Children's futures and the big screen

Epidemiological studies suggest that between 10 and 20 percent of children in the general population have severe enough symptoms to qualify them for some form of psychiatric diagnosis. Yet fewer than half will receive services to address their problems. There are also worrying signs that mental health among young people may be deteriorating in some countries, particularly the UK.

On another, similar front, long-term studies make it clear that children need strong cognitive and non-cognitive foundations upon which to build later competencies and that there is a criss-crossing between the kind of skills they learn and outcome ‘domains.'

Nobel prize winning economist James Heckman, for example, has demonstrated that non-cognitive skills are important predictors of later socio-economic success, similarly that strong cognitive foundations early in development predict later educational as well as social-emotional well-being. All the components are vital and interwoven.

The consensus is that we need better ways of identifying children with mental health problems and other impairments to learning, and that society’s strategy must move from treatment (or ‘wait-to-fail’) approaches to prevention and early intervention.

A number of universal screening tools have been developed to help schools identify children who are at risk or already experiencing specific problems.

For their part schools are accepting more responsibility for providing services and are recognising that non-academic aspects of children’s education, such as their emotional, behavioural and social development, are a necessary part of the pantheon.

Two particular tools are discussed in a recent special edition of the Journal of School Psychology. The Dynamic Indicators of Basic Early Literary Skills [1] (DIBELS; Good & Kaminski, 2002) screens for children at risk of poor reading skills by assessing sound recognition, letter naming, phoneme segmentation and word-based fluency tests. The Brief Academic Competence Evaluation Scales System (BACESS; Elliot, Huai & DiPerna, 2004) assesses both academic and social behaviour problems using a three tiered screening system.

In relation to mental health. a number of universal tools have been developed to test for a broad range of problems in the general population. They are brief and vary in their specificity and predictive validity. Promising measures include the Strengths and Difficulties Questionnaire (SDQ) and the Pediatric Symptoms Checklist (PSC).

In addition to these specific measures, some comprehensive mental health screening programmes have been developed that attempt to integrate approaches using "multiple gating". Examples include the Systematic Screening for Behavioural Disorders (SSBD; Walker and Severson, 1990) or the Columbia TeenScreen® programme.

The Journal of School Psychology describes an emerging body of tools that can screen for educational difficulties or mental health problems. None is perfect and all need technical refinement to improve their reliability and predictive validity.

Some challenges are more fundamental. Firstly, numbers of children identified at risk or experiencing educational of mental health problems will far exceed the supply of services within the school and community. Secondly, there are concerns that screening may further inflate the number of children prescribed medicinal treatments for mental health problems.

These concerns relate to current provision. For universal screening to improve outcomes, researchers say schools must take on more responsibility for children’s mental health. But this places a heavy burden upon already stretched resources. It also requires greater coordination between schools and targeted outside services. The development of adequate services must come first.

references
Elliot, S.N., Huai, N., & DiPerna, J. (2004). Brief academic competence evaluation screening system. Unpublished manuscript.

Good, R.H. & Kaminski, R.A. (2002). Dynamic indicators of basic early literacy skills (6th ed.). Longmont, CO: Sopris West.

Walker, H.M. & Severson, H.H. (1990). Systematic screening for behaviour disorders (SSBD). Longmont, CO; Sopris West.