Missed early warning signs and children’s mental health Blind Spot

Children’s mental health: Disturbing statistics In any given year, about one out of every five Connecticut children (87,500 to 125,000) struggles with a mental health condition or substance abuse problem. More than half receive no treatment.

Early difficulties: Long-term impact Interrelationship between mental health problems and poor academic outcomes is reflected in limited educational progress from school entry through secondary school years

Troubling trends Rates for expulsion from pre-school exceed those of children in Grades 1-12; Connecticut had one of the highest rates of expulsion from state-funded preschool, with more than 10 students expelled per 1000; Educational, social and behavioral outcomes worse for children with emotional disorders than for any other disability group

Josue ( Age 15 ) Born to 12-year-old mother History of early ear infections, auditory and speech problems Exposed to sexual abuse and domestic violence Age 13 – bipolar disorder, ODD, ADHD, LD Suspension from school Involvement with juvenile justice system

Arianna (Age 15) Age 4 – febrile seizures Severe expressive language delays Visual processing problems Retained Grade 4, socially promoted Grades 3,4,5,6,7,8 Grade 6 difficulty with peers School suspensions for fighting

Jaden (Age 14) Sickle Cell trait Age 1 ½ stopped talking Limited social reciprocity, echolalia, perseveration Age 7 – rule out Fragile X Syndrome Grade 4 – deficits expressive language Age 11 – PDD, Intermittent Explosive Disorder Grade 9 – Language, communication disorders, underlying thought disorder?

Early warnings Anxiety, depression, information processing problems and academic delays Phobia, Obsessive-Compulsive Disorder (OCD) Genetic disorder with elevated levels of anxiety, disruptive behavior, poor anger management Attentional issues, multiple suspensions for disruptive behavior, severe attendance problems, expulsion for possession of marijuana

Options for screening Behavioral and Emotional Screening System (BESS; ages 3-18) combines information from three sources: parents, teachers, youth (5-10 minutes administration time); Behavior Assessment System for Children (BASC-2; ages 3+) Ages and Stages Questionnaire-Social Emotional (ASQ-SE; Birth-3)

Recommendations Improve screening for mental health risk factors Improve referral for early intervention, communication and collaboration among service providers Improve community and parent education around mental health risk factors and services available to children and families Improve training for school staff, medical and other service providers to children and families