Screening and Classification

1. Screening and Classification How do we screen for and reliably identify EBD?

2. General Criteria for Acceptable Assessment • Reliability: • Test-retest reliability • Alternate forms reliability • Inter-rater reliability • Standard error of measurement (SEM) • The difference between the measured score and the true score of the individual. • Ignoring SEM will result in false negatives and positives.

3. General Criteria for Acceptable Assessment • Validity • Construct validity • Concurrent-criterion-related validity • Predictive-criterion-related validity • Content validity • Treatment utility

4. General Criteria for Acceptable Assessment • Reliable and valid measures for students with EBD must include: • Parental consent—required for initial assessment. • Applying a variety of validated tools that are specific to the child’s mode of communication. • Administration of the test by trained personnel. • Assessment of all suspected areas of weaknesses.

5. Screening • Early identification and prevention • Primary prevention: Prevent disorder from occurring • Secondary prevention: Stop the disorder from getting worse or correct it if possible. • Tertiary prevention: Used with the disorders that have reached an advanced level of development. Attempts to keep the disorder from progressing.

6. Screening • Difficulties in identifying children with EBD: • Rapid changes in behavior occur from infancy to middle childhood. • Child’s behavior interacts with that of his/her care-givers. • Parents differ in levels of behavioral tolerance.

7. Screening • Criteria for selecting and devising screening procedures as suggested by Walker et al. (1995) • Proactive not reactive • Employment of variety of people and in a variety of settings • Screening should be conducted as early as possible • Teacher nomination is appropriate, but should be supplemented by direct observation and examination of school records

8. Screening • Alternative screening instruments • Self report, • Sociometrics • Direct observation • Interviews

9. Screening • Strength-based assessment • Informal • Example: Semi-structured interviews between a teacher and a student. • Formal • Example: Behavioral and Emotional Rating Scale (BERS) • Interpersonal strengths • Family involvement • Intrapersonal strength • School functioning

10. Screening • Other Instruments • Children’s Version of Screen for Adolescent Violence Exposure (KID-SAVE) has proven appropriate for exposure to violence; • Subtests: • Traumatic violence • Indirect violence • Physical/verbal abuse

11. Screening • Scale for Assessing Emotional Disturbance (SAED) • May be the instrument most directly tied to the school environment and the effects of EBD on school performance.

12. Screening • Systematic Screening for Behavior Disorders (SSBD).Helps eliminate cases of over-referral of students with externalizing behavior problems and under-referral of students with internalizing behavior problems. This can be achieved through three steps: • Ranking and listing students’ externalizing and internalizing behavioral problems • Completing two checklists (Severity: CEI and frequency of behavior) for the highest ranked students on each list. • Direct observation of students who exceeded the established norms of the checklists.

13. Screening The School Archival Records Search (SARS) • Quantifies the existing elementary students’ records. • Identifies students at risk of dropping out of school. • Validates school assessment. • Determines eligibility for special education services.

14. Screening • Screening is the convergence and confirmation of concerns. • Accommodates: • Cultural diversity • Individual differences in screening

15. Screening • Functional Behavioral Assessment (FBA) • Using FBA, the teacher: • Defines target behavior • Identifies antecedents and consequences of the behavior • Tests hypotheses through experimental manipulation • Determines environmental factors that might increase the occurrence of the behavior • Develops hypotheses regarding the function of a behavior • Develops a behavioral intervention that addresses the contributing and maintaining factors

16. Screening • FBA is a multilevel system of assessment. • Levels of assessment: • Broad environmental assessment is applied and interventions that are beneficial to all students are implemented. • Those who still have problems after level one will be assessed for intervention in level two. Formal and informal assessment techniques can be used to identify social and communication skill deficits. Interventions are directed toward skill deficits. • If the student failed to benefit from intervention in levels 1 and 2, he/she receives further assessment and intervention.

17. Prereferral Strategies • Administrative support for the prereferral intervention done by regular classroom teachers is important. • University-based consultant team is recommended. • Parental consent is necessary.

18. Classification • Psychiatric classification: • Classification is based on presumed mental diseases. • No eligibility criteria.

19. Classification • Behavioral dimensions: Statistical analyses result in clustering of behaviors that are more likely to occur together and form a dimension. • Emotional or behavioral disorders are not all-or-nothing phenomena. • Broad-band problems: Externalizing and internalizing problems. • May co-occur. • Narrow-band problems: more specific problems • Examples: Depression, hyperactivity, delinquency.

20. Classification • Multiple classification and the issue of comorbidity: • Failing to identify comorbid disorders in the child will result in choosing less effective or even ineffective treatment. • Classification of severe disorders (psychosis): • Autistic disorder: onset before the age of three. • Schizophrenia: onset after the age of three

21. The Necessity of Classification • The complexity and ambiguity of classification: • Disordered behavior and its causes are multidimensional. • Example: • Children with conduct disorder are often hyperactive. • Conduct disorder and delinquent behavior overlap. • Factors causing conduct disorder and delinquency might also cause hyperactivity. • Therefore, classification always contains a level of ambiguity.