A comparison of children with serious emotional disturbance served in residential and school settings

The National Adolescent and Child Treatment Study (NACTS) was designed to study children identified and served by the public mental health and special education systems as seriously emotionally disturbed. Children (N=812) and their parents (N=740) participated in the first wave of data collection in this longitudinal study. Subjects lived in six states, with approximately half in psychiatric residential treatment centers and the other half in public school special education programs. A multi-method, multi-source methodology was employed. The sample is characterized by externalizing problems, poor adaptive functioning, and substantial academic deficits. Residential children were more likely to have blended families, were more likely to have previously received residential treatment, and had higher rates of conduct disorder, anxiety, and attention deficit disorder, as measured by the Diagnostic Interview Schedule for Children. The two groups did not differ on intelligence, age of onset, or rates of schizophrenia or depression. The data suggest the presence of greater at-risk factors in the residential group and different paths of entry into special education and residential treatment programs.