Despite decades of federal mandates, students with Emotional and Behavioral Disorders (EBD) continue to experience stark disparities in postschool outcomes: struggling to gain employment, to access postsecondary education, and with community integration. The purpose of this systematic review was to examine the existing research regarding the barriers and facilitators influencing postsecondary outcomes for individuals with an EBD special education label. Using a Mixed Methods Research Synthesis (MMRS) approach, 13 empirical studies (published 1998-2025) from three major database searches were analyzed and thematically coded. Findings included three overarching categories of challenges: personal barriers (e.g., academic/life skill deficits, negative self-perception, mental health needs), family-related barriers (e.g., low expectations, resource scarcity), and school-related barriers (e.g., restrictive educational settings, low educator expectations, lack of postsecondary support utilization). Key facilitators included participation in employment during high school years, strong family support, and positive school staff relationships. These consistent findings highlight the compounding effects of personal skill deficits and systemic barriers like exclusion and low expectations. The review underscores the critical need for comprehensive, interventional research focused on self-determination, life skills training, and systemic reforms to ensure successful transition for this vulnerable population.
Schools need innovative early interventions to treat severe student behaviors. Parent-Child Interaction Therapy (PCIT) may fill this gap due to its strong efficacy in reducing behaviors, the maintenance and generalization of treatment effects, and its focus on early ages (i.e., 2-7 years or below third grade). However, standard PCIT has not been widely examined in schools, and implementing school-based PCIT may be affected by factors beyond the intervention itself. Therefore, we interviewed 13 parents with PCIT expertise to explore potential feasibility issues, as parents would be intervention participants and PCIT is rarely known to schools. Five key themes of barriers and facilitators emerged: logistics (e.g., scheduling), PCIT (e.g., PCIT is rarely known), family (e.g., different philosophy), school (e.g., intrinsic motivation to help), and culture and community (e.g., community awareness). Furthermore, six parents were enthusiastic about school-based PCIT, three expressed mixed feelings, and four shared negative views. Together, the findings alert to the potential complexity of implementing school-based PCIT while offering hope. Careful planning, such as readiness assessments and motivational interviewing, would be essential to facilitate early implementation.
The current foundational study addressed the views of a stratified random sample (n = 217) of Finnish special needs teachers in grades 7-9, related to their views on supports for students with behavior problems. Seventy-eight (36%) special needs teachers responded to the survey, which focused on their views concerning two issues: (a) their responsibilities in terms of providing behavioral supports, cognitive-behavioral interventions, collaborating with others to address student behavior, and developing teacher-student relationships; (b) the specific strategies that they actually implement, which focused on the aforementioned approaches, as well as Check-In/Check-Out procedures, monitoring student behavior, and individualizing supports. The survey also queried participants on the frequency of use, and if an intervention is not used, the reason(s). Finally, special needs teachers provided an open-ended response to what they viewed as the greatest challenge in managing student behavior. With the exception of two behavioral interventions, every other intervention had at least 90% of respondents who Agreed or Strongly Agreed that the approaches were their responsibility. Concerning the approaches that special needs teachers implement, 75% of participants reported using cognitive-behavioral intervention Often or Sometimes. The use of other approaches was quite varied. Additional results and implications for research and practice are provided.
This article features two studies examining the impact of a Tier 2 intervention-Recognize. Relax. Record. (RRR)-designed to support elementary students with internalizing behaviors by helping them manage anxious feelings and increase academic engagement. We collaborated with teachers to use screening and attendance data to locate students who might benefit from RRR. Results of a multiple-baseline design across participants study with five students provided modest evidence of a functional relation between introduction of RRR Instruction and decreases in variability of students' engagement during academic instruction. These shifts were mostly small in magnitude and in need of replication and future inquiry before generalizing results.Treatment integrity data suggested high levels of implementation fidelity. Overall, social validity ratings were positive for most participants; however, some variability in ratings across students-as well as differences in adults' pre- to post-intervention ratings-suggested the intervention was more acceptable for supporting some students than others. Results of an A-B nonexperimental study provided descriptive data suggesting potential benefits of implementing RRR instruction in a small-group format. We discuss the findings of this initial test of RRR, noting limitations and directions for future inquiry.
Models that distinguish between specific forms of bullying offer a deeper understanding than unidimensional approaches. Yet the distinct negative outcomes associated with each form during adolescence remain underexplored. This study applies psychological network analysis (Gaussian graphical model) to examine cross-sectional links between bullying and victimization (physical, verbal, rumor-spreading, exclusion, and cyber), internalizing symptoms (depression, anxiety, social phobia, low self-esteem), and externalizing problems. Adolescents (N = 1,519; M age = 12.5) from 18 schools completed self-reports at two time points (3 months apart). Network models were estimated separately for each wave. The analysis showed that bullying and victimization overlapped most in verbal and physical forms, less so in rumor-spreading, peer exclusion, and cyber forms. Victimization types were linked to distinct psychological outcomes: physical victimization to self-related worries, verbal victimization to feelings of worthlessness, peer exclusion to sadness, rumor-spreading to social anxiety and appetite problems, and cyber victimization to social phobia and low self-esteem. Prevention and intervention efforts should focus particularly on verbal and rumor-spreading bullying, which were central in the networks. Support for victimized students should address feelings of worthlessness and the specific harms tied to each victimization experience.
Siblings of children with chronic disorders are at an increased risk of internalizing and externalizing problems, but the extent to which this is true varies depending on who rates sibling mental health. We examined interrater discrepancies between teachers and parents who rated the behavior of siblings of children with chronic disorders on the Strengths and Difficulties Questionnaire (SDQ) and investigated possible predictors of these discrepancies. We used Latent Profile Analysis (LPA) to identify classes of siblings with higher and lower levels of discrepancy between raters. Predictors of interrater discrepancy were also examined, including sibling age and sex, and the impact of the disorder. We identified four distinct classes of siblings with differing levels of interrater discrepancy and internalizing and externalizing problems. Sibling sex had a small effect on classes, with girls less likely to be included in the discrepant classes. Neither sibling age nor the impact of the disorder predicted being included in discrepant classes. Our findings reflect previous research showing that sibling experiences and outcomes tend to vary between individuals and across settings and that teachers tend to report fewer problems of different types than parents. Further research is needed to better understand predictors of these interrater discrepancies.
Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for developing secondary anxiety symptoms. While interpersonal functioning has been implicated in this comorbidity, the specific peer-related factors contributing to anxiety in youth with ADHD remain unclear. This study examined the roles of social problems, ADHD-related cognitive biases associated with peer difficulties (i.e., negative social information processing [SIP] and rejection sensitivity), and functional impairment in the relation between ADHD and anxiety symptoms. Parents (N = 120; 95% mothers) of 8- to 12-year-old children with elevated ADHD symptoms (58.3% [n = 70] with ADHD diagnoses) completed questionnaires, while a subset of their children (n = 69, Mage = 9.70 years, SD = 1.38; 62.3% boys) completed questionnaires and a virtual SIP task. Results indicated that social problems, anger rejection sensitivity, and functional impairment each moderated the relation between ADHD and anxiety symptoms. These findings highlight the potential role of specific peer difficulties in the development of anxiety among children with ADHD and underscore the importance of regular anxiety screening for those experiencing social challenges and functional impairment.
This exploratory study examines the interplay between different aspects of socioeconomic status (SES) and caregiver stress in relation to caregiver involvement in the education of preschool children with externalizing behavior problems. Utilizing a predominantly Black, low-income, treatment-seeking sample, we measured involvement across three dimensions: Home-Based Involvement (HBI), School-Based Involvement (SBI), and Home-School Conferencing (HSC). Caregivers in the sample were found to have below-average involvement in HBI, average involvement in SBI, and above average involvement in HSC. Contrary to past literature, higher SES was inversely associated with involvement across all domains. Caregivers with lower socioeconomic resources reported more active engagement, particularly in school social activities, teacher feedback reception, and establishing regular home routines. Significantly, non-biological primary caregivers were less involved in SBI. The model's moderate fit points to the existence of other factors influencing involvement not captured in the study. These findings suggest that economic resources do not necessarily enhance involvement. Suggestions for tailoring engagement strategies and directions for future research are discussed.
The purpose of this study was to examine where students with or at risk for emotional and behavioral disorders (EBDs) were placed in K-3 grade classroom seating assignments over time and the relation between classroom seating placement and peer-reported reputations of these students. Specifically, we investigated how proximity to the classroom teacher's desk and isolation from peers influenced peer perceptions. Results revealed variability in seat distance from the teacher's desk and that approximately half of the students were assigned a seat in isolation from their peers. Seat isolation was significantly associated with more negative peer-reported reputations, including increased nominations for fighting and giving the teacher a hard time, while reducing nominations for being nice and cooperative. Conversely, distance from the teacher's desk showed no statistically significant associations with peer reputation. These preliminary findings highlight the potential importance of classroom seating placement in shaping the social experiences of students with or at risk for EBD. Implications for classroom management practices and future research are discussed.
Despite widespread recommendations to implement universal mental health screening (UMHS), there remains an "implementation gap" between evidence-based practices and how these practices are routinely adopted and implemented in schools. Research with end-users in mind is needed to identify implementation barriers and facilitators for UMHS and inform feasible implementation strategies that ensure UMHS is used as intended in practice to reduce youths' unaddressed mental health risk. Guided by the Consolidated Framework for Implementation Research (CFIR), a qualitative study of practice-based evidence was conducted to examine the implementation determinants of UMHS within a tiered mental health system. Interviews with school leaders (n = 11) within Florida school districts implementing UMHS were analyzed using thematic analysis. Results identify how the outer, inner, individual, program, and process-level determinants affect the implementation of screening. Specifically, buy-in was considered the most significant direct and indirect factor that influenced implementation within all levels of the CFIR framework. Implementation strategies connected to the determinants identified in this study are discussed, along with recommendations for future research to improve the implementation of UMHS.
This study evaluated the psychometric properties of the Weekly Assessment of Child Behavior–Negative Form (WACB-N), a brief, nine-item caregiver-reported assessment designed for screening and progress monitoring of externalizing behavior problems in children of ages 2–10 years. The psychometric properties of the WACB-N were examined across two non-overlapping samples: a clinical population of caregiver-child dyads referred for outpatient mental health services (Sample 1; n = 164) and resource parent-foster child dyads participating in a preventive parenting program (Sample 2; n = 151). Data were analyzed using item response theory, factor analyses, test–retest reliability, convergent validity, and receiver operating characteristic (ROC) analyses. Item response theory and factor analyses supported the unidimensionality, item-level properties, and internal consistency of WACB-N subscales. Test–retest reliability was good to excellent over 3-week intervals (intraclass correlation coefficients = .82–.92). The WACB-N demonstrated strong convergent validity with established measures of child behavioral problems, socioemotional competencies, and parenting stress. The ROC analyses identified optimal WACB-N cutoff scores between 35.5 and 37.5 for detecting children with externalizing behavior problems. The WACB-N’s brief structure and strong psychometric properties support its utility for screening and monitoring progress in interventions and treatment outcome research. The measure’s public availability and simple scoring and interpretation facilitate its implementation in community settings, allowing practitioners and researchers to effectively track behavioral changes, guide clinical decision-making, and foster collaborative care with caregivers. As a brief and cost-effective measure for assessing and monitoring child behavior problems, the WACB-N has the potential to improve the quality of services for children exhibiting behavior problems and their families.
The purpose of this study was to identify emotional, behavioral, and academic co-occurring risk profiles of third-grade youth and to understand how they are longitudinally associated with later outcomes in sixth grade. The latent profile analysis of data from a community sample of 1,785 third graders resulted in five classes of risk profiles: No Risk (47%), Low Risk (36%), High Internalizing and Emotion Dysregulation (8%), High Externalizing (7%), and Co-occurring Risk (2%). The Co-occurring class had significantly worse outcomes on all sixth-grade measures compared to other classes. The High Internalizing and Emotion Dysregulation class had significantly higher internalizing problems but also higher externalizing problems. Youth with predominant externalizing features continued to evidence these problems in sixth grade, along with a high number of office discipline referrals, in-school suspensions, and out-school suspensions. Students with co-occurring social, emotional, behavioral, and academic issues are at increased risk of future challenges. Schools can use comprehensive and systematic screening to identify students with co-occurring problems. The study highlights the importance of early identification through screening and taking into consideration the co-occurring presentation of symptoms.
Children identified with emotional and behavioral support needs often demonstrate varying levels of externalizing, hyperactive, and internalizing behaviors requiring diverse prevention and intervention efforts. The current study implemented a latent profile analysis (LPA) to explore meaningful differences in a sample of 180 children receiving special education services for emotional or behavioral support needs. Six profiles were identified based on externalizing, internalizing, and hyperactive indicators. We then tested criterion variables of teacher and student reports of emotional and behavioral engagement and disaffection across the profiles. Significant differences were found for the teacher, not the student report. Finally, we created a student-teacher perception of engagement discrepancy score to explore concordance of ratings across profiles. Findings indicated evidence of student illusory bias related to perceptions of functioning compared to their teacher. Results demonstrated that student profiles with higher levels of support needs were associated with less agreement of student functioning across the four engagement and disaffection subscales. Limitations and implications for future research are provided.
The purpose of this study was to examine the relation between externalizing behavior and peer reputations of kindergarten through third-grade students ( N = 35, from 18 classrooms) with or at risk for Emotional and Behavioral Disorders (EBDs). We also examined the extent to which this relation varied as a function of teacher delivery of praise. A series of multiple regression models, adjusted for the nesting of students within classrooms, were conducted. Models revealed a significant effect of the interaction between externalizing behavior and teacher praise on peer reputations for prosocial behavior (i.e., “Being Nice”). This effect indicated a negative relation between externalizing behavior and a prosocial peer reputation for students who received low rates of teacher praise. However, a positive relation was present between externalizing behavior and a prosocial peer reputation for students who received average and high rates of teacher praise. Findings reinforce that teacher praise is an important positive behavioral support and send a preliminary signal that praise may mitigate negative peer reputations for students with or at risk for EBD. Implications for research and practice are discussed.
This naturalistic study evaluated the treatment effectiveness of a New England adolescent partial hospital program (PHP) for individuals referred from higher versus lower levels of care (LOC). Participants were adolescents ages 12 to 18 admitted to the in-person ( n = 161) and virtual ( n = 78) day programming. Chart review determined the referral source, and the Youth Outcomes Questionnaire (YOQ) assessed interpersonal relations (IR), intrapersonal distress (ID), suicidal ideation (SI), and self-injurious behavior (SIB) at the time of admission and discharge. Independent samples t-tests demonstrated the similarity of symptom severity at the time of admission for both higher and lower LOC, except for higher reports of SIB for higher LOC referrals to the virtual program. Repeated measures analyses of variance (ANOVAs) revealed improvement in all outcome measures and no significant difference in treatment effects or length of stay between higher versus lower LOC referrals. Study findings demonstrate the promise of PHPs to function effectively as both a step-up and step-down in the mental health continuum of care, reflect appropriate utilization of referrals to this LOC, and support the promise of telehealth as an alternative to in-person therapies.
Students with emotional dysregulation are not equipped with the ability to manage their own behavior. This often leads to major disruptions in the general education setting, interfering with the student’s learning and the learning of others. This study examined the effects of a mindfulness-based intervention on the presence of disruptive behavior in children with autism spectrum disorder or developmental delays in early elementary inclusion classrooms. An ABAB single-case research design was conducted on four students with characteristics of autism spectrum disorder between the ages of 5 and 8 to determine the effects of a mindfulness-based intervention on their disruptive behavior patterns. The researcher developed a mindfulness-based intervention comprised of structured breathing, mindful movement activities, and statements of positive affirmation for use during this 6-week study. Results of participation in a mindfulness-based intervention suggest an overall positive effect with mixed results on the rate of disruptive behavior. Limitations and future directions are discussed.
Home-based parental involvement and parental expectations in school are strong predictors of academic outcomes for high school students. Given this, we explored whether changes in parental involvement and parental expectations during high school were correlated with academic functioning for students with emotional or behavioral difficulties ( N = 888) compared with their peers ( N = 4,148). We found that home-based parental involvement was stable during high school for both groups of students. There was a decrease in parental educational expectations during high school that was equivalent between both groups. Students with elevated emotional and behavioral difficulties had significant correlations between increases in home-based involvement and increases in both parental expectations and grade point average, whereas the peer group had significant, yet trivial correlations among the constructs.
Emotional and behavioral issues in adolescents pose significant obstacles to psychological well-being and academic achievement, potentially leading to severe mental health conditions. The escalating prevalence of these behavioral challenges can adversely affect a nation’s educational, economic, and social health. This study aims to find appropriate solutions to behavioral problems and academic underperformance in adolescents through a two-arm randomized trial. It involves 200 students from distinct locations in India. Intervention encompasses integrated practices of yoga and physical exercises independently. Incorporation of ancient learning principles introduces a novel facet to the intervention protocol for educational and developmental purposes. Participants were evenly distributed across yoga and physical exercise groups. Preintervention and postintervention are evaluated through Strength and Difficulty Questionnaire alongside assessment of academic score of students. Findings exhibit a noteworthy transition among yoga group participants for behavioral problems from clinical risk status to normalized levels. Examination of the correlation between academic performance with various emotional and behavioral problems underscored the detrimental impact of these issues on scholastic attainment. Notably, the influence of yoga surpassed that of physical exercise in enhancing academic performance and mitigating emotional problems, conduct issues, hyperactivity, peer-related challenges, and overall strength and difficulty symptoms. The results suggest that the school-based interventions involving moderate to vigorous physical activity may be considered as a strategy to address adolescent mental health concerns and to enhance academic outcomes. It is further suggested that the policymakers and health professionals can explore such activities as an option to address the growing prevalence of mental health disorders.
This article presents initial psychometric data for scores on the Child Responsiveness Scale (CRS), an observational measure to assess child responsiveness to teacher delivery of practices designed to promote social-emotional competencies. In Study 1, 633 live observations conducted with 54 teachers and 91 children at risk for emotional and behavioral disorders in early childhood classrooms were rated independently by two coders. Interrater reliability, ICC(2,2), for the CRS item scores, averaged .67 ( SD = .06; range .55 to .72). The CRS scale scores demonstrated sensitivity to variation across teachers, children, and coders. In Study 2, 634 recorded observations with 52 teachers and 52 children in early childhood classrooms were rated independently by two coders. Interrater reliability, ICC(2,2), for the item scores, averaged .62 ( SD = .08; range .53 to .74). An exploratory factor analysis and a confirmatory factor analysis conducted on separate samples indicated that the items were best represented as two correlated factors, one for positive and one for negative items. Analyses provided preliminary evidence for CRS scale score validity. Future research directions are discussed regarding using the CRS to evaluate child responsiveness’s role in promoting child outcomes in early childhood classrooms.
