Identifying Psychosocial Problems Among Children and Youth in the Child Welfare System Using the PSC-17: Exploring Convergent and Discriminant Validity with Multiple Informants

Youth who enter foster care are at risk of mental health need, but questions arise as to the validity of their self-reported symptomatology. This study examines the screening validity of the youth-report version of the Pediatric Symptom Checklist-17 (PSC-17) in a child welfare population. Data come from 2389 youth who completed a version of the PSC-17 adapted for youth report, and their biological and foster parents who completed the parent-report version. Youth also completed a shortened version of the Screen for Child Anxiety Related Disorders (SCARED). Convergent and discriminant validity of the PSC-17 was assessed using multi-trait multi-method matrices. The PSC-17’s internalizing subscale was strongly correlated, attention subscale was moderately correlated, and externalizing subscale was weakly correlated with the SCARED’s anxiety and PTSD subscales. Comparing youth and foster parent scores, the PSC-17 had moderate convergent validity and weak/fair discriminant validity. Comparing youth, foster parent, and biological parent scores, the PSC-17 had moderate convergent validity and weak/fair discriminant validity. The current study provides some support for the validity of the PSC-17 for the population of youth in foster care

Measurement Based Care in Child Welfare-Involved Children and Youth: Reliability and Validity of the PSC-18

This study evaluates whether the psychometric properties of the Pediatric Symptoms Checklist-17 (PSC-17), a common behavioral health measure typically used as a dichotomous screening tool for mental health needs, support its use as a continuous measure for tracking behavioral health over time. A total of 6492 foster parents of children and youth aged 5.5–17 completed the PSC-17. Convergent and discriminant validity was assessed by comparing raw PSC-17 subscale scores with associated outcomes (e.g. psychiatric diagnoses). Long-term test–retest reliability was assessed over 6 months. Scores on the PSC-17 demonstrated good convergent and divergent validity. PSC-17 subscale scores were most strongly associated with analogous diagnoses. Test–retest reliability was moderate, as expected for a time window of this length. This study provides moderate support for the psychometric qualities of the PSC-17 when used with children and youth in the child welfare system as a continuous measure of psychosocial functioning over time

Tracing the Pathway from Mental Health Screening to Services for Children and Youth in Foster Care

Purpose Children and youth in out-of-home care have high rates of behavioral health need, and states are increasingly adopting screening protocols to identify and intervene with these youth. This study presents longitudinal analyses of the case flow of youth aged 3–17 in Washington State\u27s foster care system, tracking rates of screening, scoring above or below clinical criteria cutoff scores, and service receipt. This study describes what variables are associated with these three decision points. Results Eighty-nine percent of eligible youth were screened for behavioral health need soon after entry in to out-of-home care; most of those who were not screened were already receiving behavioral health services. Sixty-one percent scored above criteria on at least one screening measure by at least one respondent. Sixty percent of those who scored above criteria and 33% of those who scored below criteria received at least one behavioral health service within 4 months of entry to care. After controlling for all variables, screening above criteria was related to age, race/ethnicity, county rurality, abuse type, reason for out-of-home placement, past behavioral health service receipt, and type of past diagnosis. Service receipt for those scoring above criteria was related to age, race/ethnicity, county rurality, abuse type, and type of prior behavioral health diagnosis. Conclusions The role of screening in child welfare is dynamic and influenced by multiple factors. In the current study, youth screening above criteria was related to increased rates of service receipt. However, many children with behavioral health service needs did not receive services. The relatively high rates of youth scoring below criteria but receiving services may indicate a need for ongoing systematic screening in order to identify emergent needs, or additional screening measures at intake. States considering or employing the use of screening tools should weigh a variety of approaches to screening, assessment, and referral to services in order to ensure maximal benefit