School psychology: a public health perspective : I. Prevention, populations, and systems change

Concerns regarding American schools and mental health services for children abound, including inadequate educational achievement, school violence, over-referral to special education and disproportionate placement of minorities into special education, under-utilization of mental health services for children, and a poorly coordinated system of child mental health services. All of the above concerns share two common attributes: (a) they are statements regarding populations, rather than specific individuals; and (b) they are best addressed by changing system-wide elements of psychological service delivery. We argue that, although conceptualizing school psychology as primarily an indirect service specialty (e.g., J. Sch. Psychol. 28 (1990) 203) has advanced our thinking about effective service delivery, conceptualizing school psychological services from a public health perspective will provide an even broader framework that can increase both the efficacy and efficiency of school psychologists' work.     

Barriers to evidence-based treatment: developmental psychopathology and the interdisciplinary disconnect in school mental health practice

Reframing the role of school psychologists and related school professionals in a public health and primary prevention model represents a proactive antidote to their more traditional reactive stance to mental health problems. Two additional concepts, developmental psychopathology and complex comorbidity, are suggested as critical to complete this transition, and illustrations of these concepts for more effective school mental health services are provided.     

The Role of Interdisciplinary Teams in the Promotion of Physical and Mental Health

This article delineates important issues to be considered using special services professionals to develop and implement health promotion programs by means of a school-based interdisciplinary team approach. The current status of interdisciplinary teams is discussed and an expanded role for such teams in health promotion activities is advocated. Specific issues pertaining to interdisciplinary team organization and integration into school systems are reviewed in the context of health promotion program development.     

School psychologists' services in special education programs

Reviews school psychologists' services in special education programs. Fifty-eight credentialed school psychologists in 10 school districts were interviewed individually about background and training, professional duties, favored clinical techniques, and opinions and recommendations for improved services. According to self-reports, the bulk of time was devoted to activities directly related to assessment of pupils with little involvement in research, in-service training, or other clinical activities. Professional association memberships were primarily local. Assessment techniques tended to be limited to a few standardized tests. Overall findings support sample psychologists' expressed concerns as to need for changes in preservice and in-service training.     

Concordance Between Parent Reports of Children's Mental Health Services and Service Records: The Services Assessment for Children and Adolescents (SACA)

The concordance between parent reports of children's mental health services and medical and administrative service records were assessed in a field test of the Services Assessment for Children and Adolescents (SACA) interview instrument. Service use reports from primary caregivers, usually mothers, for their child's emotional or behavioral problems were compared against inpatient, outpatient, and school records in St. Louis, one of the pilot sites for the Multi-Site Study of Service Use, Need, Outcomes and Costs in Child and Adolescent Populations (UNOCCAP). A global any use service variable, comprised of inpatient, outpatient, and school reports, yielded an overall service use concordance kappa of .76 between parent reports and records. Parent reports of inpatient hospitalization services using the SACA yielded the highest agreement with medical records, with kappa statistics of 1.00 for use of any inpatient hospital care and for medication use. Parent reports of specific inpatient services concurred with medical records more moderately, yielding kappas from .50 to .66. Reports of any outpatient mental health services yielded variable rates of agreement, with kappas ranging from .67 for any use of outpatient care, to .66 for medication use, to negligible kappas for specific treatments. Parent reports of school services were weakly related to records for most services, except for moderate agreement (.48) on placement in special classrooms for emotional or behavioral problems. Family burden or impact discriminated more powerfully than other variables between respondents who concurred with records and those who did not.     

Role function and job satisfaction of school psychologists practicing in an expanded role model

School psychologists are typically itinerant among multiple schools and often spend up to two-thirds of their time on assessment activities related to students with disabilities and special education programs. School psychologists in delivery of an expanded role service model are assigned to a single school and provide more consultation and intervention services. 97 school psychologists assigned to an expanded role in a single southeastern urban school district were surveyed on their job roles and job satisfaction. The majority were satisfied or very satisfied with their jobs, particularly with engaging in activities that were of service to others and staying involved in a variety of job activities. School psychologists wanted to spend less time in assessment, multidisciplinary team meetings, and administrative duties. The discrepancy between the desired and actual amount of time spent in multidisciplinary meetings was negatively related to job satisfaction. Psychologists wanted to spend more time in direct and indirect intervention, professional development, and networking.     

Child Find Practices in Christian Schools

The 1997 Amendments of the Individuals with Disabilities Education Act (IDEA) states that children placed in private schools by their parents are no longer afforded the right to special education services. However, IDEA does state that child find activities between public school representatives and private schools are to remain intact. This study used an open-ended questionnaire design in order to understand Christian school representatives' perspectives regarding current child find practices.     

Serving Families of Children with Developmental Disabilities

Abstract

Increased cultural diversity in the United States and elsewhere in the west requires that the school special services providers be aware of differences among identity groups, and sensitive to how these variations influence parents' perceptions of, and responses to, their child with a developmental disability. Because concern about diversity is relatively recent, the data base for action is virtually nonexistent. Nonetheless, there exists sufficient information to alert the special services provider to such factors as culture, religion, race, and social class in developing service programs. Understanding the values, beliefs, and experiences of families enables one to provide more effective services than does operating with the assumption that everyone views the world through essentially the same lens.     

Teacher Job Stress and Satisfaction in Urban Schools: Disentangling Individual-, Classroom-, and Organizational-Level Influences

Schools remain among the most frequent providers of children’s mental health services, particularly in low-income urban settings. Several decades of research have focused on training teachers to implement evidence-based interventions for minimizing disruptive behavior. Studies consistently demonstrate robust improvements in student behavior and learning; however, the impact on teachers’ work-related stress or satisfaction is not well understood. Six urban, high-poverty elementary schools were randomly assigned to a school mental health services model (Links to Learning; L2L) for referred, disruptive students or to services and professional development as usual (SAU). Teachers (n = 71, K-4 general education teachers) in L2L schools participated in professional development and consultation in two universal and two targeted interventions to reduce disruptive behaviors and promote learning. Teachers (n = 65) in SAU schools participated in professional development as usual. Multiple regression models examined teacher reports of individual-level self-efficacy, classroom-level student functioning, and school-level organizational health as predictors of stress and satisfaction. Findings revealed no significant difference between conditions on teacher work-related stress or satisfaction. Organizational health was the strongest predictor of stress and satisfaction. Training on and implementation of evidence-based classroom interventions did not appear to significantly impact teachers’ work-related stress or satisfaction. Instead, findings point to organizational climate and teacher connectedness as potential levers for change, supporting prior work on teacher stress and satisfaction in schools. The significance of targeting organizational factors may be particularly significant in urban school districts.     

Perceptions of school psychology services from a staff perspective

This investigation examined how staff in an elementary school district perceived their school psychologists and how these perceptions differed across components of service and staff groups. We developed a School Psychological Service Questionnaire and then analyzed responses from regular education teachers, special education teachers, principals, and school psychologists in an urban school district. Although the findings are numerous, most noteworthy are, first, that consumer groups in the district had different perceptions than school psychologists about how school psychologists allocate their time and how this time should be allocated in the future. Second, consumer perceptions of school psychologists' knowledge generally were favorable. Third, in terms of domains appropriate for involvement by school psychologists, a factor analysis of consumer ratings revealed three relatively clear dimensions of recommended service provision — special education activities, interpersonal or school-climate activities, and administrative responsibilities. Fourth, the helpfulness of school psychologists, as perceived by consumers, related positively to frequency of contact. Fifth, differences in perception of school psychological services were evident across staff groups. Finally, comparisons between master's level and doctoral level school psychologists suggested numerous differences in how the staff perceived these service providers.     

School psychologists as perceived by school personnel: Support for a consultant model

Questionaires distributed by 12 school psychologists to school personnel with whom they had been consulting for six months were completed and returned by 73 teachers, counselors, and principals. The information provided by the respondents indicated the frequencies with which the school psychologists engaged in consulting and child study activities, the school personnel's evaluations of nine different school psychologist skills, and the preferences of the respondents for the different school psychologist functions in their schools. The data showed that: (1) school psychologists were doing more consulting than evaluations of individual children, (2) school personnel tended to perceive their psychologists as cooperative, knowledgeable, and skillful, though relatively inefficient and undependable, and (3) school personnel preferred consulting activities to psychometric activities. It was concluded that the consultant model had been shown to be operative and that it was more highly valued than the psychometric model by the consumers of psychological services.     

2010~2020中国内地小学生心理健康问题检出率的元分析

我国小学生心理健康问题的检出率莫衷一是, 为整合调查结果并分析其原因, 对2010~2020年来检索到的相关研究进行了元分析。结果显示：(1)小学生心理健康问题的检出率由高到低依次是睡眠问题(25.2%, 95% CI = [0.16, 0.37])、抑郁(14.6%, 95% CI = [0.12, 0.18])、焦虑(12.3%, 95% CI = [0.06, 0.23])、攻击行为(4.1%, 95% CI = [0.02, 0.10])、退缩(3.8%, 95% CI = [0.02, 0.06])、违纪行为(3.7%, 95% CI = [0.02, 0.07])、躯体化(3.6%, 95% CI = [0.02, 0.07])。(2)测量工具、检出标准、检出时间是导致小学生心理健康问题检出率不一致的关键因素。总体而言, 我国小学生除了睡眠问题、抑郁和焦虑检出率偏高外, 整体心理健康状况尚可。未来应开发适合中国小学生的心理健康状况测评工具及检出标准, 为心理健康问题的预防和精准干预提供支持。     

Psychological re-evaluations: A survey of practices and perceptions of school psychologists

The practice of psychologically re-evaluating students receiving special education services has been mandated by P.L. 94–142 and further operationalized by state departments of education. Intuitively, such a requirement appears sound, for psychologists occasionally make mistakes, children change over time, and efficacy of special education services is variable. Yet given the other mandated practices, such as yearly IEP updates, and the fact that many school psychologists spend a majority of their time testing, we wondered how important three-year psychological re-evaluations are considered by school psychologists. In the present study 40 psychologists across four states were surveyed concerning their perceptions and practices regarding re-evaluations. The psychologists' responses to a 16-item questionnaire indicated that re-evaluations comprised a substantial portion of their evaluations, involved a considerable amount of time, and were perceived as an important check on a child's diagnosis and placement. Re-evaluations and initial evaluations were described as involving nearly identical tests and related activities.     

From Mental Health to Juvenile Justice: What Factors Predict This Transition?

We identify youth who are at risk for a critical transition from mental health to juvenile justice. A statewide longitudinal sample of Medicaid-eligible youth (aged 10–17) in the public mental health system (n = 5,455), during approximately one fiscal year (July 1, 1994–August 30, 1995), was used to determine the risk factors for, and timing of, a subsequent juvenile justice detention or commitment during the three subsequent fiscal years (1994–1997). Logistic regression and Cox Proportional Hazards modeling were used. Risk factors for juvenile justice detention or commitment included being: male, black or Hispanic, in junior high school, involuntarily admitted to mental health, having a DSM-IV diagnosis of conduct disorder, alcohol problems, a constellation of risk behavior, and receiving prior mental health services. Factors that accelerate the timing of detention or commitment in the juvenile justice system after a mental health visit included most of the general risk factors except risk behavior and involuntary admission were no longer significant and having a DSM-IV nonalcohol drug use diagnosis, antisocial behavior, and school problems became significant. Our study helps to identify youth who are at risk for multiple system use so that they may be provided appropriate services to prevent multiple system use.     

Interagency Collaboration

Abstract

Child welfare, education, health, juvenile justice, and mental health systems have simultaneously initiated movements to reform services to troubled children during the past ten years. Recently, these agencies have shown increased interest in bringing their change efforts together for a more unified system of care. This paper describes essential components of systems of care and interagency collaboration. A case illustration describes a setting in which special service providers in schools, particularly special education administrators and school psychologists, played major roles in the conceptualization and implementation interagency collaboration for a system of care.     

Children at Risk: Effects of a Four-Year Head Start Transition Program on Special Education Identification

Children in Head Start are at risk for school learning or behavioral problems. While Head Start has decreased special education placement, there has been little systematic data until recently on identification of children in disability categories following preschool. In this study, two cohorts of 6,162 children across 30 sites were followed through third grade. Approximately half of these children were provided transition assistance from kindergarten through third grade. This included school transition and curricular modifications, parent involvement activities, health screening or referrals, and family social services, all similar to those received in Head Start. They were compared to a similar group of Head Start children who did not receive such services beyond the Head Start experience. Special education eligibility was determined from school records in the spring of third grade. Only 0.89% of children in the transition group were identified in the mental retardation category compared to 1.26% in the non-transition group. In the category of emotional disturbance, these same figures were 1.21% and 1.65% respectively. Both differences were statistically significant, but an opposite effect was found in the category of speech or language impairment. Findings are discussed in relation to differences in disability categories and implications for early identification.     

Pediatric topics in the school psychology literature: publications since 1981

Pediatric topics have potential importance to school psychology given the field's new, broadly conceived definition, reconceptualization of schools as health delivery sites, burgeoning pediatric knowledge with educational implications, and expansion of pediatricians' roles into behavioral realms. This article addresses the rate at which pediatric-related articles were published among school psychology journals (Journal of School Psychology, Psychology in the Schools, School Psychology International, School Psychology Review, and School Psychology Quarterly) from 1981 to 2001. The overall number of such articles increased from 11 during the 1981-1983 interval to more than twice as many during every subsequent 3-year interval. Articles, some reporting empirical findings and others offering reviews or practice suggestions, concerning traditional health conditions and attention deficit hyperactivity disorder (ADHD) appeared to be ample. Fewer articles concerned with school psychologists as health care providers and school psychologist-pediatrician collaboration were found. The available literature seems to support school psychologists' widening role definition.     

Collaboration Activities and Competencies of Special Educators Serving Students with Behavior Disorders

The role of collaboration has been emphasized as a critical component in the delivery of a comprehensive system of services for students with behavior disorders (BD). A survey of 476 special educators of students with BD was completed (a) to describe the frequency of collaborative interactions between these educators and school and community agency personnel; and (b) to describe the teachers' current level of skill for the 32 identified collaboration competencies. The data from 259 responses suggested that these educators interact the most often with their special and general education colleagues and perceive themselves to be of average skill level for a majority of the identified competencies. Implications for preservice and inservice training are discussed.     

Proposition 187 reexamined: Attitudes toward immigration among California voters

The purposes of this study were to examine socio-demographic predictors of attitudes toward immigration in a community-based sample (N = 494) from the Los Angeles area; and to explore the relationship between attitudes toward immigration and the providing of educational and health services to the children of undocumented immigrants. Not providing services to the children of undocumented immigrants was a key element of California's Proposition 187. Attitudes toward immigration were measured with the Attitudes Toward Immigration Scale (ATIS). The providing of services was measured through the participants' evaluations of a school scenario and a health care scenario. Results indicated that participants who were middle-aged or older, less educated, identified as Republican, and were third generation or greater were more likely to hold negative attitudes toward immigration. Furthermore, participants holding negative attitudes toward immigration were less likely to provide education and health care services to the children of undocumented immigrants.     

Occupational Therapy with Emotionally Disturbed Children in a Public Elementary School

This article describes a model of delivering occupational therapy services to a class of emotionally disturbed children in a public elementary school. It was determined that many of the children were placed in a special class because of inappropriate social skills. A weekly occupational therapy program was developed to address the chi Y dren's lack of age-appropriate social skills. A task-oriented group was chosen as the format, with activities selected based upon the level of the children's group interaction skills. The children exhibited an improvement in their social skills over the course of the school year.