Characteristics of Students Newly Identified By Universal Screening to Inform Multi-Tiered Intervention Planning

Universal screening for emotional and behavioral (EB) concerns shifts the focus of a reactive, wait-to-fail model to a proactive system in which the EB functioning of all youth is regularly assessed and those in need are identified at the onset of disordered behavior. Despite a substantial amount of evidence suggesting the need for universal screening and the existence of psychometrically valid screening tools, schools have been slow to implement. Many schools are concerned about their ability to respond effectively to an increase in students with identified needs given their already limited resources. However, little research has quantified the increase in identified need following implementation of universal screening nor examined characteristics of newly identified students to best support implementation planning prior to screening.

We examined differences in the number and characteristics of students who would be in need of intervention services when those identified by the universal screening were added to students already receiving services. Data came from six elementary schools (grades K-5) in two Southeastern states implementing UMHS as part of a federally funded, randomized control trial (n= 3,744 students; 51.07% male, 63.01% white).

Following screening, 679 (18.14%) additional students were identified as at-risk of EB problems, representing a 180% increase in the number of identified students. Using a series of stepwise logistic regression analyses, we identified significant predictors of newly identified students within models that explained 6% to 82% of the variance in identification strategy. Females had higher odds of being newly identified by screening than by the school prior to screening (OR = 1.678), as did students with fewer office discipline referrals (OR = 0.93) and higher grades (OR = 1.21). We also determined that students with lower levels of externalizing and internalizing and higher levels of adaptive behavioral risk ratings had higher odds of identification through screening. Schools in the sample had already identified those at most risk, but adding universal screening for EB problems provided them an opportunity for prevention and early intervention by detecting a group of students with elevated, but less extreme, academic, behavioral, and emotional impairment.

These results suggest schools need an expanded array (e.g., interventions to address both externalizing and internalizing difficulties) and continuum of interventions (e.g., early interventions to address emerging risk), as well as expanded capacity to manage the increased demand for services from students newly identified by screening (e.g., efficient teaming practices; additional mental health providers).