Outcomes of children with emotional disturbance in residential treatment for educational purposes

A study was conducted of the outcomes of all children and adolescents (N=114) with serious emotional disturbance who had been placed by school districts in residential treatment facilities for educational purposes over a three-year period. Both cost and outcome analyses were conducted. Cost analyses indicated a total annual expenditure in excess of $5 million, or $80,000 per youth per length of stay. Outcome analyses, consisting of ratings of outcomes and outcome interviews with special education directors, revealed that 63% of the youth had either made no or minimal progress, had been discharged with a negative outcome, or had run away. Positive outcomes were achieved in only 25% of the cases, measured by the students' return to school or placement into a vocational training program. Another 11% of the youth were making substantial progress. Analyses of the relationships between outcomes and cost revealed no relationship. However, positive outcomes were associated with shorter lengths of stay. Further, students in the positive outcome categories had more severe functioning deficits at intake than students in the negative outcome categories. The availability of community-based services for the student and family was the single most likely reason reported by special education directors for positive discharge status.