Accurate identification of young children at risk for mental health problems is a key step in establishing early childhood preventive intervention programs. Without psychometrically valid identification procedures, children in need of early intervention may not be identified and may not receive appropriate care. This article provides a review of universal screening measures to help teachers, school psychologists, and other mental health professionals make informed decisions about selecting tools to assist in identifying preschool-age children at risk for mental health problems. A review of the literature on broadband measures designed to screen the social and emotional functioning of children age 3 to 5 years old yielded three published measures that met predetermined inclusionary criteria. An additional unpublished measure was also included. Selected measures were reviewed according to the Standards for Educational and Psychological Testing. Special attention was given to predictive validity indices, including sensitivity, specificity, positive predictive value, and negative predictive value. The results of the review provided information on the measures that were most psychometrically sound and cost-effective for screening young children for mental health problems. Recommendations are made for routine screening, so young children can be referred for prevention programming before their problems worsen and negatively affect their development.

Universal screening is designed to be an efficient method for identifying preschool students with mental health problems, but prior to use, screening systems must be evaluated to determine their appropriateness within a specific setting. In this article, an evidence‐based validity framework is applied to four screening systems for identifying preschool students with mental health problems. The framework is influenced by the most recent standards for educational and psychological testing, research on test accessibility, and considerations for evaluating screening systems. Suggestions are provided for evaluating the accessibility (Step 1), reliability (Step 2), construct validity (Step 3), and consequential validity (Step 4) of an instrument. Other factors for consideration (i.e., developmental stage, incremental validity, and generalizability) are also identified. Special attention is given to conditional probability indices, which are highly relevant to evaluation of screening systems, given the dichotomous nature of decision making in preschool mental health. The authors suggest that this framework be used, along with specification of the construct of interest and characteristics of the environment, to identify the appropriate method to be used for each preschool screening decision. © 2011 Wiley Periodicals, Inc.

Researchers report mental health disparities that indicate that children and families with the highest need for services often are less likely to use them. Only a few investigators have focused on service delivery models to address underuse of services. This study examines the Children's Hospital of Orange County (CHOC)/University of California, Irvine (UC Irvine) Initiative for the Development of Attention and Readiness (CUIDAR) model of service delivery in reducing disparities in access to and use of services and in decreasing child behavior problems in a community-based study with 169 self-referred, low-income, and predominantly minority families. The findings indicate that among minority families, CUIDAR is both more accessible and more equitably used than local, publicly funded mental health services. Among Latinos, attendance rates are higher when services are provided in Spanish. Parents report significant improvements in overall child difficulty and conduct problems. In addition, parents report high levels of satisfaction with the program.

Screening is not a new concept. During the 7th century B.C., Sparta was a dominant Greek city-state, renowned for its focus on military training. All male infants who were eligible for Spartan citizenship were bathed in wine by their mothers as a test of strength. Those who survived were examined by the Gerousea, a council of elders, for signs of physical or mental defects or general weakness. Children who displayed signs of defect or weakness were thrown into a chasm of Mount Taygetus.Around the beginning of the 20th century A.D., the French government asked Alfred Binet to develop a method for identifying children with mental retardation. In 1905, he collaborated with Theodore Simon to develop the 30-item Binet-Simon scale, the first iteration of the Stanford-Binet scale that