Effects of School-Based Interventions With U.S. Military-Connected Children

Abstract

Objective:

To examine the effects of school-based interventions on the well-being of military-connected children (i.e., dependents of U.S. military service members, veterans, or reserve component members) who attend public or private elementary or secondary schools with parental deployment, parental reintegration, parental military-related trauma or death, or frequent moves.

Method:

Systematic review methods were employed to search, retrieve, select, and analyze studies that met inclusion criteria.

Results:

Over 1,400 citations were reviewed and 22 full-text reports were screened. One study met criteria for inclusion in this review. Effects on anxiety, self-esteem, and internalizing and externalizing behaviors were not significant.

Discussion:

The paucity of intervention research in this area is surprising, given the increased awareness and research on the stresses and impacts of military deployment and other unique stressors related to military life on children. The results of this systematic review support the need for further development and testing of school-based interventions that address the needs of military-connected children.

Keywords

systematic review military children school-based interventions

The effect of military life on children of active duty service members, members of the National Guard or Reserve, and military veterans is a significant social concern that has risen to the public’s consciousness in recent years as a result of the repetitive and lengthy military deployments in support of Operations Enduring Freedom, Iraqi Freedom, and New Dawn. Since the start of the military conflicts in Afghanistan and Iraq (2001 and 2003, respectively), the United States has experienced the largest sustained deployment of military personnel in the history of the All-Volunteer Force (Cozza & Lerner, 2013). As of 2010, over 2.1 million service members had been deployed in support of the conflicts and approximately 44% of those deployed were parents (Department of Defense [DoD], 2010). As a result, approximately 2 million U.S. children have experienced at least one parental deployment since 2001 (White House, 2011). As such, there has been considerable interest in understanding, preventing, and reducing the emotional and psychological effects that deployment separation, risk of injury or death of a parent, and frequent relocations have on the minor children of military personnel.

Recent studies suggest that parental deployment may increase the risk of emotional, behavioral, and relational difficulties in youth of all ages. Indeed, a growing body of literature suggests that military children whose parents are deployed are at much higher risk for psychosocial problems than their civilian counterparts (White, Burgh, Fear, & Iverson, 2011) and more likely to be diagnosed with a mental health problem than children whose active duty parent did not deploy (Mansfield, Kaufman, Engel, & Gaynes, 2011). Negative effects experienced by children and youth related to parental deployment include increased behavioral and stress disorders, risk behaviors, and internalizing symptoms; increased odds of experiencing sadness or hopelessness, depressive symptoms, and suicidal ideation; changes in sleeping and eating; school-related problems; and negative impacts on family and peer relationships (Cederbaum et al., 2013; Chandra, Martin, Hawkins, & Richardson, 2010; Esposito-Smythers et al., 2011; Flake, Davis, Johnson, & Middleton, 2009; Gorman, Eide, & Kisle-Gorman, 2010; Huebner & Mancini, 2005; Mmari, Roche, Sudhinaraset, & Blum, 2009).

While a growing body of evidence suggests negative impacts of parental deployment, other research points to positive or negligible impacts on children and youth. Positive effects associated with parental deployment or military lifestyle include fostering resilience and increasing responsibility and opportunities that foster growth and maturity (Card et al., 2011; Huebner, Mancini, Wilcox, Grass, & Grass, 2007; Weber & Weber, 2005). Findings from a meta-analytic review of 16 studies conducted by Card and colleagues (2011) examining associations between military deployment and child adjustment suggest that children who experience parental deployment are at slightly higher risk for overall psychosocial problems (r = .08; confidence interval [CI] = [.02, .15]) and poorer school performance (r = .08; CI = [.01, .16), but did not find compelling evidence of negative effects on internalizing (r = .09; CI = [−.09, .26) or externalizing (r = .04; CI = [−.06, .14]) behavior. Moderator analysis of the included studies in the meta-analysis revealed that some effects varied based on child’s age, study design, and who completed the measure (i.e., parent, child, and teacher). For example, age significantly predicted association between parental deployment and externalizing and internalizing symptoms, with larger effects being found with children during middle childhood (Card et al., 2011).

Although there are some inconsistencies in the literature as to the degree of impact of parental deployment and military lifestyle on children and youth, there appears to be agreement that children in military families do experience multiple stressors that, in addition to other familial and age-related stressors, are likely to have some impact on their psychosocial health and well-being. As a result, the U.S. government has made the care and well-being of military families and children a national priority. Specifically, one of the priorities established by the President is to “ensure excellence in military children’s education and their development [by] improving the quality of the educational experience…reducing negative impacts of frequent relocations and absences…[and] encouraging the healthy development of military children” (White House, 2011, p. 2). School-based mental health professionals, such as social workers, psychologists, and counselors are in a unique position to provide supports and services to meet the needs of children in military families, encourage their healthy development, and mitigate negative impacts of deployment, relocations, and risks of injury or death that children and youth in military families may experience (Jerles, 2011).

Educational Experiences of Military-Connected Children

The educational experiences of military-connected children vary based on whether their military parent is an active service member or part of the National Guard or Reserve or a veteran. For children with parents on active duty and stationed on or near a military installation, children may attend a DoD Education Activity school ([DoDEA], 2011). DoDEA schools—public schools solely under the control of the DoD that enroll approximately 87,000 students (of the approximate total 1.2 million children of active duty service members) within seven states, two U.S. territories, and 13 foreign countries—produce students with better standardized test scores and a smaller racial/ethnic achievement gap than regular civilian schools (DoDEA, 2011). Additionally, DoDEA schools are likely to have military-oriented services for students experiencing common stressors such as frequent relocations (a military child will change schools approximately every 2.9 years), parental deployment, and parental disability or loss. Peer support groups for children with deployed parents, for example, are more likely to be found within DoDEA schools, as well as community support services for the parents of these children who remain at home (DoDEA, 2013). Primarily, it is the atmosphere of the DoDEA schools that make the difference, because the education professionals employed there have an understanding of how military culture, mobility, and deployment affect student success (Esqueda, Astor, & De Pedro, 2012).

As evidenced by the DoDEA schools, the military itself has been progressive both in its support to military children and families and recognition that the happiness of the military family is important to the retention and satisfaction of high-quality personnel, and hence, affects overall mission readiness. Most military-connected children, however, do not attend DoDEA schools or even schools that serve a large military student population (Fletcher, 2012). This is particularly true for Reserve Component personnel and veterans who are more likely to be located away from military installations and military-oriented community services. Non-DoD public schools are generally not aware of or do not understand the specific and unique needs of military-connected children (Harrison & Vannest, 2008). Many public schools that serve children of active military, Reserve Component personnel, and veterans remain behind in their understanding of this population and its need simply because they may not be able to identify military-connected students in their schools and there may not be a large number of military-connected children in their schools (Fletcher, 2012). Moreover, school professional staff may not always be aware of cultural anomalies associated with being a child of a military service personnel or veteran (Esqueda et al., 2012) and as such, military-connected children’s needs may not be addressed by a system that is well positioned to provide needed support and interventions. While a large amount of support for military-connected children exists within the military itself, there seems to be a lack of military-specific support systems within school settings (Esqueda et al., 2012).

School mental health professionals are well positioned to provide necessary support and interventions to military-connected children, but there is an apparent lack of training on how school professionals can or should respond with military families (Oliver, 2012). Even if there are services available to support or intervene with military-connected children, parents and students may not be aware of them and students may not receive the services they need (Fairley, 2007), or the services that are provided are simply education about local and national military support programs (Oliver, 2012). The DoD has recognized the need for public schools to enhance their capacity to support military children, and research suggests that schools can play an important role in creating a supportive environment (Waliski, Kirchner, Shue, & Bokony, 2012).

School and Community Interventions

There are a growing number of local, regional, and national organizations and programs for military families that provide services and support to improve the well-being of military-connected children. Programs, such as the Military Child Educational Coalition (MCEC) and Operation Military Kids (OMK), tend to focus on school and community support of military-connected children. Research across all war contexts suggests these types of interventions help children adequately cope with the stressors associated with deployment (De Pedro et al., 2011). The mission of MCEC, one of the more prominent organizations, is to ensure that all military-connected children impacted by mobility, separation, and transition receive quality educational experiences (Military Child Educational Coalition [MCEC], 2013). A unique contribution MCEC has initiated is the Student 2 Student (S2S) program. The S2S is a student-led and supported program that trains both military-connected and civilian middle and high school students to provide supports for students impacted by transition and mobility (MCEC, 2013). In addition to the S2S program, MCEC established the Parent-to-Parent program that educates and trains parents on how to best advocate for their children (MCEC, 2013).

OMK (2013) is a community-focused program designed to enhance community connections with military-connected children, enhance partnerships with formal networks that can provide the social capital children need, and increase community capacity to support military-connected children at the local level. OMK has partnered with many local organizations throughout the United States, including National 4-H, American Legion, Army Child and Youth Services, Boys and Girls Clubs of America, as well as the MCEC. Much of the support offered by OMK-affiliated programs includes recreational and social activities, networking with other families experiencing deployment, day and weekend camps, and assistance with school-related concerns (Operation Military Kids, 2013).

Families Overcoming Under Stress (FOCUS), a program developed by University of California, Los Angeles, and Harvard Medical School offered at 18 U.S. military installations, is a resiliency-training program for military families based on interventions that have previously been found to improve psychological health and resiliency (Esposito-Smythers et al., 2011; Lester et al., 2011). FOCUS maintains several common core components from evidence-based interventions including psychoeducation and strengths-based, family-oriented approaches (Families Overcoming Under Stress [FOCUS], 2013). Military OneSource is another well-known source of support for military-connected children and families. It offers a DoD-sponsored program, the Joint Family Support Assistance Program that provides short-term, solution-focused counseling, and psychoeducation with a prevention/early intervention focus (Military OneSource, 2013). Both this program and FOCUS are offered to service members and their families from all service components (FOCUS, 2013; Military OneSource, 2013). In addition to programs offered across all service components, individual service components have implemented systems of care to provide school-based supports and services. For example, the Child, Adolescent, and Family Behavioral Health Office (CAF-BHO) is the lead office within the U.S. Army Medical Command (MEDCOM) responsible for child and behavioral health programs. CAF-BHO developed a school-based intervention model to improve early detection and care of behavioral health problems by embedding behavioral health triage teams in schools (Faran, n.d.). The School Behavioral Health Team at Tripler Army Medical Center uses a multidisciplinary community of practice approach, embeds programs and personnel in the schools, and uses evidence-based therapies to improve the well-being of military-connected children and youth (Whitsett & Saito, 2013).

Despite increased attention to the multiple and unique stressors and negative impacts experienced by military-connected children, little is known about interventions to improve their well-being. Several initiatives and programs have been launched in recent years to prevent or mitigate negative impacts of deployment, parental loss, and other stressors associated with military life and war; however, it is unclear whether and to what extent these programs have been implemented in DoDEA and non-DoDEA schools and whether these programs are effective. Given the national priority to ensure military-connected children’s education and development by improving the quality of their educational experience, reducing negative impacts of relocations and absences, and encouraging healthy development, it seems prudent to examine and synthesize the evidence of effects of school-based programs aimed at improving the well-being and reducing negative impacts on military-connected children to inform practice and policy in this area.

Purpose of the Present Study

The purpose of this systematic review was to examine the effects of school-based interventions on the well-being of military-connected children (i.e., dependents of military service members or veterans who attend public or private elementary or secondary schools). The specific research question guiding this review was: Are school-based supports and interventions intended to assist students with at least one active military, reserve component, or veteran parent with parental deployment, parental reintegration, parental military-related trauma or death, or frequent moves effective in promoting the social, emotional, behavioral, or educational well-being of military-connected children?

Method

Systematic review procedures were used for all aspects of the search, retrieval, selection, and coding of published and unpublished studies meeting study inclusion criteria (see Campbell collaborations review guidelines at www.campbellcollaboration.org; Littell, Corcoran, & Pillai, 2008). The review was conducted using a review protocol developed in advance that clearly stated the inclusion/exclusion criteria and an explicit search strategy that included searches for gray literature. In addition, all studies were systematically coded by two coders. The protocol and screening and coding instruments guiding the conduct of this study are available from the first author upon request.

Study Eligibility Criteria

Studies were eligible for inclusion if they examined the effects of interventions intended to assist students whose parents were active duty service members, reserve component personnel, or a veteran of a branch of the U.S. military with parental deployment, parental reintegration, parental military-related trauma or death, or frequent moves. Studies must have employed a randomized or quasi-experimental design, measured at least one behavioral, social, emotional, or educational outcome for which an effect size could be computed and conducted in a public or private Pre-K–12 school setting in the United States. Published and unpublished studies were eligible for inclusion; however, this review was limited to studies conducted between 1990 and August 2013.

Search Strategy

A comprehensive and systematic search strategy was conducted in an attempt to identify and retrieve all relevant published and unpublished studies meeting inclusion criteria. The search, completed in August 2013, involved several sources and used the following key words: (child × OR student OR adolescent × OR youth) AND school AND military AND (intervention OR treatment OR therapy). Information sources included 11 electronic databases (Academic Search Complete, Academic Search Premier, Education Full Text, ERIC, PsychINFO, PsychArticles, ProQuest Dissertations and Abstracts, Social Work Abstracts, Military and Government Collection, Cochrane Collaboration, Campbell Collaboration Library, and Teacher Reference Center); websites of relevant government and university research centers; and reference lists of retrieved studies and related articles. Additional efforts were also employed to find unpublished, or “gray,” literature, which included contacting first authors of published studies and other researchers and universities known to have military research institutes (e.g., the National Military Family Association, Purdue Military Family Research Institute, University of Southern California Center for Innovation and Research on Veterans and Military Families, Center for the Study of Traumatic Stress, Center for Health and Health Care in Schools, and the U.S. Army).

Study Selection and Coding Procedures

All titles and abstracts retrieved through the search strategy were screened by the fourth author for relevance. Those that were obviously ineligible (i.e., did not involve the target population, did not involve a child–parent intervention, or were theoretical in nature) were screened out. The full text of all studies that were not obviously ineligible or were questionable at this stage was obtained and screened for eligibility. The search procedures yielded 1,460 titles. After review of titles and abstracts, 22 potential studies were retrieved in full text for screening. Of those 22 reports, 21 were excluded due to not meeting basic eligibility criteria. As seen in Table 1, 18 of the 21 reports were not intervention studies and did not employ an experimental design. Of the remaining three studies that did examine the effects of an intervention, they did not employ a quasi-experimental or randomized study design. The final sample for this review includes one quasi-experimental study. See Figure 1 for a flowchart detailing the search and selection process.

Figure 1.

Study search and selection process flow chart. QED = quasi-experimental design.

Table 1.

List of Excluded Studies and Reasons for Exclusion.

Authors (Date)	Type of Publication	Reason for Exclusion
Classen (2007)	Dissertation	Not an intervention study
Cohen and Manarrino (2011)	Peer-reviewed	Not an RCT or QED design (single-case study method employed)
Cole (2012)	Unpublished report	Not an intervention study
De Pedro et al. (2011)	Peer-reviewed	Not an intervention study
DePedro (2012)	Dissertation	Not an intervention study
Edwin (2007)	Dissertation	Not an RCT or QED design (study employed qualitative SGPP design methods)
Esqueda et al.(2012)	Peer-reviewed	Not an intervention study
Fairley (2007)	Dissertation	Not an intervention study
Fletcher (2012)	Dissertation	Not an intervention study
Huebner and Mancini (2005)	Government report	Not an intervention study
Keim (2009)	Dissertation	Not an intervention study
Leonhart (2009)	Dissertation	Not an intervention study
Madler (2009)	Dissertation	Not an intervention study
Mansfield (2009)	Dissertation	Not an intervention study
Martin-McCoy (2010)	Dissertation	Not an intervention study
Oates (2002)	Peer-reviewed	Not an intervention study
Oliver (2012)	Master’s thesis	Not an intervention study
Perkins and Borden (2004)	Peer-reviewed	Not an RCT or QED design (SGPP design employed)
Rippe (2012)	Dissertation	Not an intervention study
Schjolberg (2012)	Dissertation	Not an intervention study
Waliski et al. (2012)	Peer reviewed	Not an intervention study

Note. RCT = randomized controlled trial; QED = quasi-experimental design; SGPP = single group pretest–posttest design.

To ensure reliability of coding procedures, two authors independently coded the included study using a coding instrument developed by the authors to guide systematic examination and extraction of data (κ = .92). The coding instrument included categories concerning all relevant bibliographic information, study context, intervention and sample descriptors, research methods and quality descriptors, and effect size data (Lipsey & Wilson, 2001). Disagreements between the two coders were resolved by consensus.

Statistical Methods

Statistical analysis was designed to produce descriptive information on the characteristics of the included study and the effect size of the intervention on reported outcomes. Although we planned a priori to conduct a meta-analysis, this was not possible due to only one study meeting inclusion criteria for this review. The standard mean difference effect size statistic, corrected for small sample size bias (Hedges’ g), was calculated using a statistical software package, Comprehensive Meta-Analysis Version 2.0 (Borenstein, Hedges, Higgins, & Rothstein, 2005) by inputting the means, standard deviations (SDs), and sample sizes for the treatment and control groups reported by the primary study authors. When authors used multiple reports of the same outcome measure (e.g., child and parent versions of the same measure) or multiple measures of the same outcome (e.g., two different instruments measuring anxiety), we took the mean of all measures of the same outcome.

Results

Descriptive Analysis

The study included in this review utilized a pretest–posttest quasi-experimental design aimed to examine the effectiveness of the Children of Deployed Parents-Group, a group counseling intervention for children whose parents were either scheduled to be or had been deployed by the military. Mitchum (1999) examined the effects of the intervention on self-esteem, state anxiety and trait anxiety, and internalizing and externalizing behaviors measured by the Coopersmith Self-Esteem Inventory, the State-Trait Anxiety Inventory for Children, and the Child Behavior Checklist-Teacher Report Form, respectively. Study participants consisted of 65 third- through fifth-grade elementary school children (30 boys and 35 girls) of enlisted military personnel in Norfolk, Virginia, attending a Norfolk City Public School. Participants’ mean age was 10.0 (SD = 1.1) for the treatment group and 9.3 (SD = 1.7) for the control group. The race/ethnicity of the participants’ mother and father was 30% and 35% African American, 4% and 7% Hispanic, 57% and 46% Caucasian, and 15% and 15% Pacific Islander, American Indian or other, respectively. In all cases, the military member was the father. Although a parent of all of the participants was scheduled to deploy during the study duration, six parents of children in the treatment group had not been deployed by posttest. For eight of the children (six in treatment group and two in control group), the parent had returned from deployment prior to the end of the intervention. Principals of the participating schools determined whether their school would provide the intervention; therefore, the intervention was conducted in some schools and not conducted in other schools. The school the child attended, then, determined assignment to condition.

The group intervention, developed by the study author to “help each child develop methods of coping and problem solving skills to effectively reduce their anxiety and negative behavior during the parent’s deployment” (Mitchum, 1999, p. 38), was delivered by master’s level school guidance counselors over six sessions to five or six students in each group. A manual with objectives for each group along with details of materials needed and activities for each session was provided by the study author. In Session 1, the goal was to introduce the child to the group, learn about the other group members, and “have the opportunity to self-disclose information about self that is relevant to the group’s purpose and hear other’s disclosure similar information” (Mitchum, 1999, p. 88). The objectives of Session 2 included learning about the different phases of the deployment cycle and helping children identify names of emotions and cognitive and behavioral reactions experienced with various emotions. Session 3 is focused on aiding the child to learn about support networks, identify people that are in their support network, and helping the child make plans to increase their support network if needed. The primary objectives of Session 4 included providing each child the opportunity to share concerns about deployment with the group and learn new coping skills for problems encountered during the deployment cycle. Providing opportunities for each child to learn how to brainstorm, evaluate possible solutions, and receiving feedback from other children in the group was the focus of Session 5. The objectives for the final session included receiving feedback from other group participants how they are coping with the current deployment, learning how they have helped other group participants, and having the opportunity to process the effect group has had on the way they each cope with deployment.

Risk of Bias of Included Study

The included study used a pretest–posttest quasi-experimental design; potential biases in non-randomized designs are likely to be greater than randomized studies. Risk of bias was assessed for selection, performance, detection, attrition, and reporting biases using the Cochrane Collaboration’s tool for assessing risk of bias (Higgins et al., 2011; see Table 2). Selection bias was rated as high risk due to differences between the control and treatment groups on baseline characteristics. In addition, the military parent of six children in the treatment group never deployed and six returned from deployment prior to posttest, whereas all of the military parents of the control group children deployed and only two returned from deployment prior to posttest. Performance bias and detection bias were rated as high risk as all participants, providers, and the investigator were aware of group assignment. Attrition bias was rated as high risk on the Child Behavior Checklist (CBCL) outcome due to high overall (31%) and differential (10%) attrition resulting from teachers not returning the CBCL questionnaire at posttest. Low risk of attrition bias was present for the self-esteem and anxiety outcomes due to no reported attrition. The study author reported data on all outcomes, thus reporting bias was rated as low risk.

Table 2.

Risk of Bias of Included Study.

Type of Bias	Judgment	Support for Judgment
Selection bias
Sequence generation	High risk	Nonrandom—children were assigned to groups by principals of the schools
Allocation concealment	High risk
Performance bias
Blinding of participants	High risk	No measures taken to blind children
Blinding of parents and teachers	High risk	No measures taken to blind parents or teachers
Detection bias
Blinding of outcome assessment	High risk	No measures taken to blind outcome assessors
Attrition bias
Incomplete outcome data	High risk	Missing data on the CBCL due to measures not being returned: total attrition = 31%; differential attrition = 10%
Reporting bias
Selective outcome reporting	Low risk	Study author reports data for all outcomes

Note. Low risk = plausible bias unlikely to seriously alter the results; unclear risk = plausible bias that raises some doubts about the results; high risk = plausible bias that seriously weakens confidence in the results. CBCL = child behavior checklist.

Effect Sizes

Effects on all outcomes were small to moderate and not significantly different from zero: state anxiety (g = −0.38; 95% CI = [−.86, .12]); trait anxiety (g = .06; 95% CI = [−.43, .54]); self-esteem (g = 0.25; 95% CI = [−.24, .74]); externalizing behavior (g = −0.47; 95% CI = [−1.00, .06]); and internalizing behavior (g = −0.51; 95% CI = −1.04, .02). Due to only one study being included in this review, additional analyses were not able to be performed.

Discussion and Applications to Social Work

The purpose of the present study was to examine the effects of school-based interventions intended to assist students whose parents are active duty service members, reserve component personnel, or a veteran of a branch of the U.S. military with parental deployment, parental reintegration, parental military-related trauma or death, or frequent moves. Systematic review procedures were used to search, retrieve, select, and extract data from studies examining effects of school-based interventions on the social, emotional, behavioral, or educational well-being of military-connected children. Despite our comprehensive search process, only one study met inclusion criteria for this review: a quasi-experimental study examining effects of a group intervention for children whose parents were deployed or scheduled to be deployed. The effects on all outcomes measured (i.e., anxiety, self-esteem and internalizing and externalizing behaviors) were small to moderate (Cohen, 1988) and did not differ significantly from zero, suggesting that the intervention was not effective at improving children’s functioning on the outcomes measured. In addition, it should be noted that while the study examined effects of interventions on military-connected children whose parents were supposed to be deployed during the study time frame, there was no ongoing major military operation at the time the included study was conducted and thus may not be generalizable to children of service members currently deployed in Iraq or Afghanistan. While the study met inclusion criteria, the quality of evidence of the included study was relatively weak and should be interpreted with caution.

Military-connected children face unique stressors and challenges, including deployment of their parents, multiple moves, anxiety and fear related to the safety of their parent while deployed, or coping with the loss or injury of a parent. These stressors can result in increased risk for negative social, emotional, behavioral, mental health, and educational effects for military-connected children (De Pedro et al., 2011; Esposito-Smythers et al., 2011). Given the increased attention and initiatives to prevent and mitigate negative effects of stressors experienced by children of military personnel and promote their well-being, we were somewhat surprised at the paucity of school-based intervention research in this area. So what could account for the lack of evidence on school-based supports and interventions designed to promote the well-being and psychosocial health of military dependents?

First, although there has been much attention to the effects of deployment and other unique stressors associated with the military life on children and adolescents, this area of research still appears to be relatively nascent. In Card and colleagues (2011) meta-analytic review examining the association between military deployment and child adjustment, they found only 16 studies published between 1978 and 2010 that met inclusion for their review, with most published after 1992. Their findings and discussion revealed several gaps and recommendations for future research related to understanding effects of military deployment on children of military parents. They noted that the studies included in the review were naturalistic and nonlongitudinal in nature, thus the studies could describe associations between child adjustment and deployment, but could not shed light onto causal mechanisms. Moreover, Card and colleagues identified the strong likelihood of considerable variability in the reactions of children, but noted that the included studies lacked the systematic examination of moderators and mediators linking deployment and child adjustment. Some research has shed light onto these potential factors, such as the conditions around the deployment (e.g., phase of deployment, length of parental absences, number of deployments, which parent is deployed), family factors (e.g., stress, anxiety, and mental health of non-deployed parent; changes in family roles), and individual characteristics (e.g., age and emotional development, child’s coping skills, personality characteristics; Barker & Barry, 2009; Cozza, Chun, & Polo, 2005; Huebner & Mancini, 2005; Morris & Age, 2009; see also De Pedro et al., 2011; Esposito-Smythers et al., 2011). Thus, there may be a variety of factors that could exacerbate or protect against negative effects of deployment on children that could lead to better or worse outcomes. More sophisticated or nuanced understandings of mediating and moderating factors could then be used to inform prevention and intervention efforts. So while there has been much attention regarding the effects of deployment and other stressors on military-connected children, research to understand these effects are yet underdeveloped.

Additionally, school social workers, mental health professionals, and education researchers may simply overlook military-connected children and their educational experiences; there appears to be an overall lack of educational research related to military-connected children (De Pedro et al., 2011; Esqueda et al., 2012). While DoDEA schools may be more supportive of the needs of military-connected children in their schools, the majority of military-connected children attend civilian public schools and may not receive adequate support and services. Indeed, civilian school personnel may be unaware of, or perhaps unsympathetic to, the unique needs of military-connected children (Esqueda et al., 2012). This lack of research and awareness of military-connected children in public schools is concerning. In De Pedro’s and colleague’s (2011) review of challenges, supports, and educational research related to children of military service members, gaps and future directions in educational research were discussed. They recommended that schools and education researchers integrate military students’ issues into future research and school reform efforts, include military families as a demographic variable in surveys and data collection systems, focus on ways schools and school professionals are trained on the risks and needs of military-connected children and how to respond to their needs, examine how current efforts and supports affect students, and improve identification and monitoring of military-connected children in schools. Additional recommendations by Esqueda, Astor, and De Pedro (2012) included the need for research that accurately documents the unique educational needs, strengths, and circumstances of military-connected children and effectiveness of current military-connected school reform efforts and district- and school-level organizational efforts. While there is a current lack of educational research on the needs, challenges, and outcomes of military-connected children, recent developments, such as the Interstate Compact on Educational Opportunity for Military-Connected Children and the recent presidential directive and financial resources to support the education and development of military-connected children (White House, 2011, p. 2) will hopefully lead to greater efforts to improve our knowledge and evidence base to develop programs and policies to respond more effectively to the needs and challenges experienced by military-connected children in schools.

Limitations and Conclusion

While this study sheds light onto the lack of evidence available to inform supports and services for military-connected children, the present study is not without limitations. Despite our attempts at a comprehensive search process, there is the possibility that we may not have captured every potentially eligible study; however, we believe that this risk is quite small, given the extensive search process. This review is also limited to the inclusion criteria that guided this review. This review was limited to school-based interventions with military-connected children, thus this review does not reflect evidence that may be available for other types of interventions with military-connected children such as outpatient or community-based interventions.

Despite these limitations, the present review provides an important contribution for both researchers and school social workers in shedding light onto the state of knowledge of interventions intended to improve the well-being of military-connected children. The paucity of intervention research in this area is surprising, given the increased awareness and research on the stresses and impacts of military deployment and other unique stressors related to military life on children; however, the nascent state of empirical research in this area and challenges associated with conducting school-based research may account at least in part for the lack of studies identified for inclusion in this review. While the results of this systematic review do not provide enough evidence to make recommendations for specific interventions to be implemented by school social workers, it is clear that school social workers could take an active role in both advocating for the tification and support of military-connected children in their schools. The results of this systematic review also clearly support the development of evidence-informed interventions in schools that address the risks and needs of military-connected children and the need for intervention outcome research, both to which school social workers could contribute. Given more recent federal initiatives and continued efforts to raise awareness of the risks and needs of military-connected children, we hope that additional efforts will be made to both understand the effects of deployment and military life and culture and improve the well-being of military-connected youth.

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.

References

References marked with an * indicate studies included in the review; references marked with ** indicate studies excluded from the review after full-text retrieval and screening.

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