A failure to address the emotional and behavioral problems of school-age children can have serious, life-changing ramifications, including poor grades, suspension and expulsion, and problems with the law later in life. However, studies show that only 1 in 5 children with emotional and behavioral disorders receive mental health services, with low-income and ethnically diverse children lagging far behind their middle class, Caucasian counterparts.

At the heart of this disparity is a shortage of specialized services in low-income communities, the high cost of these services, and the stigma attached to using such services. Moreover, evidence-based interventions are not successfully deployed in urban schools. Such interventions are all too often derailed by inadequate training and poor implementation by service providers in the school.

The National Institute of Child Health and Human Development recently awarded Children's Hospital a $3.1 million grant to study the level of support school personnel needed to effectively implement an intervention program called School-Wide Positive Behavioral Interventions and Supports (SW-PBIS) for typically developing students as well as students with, or at risk for, externalizing or anxiety disorders.

SW-PBIS is a comprehensive service delivery strategy that, by combining universal and targeted interventions to address students' emotional and behavioral issues, can help improve overall school climate, perceived school safety, and student academic performance. The program focuses on preventing new cases of problem behaviors through school-wide discipline, classroom behavior management, and effective instructional practices.

The CHOP study, which will be led by Ricardo Eiraldi, PhD, will examine whether school personnel can implement the components of a two-tier SW-PBIS program with the same level of fidelity, integrity and effectiveness when they receive a relatively low level of support from coaches and supervisors as they can with a high level of support. Dr. Eiraldi and his team partnered with the School District of Philadelphia to select six schools in North Philadelphia for participation in the project.