Behavioral Disorders RSS feed -- OnlineFirst Articles

An Examination of the Psychometric Properties of the Pediatric Symptom Checklist With Children Enrolled in Medicaid

Boothroyd, R. A., Armstrong, M. — Tue, 29 Sep 2009 21:14:02 PDT

The federal Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program requires mental health screening of Medicaid-eligible children as part of primary care medical assessments. However, decisions related to selection of a screening tool remain with the states. States need access to brief, cost effective, easily administered screening tools to comply with these regulations.

This paper examines the psychometric properties of the Pediatric Symptom Checklist (PSC) reported on 6,590 children ages 6-22 enrolled in Florida’s Medicaid program across seven areas of the state, whose caregivers participated in a mail survey at least once between 1998 and 2007. Results suggest the PSC has both good internal consistency and stability over time across children with varying health and mental health conditions. The PSC demonstrated excellent discriminant validity regarding its ability to differentiate among children with varying levels of disabilities. Evidence of the PSCs construct validity was found based on its significant associations with other measures in predicted directions. At the recommended cut-off score of 28, the PSC exhibited good sensitivity, specificity, positive predictive value, and negative predictive value. Collectively, these findings support the use of the PSC as an appropriate measure for screening the psychosocial needs of children enrolled in Medicaid.

Comparing Child, Parent, and Family Characteristics in Usual Care and Empirically Supported Treatment Research Samples for Children With Disruptive Behavior Disorders

Tue, 09 Jun 2009 11:20:06 PDT

This study compared data from 34 research trials of five empirically supported treatments (ESTs) with one large usual care (UC) sample on child, parent, and family characteristics for children with Disruptive Behavior Disorders. Large variations were found within and across ESTs on sample characteristics during the past two decades. Most parent and family characteristics were not reported in EST studies. Statistical comparisons between UC and EST samples revealed that occurrences of child demographics and symptom severity levels were similar, but occurrences of most parent and family characteristics were different, with higher rates of problems for the UC sample. Results indicate that UC clients have complex needs, with multiple child, parent, and family issues. The findings are discussed in relation to the importance of acknowledging parent and family contextual variables in implementation efforts.

Development of a Scale to Measure the Empowerment of Youth Consumers of Mental Health Services

Walker, J. S., Thorne, E. K., Powers, L. E., Gaonkar, R. — Fri, 05 Jun 2009 13:33:14 PDT

Within the field of children’s mental health, there is increasing emphasis on the idea that young people who experience mental health difficulties should be encouraged to take an active role in shaping not only their own treatment but also mental health services and systems. The terms empowerment and, to a lesser extent, self-efficacy have been used to describe consumers’confidenceandcapacityfortaking on thisactiverole.Measures of mental health empowerment andself-efficacyhave been developed for adults with mental illnesses and for parents and caregivers of children with serious emotional or behavioral disorders; however, no such measure exists to assess empowerment among youth who themselves experience serious mental health difficulties. This article describes the development of the Youth Empowerment Scale–Mental Health and provides initial evidence of its reliability and validity.

Wraparound Retrospective: Factors Predicting Positive Outcomes

Cox, K., Baker, D., Wong, M. A. — Tue, 26 May 2009 11:17:13 PDT

While research regarding the effectiveness of the wraparound process is steadily mounting, little is known about how this service delivery model works and for whom. Using data gathered on 176 youth who participated in the wraparound process, the authors examine client and service factors associated with outcomes. Bivariate logistic regression analyses were conducted to determine the likelihood of treatment success based on select child and service characteristics. Results reveal that youth who exhibited lower levels of impairment at service entry were most successful in transitioning to and preserving a home placement, while those who possessed higher numbers of collateral supports were more likely to attain treatment goals. Findings also underscore the value of a planning process that promotes youth and family involvement in community activities. High adherence to this element of practice was found to predict both goal attainment and youth success in transitioning to a home setting. Implications for the implementation of the wraparound process with youth who are in residential care or at risk of out-of-home placement are discussed.

Family Education and Support Services in Systems of Care

Gyamfi, P., Walrath, C., Burns, B. J., Stephens, R. L., Geng, Y., Stambaugh, L. — Wed, 25 Mar 2009 11:13:48 PDT

This study examines the use of family education and support (FES) services within community-based mental health systems. Using data from the national evaluation of the Children’s Mental Health Initiative (CMHI), 2,853 caregivers and their children ages 6 to 18 years from 39 communities participated in this study. The findings indicated that during the first 6 months of entry into services, one third of families received FES services, and the clinical characteristics of children whose families received FES services were found to be more severe at intake into services with significantly higher internalizing and externalizing problems and significantly lower strengths than those families who did not. Similarly, caregivers who received FES services entered services experiencing more strain. The findings have implications for the impact of FES services on children.

A Comparison of Three Types of Opportunities to Respond on Student Academic and Social Behaviors

Wed, 25 Mar 2009 11:13:49 PDT

An alternating treatments design was used to investigate the effects of three types of opportunities to respond (i.e., individual, choral, and mixed responding) on sight words and syllable practice in six elementary students with behavioral problems. During the mixed responding condition, five out of six students demonstrated a lower rate of disruptive behavior, and four out of six students had fewer intervals of off-task behavior. Results of the three types of opportunities to respond on participants’ active student responding were less clear. A discussion of limitations, implications, and future research directions is included.

Parent Agreement on Ratings of Children's Attention Deficit/Hyperactivity Disorder and Broadband Externalizing Behaviors

Tue, 27 Jan 2009 10:46:42 PST

Mothers and fathers often disagree in their ratings of child behavior, as evidenced clinically and as supported by a substantial literature examining parental agreement on broadband rating scales. The present study examined mother–father agreement on Diagnostic and Statistical Manual–based symptom-specific ratings of Attention-Deficit/Hyperactivity Disorder (ADHD), as compared to agreement on broadband ratings of externalizing behavior. Based on mother and father ratings of 324 children who participated in the Multimodal Treatment Study of Children with ADHD (MTA), parental agreement was computed and patterns of disagreement examined. Mother–father ratings were significantly correlated; however, a clear pattern of higher ratings by mothers was present. Agreement on attention-deficit/hyperactivity disorder symptom-specific ratings was significantly lower than that for broadband externalizing behaviors and oppositional defiant disorder symptoms. Of several moderator variables tested, parental stress was the only one that predicted the discrepancy in ratings. Disagreement between parents is clinically significant and may pose complications to the diagnostic process.