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Universal behavioral screening is proven effective. Here’s why you should implement it now.

February 4, 2019

Educators across the U.S. are reporting an alarming rise in behavioral disruptions among elementary school students over the last few years. Driven by the need to manage the increase in both volume and intensity of disruptive behaviors, schools are scrambling to provide adequate support resources to meet students’ behavioral and emotional needs.

Unfortunately, evidence suggests that current efforts are insufficient to manage the increase. The national student-to-counselor ratios, for example, are far below the levels recommended by the American School Counselor Association. In our own survey on behavioral disruptions, 69% of educators said that their schools support resources are currently “understaffed” or “severely understaffed.”

Districts perception of current support staff capacity to meet student needs (DLF survey data)

National student-to-counselor ratios

1 : 250

Recommended ASCA ratio of school counselors to students

1 : 482

Average national ratio of school counselors to students

The most effective way to address the rising demand for support services is through better preventive efforts. However, identifying the right students at the right time is often difficult. Many students may show no signs of distress for a long time before acting out. At the same time, support resources are naturally directed towards those who do. With behavioral disruptions on the rise, support resources are inevitably used to respond to crises rather than prevent them.

Universal screening a highly effective method of identification

In order to support effective early identification and prevention, educators and psychologists, including the American Psychological Association (APA) and the National Association of School Psychologists (NASP)1, have long promoted the use of universal screening tools for behavioral and emotional issues.

These tools take the form of short questionnaires given to a variety of groups: teachers, students, and/or parents, allowing schools to evaluate large groups of students quickly and at scale (screening usually takes a few minutes per child). Each student receives a score indicating whether they may benefit from additional support. This form of screening gives educators an objective, evidence-based way of measuring which students may be at risk of exhibiting disruptive behavior in the future.

Misconceptions among educators hinder widespread adoption of best practice

Despite decades of evidence supporting the effectiveness and efficiency of universal screening in identifying students at risk, most U.S. districts are still relying on teacher referrals alone to identify the need for student support. In a 2018 survey, only about a third of District Leadership Forum districts (30%) reported using a universal screening tool, while a 2014 national sample puts the number at an even lower 12.6%.

There are two main reasons why many educators are reluctant to adopt universal screening measures: concern that instruments will identify too many students and stretch support resources even further, and fear that teachers will end up labeling students based on the results of the screening.

Decades of research have shown that universal screening tools do not overidentify students. The most commonly used screeners demonstrate high accuracy2 in identifying at-risk students, give very few false positives3, and identify a similar number of students compared to traditional teacher referrals. However, screeners identify students much earlier than referrals, giving schools the opportunity to intervene proactively.

Furthermore, teacher referrals tend to be more subjective and open to individual bias and are much more likely to focus on externalizing behavior (e.g., students acting out). While teacher referrals are still a valuable strategy for identifying students with behavioral or emotional issues, they work best when used alongside a universal screener, not instead of one.

The other most common concern is that identified students will be labeled as “problem kids” by teachers and peers. However, district administrators already screen students for many other indicators—reading, math, health, vision, etc.—without expressing similar hesitation. The fact that educators see emotional and mental health as an area where labeling might be more concerning likely reflects a broader societal stigma on mental health. Unfortunately, students and even teachers already label others in the classroom. Universal screening is a way to prevent labeling because it allows educators to help students early, long before they have acted out and given reasons for others around them to view them as “trouble.”

  • “We will end up labeling students if we screen them”

    • Practice already common in other areas (reaching, math)
    • Screening identifies need for support, not potential threats
    • Aversion reinforces stigma associated with behavioral and mental health
  • “Screening will identify too many students and stretch our support resources”

    • Number of students identified through screening similar to numbers from teacher referrals
    • Proactive approach more cost-effective in the long run
  • “We don’t need universal screening, teachers already refer students”

    • Standardized screening procedure reduces teacher bias
    • Teacher referrals usually come after a disruption has occurred

Careful planning ensures success of universal screening

There is no single “best” universal screening tool and districts should consider carefully the pros and cons of the many available. While we have provided a reference table with summary of the latest research on the most popular evidence-based screeners, we recommend that districts conduct their own review of existing tools in consultation with support specialists. Among the most important factors they should consider are cost, time to complete per student, availability in multiple languages, availability of additional assessment and analysis tools, and ease of administration.

Finally, although the choice of evidence-based tool will differ by district, there are a few common elements that we recommend districts follow when adopting universal screening. These include ensuring parental consent via an opt-in/opt-out process, screening more than once each school year, and training teachers on using the selected tool in advance. Taking these factors into account ensures proper and smooth administration of the screening and makes it both a resource-efficient and highly effective method of assessing and identifying the emotional and behavioral needs of young students.

Comparison of evidence-based universal screeners

Strengths and Difficulties Questionnaire (SDQ)

Description:

  • Internalizing, externalizing, prosocial behavior scales
  • Teacher, parent forms
  • Student form (ages 11+)
  • 1-3 minutes per student

Strengths:

  • Free
  • Quick to administer and interpret
  • Multi-informant approach
  • Available in 70 languages

Weaknesses:

  • Limited validity and reliability
  • No published manual, reports may be too easy to misinterpret by laypeople
  • Normed on a British student sample

Student Risk Screening Scale–Internalizing and Externalizing (SRSS-IE)

Description:

  • Adapted from earlier SRSS tool that did not include internalizing behaviors
  • Teacher form
  • 10-15 minutes per classroom

Strengths:

  • Free
  • Quick to administer

Weaknesses:

  • Evidence of effectiveness on internalizing scale still new
  • Categories of evaluation may be too broad to give detailed picture of student behavior

Systemic Screening for Behavior Disorders (SSBD)

Description:

  • Screens for both internalizing and externalizing behaviors
  • Three-stage process: teacher grade in stages 1 and 2, support service professional and parent grade in stage 3

Strengths:

  • Cheap
  • Strong reliability and validity
  • Quick to administer

Weaknesses:

  • May require a lot of training before it can be used properly
  • Does not allow ranking of BOTH internalizing and externalizing behaviors for the same student
  • Only allows ranking of top 3 students per classroom, may miss at-risk students
  • Difficult to make comparisons over time

Social Skills Improvement System – Performance Screening Guide (SSIS-PSG)

Description:

  • Evaluates two behavioral areas: Motivation to learn and prosocial behavior
  • Teacher form

Strengths:

  • Quick to administer and interpret
  • Part of a broader suite that also assesses math and reading skills

Weaknesses:

  • Expensive
  • Less robust evidence of effectiveness than other screeners
  • Does not directly assess internalizing behaviors

The Behavior Assessment Scale for Children Three: Behavior and Emotional Screening Scale (BASC-3 BESS)

Description:

  • Includes multiple academic and social-emotional scales, plus internalizing and externalizing behavior scales
  • Teacher, parent forms (grades PK-2)
  • Teacher, parent, student forms (grades 3-12)
  • 4-6 minutes per student

Strengths:

  • High validity and reliability
  • Comprehensive and detailed
  • Multi-informant approach
  • Electronic scoring, access to online tools and data
  • Available in Spanish

Weaknesses:

  • Expensive
  • Can be time-consuming, particularly for bigger classrooms

Behavior Intervention Monitoring Assessment System (BIMAS)

Description:

  • Assesses broad range of behaviors, 34-item scale
  • Clinician, teacher, parent forms
  • Student form (ages 12-18)
  • 5-10 minutes per student

Strengths:

  • Multi-informant approach
  • Electronic scoring, access to online tools and data
  • Allows progress monitoring over time

Weaknesses:

  • Expensive
  • Can be time-consuming, particularly for bigger classrooms
  • Only available in English

Emotional Behavioral Screener (EBS)

Description:

  • 10 items, rates each student on a four-point Likert scale
  • Teacher form

Strengths:

  • High reliability
  • Quick to administer

Weaknesses:

  • Expensive
  • Relatively new to the field, little independent research available

Social, Academic, and Emotional Behavior Risk Screener (SAEBRS)

Description:

  • 19 items, divided into three categories (academic, social, and emotional behaviors)
  • Teacher form
  • Student form (grades 2-12)
  • 1-3 minutes per student

Strengths:

  • Quick to administer
  • Provides flexibility: evaluates three categories of behavior and can provide separate score for each category or one total score

Weaknesses: 

  • No standard definitions or examples provided for different types of behavior, leaving room for teacher discretion

1National Association of School Psychologists. (2015). The importance of mental and behavioral health services for children and adolescents (Position statement). Bethesda, MD: Author.

2Positive predictive values of most universal screeners range from 0.5 to 0.8. Positive predictive values identify proportion of correctly identified students from those identified at risk.

3Negative predictive values of most universal screeners range from 0.92 to 0.98. Negative predictive values identify proportion of correctly identified students of those not identified at risk.

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