Evaluating the Cost of Prevention Programming and Universal Screening with Discrete Event Simulation.

Discrete Event Simulation (DES) is a novel system modeling technique that allows for the evaluation of the potential costs and personnel needed for mental health services in school. A case study is presented to illustrate how DES could be used by a school's decision makers to help plan for implementation of an integrated mental health service model. Discrete Event Simulation was used to model the personnel, time, and costs of an integrated mental health service model within a school setting. In addition, costs are calculated and then compared to a business as usual model. Data from the present investigation indicate substantial cost savings of implementing a prevention oriented mental health intervention model within a school setting. In a school of 1000 students, the prevention model could result in an annual cost savings of approximately $30,000 as well as a 50% reduction in disciplinary referrals and 22% reduction in suspensions. Results from the present investigation indicate substantial savings in financial resources and overall numbers of disciplinary infractions when implementing a prevention model. The DES allows for customization of personnel and time to modify the model and resulting output to local conditions. These data may allow school administrators to modify resources to meet student needs. In addition, cost data can help address some of the common implementation barriers associated with adoption of universal screening and preventative mental health services.

Multi-informant universal screening: Evaluation of rater, item, and construct variance using a trifactor model.

Universal screening is a proactive method for identifying student risk, yet remains under-utilized in school systems. Instead, many schools rely on teacher reports and referrals without accounting for different informant perspectives. In the current study, multi-informant universal screening in evaluated using a trifactor model. The study utilized the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS), specifically the teacher (SAEBRS-TRS) and student (mySAEBRS) self-report forms, with items indicating risk for social, academic, and emotional behavior. Data from a national sample of over 24,000 K-12 teacher-student dyads were used to examine the extent and variance of discrepant reports between students and teachers of common, perspective, and item factors. Results demonstrated that informant perspective factors were a strong predictor for student and teacher emotional behavior item ratings. Whereas age had a positive effect on younger student reports of risk on the behavior items compared to older student reports, teachers showed the opposite effect. The teacherperspective of social and emotional behaviors of students was predicted by gender. Implications and directions for future research are further discussed.

Co-occurrence of academic and behavioral risk within elementary schools: Implications for universal screening practices.

The purposes of this study were twofold. The first was to use latent class analysis to identify groupings of students defined by the presence or absence of academic or behavioral risk. The second was to determine whether these groups differed across various dichotomous academic and behavioral outcomes (e.g., suspensions, office discipline referrals, statewide achievement test failure). Students (N = 1,488) were sampled from Grades 3-5. All students were screened for academic risk using AIMSweb Reading Curriculum-Based Measure and AIMSweb Mathematics Computation, and behavioral risk using the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS). Latent class analyses supported the fit of a three-class model, with resulting student classes defined as low-risk academic and behavior (Class 1), at-risk academic and high-risk behavior (Class 2), and at-risk math and behavior (Class 3). Logistic regression analyses indicated the classes demonstrated statistically significant differences statewide achievement scores, as well as suspensions. Further analysis indicated that the odds of all considered negative outcomes were higher for both groups characterized by risk (i.e., Classes 2 and 3). Negative outcomes were particularly likely for Class 2, with the odds of negative behavioral and academic outcomes being 6-15 and 112-169 times more likely, respectively. Results were taken to support an integrated approach to universal screening in schools, defined by the evaluation of both academic and behavioral risk. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Evidence for the interpretation of Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) scores: An argument-based approach to screener validation.

In accordance with an argument-based approach to validation, the purpose of the current study was to yield evidence relating to Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) score interpretation. Bifactor item response theory analyses were performed to examine SAEBRS item functioning. Structural equation modeling (SEM) was used to simultaneously evaluate intra- and inter-scale relationships, expressed through (a) a measurement model specifying a bifactor structure to SAEBRS items, and (b) a structural model specifying convergent and discriminant relations with an outcome measure (i.e., Behavioral and Emotional Screening System [BESS]). Finally, hierarchical omega coefficients were calculated in evaluating the model-based internal reliability of each SAEBRS scale. IRT analyses supported the adequate fit of the bifactor model, indicating items adequately discriminated moderate and high-risk students. SEM results further supported the fit of the latent bifactor measurement model, yielding superior fit relative to alternative models (i.e., unidimensional and correlated factors). SEM analyses also indicated the latent SAEBRS-Total Behavior factor was a statistically significant predictor of all BESS subscales, the SAEBRS-Academic Behavior predicted BESS Adaptive Skills subscales, and the SAEBRS-Emotional Behavior predicted the BESS Internalizing Problems subscale. Hierarchical omega coefficients indicated the SAEBRS-Total Behavior factor was associated with adequate reliability. In contrast, after accounting for the total scale, each of the SAEBRS subscales was associated with somewhat limited reliability, suggesting variability in these scores is largely driven by the Total Behavior scale. Implications for practice and future research are discussed.

Diagnostic accuracy of a universal screening multiple gating procedure: A replication study.

The purpose of this diagnostic accuracy study was to evaluate the sensitivity and specificity (among other indicators) of three universal screening approaches, including the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS), a SAEBRS-based teacher nomination tool, and a multiple gating procedure (MGP). Each screening approach was compared to the BASC-2 Behavioral and Emotional Screening System (BESS), which served as a criterion indicator of student social-emotional and behavioral risk. All data were collected in a concurrent fashion. Participants included 704 students (47.7% female) from four elementary schools within the Midwestern United States (21.6% were at risk per the BESS). Findings yielded support for the SAEBRS, with sensitivity = .93 (95% confidence interval [.89-.97]), specificity = .91 (.89-.93), and correct classification = .92. Findings further supported the MGP, which yielded sensitivity = .81 (.74-.87), specificity = .93 (.91-.95), and correct classification = .91. In contrast, the teacher nomination tool yielded questionable levels of diagnostic accuracy (sensitivity = .86 [.80-.91], specificity = .74 [.70-.78], and correct classification = .76). Overall, findings were particularly supportive of SAEBRS diagnostic accuracy, suggesting the MGP might also serve as an acceptable approach to universal screening. Other implications for practice and directions for future research are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Evaluating the applied use of a mental health screener: Structural validity of the Social, Academic, and Emotional Behavior Risk Screener.

Universal screening for mental health has gained prominence in schools with the adoption of multitiered systems of support. However, there is a general lack of brief, psychometrically defensible instruments that assess emotional and behavioral risk. This study employed a multilevel, confirmatory bifactor analysis to evaluate the factor structure of a novel screening instrument-the Social, Academic, and Emotional Behavioral Risk Screener (SAEBRS; Kilgus & von der Embse, 2014)-examining the structure at the student (within) and teacher or rater (between) levels. Item response theory (IRT) analyses were then used to examine the functioning of 2 existing factors, social risk and academic risk, in addition to a newly introduced third factor, emotional risk, within a sample of 834 elementary and middle school students. Results indicated good fit of a bifactor model including the addition of the new Emotional Behavior subscale. IRT analyses suggested strong item-level discriminative properties (a > 1.0) for 17 of the 19 SAEBRS items and indicated that scale precision was greatest within the low to moderate range of each respective dimension (social, academic, and behavioral risk). Overall, the findings provide support for the use of the SAEBRS as a screener for mental health-related concerns. Implications for model interpretation and model use are discussed. (PsycINFO Database Record