Academic journal article Education & Treatment of Children

A Model for Early Detection and Primary Prevention of Emotional or Behavioral Disorders

Academic journal article Education & Treatment of Children

A Model for Early Detection and Primary Prevention of Emotional or Behavioral Disorders

Article excerpt

Abstract

A truly effective early detection and primary prevention program for children who are considered high-risk should probably not begin just in the school years but should instead focus on preschool settings such as Head Start. There are effective tools for screening preschool children for emotional or behavioral disorders that can be used to detect problems before they become significant, but these are generally not in common use. There are also classroom-wide intervention techniques that are being used in the primary grades to prevent emotional or behavioral disorders; yet the nature of an effective universal mental health intervention for preschool children is not entirely clear. Skill building approaches, however, appear to be critical as prevention strategies. A sell-determination curriculum on direction following, sharing, decision making, and other social or behavioral skills would therefore seem to offer definite advantages. One of the best examples of the use of early detection and a self- determination curriculum is the Head Start Program of Youth Development Incorporated (YDI) in Albuquerque, New Mexico. The rationale for this approach and the program itself are described along with preliminary data on its effectiveness.

Although special education is a field that at least pays lip service to the topic of prevention, in actual fact, most special educators are involved neither in early detection nor in primary prevention for a variety of reasons (Kauffman, 1999). Even at its best, special education typically includes early identification rather than early detection and secondary prevention rather than primary prevention (Forness, Kavale, MacMillan, Asarnow & Duncan, 1996). Early detection involves systematic screening of all children in a given general education setting to determine who might be at risk for learning or behavior disorders. Thus children at risk for such disorders may sometimes be detected even before their problems are identified by teachers or parents. Primary prevention involves attempts to forestall probable disabilities or disorders before they actually occur in children at risk. Thus a substantial portion of children at risk may never go on to develop these disorders, in contrast to secondary prevention in which attempts are made to treat, or at least lessen the impact of, disorders once they have already occurred.

Theoretically, the most effective early detection program should begin in preschools such as Head Start where children can be screened annually for learning or behavioral problems. It should also be linked to a primary prevention program in which all children receive universal interventions such as enhanced education in social or behavioral skills and systematic activities to increase parent involvement (Coie et al., 1993). This should include consultation and/or training of general educators in effective classroom-wide interventions. It should also include parent-training groups both for parenting skills and for collaborative efforts with school. Children who are initially detected as being at risk and who do not respond to these universal interventions would then go on to prereferral interventions or formal special education programs either in inclusive or segregated settings.

The program that probably best exemplifies this approach at present is the Youth Development Incorporated (YDI) Head Start Program in Albuquerque, New Mexico. This program is focused on early detection and primary prevention of emotional or behavioral disorders (EBD) in very young children. YDI has recently adopted the Early Screening Project (Walker, Severson & Fell, 1995) in all of their sites as a mental health screening tool. YDI has also initiated in a select number of their Head Start classrooms a universal self-determination curriculum that address critical social and behavioral skills (described in Forness, Serna, Kavale & Nielsen, 1998). The curriculum has an early literacy component in that concepts are embedded in stories, songs, and accompanying picture books. …

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