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Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities
organizations should address this opportunity singly but, more importantly, in a partnership mode.
Community. Communities and neighborhoods can respond to the emotional and behavioral needs of their youth, aided by information about community-level risks and the prevalence of specific problems and disorders. Mechanisms are available for community self-assessment, for example, Healthy Cities/Healthy Communities, and Communities That Care Programs. Survey and administrative data will be needed to allow communities to move forward on this front, in particular to identify individuals and groups within the community who are most in need of intervention and support. Successful strategies will include partnerships among schools, primary care settings, the mental health professions, community agencies, and local government.
Community-based programs, such as home visitation, have incorporated behavioral screening into their interventions (Olds, Memphis Study). The Ages and Stages Questionnaire-SE, which can be used for children ages 6 months to 5 years, has been adopted by several home visiting programs. The Child Behavior Check List and the Infant Toddler Social-Emotional Assessment have also been used for home-based screening by visitors.
There should be identifiable risk or protective factors or a latentstage of the disorder to be addressed by prevention.Chapter 4 summarized published work on identification and application of knowledge concerning risk and protective factors for MEB disorders. The literature is now replete with results of randomized controlled studies that support the contention that interventions directed to these factors, whether at the community, family, school, or individual level, result in some level of protection against the emergence of MEB disorders. Many disorders display prodromal symptoms well in advance of diagnosable conditions.
There should be validated screening tools or interview techniques toidentify risks or early symptoms. Clinical judgment in medical care identifies fewer than 50 percent of children who have serious emotional and behavioral disturbances (Glascoe, 2000). This percentage is likely to be smaller for identification of risk factors or early behavioral problems.
Numerous tools and procedures are available that can be used to systematically screen for individual mental, emotional, and behavioral risks or early behavioral symptoms in such settings as primary medical care (see Box 8-1; Perrin and Stancin, 2002; Kemper and Kelleher, 1996), emergency rooms (Grupp-Phelan, Wade, et al., 2007), schools (Barbarin, 2007; Aseltine and DeMartino, 2004; Walker, Severson, and Seeley, 2007), and colleges (McCabe, 2008). Tools are available to screen for a variety of risks, including purging in young adolescent girls (Field, Javaras, et al.,