Universal Screening in Middle and High Schools: Who Falls Through the Cracks?

Navigating academic demands in middle and high school may be particularly challenging for youth experiencing emotional and behavioral difficulties, and screening practices are a necessary first step in identifying youth in need of services. The goal of this study was to inform efficient universal screening practices in secondary schools by comparing 3 common methods of screening, including self- and teacher report on the Strengths and Difficulties Questionnaire, and grade point average (GPA) to indicate moderate and high levels of risk. Participants were 2,350 secondary students (47% female; 94% non-Hispanic White) and their teachers in 1 socioeconomically diverse school district. Using the moderate-risk criteria, there was low agreement among methods, and almost half the sample (46%) was identified as at risk by at least 1 of the 3 methods, indicating that responding to the needs of students who cross this liberal cutoff may not be feasible given school resources. Using the high-risk criteria reduced the agreement among screening measures. Self-report identified the most students as high risk and was more sensitive to teacher-rated concerns than the converse. If students were uniquely identified by teacher report, teachers rated them at high levels of risk, and predominant concerns were related to conduct problems. GPA captured few students with self- or teacher-rated internalizing or externalizing difficulties. Implications for universal screening within secondary schools are discussed.