Universal Screening 101: Benefitting Students with Behavioral and Emotional Risk
In today’s school culture of frequent assessment, we may need reminding that the ultimate intent of screening for emotional and behavioral concerns is to directly benefit students. Yes, teachers and administrators can, and should, refer students for help when they are concerned. However, sole reliance on referrals can lead to unfair practices whereby some groups of students (e.g., often boys of color with externalizing problems) are referred more frequently than others. Additionally, existing referral systems often fail to ask students how they are doing, which is particularly important when considering the “quiet” nature of emotional symptoms. By universally and systematically asking teachers, parents, and the students themselves about how they are functioning, students with behavioral or emotional risk can be fairly identified and provided with timely, needed supports.
The screening process should begin with the creation of a planning and implementation team. Because of the complex decisions involved and the importance of the task, screening is not an activity that should fall in the hands of a single individual. Instead, a team of individuals, which we have deemed a “screen team”, is needed to ensure that the planning, screening, and follow-up procedures are completed in an efficient and effective manner. Schools may consider integrating with pre-existing school teams (e.g., student success teams (SST), school safety teams, or crisis response teams). Among other school professionals, we believe school psychologists are integral to a school’s screen team. In fact, because of their specialized training to utilize problem solving strategies to enhance the positive development and general social and mental health of all students, school psychologists can assume a leadership role.
Once the screen team has been created and its members designated, the purpose of the screening must be identified. A number of considerations come to play when determining this. For example, team members must determine who their target population will be (e.g., all students or certain grades), what they will be screening for (e.g., overall behavioral and emotional risk or only depression), and how the screening will benefit the students, staff, school, and community. Clear, defined purposes and goals for screening are needed to guide the entire process. For example, some schools may opt to use screening as a way to monitor all students, or the effectiveness of a school wide effort to improve student wellbeing, and thus conduct the screening with the entire school population throughout different periods of times during the school year. Other schools may decide to use screening to identify students who are at-risk for emotional and/or behavioral problems and then refer them to school or community based mental health services.
After the purposes and goals of screening have been identified, the screen team is ready to move onto other phases of the screening process. Among these are: identifying the optimal time to conduct the screening, selecting informants and screening tools, obtaining consent, and determining follow-up procedures. For example, parent and/or teacher rating scales are more suitable for elementary-aged students, while use of student self-reports are recommended for secondary students who may be more aware of their personal psychological experiences. More comprehensive systems involve numerous informants to gather information across settings and contexts. Numerous screening tools are available to conduct screenings and selecting the appropriate tool is a task that should be based on the purpose of the screening as well as the resources available to the team. Above all, though, the school should use a measure with acceptable psychometric properties that is capable of predicting a wide range of behavioral and emotional outcomes. In terms of obtaining consent, various approaches are possible. In an attempt to serve as many students as possible, screen teams at several of our partnership schools in southern California have opted for passive parental and active student consent. These teams have sent out a letter informing parents of the intent and purpose of the screening alongside the student handbook and code of conduct prior to the start of school. Parents who do not want their children to take part of the screening are asked to sign the form and return it to the school. District guidelines deserve consultation prior to engaging in an active or passive consent process.
The logistics required to carry out the actual screening ask for careful planning and timing to ensure a smooth process. Some of the high schools we collaborate with who conduct universal self-report screenings have scheduled a special and well-advertised “screening day” on their calendar. This way, all school staff and students are aware of the upcoming event and any questions or concerns can be dealt with in advance. These schools set aside an hour on this day to inform students that the school staff is genuinely interested in how they are doing and to conduct the screening. All members of the screen team are on site to help disseminate and collect screening materials as well as take care of any difficulties that may arise.
After the actual screening is conducted, decisions must be made about who will manage the data, how results will be shared, and how to connect identified students with appropriate resources. Typically, once data have been processed, school-wide de-identified information to highlight overall wellbeing and trends across the years can be shared with school faculty and staff through a staff meeting. Schools may also choose to share information with students and families. Above all, the team must have well designed follow-up plan, as not following up with students identified as at risk would be unethical. Thus, it is important for schools to identify what follow-up resources are available before embarking on the screening journey. One of the final steps of the screening process requires team members to evaluate the screening and their work to identify areas of improvement, remembering, again, that the ultimate intent is to directly benefit students.