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Accuracy of Teachers in Identifying Elementary School Students Who Report At-Risk Levels of Anxiety and Depression

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Abstract

Internalizing disorders, specifically depression and anxiety, affect up to 14 and 32 % of youth, respectively (Merikangas et al. in J Am Acad Child Adolesc Psychiatry 49:980–989, 2010). In part to overcome barriers to receiving community services, schools have become a major provider of mental health services to children. Schools need effective mechanisms in place to accurately identify students who may need such services. The current study examined the accuracy of one such method, teacher nominations, in identifying elementary school children who self-report elevated levels of depression and/or anxiety. Participants were 238 fourth and fifth-grade students within a large, urban school district in a southeastern state and their 26 classroom teachers. Regarding sensitivity, teachers identified 50 and 40.7 % of students who repeatedly reported at-risk levels of depression and anxiety, respectively. Teachers falsely identified as symptomatic 16.2 and 17.5 % of students with typical levels of depression and anxiety, respectively. These findings suggest teachers can identify approximately half of children who experience at-risk levels of depression and anxiety, but substantial miss rates call into question this method for use as either an alternative to universal screenings or as an initial step (gatekeeper role) in a multi-modal identification process.

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References

  • Albers, C. A., Kratochwill, T. R., & Glover, T. A. (2007). Where are we and where do we go now? Universal screening for enhanced educational and mental health outcomes. Journal of School Psychology, 45, 257–263. doi:10.1016/j.jsp.2006.12.003.

    Article  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Google Scholar 

  • Angold, A., & Costello, E. J. (1987). Mood and Feelings Questionnaire (MFQ). Durham, NC: Developmental Epidemiology Program, Duke University.

    Google Scholar 

  • Auger, R. W. (2004). The accuracy of teacher reports in the identification of middle school students with depressive symptomatology. Psychology in the Schools, 41, 379–389. doi:10.1002/pits.10164.

    Article  Google Scholar 

  • Beesdo-Baum, K., & Knappe, S. (2012). Developmental epidemiology of anxiety disorders. Child and Adolescent Psychiatry Clinics of North America, 21, 457–478. doi:10.1016/j.chc.2012.05.001.

    Article  Google Scholar 

  • Bradshaw, C. P., Buckley, J. A., & Ialongo, N. S. (2009). School-based service utilization among urban children with early onset educational and mental health problems: The squeaky wheel phenomenon. School Psychology Quarterly, 23, 169–186. doi:10.1037/1045-3830.23.2.169.

    Article  Google Scholar 

  • Center for Mental Health in Schools. (2005). Screening mental health problems in schools: A policy and practice analysis. Los Angeles: Author. Retrieved December 5, 2013 from http://smhp.psych.ucla.edu/pdfdocs/policyissues/mhscreeningissues.pdf.

  • Chan, W., & Chan, D. W. L. (2004). Bootstrap standard error and confidence intervals for the correlation corrected for range restriction: A simulation study. Psychological Methods, 9, 369–385. doi:10.1037/1082-989X.9.3.369.

    Article  PubMed  Google Scholar 

  • Chiu, A. W., Langer, D. A., McLeod, B. D., Har, K., Drahota, A., Galla, B. M., et al. (2013). Effectiveness of modular CBT for child anxiety in elementary schools. School Psychology Quarterly, 28, 141–153. doi:10.1037/spq0000017.

    Article  PubMed  Google Scholar 

  • Copeland, W. E., Angold, A., Shanahan, L., & Costello, E. J. (2014). Longitudinal patterns of anxiety from childhood to adulthood: The Great Smoky Mountains study. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 21–33. doi:10.1016/j.jaac.2013.09.017.

    Article  PubMed  Google Scholar 

  • Copeland, W. E., Miller-Johnson, S., Keeler, G., Angold, S., & Costello, E. J. (2007). Childhood psychiatric disorders and young adult crime: A prospective, population-based study. American Journal of Psychiatry, 164, 1668–1675. doi:10.1176/appi.ajp.2007.06122026.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Mustillo, S., Erkanli, A., Keller, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844. doi:10.1001/archpsyc.60.8.837.

    Article  PubMed  Google Scholar 

  • Dadds, M. R., Spence, S. H., Holland, D. E., Barrett, P. M., & Laurens, K. R. (1997). Prevention and early intervention for anxiety disorders: A controlled trial. Journal of Consulting and Clinical Psychology, 65, 627–635. doi:10.1037/0022-006x.65.4.627.

    Article  PubMed  Google Scholar 

  • Dywer, S. B., Nicholson, J. M., & Battistutta, D. (2006). Parent and teacher identification of children at risk of developing internalizing or externalizing mental health problems: A comparison of screening methods. Prevention Science, 7, 343–357. doi:10.1007/s11121-006-0026-5.

    Article  Google Scholar 

  • Glover, T. A., & Albers, C. A. (2007). Considerations for evaluating universal screening assessments. Journal of School Psychology, 45, 117–135. doi:10.1016/j.jsp.2006.05.005.

    Article  Google Scholar 

  • Goldman, S. (2012). Developmental epidemiology of depressive disorders. Child and Adolescent Psychiatry Clinics of North America, 21, 217–235. doi:10.1016/j.chc.2011.12.002.

    Article  Google Scholar 

  • Green, H. G., & Zar, J. H. (1989). A basic program to compute the sensitivity, specificity, and predictive values of screening tests. Educational and Psychological Measurement, 49, 147–150. doi:10.1177/0013164489491015.

    Article  Google Scholar 

  • Grover, R. L., Ginsburg, G. S., & Ialongo, N. (2007). Psychosocial outcomes of anxious first grades: A seven-year follow-up. Depression and Anxiety, 24, 410–420. doi:10.1002/da.20241.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ialongo, N., Edelsohn, G., & Kellam, S. G. (2001). A further look at the prognostic power of young children’s reports of depressed mood. Child Development, 72, 736–747. doi:10.1111/1467-8624.00312.

    Article  PubMed  Google Scholar 

  • Kalberg, J. R., Lane, K. L., Driscoll, S., & Wehby, J. (2011). Systematic screening for emotional and behavioral disorders at the high school level: A formidable and necessary task. Remedial and Special Education, 32, 507–521. doi:10.1177/0741932510362508.

    Article  Google Scholar 

  • Kendall, P. C., Furr, J. M., & Podell, J. L. (2010). Child-focused treatment of anxiety. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed., pp. 45–60). New York: Guilford.

    Google Scholar 

  • Kovacs, M. (2003). Children’s depression inventory manual. North Tonawanda, NY: Multi-Health Systems.

    Google Scholar 

  • Kuo, E. S., Vander Stoep, A., Herting, J. R., Grupp, K., & McCauley, E. (2013). How to identify students for school-based depression intervention: Can school record review be substituted for universal depression screening? Journal of Child and Adolescent Psychiatric Nursing, 26, 42–52. doi:10.1111/jcap.12010.

    Article  PubMed Central  PubMed  Google Scholar 

  • Landau, S., Milich, R., & Widiger, T. A. (1991). Predictive power methods may be more helpful for making a diagnosis than sensitivity and specificity. Journal of Child and Adolescent Psychopharmacology, 1, 343–351. doi:10.1089/cap.1991.1.343.

    Article  PubMed  Google Scholar 

  • Lane, K. L., & Menzies, H. M. (2005). Teacher identified students with and without academic and behavioral concerns: Characteristics and responsiveness. Behavioral Disorders, 31, 65–83. doi:10.1177/1063426609332343.

    Google Scholar 

  • Laurent, J., Hadler, J. R., & Stark, K. D. (1994). A multiple-stage screening procedure for the identification of childhood anxiety disorders. School Psychology Quarterly, 9, 239–255. doi:10.1037/h0088291.

    Article  Google Scholar 

  • Layne, A. E., Bernstein, G. A., & March, J. S. (2006). Teacher awareness of anxiety symptoms in children. Child Psychiatry and Human Development, 36, 383–392. doi:10.1007/s10578-006-0009-6.

    Article  PubMed Central  PubMed  Google Scholar 

  • Levitt, J. M., Saka, N., Romanelli, L. H., & Hoagwood, K. (2007). Early identification of mental health problems in schools: The status of instrumentation. The Journal of School Psychology, 45, 163–191. doi:10.1016/j.jsp.2006.11.005.

    Article  Google Scholar 

  • March, J. (1997). Multidimensional anxiety scale for children. North Tonawanda, NY: MultiHealth Systems Inc.

    Google Scholar 

  • Masia Warner, C., & Fox, J. K. (2012). Advances and challenges in school-based intervention for anxious and depressed youth: Identifying and addressing issues of sustainability. School Mental Health, 4, 193–196. doi:10.1007/s12310-012-9087-8.

    Article  PubMed Central  PubMed  Google Scholar 

  • Masip, A. F., Amador-Campos, J. A., Gómez-Benito, J., & del Barrio Gándara, V. (2010). Psychometric properties of the Children’s Depression Inventory in community and clinical sample. The Spanish Journal of Psychology, 13, 990–999.

    Article  Google Scholar 

  • McLennan, J. D., Reckord, M., & Clarke, M. (2008). A mental health outreach program for elementary schools. Journal of Canadian Academy of Child and Adolescent Psychiatry, 17, 122–130.

    Google Scholar 

  • Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989. doi:10.1016/j.jaac.2010.05.017.

    Article  PubMed Central  PubMed  Google Scholar 

  • Merikangas, K. R., He, J., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., et al. (2011). Service utilization for lifetime mental disorders in U.S. adolescents: Results of the National Comorbidity Survey-Adolescent Supplement. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 32–45. doi:10.1016/j.jaac.2010.10.006.

    Article  PubMed  Google Scholar 

  • Moor, S., Maguire, A., McQueen, H., Wells, E. J., Elton, R., Wrate, R., et al. (2007). Improving the recognition of depression in adolescence: Can we teach the teachers? Journal of Adolescence, 30, 81–95. doi:10.1016/j.adolescence.2005.12.001.

    Article  PubMed  Google Scholar 

  • Mychailyszyn, M. P., Brodman, D. M., Read, K. L., & Kendall, P. C. (2012). Cognitive-behavioral school-based interventions for anxious and depressed youth: A meta-analysis of outcomes. Clinical Psychology: Science and Practice, 19, 129–153. doi:10.1111/j.1468-2850.2012.01279.x.

    Google Scholar 

  • Nelson, W. M., & Politano, P. M. (1990). Children’s Depression Inventory: Stability over repeated administrations in psychiatric inpatient children. Journal of Clinical Child Psychology, 19, 254–256. doi:10.1207/s15374424jccp1903_8.

    Article  Google Scholar 

  • Newcombe, R. G. (1998). Two-sided confidence intervals for the single proportion: Comparison of seven methods. Statistics in Medicine, 17, 857–872.

    Article  PubMed  Google Scholar 

  • Ollendick, T. H., Oswald, D. P., & Francis, G. (1989). Validity of teacher nominations in identifying aggressive, withdrawn, and popular children. Journal of Clinical Psychology, 18, 221–229. doi:10.1037/0022-0663.85.2.377.

    Google Scholar 

  • Reynolds, W. M. (1986). A model for the screening and identification of depressed children and adolescents in school settings. Professional School Psychology, 1, 117–129. doi:10.1037/h0090504.

    Article  Google Scholar 

  • Reynolds, C. R., & Richmond, B. O. (1985). Revised children’s manifest anxiety scale: Manual. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Richardson, M. J., Caldarella, P., Young, B. J., Young, E. L., & Young, K. R. (2009). Further validation of the systematic screening for behavior disorders in middle and junior high school. Psychology in the Schools, 46, 605–615. doi:10.1002/pits.20401.

    Article  Google Scholar 

  • Roeser, R. W., & Midgley, C. (1997). Teachers’ views of issues involving students’ mental health. The Elementary School Journal, 98, 115–133. doi:10.1086/461887.

    Article  Google Scholar 

  • Soles, T., Bloom, E. L., Heath, N. L., & Karagiannakis, A. (2008). An exploration of teachers’ current perceptions of children with emotional and behavioural difficulties’. Emotional and Behavioural Difficulties, 13, 275–290. doi:10.1080/13632750802442201.

    Article  Google Scholar 

  • Stark, K. D., Streusand, W., Krumholz, L. S., & Patel, P. (2010). Cognitive-behavioral therapy for depression: The ACTION treatment program for girls. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed., pp. 93–109). New York: Guilford.

    Google Scholar 

  • Walker, B., Cheney, D., Stage, S., & Blum, C. (2005). Schoolwide screening and positive behavior supports: Identifying and supporting students at risk for school failure. Journal of Positive Behavior Interventions, 7, 194–204. doi:10.1177/10983007050070040101.

    Article  Google Scholar 

  • Walker, H., & Severson, H. H. (1992). Systematic screening for behavior disorders. Longmont, CO: Sopris West.

    Google Scholar 

  • Walter, H. J., Gouze, K., & Lim, K. G. (2006). Teachers’ beliefs about mental health needs in inner city elementary schools. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 61–68. doi:10.1097/01.chi.0000187243.17824.6c.

    Article  PubMed  Google Scholar 

  • Weist, M. D., Rubin, M., Moore, E., Adelsheim, S., & Wrobel, G. (2007). Mental health screening in schools. Journal of School Health, 77, 53–58. doi:10.1111/j.1746-1561.2007.00167.x.

    Article  PubMed  Google Scholar 

  • Williams, J. H., Horvath, V. E., Wei, H., Van Dorn, R. A., & Jonson-Reid, M. (2007). Teachers’ perspectives of children’s mental health service needs in urban elementary schools. Children in Schools, 29, 95–107. doi:10.1093/cs/29.2.95.

    Article  Google Scholar 

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Authors and Affiliations

  1. Baltimore City Public Schools, Baltimore, MD, USA

    Jennifer M. Cunningham

  2. Department of Psychological and Social Foundations, University of South Florida, 4202 East Fowler Avenue, EDU 105, Tampa, FL, 33620, USA

    Shannon M. Suldo

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  1. Jennifer M. Cunningham
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Cunningham, J.M., Suldo, S.M. Accuracy of Teachers in Identifying Elementary School Students Who Report At-Risk Levels of Anxiety and Depression. School Mental Health 6, 237–250 (2014). https://doi.org/10.1007/s12310-014-9125-9

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