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Prevalence, Treated Prevalence and Co-Occurrence of Internalizing, Externalizing, and Tic Disorders

in Colorado


​The specific aims of this study were to adapt and test an existing two-stage methodology to assess the prevalence, treated prevalence, and co-occurrence of internalizing, externalizing, and tic disorders in Colorado school-aged youth (ages 5-17 years).  In Stage 1, 858 teachers completed screens on 4,183 students included in our stratified random sample of 5,521 students.  In Stage 2, parents completed diagnostic interviews for a subsample of this population of students, 600 who scored low and 600 who scored high on the screen. 
Two hundred and thirty eight interviews were conducted through February 29, 2016, 46% with parents of girls and 54% with parents of boys.  The students are 58% Hispanic or Latino, 28% White, 25% Black or African American, 4% American Indian or Alaska Native, 2% Asian, 0.4% Native Hawaiian or Other Pacific Islander, and 3% Other (some reported more than one race/ethnicity).  For most students, their primary language is English (65%), followed by Spanish (29%) and Other (6%).  Parent reports indicated that 18% of the students have ongoing physical health problems that have been diagnosed by a health care worker, 10% are limited in activities in some way due to physical, mental or emotional problems, and 2% have health problems that require the use of special equipment. Almost 92% of students have health care coverage.  Most who do (67%) are covered through Medicaid or the Children’s Health Insurance Program (CHIP Plus).

The Behavioral and Emotional Screening System (BASC-2 Bess) and the Proxy Report Questionnaire (PRQ) were effective in differentiating between those students with a diagnosed mental, emotional or behavioral condition or developmental disability and those without any diagnosed conditions or disabilities.  Students who screened high were significantly more likely than students who screened low to have been diagnosed with: (1) at least one mental health, emotional, or behavioral condition, (2) an intellectual disability or developmental delay, (3) a learning disability, or (4) a speech or other language problem.  With regard to school programs or accommodations, students who screened high were significantly more likely than students who screened low to have received special education services or classroom accommodations, a formal educational plan, or treatment.  Within the group of students who screened high, there were no significant differences between females and males or among Blacks, Latinos and Whites on any of these variables.

A number of additional presentations/manuscripts focused on our local Colorado data are in preparation.
Reyes, N., Moody, E., Kaparich, K., Davidon. S., Rosenberg, S., & Kubicek, L. (2017, May). Child and parent factors that influence Social Communication Questionnaire Scores: An examination of an English- and Spanish-speaking sample. Presented at the 16th annual International Meeting for Autism Research (IMFAR) Conference. San Francisco, CA.

Funding Source: Funded by the Centers for Disease Control and Prevention (CDC) as a sub-contract through the University of South Carolina School of Medicine, Disability Research and Dissemination Center.

Faculty and Staff:
Lorraine F. Kubicek, Ph.D., IMH-E® (IV-R/F), PI
Sarah Davidon, Ed.D.
Kristina Hightshoe, MPH
Eric Moody, Ph.D.
Nuri Reyes, Ph.D.
Steve Rosenberg, Ph.D.

Contact Person:
Lorraine Kubicek, Ph.D.
Lorraine.Kubicek@ucdenver.edu