Screening or Assessment?

No. 1, October 2007

The Challenge:

Learning disabilities, behavior disorders, mental and physical health impairments, or other nonapparent disabilities may be present, but undiagnosed, in a youth. A screening process may be needed to determine whether a diagnostic assessment, conducted by a trained specialist, should be provided. Unfortunately, screening is not properly understood or implemented by many youth service practitioners and administrators. Because factors such as normal adolescent angst, cultural issues, and medications can affect the accuracy of screens, they should never be used to label a youth with a disability or to deny services or program access.

Proposed Solution:

Schools, workforce programs, and service providers should have specific policies about when and how to screen participants and refer them for further assessment. Screening instruments should be carefully selected based on their specificity, sensitivity, and predictive value as well as their appropriateness for the youth population served. Collaboration across agencies should be proactively arranged in order to ensure that referrals occur without delay to practitioners with the expertise to conduct more in-depth diagnostic assessments.

Promising Practices

• Columbia University Teen Screen Program, http://www.teenscreen.org
  The Teen Screen Program uses three screens to identify risk factors for mental health disorders, depression, and suicide. Organizations who wish to become TeenScreen sites must go through an approval process that includes gathering support, developing a plan, training personnel, and developing policies and practices that reflect Teen Screen quality principles.
• Learning Needs Screening Tool http://www.ncwd-youth.info/assets/guides/assessment/AssessGuide_Chapter2.doc
  This screening tool for learning disabilities was developed for welfare recipients in Washington state by Nancie Payne of Payne Associates. Accompanying materials define “screening” and describe criteria for properly using the screen and ensuring that appropriate referrals and resources are in place.

Who needs to act?

School and program administrators, youth service practitioners, youth service providers, transition teachers and coordinators, policymakers, and anyone involved in the transition planning process. You are involved if you set policy, provide services, or make transition decisions that include career assessments or other services that may be disability dependent.

Action Plan

• Determine the need for screening for hidden disabilities in your organization through surveys, staff discussions, file reviews, etc. as appropriate.
• Review available screening instruments to identify the ones that best meet the needs of the youth served and your organization. Involve outside “experts” if needed.
• Develop policies and procedures for using screens, making referrals for further assessment, and implementing recommendations from the assessment process. (See the Columbia University Teen Screen Program polices and quality principles for examples.) Be sure to address issues such as confidentiality, parental consent, training and qualifications of screeners, organizational approvals, a youth’s right to refuse screening or referral for additional assessment, and parental notification of results.
• Initiate contacts with organizations and agencies to which youth needing further assessment can be referred. Establish working arrangements that include agreements on information sharing, funding of assessment costs, and other issues.
• Initiate training of staff and develop resources for their use regarding the implementation of your screening policies and procedures.

Examples

Disability Screen: A brief process or instrument that provides preliminary information on risk factors, behaviors, or academic issues that may indicate the presence of a disability.
Disability Assessment: An in-depth evaluation for diagnosing a disability and its severity, often requiring a combination of record reviews, assessment instruments, interviews, and observations.

Disability Screen: May take as little as 8 to 10 minutes to administer and 5 to 10 minutes to score.
Disability Assessment: May take days or weeks to collect information and interpret the results.

Disability Screen: May be administered by properly trained youth service practitioners.
Disability Assessment: Must be administered by specialists such as psychologists, educational diagnosticians, and others with graduate-level training in the appropriate discipline (mental health, learning disabilities, speech-language pathology, etc.)

Disability Screen: Used to decide if referral for a disability assessment is needed.
Disability Assessment: Used to determine if a disability is present and the level of its severity.

For More Information

Podmostko, M. (In press). Tunnels and cliffs: A Guide for workforce development professionals and policymakers serving youth with mental health needs. Washington, DC: National Collaborative on Workforce and Disability for Youth, Institute for Educational Leadership. Available at http://www.ncwd-youth.info/resources_&_Publications/mental_health.html

Timmons, J., Podmostko, M. Bremer, C., Lavin, D., & Wills, J. (October, 2005). Career planning begins with assessment: A guide for professionals serving youth with educational and career development challenges (Revised edition). Washington, DC: National Collaborative on Workforce and Disability for Youth, Institute for Educational Leadership. Available at http://www.ncwd-youth.info/resources_&_Publications/assessment.html

Vocational Evaluation and Career Assessment Professionals (VECAP) http://www.vecap.org/ Professional membership organization that promotes the professions and services of vocational evaluation and work adjustment.

Vocational Evaluation and Work Adjustment Association http://www.nationalrehab.org/vewaa/index.html Professional membership organization (and affiliate of the National Rehabilitation Association) that promotes ethical and excellent practice in rehabilitation and the empowerment of people with disabilities.

This document was developed by the National Collaborative on Workforce and Disability for Youth, funded by a grant/contract/cooperative agreement from the U.S. Department of Labor, Office of Disability Employment Policy (Number #E-9-4-1-0070). The opinions expressed herein do not necessarily reflect the position or policy of the U.S. Department of Labor. Nor does mention of tradenames, commercial products, or organizations imply the endorsement by the U.S. Department of Labor.

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