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The Importance of Mental Health Screening
By Oscar Barbarin | September 16, 2019
Originally published in HighScope’s Journal for Early Educators: The Active Learner
Getting off to a good start in early childhood programs is critical to children’s long-term success in school. For some children, the transition to school goes fairly smoothly, with minor adjustment issues along the way; for others, the path to academic success presents more challenges, socially and emotionally. Early problems of adjustment, if not addressed, can be a significant impediment to later academic achievement. Early education, then, includes identifying and addressing children’s early socio-emotional difficulties as among its most important goals.
Identifying Mental Health Concerns
Head Start and some state early education programs have promulgated standards that require processes for identifying and serving the needs of children who exhibit early socio-emotional difficulties in such areas as self-regulation of attention, behavior, and emotions. Children, of course, run the gamut from socially and emotionally adept to impulsive and emotionally troubled. Program staff may have little trouble identifying children at the extremes of social-emotional competence, but encounter difficulty differentiating the vast numbers in the middle of that continuum.
Often preschool educators struggle to discern the difference between children’s temporary or transitional difficulties that will resolve in time as the child matures, and problem behavior that is predictive of severe difficulties ahead. Staff may observe a problem or have concern about some aspect of a child’s behavior but may be uncertain about whether the behavior warrants special attention and follow-up. This uncertainty may lead to a failure to take action that might ameliorate the situation or prevent more serious long-term difficulties as the child gets older. Furthermore, while few early childhood staff need to be convinced of the importance of early intervention, some may be reluctant to assign a label to a child’s behavior for fear that label may “stick” even after the issue is resolved.
Caregivers are understandably puzzled. Should they be patient and give the child the chance to self-correct, or must they develop an intensive intervention before a perceived problem escalates? Is the concern related to a temporary behavioral issue or is it a deeper, more systemic problem that may lead to major long-term challenges? Rarely are these questions resolved with complete confidence.
Mental Health Screening Tools Can Help
Parents and teachers can benefit by using a comprehensive mental health screening tool. As these tools become more prevalent, their makeup varies, but generally, a mental health screening tool is a simple self-report instrument completed by program staff and parents in which they identify aspects of child behavior that cause concern and respond to questions that can be used to judge the severity of those concerns. A developmentally appropriate screening tool can be used by persons with limited training in mental health, and while not used for diagnostic purposes, screening tools summarize information that is essential for behavioral consultants and health professionals who may ultimately make a decision on intervention. A useful and comprehensive tool addresses the adjustment issues most commonly identified by early childhood staff and is developed and designed in consultation with early childhood programs.
How do Mental Screening Tools Work?
A mental health screening provides a low intensity approach that compares the child to a reference group and, on that objective basis, concludes whether the behavior is unusual or extraordinary enough to require some follow-up action or intervention. The screening is not intended to be used alone as an end unto itself, but is instead most effective when it is incorporated into a multilevel system of mental health care and intervention. Once the screening is completed, the work of follow-up and intervention begins and appropriate intervention is provided at multiple levels: the program, the classroom, and the child and family. An effective system of mental health care utilizes screening, early intervention, and prevention.
Beginning with universal screening of mental health concerns early in the school year, the system analyzes prevalence data to identify patterns of child problems across regions of services, programs, and classrooms, providing follow-up services such as:
- Changes in the classroom structure, procedures, or rules
- An intervention by program staff focused on the specific needs of the targeted child
- A formal request for observation and feedback from a behavioral or health consultant
- Referral to services outside of the early childhood program
Finally, it links analysis of screening results to staff training, staff support, and allocation of individually focused mental health resources.
Mental health screenings can help program staff and parents use objective criteria and apply them consistently across children and settings to make the critical decisions about whether a child’s problem or concern is something that is normative, something they should try to change through their normal practices, or something that requires consultation and assistance from a mental health or learning specialist. In addition to its use by staff on an individual basis with children, a mental health screening tool can be most useful as part of a system of universal screening that programs adopt for planning purposes and for the design of preventive interventions.
Originally published by: Barbarin, Oscar “The Importance of Mental Health Screening” The Active Learner. 2.2 (2018): 33-34.
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About Oscar Barbarin
Oscar A. Barbarin is a professor of psychology and African-American Studies at the University of Maryland. He chairs the African-American Studies program and conducts research on mental health services for young children.