RESUMEN
We examined the predictive utility of the Behavior Assessment System for Children-2 Behavioral and Emotional Screening System (BASC-2-BESS) and Strengths and Difficulties Questionnaire (SDQ) in identifying students with a mental disorder. Data were collected in a two-stage study over 34 months with kindergarten-12th grade (K-12) students (aged 5-19 years) in four U.S. school districts. In Stage 1, teachers completed the BASC-2-BESS and the SDQ. In Stage 2, parents of 1,054 children completed a structured diagnostic interview to determine presence of a mental disorder. Results suggest that teacher versions of the BASC-2-BESS and SDQ have modest utility in identifying children meeting criteria for a mental disorder based on parent report. Area Under the Curve (AUC) statistics representing prediction of any externalizing disorder (.73 for both measures) were higher than the AUCs predicting any internalizing disorder (.58 for both measures). Findings can inform the use of teacher report in mental health screening, specifically the selection of measures when implementing screening procedures.
RESUMEN
In the United States (U.S.), quality rating and improvement systems (QRIS) are used by many states to incentivize quality in ECE and may be a viable lever for promoting early childhood development and mental health on a population level. We conducted a qualitative review of publicly available data on state QRIS indicators to better understand how states incorporate evidence-informed early childhood development and mental health promotion standards in QRIS. We systematically compared QRIS indicators for 41 U.S. states with child development and mental health promotion quality standards from Caring for Our Children National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition, as of March/April 2020. Of those, 39 states included at least one indicator consistent with child development or mental health promotion standards, including practices that can lead to early detection of developmental delays such as developmental monitoring, activities or curriculum addressing developmental domains, and regular communication and resource-sharing with parents/guardians. Opportunities exist within states for incorporating more specific guidance within indicators, such as use of childcare health consultants and advocates, validated screening tools, parent/guardian participation or input in developmental monitoring and screening, and staff training on family engagement. We found that in most states QRIS indicators offer guidance for ECE systems to support and monitor early development and foster mental health, with opportunities to enhance guidance. Findings point to QRIS as a viable opportunity for promotion of early childhood development and mental health standards in ECE systems.
RESUMEN
Effective methods to assess mental disorders in children are necessary for accurate prevalence estimates and to monitor prevalence over time. This study assessed updates of the tic disorder and attention-deficit/hyperactivity disorder (ADHD) modules of the Diagnostic Interview Schedule for Children, Version 5 (DISC-5) that reflect changes in diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (Fifth edition, DSM-5). The DISC-5 tic disorder and ADHD parent- and child-report modules were compared to expert clinical assessment for 100 children aged 6-17 years (40 with tic disorder alone, 17 with tic disorder and ADHD, 9 with ADHD alone, and 34 with neither) for validation. For the tic disorder module, parent-report had high (>90%) sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, while the youth-report had high specificity and PPV, moderate accuracy (81.4%), and lower sensitivity (69.8%) and NPV (67.3%). The ADHD module performed less well: parent-report had high NPV (91.4%), moderate sensitivity (80.8%), and lower specificity (71.6%), PPV (50.0%), and accuracy (74.0%); youth-report had moderate specificity (82.8%) and NPV (88.3%), and lower sensitivity (65.0%), PPV (54.2%), and accuracy (78.6%). Adding teacher-report of ADHD symptoms to DISC-5 parent-report of ADHD increased sensitivity (94.7%) and NPV (97.1%), but decreased specificity (64.2%), PPV (48.7%), and accuracy (72.2%). These findings support using the parent-report tic disorder module alone or in combination with the child report module in future research and epidemiologic studies; additional validation studies are warranted for the ADHD module.
RESUMEN
PURPOSE: This study evaluated the stability over time of prevalence estimates of mental disorders among school-aged children from the same community. METHODS: We compared screening status and weighted prevalence of selected mental disorders from the two-stage school-based South Carolina Project to Learn About Youth-Mental Health (Time 1) and its replication study (Time 2) conducted between 2014 and 2017. During stage 1, two teacher screeners were used to group students into high or low risk for a mental disorder. During stage 2, parents of selected students completed a structured diagnostic interview to assess whether their child met criteria for specific disorders. RESULTS: For stage 1, 19.9% of students screened as high risk for a mental disorder at Time 2 compared to 17.8% at Time 1. Among students included at both timepoints, 9.1% screened as high risk at both timepoints while screening status changed for 20.7%. The overall prevalence of included mental disorders was approximately 18% at both time points There were no differences (P-values >.05) in prevalence of individual mental disorders between Time 1 (range:0.3%-6.7%) and Time 2 (range:1.2%-7.7%). CONCLUSIONS: Study findings demonstrate that similar methodology yielded similar prevalence estimates of mental disorders and can inform community-level planning for improving mental health in children.