The relationship between prenatal drug exposure, emotional and behavioral disorder (E/BD) identification in Head Start, and subsequent special education kindergarten placement in a sample of 145 Head Start children was examined. Results showed that 47% of the drug-exposed group versus 35% of the non-drug-exposed group met classification criteria for E/BD. In addition, 53% of the drug-exposed group were placed into special education kindergarten programs versus 29% of the non-drug-exposed group. Previous research has suggested that identification of children with E/BD in Head Start, in itself, does not predict eventual special education placement. However, prenatal drug exposure of Head Start children was found to be an effective predictor of later special education placement in kindergarten. Examination of these issues is important considering the implementation of the IDEA Amendments of 1997, which mandate early intervention for children with disabilities.

Task-related and social behaviors of teacher-identified preschool children at risk for behavior problems were examined in two school settings, a structured instructional context and an unstructured free play context. Participating as study subjects were 42 preschoolers from low-income, minority families attending local Head Start programs, 21 from a teacher-identified problem behavior group and 21 from a nonidentified comparison group. The problem behavior group was composed of approximately equal numbers of children at risk for externalizing and internalizing behavioral problems. Results demonstrated that on-task behavior was significantly higher in the instructional context in the free play context, and group differences in on-task, aggressive, and prosocial behavior depended on context.

Research in the area of behavioral disorders suggests chronic problems in the underreferral and underrepresentation of at-risk children. Systematic preschool screening procedures for identifying such students are conspicuous by their absence in both the professional literature and actual practice. The present study adapted the elementary version of Systematic Screening for Behavior Disorders (SSBD) to a select preschool Head Start population. Primary modifications of the SSBD were made in the decision rules determining which children pass through the multiple gated system to the next stage. A secondary modification was the elimination of Stage III observation of Academic Engaged Time (AET) because of its developmental inappropriateness for preschoolers. Of the Stage II subjects, 58% passed into Stage III peer social behavior observations and 5% of the Stage III sample was referred to child study teams for further assessment. Implications for further research with this population, utilizing large-scale field testing and validation procedures, are presented and discussed.

The present study focused on children referred to a psychiatric outpatient facility from the regular classroom for evaluation of behavioral and school-learning problems. Behavioral problems noted during the initial evaluation for each child were coded according to a master list of over 60 behavioral characteristics grouped into seven broad categories: conduct disorders, emotional disorders, social relationship disorders, attentional disorders, hyperactivity, language disorders, and developmental delays/physical disorders. Then classroom placement recommendations were made by a school interdisciplinary team and categorized according to four classroom integration options ranging from total integration to integration for less than 1–2 hours daily. Results indicate general trends in the relationship between placement option(s) and the incidence and severity of presenting behavioral profiles. The meaning of these results is discussed in relation to research that emphasizes the lack of concordance between clinical, psychoeducational test profiles, psychiatric classification schemes, and classroom placement recommendations for special education students.

Children evaluated by an interdisciplinary team that provided data on psychiatric disturbance, language handicaps, and psychoeducational assessment were placed in special education classes following the complete evaluation. Discriminant analysis as a special case of multiple regression analysis determined that mean reading achievement score, pre-evaluation classroom placement, and to a lesser degree, Performance IQ predicted classroom placement. Overall, correct classroom predictions approached 90 percent. These findings highlight the value of interdisciplinary evaluation to educators and mental health professionals.

A primary characteristic of a child with a learning disability is a discrepancy between current academic achievement and level of intellectual functioning. Five commonly used formulas for identifying discrepancies for eligibility as learning disabled were applied to 137 children. These children were identified as learning disabled by interdisciplinary child study teams prior to the time when discrepancy formulas became a part of state guidelines for learning disabilities screening procedures. Varied results were found depending on the formula used. Criticism of formula strengths and weaknesses as well as implications for their use are presented.

The effects of inpatient vs. outpatient status on change in educational placement were examined for a sample of 185 inpatients and 351 outpatients evaluated at a psychiatric facility. Within thesame diagnostic categories, inpatients tended to receceive higher percentages of changes to more-restrictive educational settings than outpatients following evaluation, although such a downward trend was noted for the latter sample as well. The limitations of psychiatric diagnosis to school personnel when making educational placement decisions was discussed.

This study evaluated the psychoeducational reports of 205 children who were referred to the UCLA Neuropsychiatric Hospital for evaluation of academic achievement problems. Factor analysis of the report data indentified a medical factor, a school history factor, and a family factor. Following factor analysis, all three factors as well as measures of cognitive functioning and academic achievement were entered into a discriminant analysis in order to determine which variables, if any, helped predict the educational placement finally to be recommended for each child at the end of the individual psychoeducational work-up. Statistical analysis indicated different results for each of four educational placement options, the greatest predictability being associated with regular classroom placement. Across all placements, the variable that allowed for the greatest accuracy in predicting educational programming recommendations was academic achievement, measured as mean achievement score on standardized achievement tests.

Increased use of psychiatric diagnostic workups has occurred in determination of children's eligibility for special education or related services. Past research with small samples suggests little relationship to school functioning. The present study examined DSM III Axis I and Axis II diagnoses in 350 school children referred for psychiatric evaluation. Diagnostic categories were examined in terms of their relationship to age, sex, ethnicity, IQ, achievement, and special education placement. Findings suggested wide disparity, but certain DSM III diagnostic groups appeared to have identifiable education characteristics.

Although prospective payment using diagnostic related groups (DRGs) has been implemented for certain medical services during the past year, psychiatry in general and child psychiatry services in particular have been exempted from such forms of reimbursement. Since it is generally expected that psychiatry will not continue to be so exempted indefinitely, a preliminary study of 15 potential DRGs in a group of 184 children who received inpatient care were compared with respect to their mean length of hospital admission. Implications of these data for mental health policy are discussed.

Diagnostic related groups (DRGs) are being adopted as a practical tool in psychiatric classification, as well as a means of reducing health care costs. This study highlights a step-by-step description of the development of 16 outpatient and 14 inpatient DRGs from DSM-III Axis I and Axis II diagnoses on a sample of 591 children (ages 6-14). A plan for the application of diagnostic rules is presented, and issues of generalizability among different treatment populations are discussed.

Practice in intervention and consultation with school personnel adds to the Child Psychiatrist’s available skills to assist a crucial agency affecting the mental health of almost all children. The UCLA School Consultation program is described in terms of didactic presentations, weekly seminars and school visitation and observation. The value of the program is supplemented by evaluation from the Child Psychiatrists and contrast with other existing programs.

Four major issues in the education of children with emotional or behavioral disorders--problems in diagnostic eligibility for special education services; economic demands which dictate restoring the primacy of the teacher; barriers to interdisciplinary cooperation with parents and teachers; and controversial treatments for school children--are discussed, and the need for effective interdisciplinary cooperation is emphasized.

Although various attention disorders have been found in learning disabled children and programs to increase classroom attention have been suggested, little attempt has been made to study the link between severity of learning disabilities and severity of attention problems in ongoing classroom situations. Time-sampling of attending behavior for 28 such children in 16 different classrooms for the educational!) handicapped was converted to a percentage denoting the severity of attention problems and compared with the discrepancy between obtained and expected achievement. Results suggested a small but significant relationship, tending to confirm existing notions of the importance of attention in development of learning disorders.

Commonly accepted definitions of learning disability require the presence of a significant discrepancy between a child's potential and his/her achievement. Eight commonly used “discrepancy” formulas were applied to the IQ and achievement scores of a sample of 92 potentially learning disabled youngsters. Extremely variable results were found depending on the formula used. Implications of these findings for actual practice are suggested.

This study explores whether a synthesis of clinical and statistical data taken from the psychoeducational reports completed on a group of 42, 9- to 11-year-old boys referred to a Child Psychiatric Outpatient Department for school-learning problems, would yield discrete clinical categories or clusters of children. An amalgamated hierarchical clustering technique which formed clusters by subjects based on a measure of euclidean distance was used. Forty-two reports were evaluated by licensed educational psychologists in five input areas: Developmental History, School History, Cognitive Functioning, Sensorimotor/Perceptual Functioning, and Academic Achievement. One of three educational placement recommendations was identified for each subject: No Educational Placement Intervention Necessary, Special Tutoring or Remediation, and Special Class Placement. Using clinical characteristic ratings given by the evaluators on each variable, a similarity-dissimilarity matrix was formed which classified subjects into four discrete clusters based on their clinical profiles. A χ2 test determined that there was a significant association (p < .01) between cluster membership and educational placement recommendations.

This study was designed to investigate the relationship between diagnostic classifications and educational placement recommendations utilized by educational psychologists in the evaluation of psychoeducational reports completed on a select group of boys referred to a Child Psychiatric Outpatient Department. In the present study, 45 reports were evaluated for clinical consensus in five input areas: Developmental History, School History, Cognitive Functioning, Sensorimotor-Perceptual Functioning, and Academic Achievement. In addition, one of four educational recommendations was identified for each subject: No Educational Placement Intervention Necessary, Special Tutoring or Remediation, Special Class Placement, and Special School Placement. There was interrater agreement at a greater than chance level ( p ≤.01) for three of the input areas, and agreement at a greater than chance level ( p ≤.05) for one of the input areas. Using the maximum rating given by the evaluators on each variable, subjects were classified into six discrete clusters based on their clinical characteristics. A chi square test determined that there was no significant association ( p >.05) between cluster membership and specific educational placement recommendations. However, more global relationships between degree of clinical impairment and the need for some educational placement were found.