Our Children Cant Wait Improving Services for Children and Adolescents with Mental Illness: Mental H

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Addressing Mental Health Barriers to Learning
Through Educator-Initiated Programs
Carl E. Paternite, Ph.D. Center for School-Based
Mental Health Programs Department of
Psychology Miami University (Ohio) http//www.unit
s.muohio.edu/csbmhp Presented at the 7th
National Conference on Advancing School-Based
Mental Health Programs, Philadelphia,
PA, September 21st, 2002
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Addressing Mental Health Barriers to Learning
Through Educator-Initiated Programs

• Instructional Objectives For Presentation
• Offer a "case study" of program development.
• Increase participant awareness of the importance
  of
• educators in school-based mental health
  programming.
• Increase participant knowledge of effective
  approaches to
• enhance educator mental health professional
  collaboration.
• Increase knowledge of ways to infuse "mental
  health
• education" into the school milieu.

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Addressing Mental Health Barriers to Learning
Through Educator-Initiated Programs

• Themes Addressed in Presentation
• Program development.
• Interdisciplinary collaboration and partnership.
• Prevention.
• Research, training and education.

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Mental Health Needs of Youth and Available
Services

• 20-38 of children and adolescents need mental
  health intervention.
• One-sixth to one-third of these youth actually
  receive any service, and, of those who do, less
  than half receive adequate treatment.
• For the small percentage of youth who do receive
  service, most actually receive it within a school
  setting.
• These realities raise questions about the mental
  health fields over-reliance on clinic-based
  treatment, and have reinforced the importance of
  alternative models for mental health service
  especially expanded school-based programs.

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Expanded School-Based Mental Health Programs

• National movement to place effective mental
  health programs in schools.
• To promote the academic, behavioral, social,
  emotional, and contextual/systems well-being of
  youth, and to reduce mental health barriers to
  school success.
• Programs incorporate primary prevention and
  mental health promotion, secondary prevention,
  and intensive intervention.
• Intent is to contribute to building capacity for
  a comprehensive, multifaceted, and integrated
  system of support and care.

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Potential of Schools as Key Points of Engagement

• Opportunities to engage youth where they are.
• Unique opportunities for intensive, multifaceted
  approaches and are essential contexts for
  prevention and research activity.

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Center for School-Based Mental Health Programs
(at Miami University)

• Ohio Mental Health Network for School Success
• Six affiliate organizations working together in
  regional and state-wide activities.
• Butler County School-Based Mental Health Program
• School-based mental health promotion, prevention,
  intervention, and applied research activities.
• Addressing Barriers to Learning Program
• Annual conferences to initiate and sustain local,
  school-based projects that reduce mental health
  barriers to learning and enhance the development
  of healthy school communities.

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Center for School-Based Mental Health Programs
(at Miami University)

• Behavioral Health Advisor
• Mental health newsletter for elementary and
  secondary school educators, focusing on issues
  related to child mental health and school
  success.
• Evaluation of Alternative Education/ Discipline
  Programs
• Ongoing formative evaluation of 11 alternative
  programs in Butler County,OH.
• Partnerships for Success Academy (with the Ohio
  State University Center for Learning Excellence)
• Technical assistance to 15 counties engaged in
  efforts to build capacity to prevent and respond
  effectively to youth problem behaviors while
  promoting positive development.

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Center for School-Based Mental Health Programs
(at Miami University)Funding

• Butler County Mental Health Board
• The Health Foundation of Greater Cincinnati
• Ohio Department of Mental Health
• The Center for Learning Excellence
• Butler County Family and Children First Council
• Talawanda School District
• Miami University cost sharing

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School-Based Mental Health Partnerships Many
individuals have been instrumental to our
school-based mental health partnerships since
1998. To name just a few University-Based (3
universities, 5 academic divisions, 6
departments) Faculty/Staff Carl E. Paternite,
Karen Schilling, Julie Rubin, Denise Fox-Barber,
Amy Wilms, Betty Yung, David Andrews, Al Neff,
Diana Leigh, Alex Thomas, Randy Flora, Doris
Bergen, Valerie A. Ubbes, Raymond Witte, Joan
Fopma-Loy Psychology interns and graduate
assistants Lynne Knobloch, Becky Hutchison,
Sally Phillips, Leslie Baer, Linda Gal, Derek
Oliver, Mike Imhoff, Julie Cathey, Liz Morey,
Chris Dyszelski, Chris Mauro, Nancy Pike, Jessica
Donn, Sandra Kirchner, LaTasha Mack, Ann-Marie
Bixler, Jari Santana-Wynn, Jeanene Robinson,
Gloria Oliver, Francesca Dalumpines, Jamie
Williamson, Jill Thomas, Jennifer Malinosky,
Jason Kibby, Julia Pemberton, Ann Marie Lundberg,
Marc McLaughlin, Robin Graff-Reed
Community-Based John Staup, Kay Rietz,
Saundra Jenkins, Barbara Perez, Susan Smith,
Valerie Robinson, Jolynn Hurwitz, Kate Keller,
Terri Johnston, Charlie Johnston, Kathy Oberlin,
Ellen Anderson, Noelle Duval, Linda Maxwell, Greg
Foster, Teresa Jullian-Goebel, Suzanne Robinson,
Terre Garner, Bryan Brown, Greg Rausch, Carolyn
Jones, David Turner School-Based Teacher
consultants Sherie Davis, Marilyn Elzey, Tom
Orlow, Teresa Abrams, Sarah Buck, Jim Carter,
Julie Churchman, Amy Gibson, Joy Boyle, Chris
Carroll, Mary Hessling, Joan Parks, Joanne
Williamson, Jaimie Pribble, Pam Termeer, Pat
Stephens, Patricia Scholl, Martha Slamer, David
Wood, Susan Meyer, Monna Even, Ginny Paternite,
Connie Short, Terri Hoffmann, Karen Shearer
Guidance counselors, school psychologists,
school nurses, and administrators Marianne
Marconi, Sandy Greenberg, Tom OReilly, Roberta
Perlin, Betsy Esber, MaryBeth Bergeron, Greg
Rausch, Ann Schmitt, Alice Bonar, Stephanie
Johnson, Marcia Schlichter, Susan Cobb, Phil
Cagwin, Bob Bierly, Martha Angello, Bill Miller,
Bob Phelps, Dan Milz, Dave Isaacs, Mark Mortine,
Rhonda Bohannon, Clint Moore, Cathy Keener, Mary
Jane Roberts, Jean Eagle, Alice Eby, Kathy
Jonas, David Greenburg, Candice McIntosh, Sharon
Lytle, Terri Fitton, Steve Swankhaus, Melissa
Kessler, Mary Jacobs .. Action-Project Teams
Fourteen 2-4 person teams from ten schools in
five school districts, each with a university
faculty/graduate student liaison.
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• Center for School-Based Mental Health Programs
  (at Miami University)
• Overarching Goals
• Build collaborative university-school district
  relationships to
• address the mental health needs of children
  and adolescents
• through multifaceted programming.
• Promote mental health and school success for
  youth through
• Primary prevention and mental health education
• Early direct intervention for identified at-risk
  children
• and adolescents, and treatment for those with
  severe/
• chronic mental health problems
• Action research, training, and consultation

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The Ohio Mental Health Network for School Success

• Mission
• To help Ohios school districts, community-based
  agencies, and families work together to achieve
  improved educational and developmental outcomes
  for all children especially those at emotional
  or behavioral risk and those with mental health
  problems, including pupils participating in
  alternative education programs.

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The Ohio Mental Health Network for School Success

• Action Agenda
• Create awareness about the gap between childrens
  mental health needs and treatment resources,
  and encourage improved and expanded services.
• Encourage mental health agencies and school
  districts to adopt mission statements that
  address the importance of partnerships.
• Conduct surveys of mental health agencies and
  school districts to better define the mental
  health needs of children and to gather
  information about promising practices.

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The Ohio Mental Health Network for School Success

• Action Agenda (continued)
• Provide technical assistance to mental health
  agencies and school districts, to support
  adoption of evidence-based and promising
  practices, including improvement and expansion of
  school-based mental health services.
• Develop a guide for education and mental health
  professionals and families, for the development
  of productive partnerships.
• Assist in identification of sources of financial
  support for school-based mental health
  initiatives.
• Assist university-based professional preparation
  programs in psychology, social work, public
  health, and education, in developing
  inter-professional strategies and practices for
  addressing the mental health needs of school-age
  children.

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Educators as Key Members of the Mental Health
Team

• Schools should not be held responsible for
  meeting every need of every student.
• However, schools must meet the challenge when the
  need directly affects learning and school
  success. (Carnegie Council Task Force on
  Education of Young Adolescents, 1989)
• There is clear and compelling evidence that there
  are strong positive associations between mental
  health and school success.

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Educators as Key Members of the Mental Health Team

• Children whose emotional, behavioral, or social
  difficulties are not addressed have a diminished
  capacity to learn and benefit from the school
  environment. In addition, children who develop
  disruptive behavior patterns can have a negative
  influence on the social and academic environment
  for other children. (Rones Hoagwood, 2000,
  p.236)
• Contemporary school reformand the associated
  high-stakes testing (including recently signed
  federal legislation)has not incorporated the
  Carnegie Council imperative. That is, recent
  reform has not adequately incorporated a focus on
  addressing barriers to development, learning, and
  teaching.

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Common Messages Across Initiatives

• It is important to build on the common goals of
  expanded school-based mental health programs and
  existing community and school initiatives. For
  example, in Ohio
• Comprehensive Strategy
• Partnerships for Success
• Alternative Education Challenge Grant Program
• All share a common core focus on barriers to
  development, learning, and teaching.
• Identification of the common message across
  initiatives is extremely important for reducing
  the chances that what is being introduced by any
  one initiative will be marginalized by proponents
  of narrowly-focused school reform.

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Creating and Maintaining Ongoing, Empowering
Dialogue with Educators

• Multi-level, formal and informal dialogue with
  policy makers, formulators, enforcers, and
  implementers.
• Programs for school board members and
  administrators.
• Newsletter for teachers.
• Website resources.
• Extensive contact time with educators in their
  school buildings.
• Joining the school community.
• Key opinion leaders.

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Assessing and Responding To Educator-Identified
Needs and Concerns

• Careful, detailed, local needs assessments from
  the perspective of educators, and a commitment to
  be responsive to identified needs.
• Results used in advocacy efforts and as
  guideposts for ongoing work.

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Prioritizing Promotion of Healthy Development and
Problem Prevention

• School-based models should capitalize on schools
  unique opportunities to provide mental
  health-promoting activities.
• Recommended strategies for violence and drop-out
  prevention, including those for which the central
  role of educators is evident, can be promoted
  actively within an expanded school-based mental
  health program.

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Prioritizing Promotion of Healthy Development and
Problem Prevention

• For violence prevention, these include
• Structured social skill development programs.
• Mentoring.
• Programs that foster school engagement,
  participation, and bonding.
• Promotion of developmental assets.
• A variety of approaches that engage parents and
  families.

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Prioritizing Promotion of Healthy Development and
Problem Prevention

• For drop-out prevention, these include
• Early intervention.
• Mentoring and tutoring.
• Service learning.
• Conflict resolution and violence prevention
  curricula and training for students/staff.
• Alternative schooling.

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Teacher Consultants

• Teacher consultants develop and implement special
  projects
• related to school-based mental health
  enhancement.
• Teacher consultants serve as liaisons to the
  schools in efforts to promote school-based
  mental health programming.
• Teacher consultants serve as informal
  advisers/mentors to
• school staff on matters related to
  social-emotional adjustment and learning needs of
  children and school/climate issues.

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Incentives For Teacher Consultants

• Leadership opportunity
• Training opportunity
• Academic credit
• Stipends (supplemental contracts)
• Empowerment
• Demystification

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• Addressing Barriers to Learning Annual
  Conference and Action Projects Program
• Goal
• Conduct annual conferences, to help initiate
  planned
• local public school-based projects that
  reduce mental
• health-related barriers to learning and
  enhance the

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• Objectives of Addressing Barriers to Learning
  Program
• Demonstrate, produce and assess school-based
  mental
• health practices (classroom-based,
  classroom-linked)
• that address barriers to desired academic
  outcomes
• and personal and social skill development.
• Put into continuing practice that which
  participants learn
• in conference activities and projects.
• Increase the effectiveness of school district
• collaboration and system support for
  school-based
• mental health practices.
• Disseminate findings.

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• Resources for Addressing Barriers to Learning
  Program
• Researchers and practitioners whose work on the
• conference theme evidences quality and the
  potential for
• successful application locally.
• Web-site support.
• Resource packets.
• Small grants to support action projects.
• Ongoing consultation with action teams with
  graduate
• students/faculty.

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• Conference Themes for Addressing Barriers to
  Learning Program
• 2000 Nonviolent Schools Building Programs
  That Work
• Consultants Betty Yung and
  Jeremy Shapiro
• 2001 School, Family, and Community
  Partnerships
• Consultants Marc Atkins and
  Scott Rankin
• 2002 School, Family, and Community
  Partnerships
• Consultants Program faculty

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• Addressing Barriers To Learning
• School, Family, and Community Partnerships
• Second Annual Conference
• March 22 24, 2001
• Marcum Conference Center
• Miami University
• Oxford, Ohio
• Institute for Educational Renewal Based
• At Miami University
• Miami University Center for

Addressing Barriers To Learning School, Family,
and Community Partnerships Conference Advisory
Committee Randy Flora Institute for
Educational Renewal, MU Joan Fopma-Loy
Department of Nursing, MU Susan Mosley-Howard
Associate Dean, EAP, MU Carl E. Paternite
Department of Psychology, MU Roberta Perlin
Talawanda City Schools Alex Thomas Dept. of
Educational Psychology, MU Valerie Ubbes
Dept. of Physical Education, MU Raymond Witte
Dept. of Educational Psychology,
MU Evaluator Doris Bergen Dept. of
Educational Psychology, MU Contacts Randy
Flora floravr_at_muohio.edu [phone] 203
McGuffey Hall Oxford, OH 45056 Carl E.
paternce_at_muohio.edu [phone] Paternite Dept.
of Psychology, Benton Hall Oxford, OH
45056 Many thanks to the members of the
Conference Advisory Committee for your time and
effort. Additional thanks to our funding
providers, The Graduate School of Miami
University and the Butler County Mental Health
Board, for their support.
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Thursday, March 22, 2001500 p.m.- 840
p.m.PROGRAM
Saturday, March 24, 2001 745 a.m. 400
p.m. PROGRAM 745 Continental Breakfast 815 Set
ting the Focus on Todays Work Carl E.
Paternite 830 Conversation with
Consultants . A. Research-based Strategies
Addressing Barriers to Learning in School
Communities - Marc Atkins B. Empowering
Families and Engaging Community Agencies for
Healthy, Achieving Children - Scott
Rankin 915 Break 930 Conversation with
Consultants Continued 1015 Break 1030 Consulta
nts Synthesis From Morning Session Marc Atkins
and Scott Rankin 1045 Team Work with Technical
Assistance Clarifying Goals, Objectives, and
Strategies for School Projects 1145 Lunch 12
45 Review and Refocus Marc Atkins and Scott
Rankin 130 Team Work with Technical Assistance
Refining Project Strategies and Resource Needs
Resource Needs 215 Break 230 Assessment
Suggestions for Consideration Doris Bergen,
Dept. of Educational Psychology, Miami
University Julia Pemberton 245 Team Work with
Technical Assistance Planning Assessment
Strategies for Team Projects 315 Budget
Procedures Randy Flora and Julia
Pemberton 330 Next Steps Carl E. Paternite and
Randy Flora 345 Evaluation and
Adjournment Julia Pemberton

• 500 Reception - Highlights of 2000-2001
  Programs
• 515 Welcome and Introductions
• Carl E. Paternite, Miami University Center for
  School-Based Mental Health Programs
• 530 School, Family, and Community Partnerships
  Addressing Barriers to Learning - Research and
  Practical Applications
• Marc Atkins, University of Illinois - Chicago
• 600 Dinner
• 640 Under Pressure!
• Lakota East High School Students with Advisors,
  Richard Schmaltz and Lisa Schmaltz
• 730 School, Family, and Community Partnerships
• Scott Rankin, Fairfax School, Hamilton County
  MRDD
• 800 Imagining School, Family, and Community
• Partnerships Drawing the Pictures
• Marc Atkins and Scott Rankin

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• Addressing Barriers To Learning
• School, Family, and Community Partnerships
• Second Annual Conference
• March 20 21, 2002
• Marcum Conference Center
• Miami University
• Oxford, Ohio
• Institute for Educational Renewal Based
• at Miami University
• Miami University Center for

Addressing Barriers To Learning School, Family,
and Community Partnerships Conference Advisory
Committee Randy Flora Institute for
Educational Renewal, MU Joan Fopma-Loy
Department of Nursing, MU Susan Mosley-Howard
Associate Dean, EAP, MU Carl E. Paternite
Department of Psychology, MU Roberta Perlin
Talawanda City Schools Alex Thomas Dept. of
Educational Psychology, MU Valerie Ubbes
Dept. of Physical Education, MU Raymond Witte
Dept. of Educational Psychology,
MU Evaluator Doris Bergen Dept. of
Educational Psychology, MU Contacts Randy
Flora floravr_at_muohio.edu [phone] 203
McGuffey Hall Oxford, OH 45056 Carl E.
paternce_at_muohio.edu [phone] Paternite Dept.
of Psychology, Benton Hall Oxford, OH
45056 Many thanks to the members of the
Conference Advisory Committee for your time and
effort. Additional thanks to our funding
providers, The Graduate School of Miami
University and the Butler County Mental Health
Board, for their support.
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Thursday, March 21, 2002 815 a.m.- 300
p.m. PROGRAM

• Wednesday, March 20, 2002
• 515 p.m.- 800 p.m.
• PROGRAM

• Session 2 Goals
• School-based teams refine goal statements to
  include outcome and process goals that include
  criteria/indicators for determining success.
• Participants plan implementation strategies
  appropriate to the goals and criteria/indicators
  for determining success.
• Participants understand their
  responsibilities for implementation, budget
  management, evaluation, and reporting.
• Faculty consultants and graduate students
  are assigned to, and understand their
  consultation responsibilities for, each team for
  2002-2003.

• Session 1 Goals
• Participants understand and support the
  purpose of the
  Addressing Barriers to Learning
  initiative.
• Participants become aware of successful
  and promising school-based projects.
• Participants strengthen their commitments
  to support their
  
  
  
  respective school-based projects.

815 Continental Breakfast 845 Todays
Agenda Carl E. Paternite, Department of
Psychology, MU 900 Assessing Progress
Suggestions for Consideration Doris Bergen,
Department of Educational Psychology,
MU 930 Focusing Projects on Desired Conditions
and Outcomes Knowing What You Want Alex
Thomas, Department of Educational Psychology,
MU 1000 Work Session with Consultants 1100 Choo
sing Strategies that Earn Desired Outcomes Ray
Witte, Department of Educational Psychology,
MU 1130 Lunch 1230 Work Session with
Consultants 115 Question and Answer
Session Whole Group 145 Cross-team
Conversation Teams are paired up to describe
their projects and receive constructive input on
their projects 230 Budget Procedures and Next
Steps Carl E. Paternite 245 Evaluation and
Adjournment Julia Pemberton, Graduate Assistant,
Institute for Ed. Renewal
515 Reception - Highlights of 2001-2002
Programs 545 Welcome and Networking
Dinner Carl E. Paternite, Miami University
Center for School-Based Mental Health
Programs 700 Under Pressure! Lakota East High
School Students with Advisor, Sue
Bateman 730 Under Pressure! Question and
Answer Session with Under Pressure!
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Addressing Barriers to Learning Evaluation of
2002 Training Conference Mean ratings for each
training component (scale 1 low/no usefulness
5 very useful) Evening Session (25-26
respondents) Highlights of 2001-02
Projects 4.0 Networking dinner 4.4
Youth group performance 4.8 Full-day Session
(30-32 respondents) Assessing progress 3.6
Desired conditions and outcomes 4.1 Work
session with consultants 1 4.5 Strategies
that earn desired outcomes 4.0 Work session
with consultants 2 4.5
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• Addressing Barriers to Learning Current
  Elementary School Action Projects
• School-wide project focused on increasing
  students positive social skills, using monthly
• themes and activities (open house nights,
  assemblies, community speakers). Parent
• involvement in planning and implementation is
  emphasized.
• School-wide project focused on trait of the
  month themes (e.g., responsibility, caring)
• and activities (community service projects,
  fund raising for needy families, school-based
• counseling groups, after school activities,
  peer mediation program).
• School-wide attendance enhancement program,
  through improved monitoring, enhanced
• parental involvement with an after
  school/evening tutoring program linked to family
• dinner/activity events, and an attendance
  reward program.
• School-wide outreach program to families (The
  Road Show) taking school informational
• meetings into neighborhoods and communities,
  to overcome obstacle of the
• geographically large catchment area and to
  increase family sense of engagement with the
• school.

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• Addressing Barriers to Learning Current
  Elementary School Action Projects (contd)
• A violence reduction program, focused on
  development of resource materials and use of
• psychoeducational training in coping skills
  and strategies for at risk students.
• School-wide family engagement project
  emphasizing literacy, through school-based
• reading night dinner programs with
  storytellers and opportunities for families to
  read
• together.
• School-wide parent involvement and support
  program focused on attention to needs of
• families, efforts to increase positive
  attitudes toward learning, and enhancement of
  social
• skills of students, using community picnics
  and Parents on Board parenting classes.
• School-wide program focused on understanding and
  appreciating difference, tolerance,
• and conflict resolution skills, using
  curricula from the Center for Peace Education.

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• Addressing Barriers to Learning Current High
  School Action Projects
• Mentoring program focused on academic and
  personal success
• of students, including a strong community
  service component.
• Alternative high school service learning program
  incorporating
• intensive involvement with a senior citizens
  center and tutoring in
• an elementary school.

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• Addressing Barriers to Learning Training in the
  Project Evaluation Process
• Determine goals and objectives.
• Determine data needed to measure desired
  outcomes.
• Select measurement methods.
• Outline data collection plan.
• Collect data.
• Compile, analyze, interpret, and report results.
• Refine project based on findings.
• Note Dr. Doris Bergen (Miami University Center
  for Human Development, Learning, and
• Teaching) has provided ongoing technical
  assistance on the evaluation process.

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Addressing Barriers to LearningLevels of
Evaluation Evaluation expected on two or more
of the four levels Level 1 -- Records on
planned activities. Level 2 -- Self-report data
from participant groups on knowledge,
attitudes, behaviors. Level 3 -- Outcome data
on student effects (attendance, office
referrals, grades). Level 4 -- Systematic
observational data on behavior change
related to objectives of project. Note Dr.
Doris Bergen (Miami University Center for Human
Development, Learning, and Teaching) has provided
ongoing technical assistance on the evaluation
process.
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• Addressing Barriers to Learning Linking Project
  Objectives to Evaluation
• The Road Show
• Objectives
• Increase family involvement with school
• Increase student attendance
• Decrease discipline referrals
• Evaluation Plan
• Number of positive/negative calls to school
• Road show attendance rates and parent survey
• Attendance at parent conferences
• Student attendance rates
• Student discipline referrals

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Closing Observations

• Clearly, intellectual, social, and emotional
  education go hand-in-hand, and all are linked to
  creating safe schools, building healthy
  character, and achieving academic success
• The proper aim of education is to promote
  significant learning. Significant learning
  entails development. Development means
  successively asking broader and deeper questions
  of the relationship between oneself and the
  world. This is as true for first graders as it is
  for graduate students, for fledgling artists as
  graying accountants.
• A good education ought to help people
  become more perceptive to and more discriminating
  about the world seeing, feeling, and
  understanding more, yet sorting the pertinent
  from the peripheral with ever finer touch,
  increasingly able to integrate what they see and
  to make meaning of it in ways that enhance their
  ability to go on growing. To imagine otherwise,
  to act as though learning were simply a matter of
  stacking facts on top of one another, makes as
  much sense as thinking one can learn a language
  by memorizing a dictionary. Ideas only come to
  life when they root in the mind of a learner.
  (Daloz, 1999, p. 243)

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Closing Observations

• The need for increased attention to mental health
  promotion on behalf of youth, is quite clear
• We have a burgeoning field of developmental
  psychopathology but have a more diffuse body of
  research on the pathways whereby children and
  adolescents become motivated, directed, socially
  competent, compassionate, and psychologically
  vigorous adults. Corresponding to that, we have
  numerous research-based programs for youth aimed
  at curbing drug use, violence, suicide, teen
  pregnancy, and other problem behaviors, but lack
  a rigorous applied psychology of how to promote
  youth development.
• The place for such a field is apparent to
  anyone who has had contact with a cross section
  of American adolescents. (Larson, 2000, p. 170)

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Closing Observations

• Certainly, educators are key partners in efforts
  to intervene with children in need and to promote
  development.
• In fact, through their day-to-day interactions
  with students, educators are the linchpins of
  school-based efforts to encourage healthy
  psychological development of youth.