Pediatric School Psychology by Power Thomas J.;Bradley-Klug Kathy L.;

Author:Power, Thomas J.;Bradley-Klug, Kathy L.;
Language: eng
Format: epub
Publisher: Taylor & Francis Group
Published: 2013-08-15T00:00:00+00:00

Targeted Prevention in Primary Care: Partnering to Achieve School Success (PASS)

Children with attention, learning, and behavior problems are at risk for school failure, which often results in student disengagement from school, school dropout, and a host of adverse health and mental health consequences (Barkley, 2006; DuPaul & Stoner, 2003). Early identification and intervention for these students is critical to alter the pathway leading to failure, social alienation, and unhealthy patterns of behavior. Strengthening families, promoting family involvement in education, and connecting families and schools are essential elements of programs designed to promote child development and prevent school failure for this at risk population (Christenson & Reschly, 2009).

The PASS program addresses the needs of students at risk for school failure and early dropout by virtue of the presence of attention, learning, and behavior problems. Most of the students in this program meet criteria for attention-deficit/hyperactivity disorder (ADHD), but this is not a requirement. Hallmarks of this program are that it is based in a primary care setting and uses a colocation model whereby a mental health clinician provides services in primary care and collaborates on an ongoing basis with the child’s primary care provider (PCP; Cassano, Lefler, Tresco, Mautone, & Power, 2011). The services provided are multisystemic in nature, and include strategies to promote child development at home and school by connecting the family, school, and primary care systems.

The PASS program was designed specifically to address the challenges encountered by children and families residing in low-income neighborhoods. These families typically face significant barriers to care (e.g., insurance, scheduling, transportation, child care), and may have beliefs that pose challenges in the provision of health and mental health services (e.g., lack of trust in providers, low sense of self-efficacy in being able to obtain help and apply recommended strategies; Power, Eiraldi, Clarke, Mazzuca, & Krain, 2005). These barriers often result in low rates of engagement in services, including failure to initiate intervention and low rates of attendance (McKay & Bannon, 2004).

Referrals to the program are made by PCPs working in an urban-based practice. Eligibility criteria include enrollment in grades K-6, presence of attention or behavior problems related to ADHD, and evidence that the problems were not so serious that an alternative service was needed. About 70% of the children are eligible for Medicaid and approximately 90% are African American. Contacting families by telephone to schedule an initial session has proven to be a significant challenge. This role typically is assumed by the clinician assigned to the case, who is enrolled in a doctoral program in clinical or school psychology. The clinician is trained to engage families by making repeated phone calls and by using motivational interviewing strategies (i.e., listen empathically, indicate how the service can address specific concerns, identify barriers to care, and engage in problem solving to address barriers) when families are successfully contacted.

During the initial cohort of families offered this program, 80 referrals were made by PCPs and 66 children were eligible for services. Clinicians were able to make contact with

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