Wednesday, December 29, 2010

Universal Screening (Rocks!)

Say there is a mass traumatic event - many people affected. Or say you work at a school - with thousands of students.

What is the most efficient way to identify those that need intervention?
  • Individual clinical interviews? (Probably not)
  • A brief questionnaire excellent at predicting a PTSD diagnosis that "performs equivalent to agreement achieved between two full clinical interviews"!
Edna Foa et al. has developed a questionnaire for efficient identification of PTSD among children and adolescents. This can be done for other common, and sometimes hidden, disorders. Teachersfrequently refer students (boys) with disruptive behavior disorders. But how can clinicians identify the underlying disorders (ADHD, PTSD, attachment disruption)? And for students not presenting with disruptive behavior disorders, how can clinicians identify the internalizing disorders (depression, anxiety, PTSD)? And what about the girls?

Universal screening is not only promising for efficient identification of disorders, but a fair and equitable referral system for distributing services. Otherwise, only the most disruptive students get the attention and mental health services. Universal screening provides practical hope for preventing children from "falling through the cracks."

Source:

Brief screening instrument for post-traumatic stress disorder
CHRIS R. BREWIN, SUZANNA ROSE, BERNICE ANDREWS, JOHN GREEN, PHILIP TATA, CHRIS McEVEDY, STUART TURNER and EDNA B. FOA
BRITISH JOURNAL OF PSYCHIATRY (2002) , 181, 158 - 162

2 comments:

  1. Think of the extra help those students would receive instead of being labeled "troublemakers" or wading/ waiting through the red tape of getting students help when we KNOW they need it. On the other hand... I understand there is a segment of parents who would not want their children given "psychological tests" for any reason without their consent... how to deal with that?

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  2. Important detail, Mama Steff! Even universal screening requires active parental consent (vs. passive consent, where something is done unless parent opts out). Parents must always be involved and consulted with any intervention, including assessment. When I have implemented a universal screening protocol, most parents provide consent and are often surprised by the results of the assessment. Sometimes we just don't know what is in the hearts and minds of our little ones unless we ask directly.

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