the environment in which youth are raised, the family structure, and direct observation or reports of the child or adolescent behavior. Furthermore, once an intervention to reduce risk is initiated, screening must continue to assess benefits, and the need for repeated screening imposes a burden, both in terms of workforce and economic demands, on present systems of surveillance. This dimension of screening for MEB disorders deserves additional consideration and analysis.

Screening Versus Assessment

Research has demonstrated that some groups of young people are at great risk for emotional or behavioral disorders because they have entered a service system, such as criminal justice or child welfare, or because of their particular life circumstances. Children in foster care, children of depressed or alcohol- or drug-dependent parents, incarcerated children, children with chronic health conditions, children exposed to trauma or violence, or runaway youth all are at heightened risk of emotional or behavioral disorders. In the foster care system, given the known elevated risk, all young people are typically screened or accessed for MEB disorders (Child Welfare League of America, 2007; Stahmer, Leslie, et al., 2005).

CONCLUSIONS AND RECOMMENDATIONS

One of the criteria for assessing the applicability of screening is the availability of facilities to conduct the screening and provide an intervention. The vast majority of young people attend school, see a primary care physician, or both. These settings are likely to be viewed as less stigmatizing than other service environments.

Conclusion: Schools and primary care settings offer an important opportunity for screening to detect risks and early symptoms of mental, emotional, and behavioral problems among young people.

Multiple screening instruments are available for a variety of ages, settings, and behavioral risks. For many reasons, these instruments are not uniformly used. Schools and primary care settings may also be able to readily identify high-risk groups, such as children in divorced families or children in foster care.

Conclusion: A variety of screening instruments and approaches are available, but there is no consensus on the use of these instruments.

Although potential screening settings and tools are available, an overarching principle in determining the applicability of screening should be



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement