Measuring behavior change in young children receiving intensive school-based mental health services

An innovative urban school-based mental health program was developed to treat the subset of elementary school-referred children who are experiencing severe emotional and behavioral difficulties. The program served a group of 201 students and their families, referred from 15 elementary schools through a large urban school district in Ohio (K through fifth grade). The children in the sample are predominantly African-American (N = 157, 78.1%), and male (N= 154, 76.6%), with an average age at admission of 9.23 years (SD = 1.75). Parents and teachers provided behavioral rating data using a standardized psychiatric assessment instrument (i.e., the Devereux Scales of Mental Disorders - DSMD). Results showed that at intake 68.7% of children scored above the clinical cutoff score of 60 on the conduct disorder subscale of the DSMD, with more than 40.8% of youth scoring 70 or higher. On the depression subscale 55.7% scored above the cutoff score, with slightly less than a third (30.8%) scoring 70 or higher. Hierarchical linear modeling (HLM) was used to measure longitudinal behavior change. Children evidenced statistically significant reductions in conduct disordered behavior (p < .01), attention deficit/hyperactivity (p < .05), and depressive symptomatology (p < .01) over the course of approximately 1 year.