Comprehensive Universal School-Based Early Child Screening: Selecting item clusters, for the prediction and prevention of mental illness in adolescence and early adulthood.
A validated scale based on early school assessment is needed to provide a comprehensive system to IDENTIFY mental health problems at Pre-school/Day Care, School Entry and Late Primary to prevent the occurrence of these problems in adolescence. Thompson and Carpenter (2014) emphasised that, “Students with mental health issues will present with academic, emotional and social challenges” (p. 154). Gleeson et al. (2012) stated, “The first step towards intervention is identification … in Child Care” (p. 2). Guy et al. (2016) reported that, “51.7% of infants were at-risk for adult mental illness … and at 8-9 years more than 18% had five risk factors”. They concluded that, “Considerable capacity will be required in child mental health services … if risk factors … in infancy are to be addressed” (p. 1).
Essex et al. (2009) aimed to screen for “mental health problems from kindergarten to Grade 5”. They screened 328 children’s internalising and externalising symptoms in Kindergarten, Grades 1, 3 and 5. Grade 5 Teachers also reported on children’s functional impairments and physical health (Abstract), but these were screened only at Grade 5, whereas, universal monitoring is necessary at Day Care (Gleeson et al.). Also, screening at Grades 1, 3 and 5 was only based on internalising and externalising behaviour, but behaviour does not address overall mental health. Also, pre and post-natal medical problems and screening for Speech-Language, important markers, were not reported.
Reddington and Wheeldon (2009) researched 215 school entry children, scored by Parents and Teachers.
Sub-scales:
| Parent Screen (12.7 mins) 1. Socio-Economic-Status 2. Medical: genetic, pregnancy, birth, early illness 3. Speech-Language (plus auditory processing) 4. Motor (fine, gross) 5. Resilience (family concerns, ability level) 6. Behaviour (internalising, externalising) 7. Inattention (plus auditory processing) 8. Early Education (literacy, numeracy) 9. Parent Comments
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Matching Teacher Screen (3.0 mins) 1. Auditory Processing 2. Previously identified items (academic, social) 3. Behaviour (internalising, externalising) 4. Inattention 5. Teacher estimate of overall risk (1-9 scale) 6. Risk: developmental, or environmental? 7. Ability level 8. Risk: greater at Home, or, School? 9. Teacher Comments
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Deighton et al. (2013) reported on an, “Initial validation of case samples of children by self-report at both 8-9 and 11-12 years. Although they emphasise “early detection” (p. 247), this age range is not early enough. Children from 0–5 undergo sensitive periods of brain development. Guy et al. reported, “ … defined as the antenatal period to five years of age … . In this crucial early period brain circuits associated with a child’s future social, emotional and cognitive capacities is largely established” (p. 2).
Conclusion
It is essential that clinical besides experimental research examines relevant item clusters in mental health before they reach “crisis point” in Adolescent and Early Adulthood (ages 12-25). The most comprehensive research in the area so far appears to be that of Reddington and Wheeldon. However, this still needs replication and the computer scoring procedures which previously addressed individual children now needs to embrace automated scoring. Child-report will now be incorporated into the scoring procedures.
Dr. John Reddington, Ph.D, M App Psych, MAPS
Prev. Senior Lecturer Griffith University, Psychology & Special Education
Registered Psychologist, focus children, 24 years.