Scanlan Center for School Mental Health
two students sitting with teacher
Practice Briefs

The purpose of the Practice Briefs on School Mental Health project is to provide free-access research-based summaries on important topics that are relevant to practicing educators and school mental health professionals. Our practice briefs are written by national experts in the field, reflect best practices in education and school mental health, and undergo a peer-review process before publication.

Sarah Ketchen Lipson, Ph.D., EdM, Associate Professor in the Department of Health Law Policy and Management, Boston University School of Public Health + Principal Investigator, Healthy Minds Network
Description
As a prospective college student, or a parent of a prospective college student, there are numerous, nearly universal challenges that new college students experience, including adjusting to a new environment (often having left home for the first time), dealing with homesickness, making friends and building new support networks, establishing routines (often with less structure than in high school), and being responsible for things like healthcare use, sleep, and personal finances, all on top of heightened academic standards and mounting concerns over debt and the cost of higher education. This is far from an exhaustive list of the challenges new students encounter, and of course, there are distinct stressors based on students’ backgrounds and identities (e.g., for international students, there is immersion into new cultures). College is also a time when mental health problems often begin or intensify. For depression, the average “age of onset” (or time when symptoms first appear) is in the mid-20s, which coincides with the traditional college years. In fact, 75% of lifetime mental health problems will onset by about age 25. With roughly half of all adolescents and young adults in the U.S. enrolled in postsecondary education, mental health in college student populations is increasingly recognized as a public health priority. As such, the topic of mental health at colleges and universities has received a significant amount of media attention in recent years. National data reveal high and rising prevalence of mental health concerns among students. My colleagues and I lead the Healthy Minds Study, a mental health survey conducted at hundreds of colleges and universities annually. In our 2022-2023 data, 41% of students screened positive for symptoms of depression and 36% for symptoms of anxiety, nearly doubling in symptom prevalence over the past decade. Though less frequently discussed in the media, many students are also thriving in college; in the most recent Healthy Minds data, 36% of students met criteria for ‘flourishing’ (or positive mental health). Of note, the prevalence of depression, anxiety, flourishing, and other mental health outcomes varies significantly across both student and institutional characteristics; the patterns are complex and point not only to urgent opportunities for system-level change but also to the importance of college “fit,” as discussed below. My career’s work studying and reporting on the mental health needs of college students was originally motivated by my time working in residence life, where I served as a live-in advisor to first-year undergraduates (most fresh out of high school). Drawing from both the national data my colleagues and I have collected through Healthy Minds as well as my lived experiences in residence life and now as a faculty member, I see many opportunities for high school students (prospective college students) to prepare for holistic success in college by prioritizing their mental health and wellbeing at each stage of the process. What follows are recommendations and considerations primarily aimed at prospective students and their families.   Strategies to Prepare When and Where to Go College We’ll start with the decisions of when and where to go to college. These are, of course, some of the most important decisions a young person will make in their life. As such, the college application and decision-making processes are riddled with anxiety and uncertainty; naming the anxiety and uncertainty is an important first step. There are resources for handling this stress, including recommendations offered in Set to Go, a program from the Jed Foundation; these include the need to be realistic in where one applies and the importance of avoiding peer comparisons to the extent possible (see Related Resources below). Of course, the prioritization of one’s mental health in deciding when and where to go to college will look different for each individual, but here are some overarching considerations for prospective college students. In deciding when to go to college, be open to the idea of a gap year. For a number of reasons, starting college immediately after high school may not be the right timing for you. Generally speaking, a gap year can be thought of as taking the year after high school to work, volunteer, travel, etc. before starting college. Think of the possibility of a gap year as a potentially empowering decision; after 13+ consecutive years of mandatory schooling, you don’t necessarily need to start college immediately after completing your K-12 education. There may be compelling reasons to take a gap year, and these reasons should be taken seriously. Ideally, you will begin college fueled by curiosity. This may not be possible if you are ‘burned out’ from high school; your academic brain may need a well-deserved break. You may want to get ‘real world’ professional experience; working full-time and saving money during a gap year may alleviate some financial stress, lessening angst about costs when you do begin college. You may simply feel like you need another year to mature. Parents should be reminded that a gap year is not an indication that your child has lost or will lose momentum. Empirical research has demonstrated that gap year participation positively predicts academic motivation in college (Martin, 2010). The Child Mind Institute offers recommendations for picking a gap year program, and the aforementioned Set to Go program lists pros and cons when considering a gap year (see Related Resources below). Whether logistical, emotional, financial, or otherwise, your reasons to take a gap year should be thought of as signs of self-awareness. A gap year may be the best decision for achieving the longer-term goal of having a positive, enriching college experience. In deciding where to go for college, prioritize “fit” (and de-prioritize the rankings). When choosing where to apply and eventually which college or university to attend, prospective students should be focusing on “fit.” “Fit” is related to other terms that are commonly used and measured in survey studies, such as students’ “sense of belonging” in school. But what does it mean to find a school that is a good “fit”? The somewhat nebulous concept is really about the relationship between the person (prospective student) and the environment (college/university). The person-environment fit is not accounted for in the rankings, which some prospective students and their families allow to supersede individual preferences; this rarely works out well in my experience. Early in my career, as an advisor at arguably the most prestigious university in the world, I once sat with a first-year student who tearfully admitted that they knew this was not the right place for them, but they’d felt they had to apply and then attend because of the institutional reputation. The student was filled with regret, which they recognized as avoidable. The “fit” was not right. It is important to think about “fit” along several dimensions. In addition to financial fit (the means to attend a school), there are several, concrete things to consider with fit, including: Institutional size: Do you want to go to a big school or a small school? Location: Do you want to be a car or plane ride from home?; In a city or on a less urban campus? Social life: Do you want to be at a school with Greek life (i.e., fraternities/sororities)? Academics: How well do courses/majors and internship opportunities align with your interests/goals? If you have the ability to visit schools as a prospective student (to tour the campus and potentially spend time with current students), “fit” should be top of mind. Ask yourself versions of: Do I see myself as part of this college community? Why or why not? Virtual tours and admissions open houses are also valuable opportunities to assess fit if visiting a campus is not feasible. On top of some of the more straightforward considerations listed above about location, size, etc., there may be other dimensions of fit that are important based on your goals (e.g., for student-athletes), your identities, and your needs and preferences. Some lesser-emphasized dimensions that warrant attention are: the institutional policies that govern student life and the resources available to support students at a college or university. For example, in the U.S. there is significant variation across colleges and universities in terms of policies that may uniquely affect LGBTQ+ prospective students; the Campus Pride Index allows prospective students and families to search a database of LGBTQ-friendly campuses based on such factors as the school’s anti-discrimination and housing policies. Unfortunately, many schools have systems, forms, and facilities that reinforce a gender binary. Until more institutions adopt protective policies such as allowing students to change their names and pronouns in campus records (a practice that helps prevent against deadnaming and misgendering), it is sadly far from guaranteed that transgender and nonbinary students will be safe and supported on all campuses (even those that may espouse inclusivity in broad terms). As prospective students, you should educate yourself about a school’s policies and systems and consider these to be indications of a school’s underlying values. Prioritize selecting a school with values that align with your own. This can enhance belonging and prevent future discomfort and potential experiences of systemic discrimination. Prospective students should also ask about or look into a college or university’s policies and resources pertaining to mental health and well-being. Much of this information is likely to be available online at institutional websites, but can also be asked about on-campus tours, admissions open houses, etc. Understanding a school’s mental health policies and resources is particularly important for the growing number of prospective students who begin college with a history of mental health treatment (more on continuity of care in the next section). Prospective students and their families should educate themselves about the mental health resources available at a school, including counseling/therapy and psychiatry services on campus and in the local community as well as prevention efforts. Regarding prevention efforts, prospective students and their families should be looking for a school to have a ‘public health ’ (or population-level) approach to mental health on campus, which means that mental health is prioritized not just when it is a problem/crisis, but more holistically and among all students. Because there is no one-size-fits-all approach to prioritizing population-level mental health, prospective students and their families may find it useful to see examples of colleges and universities that received the Healthy Campus Award from the nonprofit organization, Active Minds for their efforts to “champion student health;” importantly, many past recipients of this award have been schools with fewer resources, including community colleges, underscoring that a school’s prioritization of mental health is in no way contingent on endowment. Indications that a school prioritizes mental health at a population level may be evident in the promotion of and attention to wellbeing in academics, through extracurriculars, and within residence life as well as changes to the ‘built environment’ to promote social connectedness and reduce means of self-harm. Relatedly, another discernible signal of a college or university’s approach to student mental health is the institution’s leave of absence policy, which includes their return from absence policy. These policies should be readily available on the college’s website and should be specific but easy to understand. Leave policies should be nonpunitive and should demonstrate parity, meaning that mental health should be held to the same standards as any other medical reason. The Bazelon Center for Mental Health Law provides more detailed information about leave of absence policies, including involuntary leaves, along with a guide to students’ rights under the Americans with Disabilities Act. Additionally, a 2021 guide listed in Related Resources below, details best practices for college and university leave of absence policies. For prospective students, particularly those with no history of mental health problems, it may seem like an irrelevant policy to consider in the application process, but I argue that leave policies can provide clues as to the degree to which a school supports student well-being and mental health needs. Before Starting College We’ve covered some considerations for the decisions of when and where to attend college. Now let’s fast forward to the spring/summer before starting college. Importantly, the strategies offered here will be more effective if built on a foundation of good health behaviors, including healthy sleep, diet, exercise, and use of technology. Preparing to start college will look different for everyone, but what follows are some overarching recommendations. In my experience working in residence life and now as a faculty member, I can tell you that rejection and “failure ” are inevitable in college. The truth is that there will be setbacks and challenges. I don’t know anyone for whom this is not true. Relative to high school, the stakes may feel higher in college, due in part to factors mentioned earlier, including more rigorous academic standards. For many new college students, failures (subjectively defined) can seem catastrophic. Perspective is important. Remember that everyone around you, including your professors, has failed and been rejected. Myself, I have received far more rejections (from journals, organizations, funders, you name it) than acceptances throughout my career. In my experience, rejections and failures have become easier to deal with over time. But as a first-year undergraduate, I did not have the same resilience or perspective I do now. A strategy that can be helpful for new college students is ‘coping ahead, ’ an anxiety management technique borrowed from dialectical behavioral therapy. Briefly, ‘coping ahead’ means thinking about and preparing for the inevitable setbacks, challenges, and failures that one will experience. Not getting into a first-year seminar course. Getting passed over for a spot in a club or on a sports team. Not connecting with your roommate. All of these normal experiences can feel all-consuming and devastating. Being prepared for these scenarios can prevent being “blindsided” by the challenges that will definitely (not maybe) come with college. This is of course made easier by building autonomy and self-efficacy before getting to college. For most students, particularly those who move away, beginning college represents a big leap in independence; just how big a leap depends in part on maturity and life skills. These include executive functioning, time management, and problem-solving skills, all of which can be honed with practice and experience. The Child Mind Institute points to questions that prospective college students can ask themselves, such as: “What would you do if you got a bad grade?” and “Who would you call if you were distressed?”. While many parents may want to help their high school students navigate challenges, doing so may stifle skill development. Importantly, a lack of problem-solving skills has been linked to mental health problems such as depression. The final recommendation before beginning college applies specifically to prospective students with pre-existing mental health needs. Students need to be comfortable self-administering any mental health medications as prescribed, and students should be educated about how alcohol and other substances may interact with medications. Relatedly, continuity of mental health care is extremely important to plan for in the transition to college, which may involve establishing care networks in a new location. Starting College My main advice for the first year of college is to set goals that focus less on grades and academic performance and more on skill-building. Think of the start of college not as a time to achieve, but as a time to grow and set goals accordingly. Take advantage of resources to help you navigate the transition to college; this includes many human resources in the form of peer advisors, faculty mentors, coaches, and student affairs professionals. Ask questions, ask for help, let people support you (and reciprocate when you are in a position to do so). Despite what social media may portray, loneliness is very common among college students. As with the challenges described above, I don’t know anyone for whom loneliness did not at least creep in during college. In our Healthy Minds data, 20-25% of students report “often” feeling “left out,” “isolated from others” or that they “lack companionship.” Particularly for first-year students, remember that some degree of loneliness is to be expected. You are in a new environment and that can feel isolating, even if you are physically surrounded by other people. It will take time for most new students to build relationships with peers and faculty. Be patient but proactive. Don’t expect loneliness to resolve on its own (or linearly). Make time to engage in social and extracurricular activities, the offerings for which are often far more extensive than in high school. Get involved in something (but not too many things). The Set to Go program also offers a guide to making connections on campus. Lastly, students and families need to enhance what is known as ‘mental health literacy.’ Schools should be a setting where this is fostered. Prospective students should look into whether the college/university offers first-year seminars about mental health and wellness. As noted earlier, the traditional college years (~ages 18-25) are a vulnerable time for the onset of mental health problems. Unfortunately, in the U.S., the delay from symptom onset to first treatment contact is, on average, about a decade. Part of mental health literacy is understanding that treatment is most effective when received early. Students and their families should know the mental health resources available at a school as well as the signs and symptoms to look out for; parents are especially well-positioned to observe any changes in the mental or emotional state of students at the start of college (when peer networks are being established). It is also important to be knowledgeable about other supportive resources such as academic tutoring, peer coaching, and resources specific to certain student groups (e.g., for first-generation college students).   Key Implications for Practice In deciding when to go to college, be open to the idea of a gap year. This may be the best decision for having a positive, enriching college experience. In deciding where to go for college, prioritize “fit” along several dimensions, including institutional policies that govern student life and available resources. Expect challenges in college and be prepared by ‘coping ahead.’ Build autonomy and problem-solving skills before coming to college, including the skills and knowledge to manage pre-existing mental health conditions. In starting college, set goals that focus less on grades and more on skill-building. Take advantage of resources to help navigate the transition to college. Students and their families should know the mental health resources available at a school as well as the signs and symptoms to look out for. Engage in social/extracurricular activities and get involved in something (but not too many things). Conclusion The advice and recommendations offered here are rooted in evidence-based risk and protective factors—that is, reducing factors known to negatively affect mental health and fostering factors known to positively support well-being and flourishing in college populations. I hope that these recommendations help prospective college students and their families prepare for higher education in ways that prioritize mental health and well-being. Related Resources Child Mind Institute When to Consider a Gap Year Program: support for students who aren’t ready for college (https://childmind.org/article/when-to-consider-a-gap-year-program/) Preparing for College Emotionally, Not Just Academically (https://childmind.org/article/preparing-for-college-emotionally-not-just-academically/) Medication Management in College: it takes practice, so high school is the time to start (https://childmind.org/article/managing-medication-in-college/) Jed Foundation Deciding Whether You Should Take a Gap Year (https://jedfoundation.org/resource/deciding-whether-you-should-take-a-gap-year/) Tips for Handling College Application Stress (https://jedfoundation.org/resource/tips-for-handling-college-application-stress/) College Relationships 101: Building Connections (https://jedfoundation.org/resource/college-relationships-101-building-connections/) How to Deal with Homesickness in College (https://jedfoundation.org/resource/how-to-deal-with-homesickness-in-college/) Exploring Financial Aid and Loan Options for College (https://jedfoundation.org/resource/exploring-financial-aid-and-loan-options-for-college/) Leaves of absence and other campus policies Taking a Leave of Absence: A Guide for College Students (https://rudermanfoundation.org/white_papers/leave-of-absence/) Bazelon Center for Mental Health Law (https://www.bazelon.org/) The Campus Pride Index (https://campusprideindex.org/) Active Minds Healthy Campus Award (https://www.activeminds.org/programs/healthy-campus-award/)   https://doi.org/10.17077/rep.006643 
Three students walking down hall
Yanchen Zhang, Ph.D., LP, NCSP, Assistant Professor of Psychological & Quantitative Foundations, University of Iowa
Description
A significant proportion of students in the US struggle with social, emotional, and behavioral (SEB) needs (Ghandour et al., 2019). If untreated or treated inadequately, SEB problems can cause various short- and long-term negative outcomes, such as academic failure, disruption to peers' and their own learning, poor relationships with peers and educators, and increased exposure to exclusionary disciplines (e.g., suspension). Unmet SEB needs also contribute to longstanding disparities for students from historically disadvantaged backgrounds. As a result, educators worldwide consistently rank SEB problems among their top concerns. Often, evidence-based practices (EBPs) are used infrequently or not adopted at all in schools. Even if adopted, about 50-75% of EPBs were implemented with low fidelity or quality. Implementation science focuses on the factors, strategies, and processes to translate EBP research effectively and efficiently into routine practices in schools (Williams & Beidas, 2019). In schools, the implementation of EBPs is never an event but an iterative process that requires deliberate attention to factors and strategies that either obstruct or enable the implementation of EBPs (Lyon & Bruns, 2019).   https://youtu.be/B59bybNmo7M   This practice brief focuses on the Consolidated Framework for Implementation Research (CFIR; Damschroder et al., 2022), to support the implementation of EBPs. The CFIR emphasizes the social-ecological system by using "contextual domains" to categorize factors based on their level of influence on the implementation of EBPs (Figure 1). Specifically, the CFIR contextual domains include (a) outer setting (e.g., policy, finance), (b) inner setting (e.g., leadership, climate), (c) characteristics of individuals (e.g., attitudes, intentions), (d) EBPs (e.g., fidelity, flexibility, acceptability), and (e) implementation process (e.g., implementation stages, implementation strategies). We will base our discussion on three domains (i.e., inner setting, individuals, and EBPs) because they are more relevant and actionable for most school personnel. Prevention/Identification Strategies As a fast-growing field, numerous assessments of implementation factors based on the CFIR domains were developed and validated in many child-serving settings (e.g., child welfare, schools). These assessments can help professionals identify important and malleable implementation factors that either facilitate or impede their current efforts to adopt and implement evidence-based practices (EBPs). Based on the assessment results, schools can select preventive or interventive implementation strategies to improve the identified implementation factors. Below we summarized several widely used, validated, and pragmatic (i.e., cost-effective, free, and easy to use) assessments of selective key factors related to the successful implementation of EBPs for student SEB needs. (For more assessments, see Related Resources). Implementer-Related Factors mplementers' (e.g., teachers, social workers, school psychologists) attitudes about a given EBP and their intentions to implement can predict their subsequent implementation behaviors (e.g., actual use of EBPs in work, intervention fidelity), which are crucial for achieving expected student outcomes. Evidence-Based Practice Attitudes Scale (Aarons et al., 2007) assesses implementers' attitudes toward a specific or generic EBP. It contains 15 items rated on a 5-point Likert scale, which fall into four subscales: (1) Appeal of EBP, (2) Requirements (to use EBP), (3) Openness (to new EBPs), and (4) Divergence (e.g., one believes EBP are not useful). Intentions to Use Scale assesses one's intention to implement a new EBP (Kortteisto et al., 2010). It consists of five items on a 7-point Likert scale ranging from "greatly disagree" to "greatly agree". EBP-Related Factors Some common characteristics of an EBP as perceived by school personnel can either promote or jeopardize their adoption and use of an EBP: (1) feasibility, (2) acceptability, (3) appropriateness, and (4) intervention fidelity. Feasibility is the degree to which a new EBP can be properly adopted and delivered by school-based implementers. Acceptability refers to the degree to which an EBP is agreeable or satisfactory for school-based implementers. Appropriateness refers to the perceived fit, relevance, and/or compatibility of an EBP for school mental health. The Suite of Feasibility, Acceptability, and Appropriateness Scales (Weiner et al., 2017) is a widely used and brief measure, which contains 12 items (four for each factor). Educators can use the suite of measures to assess these three factors together or separately based on their needs. Adequate intervention fidelity (also known as intervention/treatment integrity, or implementation fidelity) is crucial to expected student outcomes. The most important and relevant dimension of intervention fidelity is implementers' adherence (i.e., deliver all core components of an EBP as intended by the original protocol/manual). Many EBPs offer accompanying measures of intervention fidelity that are specific to each EBP. Educators can also customize their own fidelity measures by (a) counting the number of core components they have delivered, and then (b) dividing it by the total number of core components of an EBP. School Inner Setting Factors School-level leadership and climate that are specific to EBP implementation are critical to fostering a "pro-EBP" working environment for all staff and educators, which can in turn reward and motivate their use of EBPs (Zhang et al., 2022b). School-Implementation Leadership Scale (Lyon et al., 2022) assesses educators’ perceptions of their school leaders' behaviors relevant to the delivery of EBPs. The scale has 12 items that fall into four subscales: (1) Proactive, (2) Knowledgeable, (3) Supportive, and (4) Perseverant. All items are scored on a 5-point Likert-Scale ranging from 0 (not at all) to 4 (very great extent). School-Implementation Climate Scale (Lyon et al., 2018) assesses educators' perceptions of the climate in their schools that strategically support the implementation of EBPs. The scale has 29 items that fall into nine subscales: (1) focus on EBP, (2) educational support for EBP, (3) recognition for EBP, (4) rewards for EBP, (5) selection for EBP, (6) selection for openness, (7) use of data, (8) existing supports to deliver EBP, and (9) EBP integration. Implementation Strategies School-based implementation of evidence-based practices (EBPs) often yields lower than desired student social-emotional, and behavioral (SEB) outcomes due to deficits in certain implementation factors (e.g., fidelity, acceptability, leadership). Hence, the main targets of implementation science are implementation factors (or implementation outcomes), which are prerequisites to effective interventions and expected student SEB outcomes. School-based implementation researchers have adapted a compilation of 75 evidence-based implementation strategies to the school settings that map onto nine categories: (1) use evaluative/iterative strategies, (2) provision of interactive assistance, (3) adapt and tailor to context, (4) develop stakeholder relationships, (5) train and educate stakeholders, (6) support educators, (7) engage consumers, (8) financial strategies, and (9) change infrastructure (School Implementation Strategies, Translating ERIC Resources (SISTER); interested readers please see Cook et al., 2019; Waltz et al., 2015; Gaias et al., 2022). In this brief, we introduce best practices for decision-making in the selection and delivery of appropriate implementation strategies based on CFIR (Consolidated Framework for Implementation Research) and SISTER to address common needs or implementation factors related to educators' implementation of EBPs. #1 Preparation School-based implementation of EBPs relies on collaboration among all stakeholders (e.g., school leaders, mental health professionals, educators, consultants/coaches, students, and family representatives). A school needs to make team-based decisions about which implementation strategy to adopt to enhance their existing implementation efforts for a given EBP. Actively engaging stakeholders can ensure that the identified implementation needs/issues and corresponding strategies align with the actual needs and priorities of the school community, which can ensure wrap-around support. #2 Identify the delivery format of the target EBP Different types of EBPs require different levels of implementation strategies. For instance, school-wide positive behavior interventions and supports (SW-PBIS) and universal social-emotional learning curricula require system-wide implementation efforts. So, school teams need to select implementation strategies that target school-level factors (e.g., leadership, climate). Conversely, school-home notes rely on individual participation. Hence, one should use strategies that promote individual-level implementation factors (e.g., teacher buy-in, teacher-family relationship). #3 Identify the current implementation stage The school team needs to match implementation strategies to their current implementation stage. Generally, implementation efforts can be divided into four stages: Exploration, Preparation, Implementation, and Sustainment (Moullin et al., 2019). Different stages require different implementation strategies (Zhang et al., 2022a). For instance, if a school plans to test-drive SW-PBIS, they should select pre-implementation strategies that build up the school-wide readiness for SW-PBIS (e.g., training, change commitment, professional learning communities). On the other hand, if a school is already implementing SW-PBIS but lacks fidelity, they should select strategies to improve fidelity (e.g., hiring coaches, performance-based feedback, motivational interviews). #4 Review school needs and lacking implementation factors The school team will conduct a needs assessment with implementers and then use validated assessments of implementation factors to identify the gaps in their implementation efforts. The assessment process should follow the CFIR model to cover critical domains based on the school team and implementers' consensus (e.g., implementer-related or inner-setting factors). The school team can then refer to the SISTER, ERIC, or other compilation of strategies (Powell et al., 2015; Cook et al., 2019) to select implementation strategies that pinpoint the identified lacking factors. #5 Identify implementation-related contextual factors Consider the contextual factors that may influence the use of the implementation strategy, such as school leadership, climate, policies, existing practices, and the availability of resources required for certain strategies. The school team should assess how feasible each implementation strategy is given their existing infrastructure and resources (e.g., staffing, time, money, material). Then, the school team should work on solutions to identified barriers (e.g., allocate time and incentives for a school team to carry out the identified strategy) (Zhang et al., 2022c). #6 Determine implementation strategies, corresponding goals, and action plan (a) Based on the results of previous steps, the school team will select an ideal implementation strategy and specify their implementation goals (i.e., implementation factors to improve with the selected strategy). (b) Then the school team will set a schedule to monitor their goals for future data-based decision-making. For instance, if the goal is to increase intervention fidelity of behavioral contracting, the school team can have the counselor conduct monthly structured observations of a teacher's intervention fidelity and provide performance-based feedback. (c) Last, the school team needs to decide who, when, and where to deliver the selected strategies to achieve their implementation goals. Accountability measures should be taken by the school team to ensure the strategies were carried out with adequate fidelity (i.e., good fidelity of implementation strategy in addition to good fidelity of intervention). #7 Monitor and make data-based decisions about selected implementation strategies The school team must use validated and pragmatic measures to continuously monitor the target implementation factors. Periodically, the team will convene to review the progress data to make data-based decisions about whether the selected implementation strategies effectively improved the effectiveness of the EBP and student outcomes. Key Implications for Practice In the context of school mental health, implementation science has several implications for how to effectively implement evidence-based practices (EBPs) as part of routine practices in schools. Without adequate implementation factors and strategies in place, even the most established EBP may not yield expected student social-emotional, and behavioral (SEB) outcomes. Common factors that either promote or impede the implementation of EBPs in schools can be categorized into five contextual domains (a) outer setting (e.g., policy), (b) inner setting (leadership), (c) characteristics of individuals (e.g., attitudes), (d) EBPs (e.g., fidelity, acceptability), and (e) implementation process (e.g., implementation stages). There are many validated and pragmatic measures of key implementation factors. School teams can use them to identify the gaps and needs of existing implementation efforts for a given EBP in schools. The results can also be used to inform data-based decision-making about the selection, delivery, and evaluation of implementation strategies for identified gaps or needs in existing implementation efforts. Schools can use implementation strategies to change implementation factors at individual and/or school levels, which will in turn improve the outcomes of their existing interventions (i.e., student SEB needs and/or academic performance). To select appropriate implementation strategies, the school team needs to be mindful of (a) their current stage of implementation, (b) the delivery level of their target EBP, and (c) existing implementation factors that are lacking or barriers in their school context. Related Resources UW School Mental Health Assessment, Research, and Training (SMART) Center (Specific to school-based implementation resource) Evidence-based Prevention and Implementation Support Center Measures for Implementation Research (contains many free and validated measures) Consolidated Framework for Implementation Research (details all CFIR domains) California Evidence-Based Clearinghouse for Child Welfare Evidence-Based Behavioral Practice Active Implementation Hub   https://doi.org/10.17077/rep.006662 
two students with laptops
Jared T. Izumi, Ph.D., Assistant Professor of School Psychology in the Attallah College of Educational Studies at Chapman University
Description
Social-emotional-behavioral health (SEBH) includes a spectrum of protective and risk factors that are associated with positive and negative life outcomes, including a future diagnosis of a mental health disorder. Screening for SEBH is a foundational component of comprehensive multi-tiered systems of support (MTSS) as it provides quick and efficient information to educators that informs instruction and intervention. Taking into consideration resource availability, the implementation of universal screening requires systems to meet the needs of schools and students. This brief provides an overview of considerations when conducting universal SEBH screening. Universal screening of SEBH in children and adolescents has been promoted as a proactive solution to identify and intervene before SEBH problems become resistant to change. Universal screening is a preventative practice to address an estimated 50% of youths with unmet mental health needs (Whitney & Peterson, 2019). Screening data provides the necessary information to recognize the SEBH needs of students and to facilitate systems-level continuous improvement (Mahoney et al., 2021; Romer et al., 2020). Universal screening offers several advantages over targeted methods of identification by: (1) identifying students before problems become resistant to change, (2) identifying students that would have been previously unnoticed, (3) providing data at the system-level, and (4) monitoring progress over time (Romer et al., 2020).   https://youtu.be/V0yJ3iqiKzc What is Social-Emotional and Behavioral Health? SEBH includes both symptoms associated with psychological problems (e.g., internalizing and externalizing problems) and the presence of psychological well-being (e.g., prosocial and adaptive skills; Kamphaus, 2012). SEBH screeners that are conducted in schools should also contain items that promote academic success (e.g., work completion and attention; Kamphaus, 2012). As such, the state of Iowa defines SEBH as “social, emotional, behavioral, and mental well-being that…contribute to resilience and to how one relates to others, responds to stress and emotions and makes choices…that support positive wellbeing and academic success” (IAC §281—14.7).   Identification/Assessment Strategies The first step before conducting universal SEBH screening is to identify a broader mission or vision of SEBH screening and its relationship to a comprehensive MTSS framework. The broader mission or vision should identify the goals/objectives of the school or district and its relation to how the data will be used. For example, SEBH screening data may be used to identify students in need of additional supports or to monitor the functioning of system-wide interventions. The goals/objectives and the SEBH screening tool must be aligned with instructional and intervention practices. When and How Often Should Universal SEBH Screening Be Conducted? When teachers are completing screeners about their student, ample time is needed for the teacher to get to know the students (e.g., one month for most screening tools). Allowing for teachers to have sufficient time to observe their students should be balanced with early identification before problems become resistant to intervention. If the goal/objective is to identify students in need of SEBH intervention, then screening should be conducted in the fall after at least one month has passed, but not long after that time. While there is no definitive number of times SEBH screening should be conducted (Romer et al., 2020), it typically occurs three times per school year. Research indicates SEBH risk status remains relatively stable; however, additional students would be identified during subsequent screening periods (Miller et al., 2019). Screening multiple times per year also allows for systems-level progress monitoring and decision-making such as resource allocation. Who Will Provide the SEBH Information? Teachers, parents, and students may provide information on student SEBH functioning. School and district teams should consider the costs and benefits of each source of data (Glovers & Albers, 2007). Teachers can provide reliable information for universal SEBH screening data, especially when identifying externalizing behaviors and academic enablers (Dowdy & Kim, 2012). School teams may elect for students to provide self-reports on SEBH skills starting in adolescence when rates of internalizing problems increase (Romer et al., 2020). Lastly, parents offer a unique perspective by being able to provide information based on the years of development in multiple contexts. They can also provide information before key transitions (e.g., start of kindergarten; Glovers & Albers, 2007). School and district leadership should also consider how students, parents, and teachers will be informed and consent to SEBH screening. The Individuals with Disabilities Education Improvement Act (IDEA) and the Protection of Pupil Rights Amendment (PPRA) are two federal laws related to SEBH screening. The IDEA (2004) indicates that screening for the purposes of identifying instructional strategies is not considered an evaluation requiring parental consent (34 CFR § 300.302) or evaluations administered to all students do not require parental consent (34 CFR § 300.300[d][ii]). The PPRA (2002) states that schools cannot require students to complete surveys related to “mental or psychological problems” without prior written consent (34 CFR Part 98). In general, universal SEBH screening that has opt-out procedures would not require prior written consent; however, schools and districts should consult with their legal team. In addition, schools and districts should consider how state laws may impact SEBH screening (e.g., prior written consent is required in the state of Iowa if the school is contracting with an outside agency to conduct SEBH screening; IAC §280A.2). How Will Data Be Collected and Stored? Districts and schools must consider how universal SEBH screening data will be collected and stored to ensure student privacy and appropriate access to the data. District and school personnel should consult with their legal counsel to ensure appropriate data storage and access practices are in place. Prior to decision-making, schools should inspect the data to ensure it was properly collected (e.g., missing and duplicate data). Individuals with access to the data should be able to analyze the results quickly and easily. This can be facilitated by being integrated with other data systems (e.g., office discipline referrals [ODRs], grades, and other screening data) and viewed at different levels of specificity (i.e., student-, class-, grade-, school-, and district-level). Lastly, the school or district should consider how data will be shared with key stakeholders, specifically parents. Particular care should be taken when individual student data are shared to ensure proper interpretation of SEBH risk rather than mental health diagnosis, as screeners are NOT used to diagnose students. How Should Screening Data Be Used to Inform Intervention Selection? First, before conducting SEBH screening, schools should determine their capacity for providing intervention. Determining the capacity for intervention allows schools to identify the range and types of students that can be served in a meaningful manner (Romer et al., 2020). This includes creating a problem-solving team (PST) that will examine and make data-based decisions on the data. Members of the PST will depend on each school, but should include administrators, teachers, and individuals with expertise in SEBH at a minimum (Romer et al., 2020). After screening, PST should examine system-wide data to determine if Tier 1 supports are functioning adequately (i.e., less than 20% of students have SEBH risk). If screening data identifies significantly more students than the maximum capacity for intervention or greater than about 20% of students are at risk, then Tier 1 interventions must be considered or changed. Next, PST may examine information available to identify individual students in need of intervention. Multiple pieces of information from different perspectives should be used when identifying students in need of intervention (e.g., ODRs, attendance, and grades; Romer et al., 2020). What Universal SEBH Screening Measures Should I Use? A comprehensive evaluation of available SEBH screening measures is beyond the scope of this brief; however, a list of some assessment tools is provided. For a more comprehensive list of SEBH assessment tools readers are forwarded to the RAND Education Assessment Finder. Screening measures should be selected based on the match between domains evaluated and domains of interest, appropriateness for the students of interest, accuracy of information, feasibility of administration, and utility of outcomes (Glover & Albers, 2007). Caution should be taken by schools against selecting SEBH screening methods based primarily on feasibility (i.e., teacher nominations and ODRs). Limitations to teacher nominations and ODRs as a universal screener for SEBH risk preclude recommending their use in isolation. Teacher nominations and ODRs are more likely to be biased toward historically marginalized students, misidentify or underidentify students with internalizing problems, wait for significant SEBH problems to occur, and misalign with the goals of SEBH screening (Eklund & Dowdy, 2014; Gregory et al., 2021; McIntosh et al., 2010; Raines et al., 2012). Using brief behavioral rating scales (BBRS) as a method of universal SEBH screening can help increase the feasibility of collecting screening data from multiple sources. Brief Behavioral Rating Scales (BBRS) BBRS are short surveys that are completed for all students. Each student is rated on the same criteria, leading to more objective identification practices (Raines et al., 2012). School teams should consider the goals/objectives of SEBH screening based off their unique needs to identify the appropriate SEBH screening tool. For example, a high school may be more interested in identifying students with internalizing problems; therefore, they should select a BBRS that measures internalizing problems via self-report. Alternatively, an elementary school may be interested in identifying relationship skills in their students through teachers as informants. BASC-3 Behavioral and Emotional Screening System (BESS) The BESS can be completed by teachers, parents, or student self-report, and is available for students in grades K through 12. The teacher and parent versions include a total Behavioral and Emotional Risk Index, Externalizing Risk Index, Internalizing Risk Index, and Adaptive Skills Risk Index. The student index has an Internalizing Risk Index, Self-Regulation Risk Index, and Personal Adjustment Risk Index. Students are categorized into Normal Risk, Elevated Risk, and Extremely Elevated Risk. The BESS is available in Spanish for parents and students. The BESS may be purchased from Pearson for $1.50 per student (as of June 2023) and may be used with Peason’s QGlobal or aimswebPlus. Devereux Student Strengths Assessment (DESSA)-Mini The DESSA-mini is a teacher, parent, or other child-serving agency survey that takes about 1 minute per student to complete. There is a K through 8 version and a high school version. The DESSA-mini provides a Social and Emotional Total score. Students are categorized into Need for Instruction, Typical, and Strength. The full DESSA can be administered as a follow up, which is a comprehensive assessment that provides more detailed information, which may be helpful to learn about some students that score as Need for Instruction. The DESSA-mini is also available in Spanish. The DESSA-mini may be purchased through Aperture Education for $8.50 per student (as of June 2023 with lower prices for more students) and comes with the full DESSA for schools that prefer to collect additional data on some students. The DESSA-mini also comes with recommended interventions. Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) The SAEBRS is a teacher and student self-report form that takes about 2 minutes per student to complete. The teacher version can be used for students in grades K through 12 and the self-report can be used for students in second grade and above. The SAEBRS provides scores on Total Behavior, Social Behavior, Academic Behavior, and Emotional Behavior. Students are placed into one of three risk categories on each of the scales: Low, Some, and High Risk. The self-report version is available in Spanish. The SAEBRS may be purchased for $3 per student through Illuminate Education or Renaissance Learning (as of June 2023). The SAEBRS requires additional onboarding costs of about $2,000, which include system management and teacher professional development. Strengths and Difficulties Questionnaire (SDQ) The SDQ is a teacher, parent, or student self-report survey that takes about 5 minutes to complete per student. The teacher and parent versions can be completed for children ages 2 to 17 and the self-report version can be completed for ages 11 to 18 or older. The SDQ provides a Total Difficulties scale, Emotional Symptoms subscale, Conduct Problems subscale, Hyperactivity/Inattention subscale, Peer Relationship Problems subscale, and Prosocial Behavior subscale. There is a three and four-category scoring method for identifying risk. The three-category method groups students into Normal, Borderline, and Abnormal categories and the four-category method groups students into Close to Average, Slightly Low/Raised, Low/High, and Very Low/High categories. The SDQ has been translated into over 75 languages. SDQ is offered for free for noncommercial purposes or may be purchased for $1.00 per student (as of June 2023) at SDQplus.org for online administration. Student Risk Screening Scale-Internalizing Externalizing (SRSS-IE) The SRSS-IE is a teacher-completed rating scale that takes about one minute per student to complete. The SRSS-IE has an elementary version and middle/high school version. The SRSS-IE identifies students at-risk for antisocial behavior and internalizing behavior. Students are placed into one of three categories: Low, Moderate, and High Risk. The SRSS-IE is only available in English. The SRSS-IE is provided free of charge and the developers provide a Microsoft Excel template to score the measure. However, additional data management may be required to aggregate data across classrooms to conduct data-based decision-making.   Key Implications for Practice District/school team leaders and key stakeholders (e.g., parents and community members) identify the goals/objectives for conducting universal SEBH screening Select a screening tool that aligns with the identified goals/objectives, has adequate accuracy, and will be feasible to implement Identify other pieces of information to support screening data Use screening data to inform individual and system-wide interventions Related Resources Supporting Child and Student Social, Emotional, Behavioral, and Mental Needs - U.S. Department of Education National Center for School Mental Health RAND Education Assessment Finder School Mental Health Collaborative https://doi.org/10.17077/rep.006638 
Student at desk
Isaac T. Petersen, Ph.D., Assistant Professor, Department of Psychological and Brain Sciences, University of Iowa
Description
Externalizing behavior problems encompass a wide range of acting out behavior difficulties with the (external) environment, including behaviors such as aggression, bullying, conduct problems, callousness, inattention, hyperactivity, oppositionality, rule breaking, defiance, substance use, and disruptive behavior. Externalizing problems are prevalent in school-aged children and are costly and burdensome to individuals, families, schools, and society. Externalizing problems are disruptive to classrooms and make it challenging for educators to focus on teaching and for the child and classroom to learn. Moreover, early externalizing problems can predict later, more severe problems like violence if left untreated, so accurate assessment of externalizing problems is crucial to ensure children and adolescents receive the services they need. The goal of this practice brief is to help clinicians and school psychologists conduct accurate assessments of externalizing behavior in school-aged children to support effective intervention and prevention. Identification/Assessment Strategies Conduct a Multi-Stage Approach to Assessment Effective assessment of externalizing behaviors uses a multi-stage approach including screening, using multiple assessment methods, interpreting results, designing the treatment plan, and evaluating treatment progress (Volpe & Chafouleas, 2011; Youngstrom & Van Meter, 2016). Consider the Goals of the Assessment When selecting assessment tools to use, it is important to consider the goals of the assessment process. Various goals of assessment include (a) screening, (b) diagnosis, (c) monitoring progress, (d) and characterizing the full range of strengths and difficulties. Different assessments should be selected depending on the goal(s). Another consideration is whether to assess behavior problems at a more general, broad-band level (e.g., externalizing problems), or in more specific, narrow-band ways—e.g., callous-unemotional behaviors, inattention/impulsivity/hyperactivity, oppositionality, aggression, conduct problems, or substance use. Assessments that focus on broad-band problems tend to provide limited depth in any specific concern (Collett et al., 2003). If time allows, it can be helpful to include both the assessment of general, broad-band problems as well as more focused assessment of narrow-band problem dimensions in the areas of greatest potential concern (Achenbach et al., 2016). Screening devices tend to be brief, broad-band, and aim to identify children who are at risk of showing clinically significant problems in their current or future behavior. Schools often implement school-wide screening. Because screening devices aim to identify children who are at risk, screening devices focus on differentiating the top half of the distribution (i.e., the 50th percentile of misbehavior and above) as briefly (i.e., with as few items) as possible. Another purpose of assessment may be to monitor a child’s progress, such as their response to treatment. Instruments designed to monitor progress tend to be brief, so they can be completed regularly (e.g., daily or weekly). A consideration for such measures is whether it is sensitive to change to detect improvement in a child’s behavior over a short timeframe. A fourth purpose of assessment may be to characterize the full range of a child’s strengths and difficulties. Here, the goal is to determine where in the distribution (e.g., what percentile) the child is relative to their peers on dimension(s) of interest (e.g., aggression). Such instruments are longer because they aim to differentiate children across the full distribution (i.e., 1st to 99th percentile), which requires items that differ in severity and requires more items. Other Considerations When Selecting Assessment Tools Other important considerations when selecting assessments include psychometrics: reliability and validity. That is, scores from a given measure should be precise and accurate for the intended construct (i.e., externalizing problems), population, and purpose. The psychometric properties of measures are reviewed by Sattler (2022) and the Buros Mental Measurements Yearbook. It is important to consider whether the measure’s content and items are developmentally appropriate for the child’s age and developmental level (Wakschlag & Danis, 2004). In addition, it is important to consider whether the measures’ scores and norms are appropriate for special populations, including those with intellectual disabilities, those in the child welfare system (Keil & Price, 2006), and those who may not be proficient in English (Paalman et al., 2013). If the instruments used do not have established validity or norms with respect to the particular population of interest (e.g., 13-year-olds), it is important to note potential interpretive concerns in any reports. Use Multiple Methods and Perspectives at Multiple Time Points It is best to conduct the assessment with at least two assessment methods and at least two perspectives, at multiple points in time (Lochman et al., 2001). Assessment methods include questionnaires, interviews, observations, behavior tracking, and school records (e.g., Walker et al., 1991). It is preferable for the perspectives represented to span the home and school contexts. Perspectives could include, for instance, parents, teachers, other caregivers, the child, siblings, and peers. Easily observable misbehavior may be best reported by informants, whereas more hidden or covert misbehavior may require self-report. To ensure validity, the assessments should be administered and interpreted by licensed professionals who are trained to use them. Questionnaires Questionnaires can be a quick, easy way to collect information from multiple informants. However, questionnaires have limitations, including (a) they require respondents to be able to read proficiently in the language, (b) they involve informant bias, (c) they often have subjective response formats (e.g., “sometimes”, “often”) that lead to bias and imprecision, and (d) they do not provide systematic opportunities for respondents to ask clarifying questions or for examiners to ask follow-up questions, making it more likely that a respondent will misinterpret a question. One of the most widely used assessments of externalizing problems is the Achenbach System of Empirically Based Assessment (ASEBA). The ASEBA includes assessment of broad-band problems as well as more narrow-band problems, and it includes varying items for different informants and ages to maintain developmental and contextual relevance. For instance, parents provide reports on the Child Behavior Checklist, which has different versions based on the child’s age. Teachers provide reports on the Teacher’s Report Form, which also has different versions based on the child’s age. The ASEBA also includes an optional Multicultural Supplement with multicultural norms. Moreover, the ASEBA includes a brief form, the Brief Problem Monitor that is more sensitive to change for the purposes of monitoring progress. The Peer-report Measure of Internalizing and Externalizing Behavior uses peer nomination to identify externalizing problems. Another widely used questionnaire of externalizing problems is the Strengths and Difficulties Questionnaire*. It assesses functional impairment, has different forms for various ages and informants, and has translated versions in many languages. A questionnaire that is well-suited to study the full range of strengths and weaknesses is the Extended Strengths and Weaknesses of Normal Behavior*. In addition to broad-band questionnaires, there are also questionnaires designed to assess more narrow-band problems, including for callous-unemotional behaviors (Inventory of Callous-Unemotional Traits*), inattention/impulsivity/hyperactivity (Conners 4), oppositionality (Disruptive Behavior Disorder Rating Scale*), aggression (Children’s Aggression Scale), conduct problems (Conduct Disorder Rating Scale), or substance use (Problem-Oriented Screening Instrument for Teenagers*). The Conners 4 is also available in Spanish and French. Interviews Interviews are another common form of assessment. Interviews do not require respondents to be able to read, and they allow examiners to ask follow-up questions. However, interviews take more time to conduct than questionnaires and can be subject to confirmatory bias on the part of the interviewer. For instance, interviewers tend to assess only the behavior problems that fit their hypotheses of the child’s difficulties (Sharp et al., 2013). To prevent confirmatory bias, it is important to use structured or semi-structured interview approaches and to supplement the approach with assessments that span a wider array of potential difficulties than the clinician’s hypotheses might suggest. Some interviews assess broad-band problems, whereas others focus on more narrow-band problems. General interviews include the Schedule for Affective Disorder and Schizophrenia for School-Age Children*, Child and Adolescent Psychiatric Assessment (CAPA)*, and Development and Well-Being Assessment* (DAWBA). CAPA has a child interview and a parent interview. The DAWBA has translations in many languages. Interviews that are focused on externalizing behavior include the Disruptive Behavior Disorders Parent Interview*, Kiddie Disruptive Behavior Disorders Schedule, and Clinical Parent Interview for Externalizing Disorders in Children and Adolescents. An interview focused on callous-unemotional behavior is the Clinical Assessment of Prosocial Emotions*. Observation Observational assessment is a valuable assessment process for externalizing behaviors. Observations are less influenced by informant bias. However, observations can be time consuming to conduct. Moreover, during a brief observation period, it may be unclear how representative a child’s behavior is of their behavior in other situations or contexts, especially if the child acts differently because they are being observed (i.e., reactivity). In addition, if the target behavior is infrequent or covert, it can be more difficult to observe. A widely used approach to observational assessment is functional behavior assessment (FBA). FBA involves observing patterned sequences of antecedents and consequences of the target problem behavior to generate and test potential hypotheses regarding the function(s) of the behavior, which can be useful in intervention (Broussard & Northup, 1995; Gresham, 2015). The same behavior can occur for different reasons, and it is important to know why the child engaged in the problem behavior, because each function might be targeted differently in intervention. Common hypotheses regarding the functions of problem behavior include approach- (e.g., access to attention or access to tangibles, such as toys or preferred activities) and avoidance-related functions (e.g., escape from undesirable situations). When conducting observational assessments, it is helpful to observe the child in different situations (e.g., lunch time, recess, math work), times of day (e.g., morning, afternoon, evening), and contexts (e.g., home, school). Rating specific behaviors close to when they are exhibited is helpful for monitoring progress (Daniels et al., 2021). Schools may also have FBA processes and tools developed by their district, intermediate service agencies, or state departments of education that they are required to use as part of processes like multi-tiered systems of support (MTSS) and special education identification. In addition to FBA, several observational assessments have been developed for externalizing behavior, including the ADHD School Observation Code, ADHD Behavior Coding System, Disruptive Behavior Diagnostic Observation Schedule, Direct Observation Form, Adjustment Scales for Children and Adolescents, Overt Aggression Scale, Revised Edition of the School Observation Coding System, and Classroom Observation Code. There are also playground-based observational systems (Leff & Lakin, 2005). Behavior Tracking  Behavior tracking is a form of observational assessment that aims to assess children prospectively in a less time-consuming way. For instance, it may involve the parent or teacher making a tally for each instance of various behaviors, including compliance, noncompliance, and aggression. Behavior tracking is sensitive to change and is therefore particularly useful for progress monitoring. For instance, behavior tracking may allow practitioners to evaluate whether the frequency of the target problem behaviors change on a day-to-day or week-to-week basis. Handling Informant Discrepancies Informants (e.g., parent, teacher) often disagree about the extent to which a given child shows behavior problems. Informant discrepancies likely occur for many reasons, including (a) the child may behave differently in different contexts and/or with different people, (b) informants may have differing knowledge and perspectives of what is developmentally typical versus atypical; for instance, teachers may generally have a wider range of comparisons than parents and may thus be uniquely positioned to rate the child, (c) there may be cultural differences in what is considered developmentally appropriate behavior, (d) informants have biases to respond in particular ways, and (e) measurement error. To handle informant discrepancies when there is not a clear primary informant who is best positioned to rate the child most accurately, one can count a symptom as present if it is endorsed by any of the informants (Hinshaw & Nigg, 1999). What to Assess It is important to assess many facets of the problem behavior, including its frequency, intensity/severity, onset, and duration; that is, how long it has been occurring, how frequently it occurs, and how intense or severe the behavior is when it occurs. It is also important to consider potential function(s) of the misbehavior (Reitman et al., 1998). Functional impairment should also be considered. For instance, it is important to consider whether the behavior impedes the child’s ability to perform well in school, to hold a job, or to develop meaningful relationships with peers, teachers, and family members. In addition, it is important to consider cultural and contextual factors, including the family and social context (Knapp et al., 2012). It is also important to consider co-occurring issues and conditions. Many cognitive, academic, emotional, behavioral, and medical difficulties commonly co-occur with externalizing problems and are important to assess. Commonly co-occurring issues include internalizing problems (e.g. mood and anxiety-related problems; Achenbach et al., 2016; Cunningham et al., 2013), intellectual disabilities, learning disorders, academic difficulties, neurodevelopmental conditions such as autism, and problems related to sleep, feeding (e.g., picky eating), and voiding (e.g., enuresis, encopresis; McKinney & Morse, 2012) . Data Privacy and Sharing Federal laws protect the privacy of protected health information (HIPAA) and of educational records (FERPA). It can be helpful for clinicians, schools, and families to work together to address a child’s needs. To achieve this, it is important to obtain informed consent and two-way releases of information to ensure that the clinician can share information with the school, and that the school can share information with the clinician. For instance, a parent and teacher might rate the child’s behavior for a clinician conducting an assessment. The clinician then might share their assessment results and a suggested treatment plan with the family and might work with the teacher and family to help them enact the treatment plan. The school may then share the child’s treatment progress with the family and clinician. Putting It Altogether With the assessment information collected, the clinician can develop a case formulation that considers predisposing factors, precipitating factors, perpetuating factors, and protective factors for the given child’s misbehavior. Such a case formulation is helpful when developing a treatment plan. Intervention often aims to address a child’s perpetuating/maintaining factors (e.g., low frustration tolerance; ineffectual caregiver responses) and minimize how frequently the triggering situations occur, while building on the child’s strengths and considering predisposing factors (e.g., family history, temperament). To maximize the usefulness of assessment results for schools, it is important to write a concise and clear report and be timely and attentive to requests for data sharing. In sum, externalizing behavior problems in school-aged children are prevalent, burdensome, and important to assess and address. Key Implications for Practice Conduct a multi-stage approach that includes screening, multi-method assessment, interpreting results, designing the treatment plan, and evaluating treatment progress. Select measures based on their psychometrics, their intended depth and breadth, and the goals of the assessment: screening, diagnosis, monitoring progress, or patterns of strengths and weaknesses. Consider cultural and contextual factors and co-occurring issues. Incorporate multiple perspectives (e.g., parents and teachers) and methods, including observational assessment, across multiple time points. Consider frequency, intensity, duration, functions, and impairment of problem behaviors. Develop a case formulation based on predisposing, precipitating, perpetuating, and protective factors for the child’s problem behaviors. Ensure information sharing forms are completed and reports are shared with families and schools, so that schools can use the information in their planning and delivery of services. Related Resources Supporting Child and Student Social, Emotional, Behavioral, and Mental Needs - U.S. Department of Education Brochures and Facts Sheets - National Institute of Mental Health Attention-Deficit/Hyperactivity Disorder in Children and Teens: What You Need to Know - National Institute of Mental Health Disruptive Mood Dysregulation Disorder: The Basics - National Institute of Mental Health Resources Centers - American Academy of Child & Adolescent Psychiatry Child, Youth and Family (CYF) Database - Centre for Effective Services as part of the Prevention and Early Intervention Research Initiative Mental Measurements Yearbook - Buros Center for Testing Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) Institute on Violence and Destructive Behavior (IVDB) Systematic Screening - Comprehensive Integrated Three-Tier Model of Prevention Conduct Disorder - Mental Health America Externalizing Academic Educational - youth.gov * indicates an assessment instrument that is freely and publicly available https://doi.org/10.17077/rep.006639
Student reading at desk
Naomi H. Rodgers, Ph.D., CCC-SLP , Assistant Professor in the Communication Sciences and Disorders Department, University of Iowa
Description
Roughly 8% of children between the ages of 3 and 17 years have documented speech and/or language disorders (Black et al., 2015). Speech disorders impact how people produce sounds including articulation, phonology, fluency, and voice. Language disorders impact how people understand and formulate vocabulary, grammar, and pragmatics in both oral and written modalities. https://youtu.be/j6AoP_300Ts Students with receptive communication challenges may have difficulty understanding what others say to them, while students with expressive challenges may be unsuccessful in communicating in ways that are understandable by others. While communication disorders are sometimes caused by underlying impairments like hearing loss, intellectual disability, or other genetic issues, they often arise without any identifiable underlying or co-occurring issues. Given how central communication is to one’s personhood, cultural identity, and social belonging, students with communication differences and disorders often experience a range of social-emotional effects due to repeated difficulties with understanding and/or being understood. Research shows that children with a variety of communication disorders experience greater social-emotional issues compared to typically developing peers. For example, children with speech sound disorders are often teased (McLeod et al., 2013), and those who stutter often harbor negative attitudes about communication (Guttormsen et al., 2015). Children with developmental language disorder have smaller peer groups (Chen et al., 2020), and those who are deaf/hard of hearing report lower levels of social competence (Stevenson et al., 2015). Across the board, children with communication disorders tend to experience higher levels of anxiety than typically developing peers (Bernard et al., 2022; Lewis et al., 2016; Samson et al., 2020; Theunissen et al., 2012). This poses serious threats to personal well-being, social engagement, and educational/vocational fulfillment.  Prevention and Identification Strategies There are individual differences in how children with communication disorders cope with communicative adversity. Some may internalize or externalize their frustrations with interpersonal situations (Petersen et al., 2013). Internalizing behaviors may look like reduced participation in class activities, minimal talking, distress during public speaking, difficulty concentrating on communication tasks, and withdrawal during social activities. Students may externalize their frustration through off-task behaviors, refusal to participate, and aggression. Additionally, students with communication disorders are more likely to be victimized by peers (Hughes, 2014). Bullying prevention strategies for students with disabilities involve fostering peer relationships, helping students develop empathy, creating a buddy system for children with communication challenges, involving students in adaptive communication strategies in the classroom, facilitating team-based learning activities, implementing social-emotional learning activities, and rewarding positive, helpful, inclusive behaviors. If teasing or bullying are observed, teachers and other school personnel should address it immediately (see strategy 5 below). Students with communication challenges may qualify for school-based special education services by a speech-language pathologist (SLP) if (a) the student is diagnosed with a communication disorder, (b) the communication disorder adversely affects their educational performance, and (c) specialized services are necessary to help the child make progress (IDEA, 2004). Regarding (b) “educational performance,” school SLPs take into consideration students’ oral participation, social-emotional adjustment/behavior, and reactions of self/peers/teachers/parents to the students’ communication patterns (Farquharson & Boldini, 2018). School personnel can talk to the school SLP if a child’s communication challenges appear to be interfering with their classroom and social engagement. Intervention Strategies Supporting the mental health of students with communication disorders requires a collaborative, ecological approach (Hoff & Unger, 2021). Although research efforts in this area are desperately needed, the following six strategies are offered as a preliminary approach to supporting social-emotional well-being in students with communication challenges. These strategies can be implemented by all school personnel, not just SLPs. #1 Educate peers about communication differences. Facilitate a classroom discussion about communication differences present in the classroom—what they are, what they are not, and how listeners can be helpful communication partners. The topic of the presentation should be created collaboratively, at least with the student(s) with communication differences, but the school SLP and the parent(s) can also be involved. The content should be factual and discuss communication differences in a judgement-free, strengths-based way. For example, for a student who stutters, it could be helpful to provide facts and dispel myths about stuttering: stuttering sounds like speech repetitions and blocks, that people stutter because that’s how their brains are wired for talking not because they’re nervous people, and that the most helpful thing listeners can do is wait patiently for the person who stutters to finish their own words. In this example, it would be important not to describe stuttering as “worse” than fluent speech. The goal of this type of presentation is to create an environment where students with communication differences feel safe and valued as communicators, and that environment is created when teachers and peers see the student’s communication style as valid—not inferior to mainstream communication patterns (e.g., Weidner et al., 2018). In addition to collaborating on content, it is important to involve the target student in the presentation in a way that they are comfortable. One student may want to present on the topic themselves or co-present along with the teacher or SLP, while another student may want to be out of the room when the teacher talks about it. The student’s wishes and comfort level should always be honored, and they should not be required to do anything they are not comfortable with. #2 Share messages of empowerment and representation. When a student hears messages from adults like “That’s not how we talk,” “Say that again using your good sounds,” or “Your talking has been worse today,” this sends the message that the way a student talks is not the “right” way. These messages are often shared with good intentions; adults recognize that communicating in a certain mainstream way can afford people access to certain opportunities. However, students may internalize guilt and shame about how they talk (Gerlach-Houck et al., 2023). An impactful way to show students that they have allies at school is to use accepting and empowering language when talking about their communication. If someone is unable to understand what the student says, the listener may say something like: “You have such important things to say and I want to make sure I understand” and then help the student problem-solve how to express themselves in a way that they are understood. Get down on the child’s level and prompt them to try repeating themselves, using different words that communicate the same idea, or augmenting their verbal message with gestures or writing. Because communication differences are usually noticed via audio/visual modalities, teachers can include stories in their classroom that involve characters who have communication differences and watch videos of people who speak different dialects. More visible communication differences like using a communication device, signing, or wearing hearing aids/cochlear implants can also be represented in print materials. #3 Increase classroom accessibility. Teachers and school staff can collaborate with students with communication disorders to personalize their access to educational and social activities. This can happen officially through the student’s individualized educational plan (IEP), a 504 plan, or informal discussions with the student (and SLP, if feasible). Teachers should think creatively and proactively about how to make the classroom a welcoming place that invites students to take communication risks on their own terms. For example, students who have difficulty reading aloud perhaps because of dyslexia, articulation challenges, stuttering, or voice issues that make it difficult to project loudly may work out an alternative plan to practice reading aloud in a setting with less social pressure. For classroom presentations, it could be helpful to increase or remove a time limit for students who need more time to communicate, and to consider how grading criteria for “clarity” or “fluency” disproportionally affect students with communication differences. #4 Embed opportunities to develop resilience. To support students’ emotional resilience, help them build emotional awareness and regulation. Provide opportunities for students to develop an emotional vocabulary through structured activities, role play, book reading, and capitalizing on teachable moments as they arise. Extend their emotional vocabulary so they are better able to identify nuanced feelings and put words to those emotions. For example, happiness can be relief, excitement, or pride, and sadness can be frustration, disappointment, or guilt. Creating a visual feelings wheel or map can be an accessible way for students to point to how they feel when verbally expressing it may be difficult. When students “name it to tame it” (Siegel, 2010), it grounds them in the present moment when they feel emotionally overwhelmed, and this emotional vocabulary expansion can be especially important for students with vocabulary challenges. Students can also explore how different emotions feel in their body. Keep in mind that students with language or pragmatic challenges may have difficulty understanding idioms and metaphors. For example, “when I’m excited, I get ants in my pants” may be taken literally, so it would be more helpful to model “when I’m excited, I feel buzzing in my body, and I have a big smile on my face.” Once a foundation of emotional awareness has been established, students can develop their emotional regulation. This may be particularly difficult (and thus important) for students with communication disorders as some findings reveal lower levels of self-regulation in this population (Binns et al., 2019). Mindfulness activities like body scans and mindful walking can promote cognitive performance, resilience, and stress relief (Zenner et al., 2014). Calming strategies like deep breathing, 5-5-5 (naming five things they see, hear, and feel), leaving the room for a few minutes to reduce sensory overload, or reciting an affirmation (e.g., “I have important ideas to share,” “my voice matters”) may be useful. Using tangible materials for experiential self-regulating activities may be particularly helpful for students with language difficulties. For example, students can make a glitter bottle representing their swirling thoughts/feelings as they watch them settle on their own, or they can draw a picture of ocean waves carrying away their difficult thoughts/feelings (Black, 2022; Fang & Ding, 2020). In the realm of social resilience, students with communication challenges can be supported in recognizing cues when their communication partners are not understanding them and problem-solve ways to self-advocate and get their message across. Students with limited verbal output or low intelligibility may benefit from an alternative or augmentative communication system in the classroom and other social settings. There are low-tech options (e.g., picture boards) and high-tech options (e.g., iPad apps) that the school SLP can help with. #5 Address teasing and bullying. Communication disorders are protected disabilities. When bullying is directed at a child because of how they communicate, it is considered “disability harassment” which the school must address under Section 504 of the Rehabilitation Act of 1973 and Title II of the Americans with Disability Act of 1990. Support students with communication differences/disorders by assuring them it is okay to talk with you about bullying and thank them for telling you about bullying when it arises. Listen to them to learn what happened, show you want to help, and assure the student that bullying is not their fault. Help them to develop problem-solving strategies through role play, give advice through age-appropriate discussions, and guide them to seek social support from trusted peers and other adults (Hughes, 2014). Address bullying behavior by ensuring the student who bullies knows what the problem behavior is, showing them that bullying is taken seriously, taking steps to understand why the child bullies, using consequences to build empathy, and involving the student who bullies in making amends with the student they bullied. #6 Support students’ parents. Parents of students with communication disorders want to be listened to, taken seriously, and not blamed for their child’s difficulties (Hobson et al., 2022). When teachers meet with these parents, it is important for them to be supportive and work with the parents to understand the student’s issues and collaborate to make a plan together. Listen to parents and validate their concerns, even if the child’s behavior is different at home than it is at school. Key Implications for Practice Students with communication disorders have challenges with speech and/or language, which can impact their oral and written engagement in learning and social environments. Students with communication challenges are disproportionately affected by round-robin style speaking and oral reading activities, time limits for presentations, and grading rubrics for “clarity” or “fluency.” Students with language disorders may better engage in multi-modal learning activities. Use concrete language, limit the use of idioms/metaphors, and supplement with visuals. Create an accepting, accommodating environment where all students feel empowered to communicate. Educate peers about communication differences and how to be a helpful communication partner. Help students problem solve communication breakdowns and ways to self-advocate for their communication needs.   Related Resources Bullying and Youth with Disabilities and Special Health Needs - StopBullying.gov Support the Kids Involved - StopBullying.gov School-Based Language Pathologists: Who We Are and What We Do - American Speech-Language-Hearing Association Cultural Competence Check-Ins - American Speech-Language-Hearing Association https://doi.org/10.17077/rep.006640
Teacher and student walking together
A. Stephen Lenz, Ph.D., LPC-S, Professor, Texas A&M University-San Antonio
Description
School climate is a broad concept representing the academic and non-academic factors that distinguish the felt experience of interactions with a school campus. While a single representative definition of school climate has eluded practitioners, several systematic reviews have identified four composite domains that can support assessment, planning, intervention, and evaluation activities (Lenz et al., 2021; Rocha et al., 2019; Wang & Degol, 2016).   https://youtu.be/vlax0C_YkvA   Academic climate is characterized by features that promote student achievement and a culture of learning through developmentally responsive instruction, sufficient allocation of teaching resources, and an affirming culture of learning. At its core, a positive academic climate is grounded in strong leadership, high expectations of learning, support for students and teachers, timely assessment and monitoring practices, personalized learning plans, and the use of technology to promote engagement, collaboration, and success. School community is defined by the quality of interpersonal relationships grounded in a strong relationship between students, teachers, staff, parents, and community members that promotes inclusion, mutual respect, trust, safety, and connectedness. A positive school community is characterized by fair and equitable engagement of school stakeholders to share input, innovations, and resources during evaluation, decision-making, and planning processes that inform activities such as positive behavior programs, student well-being initiatives, professional development, and public relations. School safety is represented by the degree of physical and emotional security experienced by students, teachers, and staff that is conducive to a sense of protection and well-being that allows for optimal learning experiences. School safety is cultivated through physical and digital learning environments that minimize exposure to safety hazards, but also include policies for security and emergency readiness, procedures to address compliance with rules, and an integrated approach to prevention and intervention for social-emotional well-being threats such as bullying, conflict, and mental health challenges. Institutional environment is evidenced by the organizational, structural, and physical features through which school activities are conducted. These include variables ranging from the hours of operation, campus layout, quality of upkeep and maintenance, and class size to the degree of transparency and communication regarding the availability and allocation of technology, resources, supports, and materials. Taken together, the composite domains of school climate are expressed in synergistically complex ways that are both uniquely subjective and objectively observable experiences; they operate not only within student-student dyads, but within a matrix of interactions between students, teachers, staff, parents, and community members; they are influenced both actively and as a part of natural developmental processes; they are both input and output and often function as both process and outcome in their contribution to overall school climate. Despite these complexities, investments in school climate are certainly worthwhile as researchers continue to find promising associations with academic achievement (Daily et al., 2019), graduation rates (Buckman et al., 2021), college-going and persistence (Knight & Duncan, 2020), reductions in physical, emotional, and cyberbullying behaviors (Acosta et al., 2019), positive student and teacher mental health (Dreer, 2022; Wang et al., 2020), teacher job satisfaction and retention (Casely-Hayford et al., 2022; Otrębski, 2022), and civic engagement (Torney-Purta, 2002). Prevention and Identification Strategies Supporting a positive school climate requires intentional collaboration among multiple stakeholders and decision-makers to foster a proactive preventative agenda that targets the academic and non-academic development and well-being of the school community. Key among the related activities is the use of a well-designed assessment strategy to develop a data-driven plan to implement age-appropriate prevention programs. The American Institutes for Research (2023) cited school climate assessment as the principal activity to support a positive school climate through the identification of similarities and differences in perceptions between groups of stakeholders. When selecting an assessment for your campus, consider that the reliability and validity of all scores do not generalize to all stakeholders equally. Thus, it is imperative to consider not only the constructs, costs, length, and logistics of a school climate measure but also the degree that normative data reflects your campus. Furthermore, an equity-minded approach to school climate need identification will need to account for the representativeness of the sample with the corpus of students, teachers, and staff, as well as, a multi-method analysis that articulates both broad and disaggregated data trends. Some measures available for consideration include: Panorama Student Survey (Grades 6-12; Students, no cost); School Climate Assessment Instrument (Grades K-12; Students, Teachers, Staff, Parents/ Guardians, no cost); U.S. Department of Education School Climate Surveys (Grades 5-12; Students, Teachers, Staff; no cost); Comprehensive School Climate Inventory (Grades 3-12; Students, Staff, Parents/Guardians, Community Members, fee-based). Once campus characteristics are identified, it is possible to develop data-responsive prevention campaigns. School-based prevention programs vary in nature from universal to targeted, persistent to short-term, digital to face-to-face, and resource intensive to logistically modest. Once campus characteristics are identified, it is possible to develop data-responsive prevention campaigns. School-based prevention programs vary in nature from universal to targeted, persistent to short-term, digital to face-to-face, and resource intensive to logistically modest. Taken together, the campaigns selected for implementation also bear varying degrees and paces of impact. For example, some preventative programs may be short-term and efficacious; by contrast, others may feature multi-year campaigns with small but systemic cumulative effects. Therefore, it is prudent to develop a campus prevention programming agenda that not only responds to school climate data but can also be monitored for global and differentiated responses among stakeholders. While many areas of academic and non-academic development are worthwhile foci for prevention efforts, common topics include: Alcohol and drug use prevention programming that provides normative education, teaches social resistance skills, provide normative education, and reinforces competence;  Anti-bullying programs that develop the knowledge and skills to recognize, respond, and report wide-ranging forms of bullying such as verbal, physical, social, and cyberbullying;  Civic engagement and social responsibility efforts aimed to promote volunteerism, participation in public elections, and advocacy;  Cybersecurity awareness raising related to issues such as the use of good netiquette, identity protection, interacting with others online, and sharing sensitive information;  Personal wellness and mental health promotion initiatives that include healthy living, nutrition, personal resilience, mental health literacy, and social-emotional coping skills;  Positive relationships and social skills that teach active listening, effective communication, character education, non-violent conflict resolution, and self-advocacy;  Safety and security of self and others in school and non-school-based spaces.  Intervention Strategies School-based interventions have a prominent position within the cadre of approaches to improve, support, and maintain a positive school climate. While many of the topics and methods of intervention delivery are similar to those of prevention efforts, there are key differences in the purpose and intended outcomes. Among these key differences is a focus on (a) directing efforts to children who have developed a problem rather than those who are at risk, (b) deliberate rather than incidental risk reduction, and (c) targeted rather than universal implementation. There is substantial evidence that well-designed intervention programs can affect the domains of school climate with some prominent options available in urban and rural campuses described below. However, the selection of which intervention may be best suited for your campus would rest on thoughtful deliberation of available data, feedback, and available resources. #1 School-Wide Positive Behavioral Interventions and Supports (PBIS) The implementation of PBIS has increased in recent decades as campus stakeholders attempt to support academic and non-academic success through teaching, modeling, and rewarding positive behaviors as an alternative to practices such as admonishment, inconsistent punishment, and exclusionary practices. Rather than rely on a standardized curriculum, PBIS is grounded in a foundational framework of measurable goals and outcomes, databased decision-making, identification and implementation of evidence-based practices, and a systems-level application (Center on PBIS, 2023). These composite interventions are supported across 3 tiers (Universal, Targeted, Intensive and Individualized) as indicated by student needs and school capacity (Harlacher et al., 2018). Despite the unique expression of PBIS across campuses, there is promising evidence for the fidelity of implementation and desired associations with academic achievement, prosocial behavior, discipline referrals, and suspensions (Noltemeyer et al., 2019). #2 Mental Health Support Services School-based mental health support services (MHSS) increase student access to individual or team-based care delivered by licensed and non-licensed providers for commonly occurring clinical issues. MHSS approaches are based on the assumption that mental health and academic achievement have reciprocal influences on one another and consider evidence-based and manualized interventions as a pathway to promote to support development and well-being across the lifespan (Raffaele Mendez, 2017). Students participate in individual and small group services using any combination of in-person and telehealth mediums. Programs such as Think First (Larson, 2005), Brief Coping Cat (Kendall et al., 2013), Stop and Think (Caselman, 2005), the Adolescent Coping with Depression Course (Clark et al., 1990), and Cognitive Behavioral Intervention for Trauma in Schools (Jaycox et al., 2018) are available for treating aggression, anxiety, attention-deficit/hyperactivity disorder, depression, and posttraumatic stress, respectively. While considerable evidence exists for the application of such programs, the observed effects tend to be largest for targeted interventions and moderated by a combination of program type, length of intervention, and age group (Feiss et al., 2019; Sanchez et al., 2018). #3 Conflict Resolution and Peer-Mediation Programs Teaching students to resolve disagreements provides a supportive platform to increase felt safety and reduce incidents of violence while concurrently fostering the communication, problem-solving, and interpersonal effectiveness skills that will be adaptive across the lifespan. Conflict resolution skills are taught to individual students by teachers, administrators, and school counselors who focus on applications such as early intervention, real-time remedies, and follow-up training. Common elements include the use of constructive communication, steps in negotiation, and debriefing activities. Staff and students can also serve as a mediator between 2 or more students when students require additional support to resolve a disagreement. While standalone programs and curricula Teaching Students to Be Peacemakers (Johnson & Johnson, 2005) and Overcoming Obstacles are available for access, school personnel often develop and implement interventions based on units within a universal social-emotional learning curriculum or to meet established standards. Evidence has indicated program effects ranging from small to moderate based on various implementation characteristics (McElwain et al., 2017; Turk, 2018). #4 Peer Mentoring and Support Programs Peer mentoring programs offer a dynamic and relational way to support student success by matching an older student with a younger one who shares a similar developmental pathway. These interventions have the potential to stimulate mutual growth and learning for mentors and mentees by capitalizing on the youth's inherent interest in peer relationships and innate tendency to look up to slightly older peers (Garringer & MacRae, 2008). Effective peer mentoring programs need to consider several elements such as (a) goals and intended impact, (b) participant recruitment, screening, and selection, (c) mentor training, (d) strategies for matching, (e) parent education and orientation, (f) mentor and mentee supports and monitoring, and (g) approaches to resolving the relationship. Several models such as Big Brothers Big Sisters of America, the Cross-Age Mentoring Program (CAMP) Cross-Campus Model (Karcher 2012), and Just for Kids! (Smith, 2011) are available for reference, as well as, toolkits provided by groups such as the National Success Mentors Initiative and National Mentoring and Resource Center. Well-designed peer mentoring and support programs have been associated with promising evidence for academic, psychosocial, and health outcomes, particularly when delivered off-campus and with adult supervision and support (Burton et al., 2022; Raposa et al., 2019). #5 Restorative Practices Restorative practices provide an alternative to zero-tolerance disciplinary policies and punitive discipline through the facilitated repair and strengthening of relationships among individual students when harm has occurred. These aims can be reached through several strategies including (a) informal proactive discussions that allow for respectful, empathic, accountability-oriented, and collaborative conversations; (b) reactive strategies that address individual and classroom-wide incidents of harm; and (c) formal discussions that focused on support and accountability to increase empathy, acceptance, and belonging. Specific restorative practice interventions include restorative conferences, restorative conversations, conversation circles, classroom conferences, and classroom lessons (Winslade et al., 2014). Numerous program models and training guides are available through groups such as the International Institute for Restorative Practice and Restorative Practices Partnership which can be referenced by school administrators, teachers, and staff. Preliminary evidence reviews of restorative practices have indicated trends between intervention with decreased disciplinary referrals and improved student-teacher relationships (Zakszeski & Rutherford, 2021). However, given the correlational nature of evidence to date, school personnel must consider the unique intersection of campus characteristics, training and support resources, implementation capacity, and emerging research findings when developing their approach to cultivating school safety and security. Key Implications for Practice Fostering a positive school climate is a complex task requiring an intentional approach that includes stakeholders across the ecology of student academic and non-academic development. Scoping reviews of best practices and evidence-based approaches offer numerous considerations including: The importance of articulating, adopting, and communicating a shared vision of a positive school climate and related campus priorities, goals, and activities;  Establishing and nurturing a culture of quality improvement that emphasizes transparency, developmental supports, multiple sources of feedback and data and avoids interpersonal pitfalls such as toxic positivity, stereotyping, and scapegoating;  Implementation across the campus’ multi-tiered system of supports using evidence-based approaches to prevention and intervention that are delivered with consistent vernacular and a sense of shared ownership;  Intentional and consistent inclusion of internal stakeholders such as students, teachers, and school/district staff, as well as, external stakeholders who are outside of the day-to-day operations, but whose interests can support success; and  District support for school climate-promoting initiatives through the allocation of funding, resources, personnel, and training to promote implementation fidelity, monitoring, and accountability practices.  Related Resources Every Student Succeeds Act (ESSA)  This guiding legislation empowered school districts to establish accountability standards and related interventions and supports to promote student success. The ESSA requires annual reporting of school climate and safety data and creates opportunities to create learning environments that support the academic and non-academic success of all students.  National School Climate Standards  The National School Climate Standards represent a set of criteria intended to support school climate assessment, intervention, and accountability. Rather than provide specific guidance, the Standards provide a framework for identifying, planning, and implementing local practices that are based on campus characteristics, priorities, and resources.  National Center on Safe and Supportive Learning Environments  The National Center on Safe Supportive Learning Environments is funded by the U.S. Department of Education, Office of Elementary and Secondary School's Office of Safe and Supportive Schools. The Center offers information and technical assistance focused on improving school climate and conditions for learning for all students.  School Climate Survey Compendium  This compendium includes links to several surveys that can be administered to pre-K through postsecondary campus stakeholders to identify and monitor school climate. All of the listed surveys have score reliability and validity data available for inspection; however, the constructs representing the internal structure of the measures may vary.  School Climate Literature Compendium  This compendium includes access to peer-reviewed publications that address issues, trends, policies, best practices, and research related to planning, implementation, and monitoring of school climate. The hosting site provides links to organizations and resources that support youth, parents, educators, and community involvement in positive school climate promotion.  https://doi.org/10.17077/rep.006641 
Teacher working with 2 students