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Mental health matters in elementary school: first-grade screening predicts fourth grade achievement test scores

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Abstract

The objective of the study was to evaluate whether mental health problems identified through screens administered in first grade are related to poorer academic achievement test scores in the fourth grade. The government of Chile uses brief teacher- and parent-completed measures [Teacher Observation of Classroom Adaptation-Revised (TOCA-RR) and Pediatric Symptom Checklist (PSC-Cl)] to screen for mental health problems in about one-fifth of the country’s elementary schools. In fourth grade, students take the national achievement tests (SIMCE) of language, mathematics and science. This study examined whether mental health problems identified through either or both screens predicted achievement test scores after controlling for student and family risk factors. A total of 17,252 students had complete first grade teacher forms and these were matched with fourth grade SIMCE data for 11,185 students, 7,903 of whom also had complete parent form data from the first grade. Students at risk on either the TOCA-RR or the PSC-Cl or both performed significantly worse on all SIMCE subtests. Even after controlling for covariates and adjusting for missing data, students with mental health problems on one screen in first grade had fourth grade achievement scores that were 14–18 points (~1/3 SD) lower than students screened as not at risk. Students at risk on both screens had scores that were on average 33 points lower than students at risk on either screen. Mental health problems in first grade were one of the strongest predictors of lower achievement test scores 3 years later, supporting the premise that for children mental health matters in the real world.

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Acknowledgments

We wish to thank Iris Delgado and Lilian Jadue for their help in preparing the dataset and Haley Kamin for her help in preparing the manuscript. The MGH Department of Psychiatry and a Fuss Family Fund grant to Newton Wellesley Hospital made the current data analysis and paper writing possible. Correspondence should be addressed to Michael Murphy, Ed.D.

Conflict of interest

All of the Chilean authors received salary support from the Chilean government for administering the mental health program. All US authors except Dr. Jellinek received salary or consultation support for data analysis or report writing. Drs. Jellinek and Murphy are the authors of the PSC, but they received no income from this since it is available free in the public domain. No other authors reported any financial disclosures or conflict of interest.

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Authors and Affiliations

  1. Department of School Health, Junta Nacional de Auxillo Escolar y Becas, Santiago, Chile

    Maria Paz Guzman, Myriam George, Marcela Hartley, Ana Maria Squicciarini & Javier Guzman

  2. Faculty of Psychology, University of Chile, Santiago, Chile

    Myriam George

  3. Department of Psychiatry, Massachusetts General Hospital, Boston, USA

    Michael Jellinek & J. Michael Murphy

  4. Department of Psychiatry, Harvard Medical School, Boston, USA

    Michael Jellinek & J. Michael Murphy

  5. Newton Wellesley Hospital, Newton, USA

    Michael Jellinek

  6. Department of Psychology, University of Massachusetts, Boston, USA

    Katia M. Canenguez

  7. Department of Pediatrics, Massachusetts General Hospital, Boston, USA

    Karen A. Kuhlthau

  8. Department of Epidemiology and Biostatistics, State University of New York at Albany, New York, USA

    Recai Yucel

  9. Department of Psychology, Rutgers, The State University of New Jersey, New Jersey, USA

    Gwyne W. White

  10. Child Psychiatry Service, Massachusetts General Hospital, Yawkey 6a, Boston, MA, 02114, USA

    J. Michael Murphy

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  1. Maria Paz Guzman
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  11. J. Michael Murphy
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Correspondence to J. Michael Murphy.

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Guzman, M.P., Jellinek, M., George, M. et al. Mental health matters in elementary school: first-grade screening predicts fourth grade achievement test scores. Eur Child Adolesc Psychiatry 20, 401–411 (2011). https://doi.org/10.1007/s00787-011-0191-3

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  • DOI: https://doi.org/10.1007/s00787-011-0191-3

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