School-based Universal Screening Research Articles

Measurement Invariance of the Social, Academic, and Emotional Behavior Risk Screener - Teacher Rating Scale

School-based universal screening in the social, emotional, and behavioral (SEB) domains allows for the early identification of students in need of SEB support. Importantly, equitable assessment in universal screening for the SEB domains is critical to engage in accurate and ethical data-based decision-making. Measurement invariance is one method for examining potential inequities in assessment tools, permitting the ability to evaluate which assessments or assessment items perform differently across groups. As such, this study utilized multi-group confirmatory factor analysis to evaluate the extent of measurement invariance for a commonly used universal screening tool for the SEB domains: the Social, Academic, and Emotional Behavior Risk Screener - Teacher Rating Scale (SAEBRS-TRS). The sample consisted of 1949 students in kindergarten through fourth grade in a Midwest, suburban school district. Examination of factor structures indicated the bifactor model yielded adequate fit and was utilized for measurement invariance testing. Multi-group confirmatory factor analysis results provided preliminary evidence that the SAEBRS-TRS displays invariance across a variety of student characteristics. Specifically, results supported configural and metric/scalar invariance of the bifactor model across the student characteristics of racial or ethnic identity, sex assigned at birth, and eligibility for free or reduced-price lunch. Yet, future research is needed to corroborate these findings. Limitations, implications for practice, and directions for future research are discussed.

Informant Discrepancies in Universal Screening as a Function of Student and Teacher Characteristics

Despite the widespread use of school-based universal screening systems for social, emotional, and behavioral risk, limited research has examined discrepancies in ratings provided by teachers and their secondary students. Using the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS; teacher report) and mySAEBRS (student report) scores from a middle school sample, we examined the magnitudes and prevalence of informant discrepancies as well as associated student and teacher factors. Analyses revealed discrepancies consistently in the direction of teachers reporting lower levels of risk than students and were starkest for the Emotional Behavior Risk subscale. Across subscales, multiple student and teacher factors significantly predicted variance in discrepancies. We discuss these findings in the context of implications for selecting screening informants at the secondary level and opportunities to advance practical guidance in this area. Impact Statement Middle school students and their teachers provide discrepant ratings within universal screenings of students’ social, emotional, and behavioral risk. In this sample, students self-reported higher levels of risk than their teachers reported for them. This was especially true for risk in the Emotional Behavior domain and for students and teachers with certain demographic characteristics.

School-Based Universal Screening to Identify Suicide Risk

School-Based Universal Screening to Identify Suicide Risk

School-based universal screening for hypercholesterolemia in children.

In 2011, the American Academy of Pediatrics recommended universal lipid screening during childhood and adolescence. However, this approach was shown to be lacking in adherence. Only 6% of non-high-risk children received lipid screening by age 12. Our study designed a school-based universal screening for hypercholesterolemia in children. The goal was to investigate a feasible strategy for lipid screening of children. The study enrolled all the fourth-grade students of 30 elementary schools from 2020 to 2021. Non-fasting non-HDL was used as a screening tool. These students were classified into three groups: acceptable group (non-HDL < 120mg/dL), borderline group (120-144mg/dL), and abnormal group (≥145mg/dL). The abnormal group was referred to our hospital for confirmatory fasting lipid studies. The complete rate and timing were calculated. Six hundred students were enrolled in this study. In the abnormal group (95 children), a total of 92 students received confirmatory fasting lipid studies. These confirmatory studies were completed within three months after the family received their reports. The study had a rate of coverage of 62% and the referred percentage of the abnormal group was 97%. BMI had poor association with fasting LDL (CORR=0.06752, p=0.444). In the abnormal group, only 29.5% children had family history of early CVD or dyslipidemia. School-based universal screening for hypercholesterolemia in children is a feasible and effective way to identify patients at high-risk for early CVD. Neither BMI nor family history was a good indicator for the screening of dyslipidemia.

Psychometric Properties of the Behavior Assessment System for Children-3 Behavioral and Emotional Screening System Student-Report Form among a Predominantly Latinx Elementary School Sample

School-based universal screening for behavioral/emotional risk is a necessary first step in the identification of students who might need services within a behavioral response to intervention model. When choosing among the available screening measures, psychometric information such as reliability and validity of the scores is critical to inform such decisions. The purpose of the present study was to examine the reliability and validity of the Behavior Assessment System for Children (BASC)-3 Behavioral and Emotional Screening System (BESS) Student-report screening measure within a predominantly Latinx sample of 210 elementary school students. The proposed three-factor structure was generally upheld. The results supported adequate to strong test–retest reliability and internal consistency of both the overall score and the subscales (self-regulation, internalizing, and personal adjustment). Finally, the BASC-3 BESS Student also correlated to concurrent and future academic and behavioral outcomes, although the strength varied by domain.

Evaluation of a German language school-based universal screening for student social, emotional, and behavioral risk

ABSTRACT The current study represents the first psychometric evaluation of an expanded version of the Integrated System Teacher Rating Form, which is a German language school-based universal screening measure initially developed to identify students with academic productivity problems and oppositional behavior. The measure was expanded to include assessment of internalizing problems experienced by children and youth. This initial study examines the factor structure of the expanded measure in a large sample of 2,416 German schoolchildren attending grades 1–6 in Western Germany. A total of four factors (Anxious/Depressed, Oppositional/Disruptive, Academic Productivity Problems/Disorganization, and Socially Withdrawn) were extracted via exploratory factor analysis. Collectively, the four factors accounted for over 52% of the variance in teacher ratings. Each factor demonstrated excellent internal consistency indicated by alpha and/or omega coefficients above .90. Results of the current study support continued investigation of the expanded ITRF-G for use in universal screening in German-speaking schools.

Development and validity of the Rating Scales of Academic Skills for Reading Comprehension.

The development and psychometric qualities of a measure using teacher judgment to rate performance in reading comprehension for narrative text is described-the Rating Scales for Academic Skills-Reading Comprehension Narrative (RSAS-RCN). Sixty-five teachers from the third, fourth, and fifth grades of 8 elementary schools completed the measure on 177 students. Each teacher rated students who had been identified through school-based universal screening to be below the 25th percentile, between the 25th and 74th percentile, and at or above the 75th percentile on national normative standards. Results indicated the RSAS-RCN has strong to moderate evidence of (a) 1-week test-retest reliability, (b) concurrent validity with the Group Reading Assessment and Diagnostic Evaluation (GRADE) and end of year state assessment in reading, and (c) significant classification accuracy across student ability levels. Principal component analysis and item response theory (Rasch modeling) indicate the RSAS-RCN is comprised of a single general dimension. Overall, this examination of the RSAS-RCN suggests teacher judgment may be a potentially valuable tool in assessing reading comprehension among upper elementary school students. (PsycINFO Database Record

A universal behavioral screener linked to personalized classroom interventions: Psychometric characteristics in a large sample of German schoolchildren

The current study represents the first psychometric evaluation of an American English into German translation of a school-based universal screening measure designed to assess academic and disruptive behavior problems. This initial study examines the factor structure and diagnostic accuracy of the newly translated measure in a large sample of 1009 German schoolchildren attending grades 1–6 in Western Germany. Confirmatory factor analysis supported a two-factor model for both male- and female- students. Configural invariance was supported between male- and female-samples. However scalar invariance was not supported, with higher thresholds for ratings of female students. Results of receiver operating characteristic (ROC) curve analyses were indicative of good to excellent diagnostic accuracy with areas under the curve ranging from 0.89 to 0.93. Optimal cut-off scores were 10, 5, and 13 for the Academic Productivity/Disorganization, Oppositional/Disruptive, and the Total Problems Composite scores of the Integrated System Teacher Rating Form respectively. This initial study of the newly translated measure supports further investigations into its utility for universal screening in German speaking schools.

A school-based public health model to reduce oral health disparities.

Although dental decay is preventable, it remains the most common pediatric chronic disease. We describe a public health approach to implementing a scalable and sustainable school-based oral health program for low-income urban children. The Los Angeles Trust for Children's Health, a nonprofit affiliated with the Los Angeles Unified School District, applied a public health model and developed a broad-based community-coalition to a) establish a District Oral Health Nurse position to coordinate oral health services, and b) implement a universal school-based oral health screening and fluoride varnishing program, with referral to a dental home. Key informant interviews and focus groups informed program development. Parent surveys assessed preventative oral health behaviors and access to oral health services. Results from screening exams, program costs and rates of reimbursement were recorded. From 2012 to 2015, six elementary schools and three dental provider groups participated. Four hundred ninety-one parents received oral health education and 89 served as community oral health volunteers; 3,399 screenings and fluoride applications were performed on 2,776 children. Sixty-six percent of children had active dental disease, 27 percent had visible tooth decay, and 6 percent required emergent care. Of the 623 students who participated for two consecutive years, 56 percent had fewer or no visible caries at follow-up, while only 17 percent had additional disease. Annual program cost was $69.57 per child. Using a broad based, oral health coalition, a school-based universal screening and fluoride varnishing program can improve the oral health of children with a high burden of untreated dental diseases.

Multilevel Prevention Trial of Alcohol Use Among American Indian and White High School Students in the Cherokee Nation.

To evaluate the effectiveness of a multilevel intervention designed to prevent underage alcohol use among youths living in the Cherokee Nation. We randomly assigned 6 communities to a control, Communities Mobilizing for Change on Alcohol (CMCA; a community-organizing intervention targeting alcohol access) only, CONNECT (a school-based universal screening and brief intervention) only, or a combined condition. We collected quarterly surveys 2012-2015 from students starting in 9th and 10th grades and ending in 11th and 12th grades. Response rates ranged from 83% to 90%; 46% of students were American Indian (of which 80% were Cherokee) and 46% were White only. Students exposed to CMCA, CONNECT, and both showed a significant reduction in the probability over time of 30-day alcohol use (25%, 22%, and 12% reduction, respectively) and heavy episodic drinking (24%, 19%, and 13% reduction) compared with students in the control condition, with variation in magnitude of effects over the 2.5-year intervention period. CMCA and CONNECT are effective interventions for reducing alcohol use among American Indian and other youths living in rural communities. Challenges remain for sustaining intervention effects.

The Behavioral and Emotional Screening System Student Form: Is There Evidence of a Global At-Risk Factor in a Sample of Predominantly African American Youth?

School-based universal screening for behavioral and emotional risk can serve as a foundation for effective multi-tiered service delivery systems. The current study examines the measurement and structure of one such universal screener, the Behavioral and Emotional Screening System Student Form (BESS SF). Four models were investigated including a unidimensional model, a multidimensional model, a second-order model, and a bifactor model. This study is the first to use a bifactor model in examining the structure of the BESS SF, and further adds to the literature by using bifactor modeling with a predominantly low-income, urban, African American sample. Results indicate that the bifactor model provided the best fit. Practically, results support interpretation of the global risk score as well as the domain-specific factors.

Development and Validation of the Social, Academic, and Emotional Behavior Risk Screener–Student Rating Scale

School systems are the primary providers for the increasing number of children with mental health needs. School-based universal screening offers a valuable way to identify children that would benefit from school-based mental health services. However, many existing screening systems rely on teacher ratings alone and do not incorporate student self-ratings. The current study evaluates the psychometric properties of the Social, Academic, and Emotional Behavior Risk Screener–Student Rating Scale (SAEBRS-SRS), a new 20-item multidimensional universal screener intended to provide assessment data on students’ social, academic, and emotional functioning. The SAEBRS-SRS complements the SAEBRS Teacher Rating Scale (TRS), which has previously demonstrated robust psychometric evidence. In the current study, data were collected from a racially and ethnically diverse sample of middle school students. Confirmatory factor analyses supported a bifactor structure consistent with the SAEBRS-TRS, with items corresponding to internally consistent Social, Academic, and Emotional Behaviors subscales, as well as an overall Total Behavior scale. The current analyses yield promising initial support for the development of the SAEBRS-SRS. Implications and the need for future research to provide additional psychometric evidence are discussed.

Direct behavior rating as a school-based behavior universal screener: Replication across sites

The purpose of this study was to evaluate the utility of Direct Behavior Rating Single Item Scale (DBR–SIS) targets of disruptive, engaged, and respectful behavior within school-based universal screening. Participants included 31 first-, 25 fourth-, and 23 seventh-grade teachers and their 1108 students, sampled from 13 schools across three geographic locations (northeast, southeast, and midwest). Each teacher rated approximately 15 of their students across three measures, including DBR–SIS, the Behavioral and Emotional Screening System (Kamphaus & Reynolds, 2007), and the Student Risk Screening Scale (Drummond, 1994). Moderate to high bivariate correlations and area under the curve statistics supported concurrent validity and diagnostic accuracy of DBR–SIS. Receiver operating characteristic curve analyses indicated that although respectful behavior cut scores recommended for screening remained constant across grade levels, cut scores varied for disruptive behavior and academic engaged behavior. Specific cut scores for first grade included 2 or less for disruptive behavior, 7 or greater for academically engaged behavior, and 9 or greater for respectful behavior. In fourth and seventh grades, cut scores changed to 1 or less for disruptive behavior and 8 or greater for academically engaged behavior, and remained the same for respectful behavior. Findings indicated that disruptive behavior was particularly appropriate for use in screening at first grade, whereas academically engaged behavior was most appropriate at both fourth and seventh grades. Each set of cut scores was associated with acceptable sensitivity (.79–.87), specificity (.71–.82), and negative predictive power (.94–.96), but low positive predictive power (.43–.44). DBR–SIS multiple gating procedures, through which students were only considered at risk overall if they exceeded cut scores on 2 or more DBR–SIS targets, were also determined acceptable in first and seventh grades, as the use of both disruptive behavior and academically engaged behavior in defining risk yielded acceptable conditional probability indices. Overall, the current findings are consistent with previous research, yielding further support for the DBR–SIS as a universal screener. Limitations, implications for practice, and directions for future research are discussed.

Impact of Early School-Based Screening and Intervention Programs for ADHD on Children's Outcomes and Access to Services

To investigate the impact of early school-based screening and educational interventions on longer-term outcomes for children at risk for attention-deficit/hyperactivity disorder (ADHD) and the predictive utility of teacher ratings. A population-based 5-year follow-up of a randomized, school-based intervention. Schools in England. Children between 4 and 5 years of age with high teacher-rated hyperactivity/inattention scores. Follow-up data were collected on 487 children in 308 schools. Following screening, using a 2 x 2 factorial design, schools randomly received an educational intervention (books about ADHD for teachers), the names of children with high hyperactivity/inattention scores between ages 4 and 5 years (identification), both educational intervention and identification, or no intervention. Parent-rated hyperactivity/inattention, impairment in classroom learning, and access to specialist health services for mental health or behavioral problems. None of the interventions were associated with improved outcomes. However, children receiving the identification-only intervention were twice as likely as children in the no-intervention group to have high hyperactivity/inattention scores at follow-up (adjusted odds ratio, 2.11; 95% confidence interval, 1.12-4.00). Regardless of intervention, high baseline hyperactivity/inattention scores were associated with high hyperactivity/inattention and specialist health service use at follow-up. We did not find evidence of long-term, generalizable benefits following a school-based universal screening program for ADHD. There may be adverse effects associated with labeling children at a young age.

Examining the Relationship Between Scores on the Behavioral and Emotional Screening System and Student Academic, Behavioral, and Engagement Outcomes: An Investigation of Concurrent Validity in Elementary School

Universal screening of emotional and behavioral problems among students warrants further consideration by school professionals. School-based universal screening may provide opportunities for early identification and intervention, ultimately preventing the development of more severe problems and promoting more positive outcomes in the future. The Behavioral and Emotional Screening System (BESS) is a contemporary screening instrument that may be used to identify risk for emotional and behavioral problems in students from preschool to high school. The purpose of the present study was to examine the concurrent validity of the BESS in elementary school settings. Specifically, this study examined the relation between BESS ratings and report-card outcomes (i.e., academic, behavioral, and engagement marks). The results supported the hypotheses that students’ risk-level classifications were significantly related to school-based outcome criterions and that school-based outcome criterions were deemed to be effective discriminators of students’ risk-level classification. Limitations, future directions for research, and implications for practice are discussed herein.

Considerations for evaluating universal screening assessments

Universal screening is a critical prerequisite to providing early school-based prevention and intervention services for students at risk for or with academic, behavioral, or emotional difficulties. Although use of academic and behavioral screening has become more prevalent, criteria for making informed decisions about appropriate screening tools are not readily available to those who work in educational settings. The purpose of this article is to (a) highlight several considerations about the appropriateness, technical adequacy, and usability of academic or behavioral screeners and (b) provide a general assessment of the current state of science pertaining to universal screening. The article concludes with considerations for policy and practice. The framework presented may be useful in guiding those interested in evaluating, selecting, and researching school-based universal screening assessments.