Anxiety, depression, substance use, conduct disorders, attention-deficit/hyperactivity disorder, and learning disorder are but a subset of problems that youth experience throughout their lives. Chapter 1 presents the school-based practitioner as a first-line interventionist for these difficulties. Framing school-based care within a multi-tiered system of support, Chapter 1 introduces cognitive behavioral therapy (CBT), an evidence-based intervention with flexible applications for children and adolescents. It acknowledges the complex intersection between CBT, 504 plans, and Individualized Education Programs; discusses the many ways students may receive services under the law (and otherwise); and highlights the details of school-based practice integral to evaluating these plans. Chapter 1 ends with a thorough case presentation complete with background information, interviews, behavior and symptom assessment, CBT session planning, and outcome data.
Hoarding disorder is present in 2–6% of the population and can have an immense impact on the lives of patients and their families. Before its inclusion the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, pathological hoarding was often characterized as a symptom of obsessive–compulsive disorder, and several different diagnostic assessment methods were used to identify and characterize it. Although the age of onset of pathological hoarding is an important epidemiological measure, as clarifying the age of onset of hoarding symptoms may allow for early identification and implementation of evidence-based treatments before symptoms become clinically significant, the typical age of onset of hoarding is still uncertain. To that end, this study is a systematic review and meta-analysis of research published in English between the years 1900 and 2016 containing information on age of onset of hoarding symptoms. Twenty-five studies met inclusion criteria. The mean age of onset of hoarding symptoms across studies was 16.7 years old, with evidence of a bimodal distribution of onset. The authors conclude by discussing practice implications for early identification and treatment.
Internalizing disorders – including depressive disorders, anxiety disorders, and obsessive-compulsive and related disorders – are common among children and adolescents, ranking among the most damaging causes of disability-adjusted life years lost from fourth grade through postsecondary school . Nevertheless, less than half (45%) of school-aged children in the United States with a diagnosis receive critical mental health interventions. Consequently, students experience low self-worth, decrements in information processing, poor task mastery compliance, impaired problem-solving strategies, and decreased quality of life.
Few studies have investigated the relationship between comorbid depression and anxiety and cognitive and academic functioning. To understand this relationship, this study used a retrospective chart review from an inpatient facility for 42 adolescents diagnosed with a comorbid anxiety and depressive disorder. Multiple regression was used to determine whether anxiety and depression predicted academic achievement, as well as whether intelligence predicted current levels of anxiety and depression. Results indicated that higher severity of depression was associated with lower reading (β = -0.39) and writing (β = -0.40) achievement, while higher severity of anxiety was associated with higher scores on reading (β = 0.41) and writing (β = 0.36). Full-scale IQ was not significantly predictive of anxiety severity (β = 0.08) or depression severity (β = -0.24). Results are discussed in terms of identifying risk factors and improving outcomes for adolescents with severe comorbid anxiety and depression psychopathology.
The Cross-Battery Assessment (XBA) approach to identifying a specific learning disorder (SLD) is based on the postulate that deficits in cognitive abilities in the presence of otherwise average general intelligence are causally related to academic achievement weaknesses. To examine this postulate, we conducted a classification agreement analysis using the Woodcock-Johnson III Tests of Cognitive Abilities and Achievement. We examined the broad cognitive abilities of the Cattell-Horn-Carroll theory held to be meaningfully related to basic reading, reading comprehension, mathematics calculation, and mathematics reasoning across age groups. Results of analyses of 300 participants in three age groups (6–8, 9–13, and 14–19 years) indicated that the XBA method is very reliable and accurate in detecting true negatives. Mean specificity and negative predictive value were 92% and 89% across all broad cognitive abilities and academic domains. Mean sensitivity and positive predictive values, however, were generally quite low, indicating that this method is very poor at detecting true positives. Mean sensitivity and positive predictive value were 21% and 34% across all broad cognitive abilities and academic domains. In sum, results of this study do not support the use of the XBA method for identifying SLD. Implications of our findings for research and practice are discussed.
The current study examined quality of life (QOL) and its clinical correlates among 225 intensive treatment-seeking children and adolescents with obsessive-compulsive disorder (OCD) using the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Youth completed the PQ-LES-Q along with self-report measures assessing functional impairment, anxiety sensitivity, OCD symptoms, nonspecific anxiety, depression, and social anxiety. Parents completed measures on their child's anxiety, the presence of inattention/hyperactivity, depression, functional impairment, and frequency of family accommodation of symptoms. Contrary to expectation, child-reported OCD symptoms did not significantly predict QOL; however, lower overall QOL was strongly associated with the presence of comorbid major depressive disorder (g=3D −0.76) and slightly related to comorbid social phobia (g=3D −0.36). These results suggest that assessing and addressing comorbid conditions in the treatment of youth with OCD is an important component of intensive treatment.
Thousands of students in the United States suffer from anxiety and depressive disorders, many of which may be ameliorated with early intervention and evidenced-based treatment. At the same time, complete student wellness requires a consideration of both pathology and well-being. Using a dual-factor model, this chapter reviews the symptoms, resilience factors, and functional impairments associated with anxiety and depression. Recommendations for early identification, assessment, and treatment—including psychoeducation, mindfulness, and behavioral techniques—are discussed within a multitiered system of supports. Special consideration is provided to address suicide prevention and intervention. Practical recommendations and techniques for school-based practitioners are offered, in addition to assessment measures and technology resources.
