Preschool Screening

Abstract

The preschool years are a critical time to identify and treat early emotional or behavioral problems. Universal screening can be used to identify emotional and behavioral risk in preschoolers and fits well within current service delivery frameworks. This criterion-related validity study examined the use of a brief teacher-rated screener, the Behavioral and Emotional Screening System (BESS Preschool) in a sample of 65 preschool-age students from a predominately Latino/a background. Findings suggest that screening results from the BESS Preschool are highly correlated with important outcomes, including kindergarten readiness, receptive vocabulary, and social emotional development.

Keywords

screening rating scales middle school BASC-2 BESS

Preschool offers a critical opportunity to place students on positive academic and behavioral trajectories. In addition to an amplified focus on academic preparation and the development of school readiness skills (Ward & Rothlisberg, 2011), preschool is increasingly seen as an optimal time to provide behavioral and emotional support to students (McCabe & Altamura, 2011). A variety of research has indicated that children with behavioral difficulties in preschool are likely to experience a wide range of difficulties including peer rejection (Wood, Cowan, & Baker, 2002), poorer literacy outcomes (Bulotsky-Sherer & Fantuzzo, 2011), lower peer social competence (Bulotsky-Shearer, Dominguez, Bell, Rouse, & Fantuzzo, 2010), and later clinical diagnoses of mental disorders such as ADHD (attention deficit hyperactivity disorder (ADHD) and/or oppositional defiant disorder/conduct disorder (ODD/CD; Harvey, Youngwirth, Thakar, & Errazuris, 2000).

Fortunately, there is also wide support for prevention and early intervention efforts to ameliorate early behavioral and emotional problems. Early treatment has been associated with higher rates of positive functioning for behavioral and emotional functioning (Webster-Stratton & Reid, 2003) and children who receive early intervention have been found to be more socially and emotionally competent than their counterparts who did not receive services (Brophy-Herb, Lee, Nievar, & Stollak, 2007). However, the effectiveness of prevention or early intervention programs hinges on the ability to accurately assess the needs of the children involved (Ward & Rothlisberg, 2011). Proactive universal screening efforts are seen as a necessary first step aimed at identifying symptoms of risk at an early stage in order to reduce the development of more serious behavioral and emotional problems and related outcomes (Severson, Walker, Hope-Doolittle, Kratochwill, & Gresham, 2007).

The increased attention to early identification has led to significant advances in screening tools for use with preschool children. In a recent review, Feeney-Kettler, Kratochwill, Kaiser, Hemmeter, and Kettler (2010) used criteria from the Standards for Educational and Psychological Testing (American Educational Research Association [AERA], American Psychological Association [APA], & National Council on Measurement in Education [NCME], 1999) to compare four promising screening systems. One instrument, the Behavioral Assessment System for Children Second Edition (BASC-2), Behavioral and Emotional Screening System Preschool Form (BESS Preschool; Kamphaus & Reynolds, 2007), was described as having several benefits such as the inclusion of multi-informant rating scales, good internal consistency and interrater reliability, the inclusion of adaptive skills, Spanish version availability, and the ability to be useful as a classwide screener due to its brevity (Feeney-Kettler et al., 2010).

Despite the promising characteristics of the BESS Preschool, a variety of foundational evidence is still lacking. For example, the available psychometric information is either based on analyses examining the items chosen during the BASC-2 norming process or on preliminary BASC-2 screeners that have similar item content to the BESS Preschool but are not identical (DiStefano & Kamphaus, 2007; Yanosky, Schwanenflugel, & Kamphaus, in press). Although studies examining preliminary versions of the BESS Preschool provide useful information and inform hypotheses, practitioners interested in conducting screenings are likely to utilize the published, final version of the BESS Preschool for which there is limited psychometric information available.

This study was designed to further examine the criterion-related validity of scores obtained from the preschool BASC-2 BESS teacher report form (BESS Preschool) in a predominately Latino/a sample. This study augments the current literature as it is the first to examine the measure in its current published form and also the first to examine its use with a predominately Latino/a sample. To assess criterion-related validity, the BESS Preschool and measures of school readiness, social and emotional functioning, and receptive vocabulary were administered to the same students within the same quarter of an academic year. Since behavioral and emotional problems in preschool have been associated with academic performance and later kindergarten performance (e.g., Bulotsky-Sherer & Fantuzzo, 2011), it is important to further examine the BESS Preschool as a potential screening measure that could be used for early identification.

Method

Participants and Procedure

All preschool children (N =65) at one public preschool housed within an elementary school in central California during the 2010 to 2011 school year participated in this study. The sample was 57% (n = 37) male, 20% (n = 13) reported English as their primary language, and 77% (n = 50) reported Spanish as their primary language (3% did not report primary language). At the beginning of the school year 32% (n = 21) of students were 3 years old and 68% (n = 44) were 4 years old. Demographics at the participating school included 94% Latino/a, 3% Anglo, and 1% African American students, and a significant proportion of students were from families experiencing low income, with 92% eligible for free or reduced-price lunch.

Teachers completed the BESS Preschool and a kindergarten readiness instrument for all preschoolers. Teachers were also given the option to fill out a third measure assessing social and emotional development if the teacher was concerned about a student’s developmental progress (N = 38). Teachers completed all measures within the first quarter of the academic year; although all measures were provided to teachers at the same time, teachers were given a time frame (approximately 3-4 weeks) and were allowed to complete the measures during several sessions. Trained graduate students directly assessed the receptive language of all preschoolers within the same 3 to 4 weeks in which the teachers completed the surveys.

Instruments

BASC-2 BESS Teacher Rating Scale–Preschool (BESS Preschool)

The BASC-2 Behavioral and Emotional Screening System is a set of instruments designed to identify behavioral and emotional risk in children (Kamphaus & Reynolds, 2007). Brief rating scales are available for teacher-report, parent-report, and student self-report (child/adolescent only) with separate forms for preschool (ages 3-5) and child/adolescent (grades kindergarten through 12). For the purposes of this study, only the teacher rating scale, preschool level form was used.

There are 25 items on the BESS Preschool teacher rating scale and respondents are given four rating options for each item—never, sometimes, often, or almost always. The majority of the BESS items were taken from the pool of items created during the development of the Behavior Assessment System for Children–2 (BASC-2; Reynolds & Kamphaus, 2004), with three new items developed specifically for the teacher (preschool) form. The sum of the items generates a total T-score with high scores reflecting more problems (Kamphaus & Reynolds, 2007).

The BESS was developed using a normative sampling group of 12,350 teachers, parents, and student forms, collected from 233 cities in 40 states (Kamphaus & Reynolds, 2007). Split-half reliability estimates range from 0.94 (3 year olds) to 0.95 (4 and 5 year olds). Test–retest (0.83) and interrater (0.80) reliability estimates are high. The criterion-related validity of the BESS Preschool form was examined by coadministering the items with other social-emotional measures including the Achenbach System of Empirically Based Assessment Teacher Report Form (ASEBA, 0.60–0.79), and the Vineland Adaptive Behavior Scales (Vineland, 0.37–0.59). For this sample, the internal consistency (Cronbach’s α) of the BESS Preschool ratings was 0.95, with total T-scores ranging from 38 to 92 (M = 56.63, SD = 11.76).

School Readiness

Children’s school readiness was assessed using the Kindergarten Student Entrance Profile (KSEP; Quirk, Furlong, & Felix, 2010). The KSEP is a rating scale completed by teachers on the basis of their observations and professional judgments regarding the readiness of children whom they have had the opportunity to observe in the natural classroom environment over at least a three-week period at the beginning of the school year. The KSEP is comprised of 12 items that assess children’s social-emotional/behavioral (6 items) and cognitive (6 items) readiness. All items are measured on a 4-point scale (1 = not yet to 4 = mastery). A rating rubric is associated with each individual item that provides an operational definition and an example of the type of behaviors that would be indicative of a child that exhibits various levels of mastery. Total scores on the KSEP range from 12 to 48, with a score of 48 indicating that a child was rated as “mastered” on all items. Previous research has found the KSEP to exhibit scores with adequate reliability and validity, with internal consistency coefficients ranging from 0.91 to 0.92 and ratings on the KSEP significantly predicting children’s later academic performance (Lilles et al.,2009; Quirk, Furlong, Lilles, Felix, & Chin, 2011). For this sample, the internal consistency (Cronbach’s α) of the KSEP ratings was 0.88, with total scores ranging from 16 to 42 (M = 29.06, SD = 6.46).

Social Emotional Development

Social emotional development was assessed using the Ages and Stages Questionnaire: Social-Emotional (ASQ-SE; Squires, Bricker, & Twomby, 2003). The ASQ-SE is a screening tool designed to identify early social and emotional developmental risks amongst children between the ages of 3 and 66 months. The 60 month/5 year questionnaire was used for this study. The survey has 25 items with three rating options for each item (most of the time, sometimes, rarely or never). Scores for each item are combined into a total score with higher scores indicative of more social and emotional problems. Based on normative studies including 3,014 preschool-age children and their families, internal consistency estimates ranged from 0.67 to 0.91, test–retest reliability was 0.94, and construct validity information was reported by indicating agreement on constructs between the ASQ-SE and the Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2000) and the Vineland Social Emotional Early Childhood Scale (SEEC; Sparrow, Balla, & Cicchetti, 1998), which ranged from 81% to 95%.

Receptive Vocabulary

Although a large percentage of the children from our sample spoke English as a second language, receptive vocabulary was assessed in English as it was the primary language used in all instructional activities at this school. Children’s receptive vocabulary in English was assessed using the Peabody Picture Vocabulary Test–Fourth Edition (PPVT-4; Dunn & Dunn, 2007), one of the most widely used tests of children’s receptive vocabulary. Children are presented a page with four pictures, and after hearing a word spoken aloud by the examiner, they are asked to point to the picture that best represents the word. The PPVT-4 allows for a verbal or nonverbal response. Two alternate forms are available. Internal consistency estimates are high, with α estimates averaging 0.97 and 0.96 for Forms A and B, respectively. Alternate form reliability (M = 0.89) and test–retest reliability (M = 0.93) estimates are also high. The manual provides extensive information demonstrating the validity of scores obtained across diverse samples, including convergent validity evidence with other measures of expressive vocabulary, language ability, and reading achievement (Dunn & Dunn, 2007). Standard scores are reported (M = 100, SD = 15).

Statistical Analyses

All analyses were conducted using SPSS Statistics Version 17.0. Criterion-related validity was assessed by using bivariate Pearson product–moment correlations to assess the relations between the standardized T-scores (M = 50; SD = 10) from the BESS Preschool and (a) KSEP social emotional readiness, cognitive readiness, and total readiness scores, (b) ASQ-SE total scores, and (3) PPVT total scores. Interpretation of correlation coefficient effect size was guided by Cohen (1988): 0.10, 0.30, and 0.50 represent small, medium, and large effect sizes, respectively.

Results and Discussion

Findings suggested that screening results from the BESS Preschool were highly correlated with important outcomes, including kindergarten readiness, receptive vocabulary, and social emotional development. Results are summarized in Tables 1 and 2. In terms of kindergarten readiness, bivariate correlation analyses revealed statistically significant correlations with large effect sizes between the BESS Preschool (M = 56.63; SD = 11.76) and the KSEP total score (M = 29.27; SD = 6.57; r = −.71; p < .001), as well as between the BESS Preschool and both of the KSEP subscales, social-emotional readiness (M = 14.56; SD = 3.63; r = −.67; p < .001) and cognitive readiness (M = 14.71; SD = 3.86; r = −.56; p < .001). Receptive vocabulary scores were also highly correlated with BESS Preschool ratings. Bivariate correlation analyses revealed a statistically significant correlation, with a large effect size, between the PPVT (M = 76.88; SD = 17.85) and the BESS Preschool (M = 56.63; SD = 11.76; r = −.52, p < .001). All of the above correlations were negative, indicating that higher levels of teacher-reported behavioral and emotional risk were associated with lower levels of school readiness and receptive vocabulary. In addition, the ASQ-SE (M = 43.61; SD = 25.78) was also significantly correlated to the BESS Preschool (r = .46, p < .004) with a moderate effect size. Overall, these results indicate moderate to large associations between the BESS Preschool and measures of kindergarten readiness, receptive vocabulary, and social emotional development, providing criterion-related validity evidence in support of the scores obtained from the BESS Preschool.

Table 1.

Descriptive Statistics for BESS Preschool, KSEP, ASQ-SE, and PPVT.

	M	SD	Range	N
BESS Preschool	56.63	11.76	38-92	65
KSEP total score	29.27	6.57	16-42	52
Social-emotional readiness	14.56	3.63	6-21	52
Cognitive readiness	14.71	3.86	6-21	52
ASQ-SE total score	43.61	25.78	0-113	38
PPVT	76.88	17.85	47-122	51

Note: BESS = Behavioral and Emotional Screening System; KSEP = Kindergarten Student Entrance Profile; ASQ-SE = Ages and Stages Questionnaire: Social-Emotional; PPVT = Peabody Picture Vocabulary Test.

Table 2.

Bivariate Correlations with BESS Preschool and KSEP, ASQ-SE, and PPVT.

	BESS Preschool
	r	P	N
KSEP total score	−.71	< .001**	51
Social-emotional readiness	−.67	< .001**	51
Cognitive readiness	−.56	< .001**	51
ASQ-SE total score	.46	.004*	38
PPVT	−.52	< .001**	50

Note: Pairwise deletion was used in the calculation of bivariate correlation coefficients, resulting in small decreases for the sample sizes across the measures included in this analysis. BESS = Behavioral and Emotional Screening System; KSEP = Kindergarten Student Entrance Profile; ASQ-SE = Ages and Stages Questionnaire: Social-Emotional; PPVT = Peabody Picture Vocabulary Test.

In an era where schools are required to implement a child-find process to identify students at risk for developmental problems and where a portion of IDEA (Individuals With Disabilities Education Act Part C, 2004) funds can be used for early identification efforts, screening is likely to become a mainstay within educational programs. The importance of screening in preschool is particularly critical due to the enduring nature of untreated emotional and behavioral problems and the greater likelihood of successful treatment when problems are identified and treated at an early stage.

Although not all children attend preschool, most students participate in school readiness testing prior to entry into kindergarten (Feeney-Kettler et al., 2010). The BESS Preschool may be particularly useful to incorporate into kindergarten entrance screenings due to its correlation with kindergarten readiness and academic functioning. The relationship between academic and behavior problems has been well established (Algozzine, Putnam, & Horner, 2010) and the importance of screening for both has been suggested as a means to “consider the needs of the school child” (Feeney-Kettler et al., 2010: 228). Universal screening for behavioral risk could be incorporated into existing service delivery models, such as Positive Behavioral Interventions and Supports (PBIS) and Response to Intervention (RTI) frameworks, which advocate for the use of screening as a first step to identify students’ levels of risk (Essex et al., 2009; Severson et al., 2007). Screening results could help inform which children may benefit from additional services upon entry into kindergarten. Additional research and replication is needed to overcome current study limitations including (a) sample size and characteristics; (b) collection of measures over a 4-week period that may have contributed to differing sample sizes across measures; and (c) the use of outcome measures only examining school readiness, social emotional development, and English language receptive vocabulary. Longitudinal outcomes, particularly behavioral indicators such as suspensions or office disciplinary referrals, are needed to examine the ability of the BESS Preschool to predict later academic and behavioral functioning. However, the results of this study provide preliminary support for use of the BESS Preschool as a screener to assess young children’s levels of social-emotional and behavioral risk.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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