An estimated 9 to 13% of American children An estimated 9 to 13% of American children and adolescents between ages nine to 17 and adolescents between ages nine to 17 have serious diagnosable emotional or have serious diagnosable emotional or behavioral health disorders resulting in behavioral health disorders resulting in substantial to extreme impairment.substantial to extreme impairment.(Friedman, 2002) (Friedman, 2002)

More than half of students More than half of students with SED drop out of grades with SED drop out of grades 9-12, the highest rate for all 9-12, the highest rate for all disability categories. disability categories. (U.S. Department of Education, 2002; 2006)(U.S. Department of Education, 2002; 2006)

At 2 years post high At 2 years post high school, 58% of youth have school, 58% of youth have been arrested at least once been arrested at least once and 42% are on probation or and 42% are on probation or parole. parole. (NLTS2, 2005).(NLTS2, 2005).

Students with ED reported Students with ED reported use of alcohol (54%), illegal use of alcohol (54%), illegal drug use (36%), marijuana drug use (36%), marijuana use (33%), and smoking use (33%), and smoking (53%) at rates higher than all (53%) at rates higher than all other disability categories other disability categories (NLTS2, 2008)(NLTS2, 2008)

Over 15% of all students with disabilities (6-21) are taking psychotropic medications (USDOE, 2005)

About 1/3 of all adolescent students with disabilities have been suspended or expelled (USDOE, 2005)

Campbell (1995) estimated that approximately 10-15% Campbell (1995) estimated that approximately 10-15% of all typically developing preschool children have of all typically developing preschool children have chronic mild to moderate levels of chronic mild to moderate levels of behavior problems.behavior problems.

Children who are poor are much more likely to develop Children who are poor are much more likely to develop behavior problems with prevalence rates that approach behavior problems with prevalence rates that approach 30% (Qi & Kaiser, 2003).30% (Qi & Kaiser, 2003).

The proportion of preschool children The proportion of preschool children meeting the criteria for the clinical meeting the criteria for the clinical diagnosis of ODD (Oppositional diagnosis of ODD (Oppositional Defiant Disorder) ranges from 7% to Defiant Disorder) ranges from 7% to 25% of children in the United States, 25% of children in the United States, depending on the population depending on the population surveyed surveyed ( Webster-Stratton, 1997)( Webster-Stratton, 1997) . .

Children who are identified as hard to Children who are identified as hard to manage at ages 3 and 4 have a high manage at ages 3 and 4 have a high probability (50:50) of continuing to have probability (50:50) of continuing to have difficulties into adolescence (Campbell & difficulties into adolescence (Campbell & Ewing, 1990; Campbell, 1997; Egeland et al., Ewing, 1990; Campbell, 1997; Egeland et al., 1990).1990).

Early Predictors

•Temperamental Difficulties

•Early Aggression

•Language Difficulties

•Noncompliance

Family Factors

•Maternal Depression

•Harsh Parenting

•Stressful Family Life Events

•Low Social Support

•Family Instability

Depression Hurts

• D• Children of mothers who were depressed in their infancy are more likely to be delayed

• Children of depressed mothers are at increased risk for behavior problems, depression, and mood disorders in adolescence

The correlation between The correlation between preschool-age aggression preschool-age aggression and aggression at age 10 and aggression at age 10 is higher than that for IQ.is higher than that for IQ. (Kazdin, 1995)(Kazdin, 1995)

Early appearing Early appearing aggressive behaviors are aggressive behaviors are

the best predictor of the best predictor of juvenile gang juvenile gang membership membership and violence.and violence.

(Reid, 1993)(Reid, 1993)

When aggressive and When aggressive and antisocial behavior has antisocial behavior has

persisted to age 9, further persisted to age 9, further intervention has a poor intervention has a poor

chance of success.chance of success. (Dodge, 1993)(Dodge, 1993)

Young Children with Young Children with Challenging Behavior:Challenging Behavior:

•Are rejected by peersAre rejected by peers•Receive less positive Receive less positive

feedbackfeedback•Do worse in schoolDo worse in school•Are less likely to be Are less likely to be

successful in successful in kindergartenkindergarten

Preschool children are three times more likely to be “expelled” than

children in grades K-12

(Gilliam, 2005)

Faculty in higher education early childhood programs report that their graduates are least likely to be

prepared to work with children with persistently challenging behavior

(Hemmeter, Santos, & Ostrosky, 2004)

Of the young children who need mental Of the young children who need mental health services, it has been estimated health services, it has been estimated that fewer than 10% receive services that fewer than 10% receive services for these difficulties. for these difficulties.

(Kataoka, Zhang, & Wells, 2002) (Kataoka, Zhang, & Wells, 2002)

There are evidence-based practices that are effective in changing this developmental trajectory…the problem is not what to do, but rests in ensuring access to intervention and support (Kazdin & Whitley, 2006)