Enhancing No Child Left Behind-School Mental Health Connections
The authors examine the inherent challenges for students, caregivers, educators, and school mental health professionals that result from the goals of No Child Left Behind, including increased accountability for student performance, expanded parental options and information, a focus on teacher qualifications, fiscal flexibility, and an emphasis on using strategies and programs demonstrating an empirical basis of effectiveness. Finally, they present ideas for the 2 broad goals developed by meeting participants as they relate to the recommendations and future directions to improve the No Child Left Behind school mental health interface.
By Daly, Brian P; Burke, Robert; Hare, Isadora; Mills, Carrie; Et al
The No Child Left Behind Act of 2001 (PL107-110) was signed into law by President George W. Bush in January 2002 and is regarded as the most significant federal education policy initiative in a generation.' Enactment of the No Child Left Behind Act represented a radical shift in the nation's educational focus and goals and also has significant ramifications for the role of school mental health. The goals of the No Child Left Behind Act include increased accountability for student performance, expanded parental options and information, a focus on teacher qualifications, fiscal flexibility, and an emphasis on using strategies and programs demonstrating an empirical basis of effectiveness. The primary focus of the No Child Left Behind Act is on promoting educational success for all children; however, the legislation also contains opportunities to advance school mental health.2
Unfortunately, the complexities of the provisions of the No Child Left Behind Act have made it difficult for educators, stakeholders, and mental health professionals to understand the legal and practical interface between the No Child Left Behind Act and the school mental health movement. This confusion has contributed to a lack of progress in developing effective strategies that connect the goals, provisions, and timelines of the No Child Left Behind Act with school mental health and has resulted in a narrow focusing of resources to curriculum and instruction in many communities.
In response to the need to delineate links between No Child Left Behind and school-based mental health, the Center for School Mental Health Assistance at the University of Maryland School of Medicine (now the Center for School Mental Health Analysis and Action, see http:// csmha.umaryland.edu) sponsored a critical issues meeting in February 2004 that focused on connections between the No Child Left Behind Act and the school mental health movement. Participants in the meeting included experts in school mental health, education, mental health, and other child-serving systems at local, state, and national levels; family advocates; and federal officials. The Center for School Mental Health Assistance and a companion center at the University of California, Los Angeles (http://smhp. psych.ucla.edu), are funded by the Maternal and Child Health Bureau of the Health Resources and Services Administration, with cofunding from the Center for Mental Health Services of Substance Abuse and Mental Health Services Administration.
The purpose of the meeting was to engage the above experts and stakeholders in a facilitated conversation on the interface between No Child Left Behind and training, practice, research, and policy in school mental health. The meeting resulted in the articulation of 2 broad goals: (1) to raise awareness about the challenges educators and school mental health professionals face as a result of the implementation of the No Child Left Behind Act and (2) to provide strategic recommendations to advance the interface between No Child Left Behind and school mental health, which will support key provisions of the act and the growth of the field.
In the following, we examine the inherent challenges for students, caregivers, educators, and school mental health professionals that result from the goals of No Child Left Behind, including increased accountability for student performance, expanded parental options and information, a focus on teacher qualifications, fiscal flexibility, and an emphasis on using strategies and programs demonstrating an empirical basis of effectiveness. Finally, we present ideas for the 2 broad goals developed by meeting participants as they relate to the recommendations and future directions to improve the No Child Left Behindschool mental health interface.
Accountability for Student Performance
One of the hallmarks and major challenges to school mental health of the No Child Left Behind Act is the nearly exclusive focus on improving students' academic achievement. This singular focus is emphasized through a reliance on outcome measures that examine student achievement and progress. For example, the markers used to determine acceptable levels of achievement and progress include state-determined proficiency levels for reading and mathematics, student performance goals, and standardized test scores. Schools are required to document adequate yearly progress, providing yearly results of their standardized testing programs. The No Child Left Behind Act establishes a progression of increasingly intensive contingencies for schools, particularly title 1 schools, for failing to make adequate yearly progress.' If a school fails to meet adequate yearly progress criteria for 2 or more years, the school is subsequently classified as in need of improvement and is then subject to the contingencies. The Council for Exceptional Children, noting the insistence on outcome measures, indicates that one of the most significant ways No Child Left Behind will affect policy is through the requirement for adequate yearly progress for all students in both general and special education.3
Notably, nonacademic outcomes for youth, such as the development of positive social and emotional competencies, are not directly addressed in the No Child Left Behind Act. Although academic achievement represents an important variable in the determination of successful outcomes for children and youth, it represents only 1 of many variables that contribute to positive youth development. For example, research has consistently demonstrated the positive role of social and emotional competencies toward successful youth outcomes, including academic achievement.4,5 Many scholars have suggested that in order to improve achievement, students' social and emotional functioning, along with their academic functioning, needs to be addressed.6,8
Although No Child Left Behind contains language that promotes educational success for all children, when put into practice in many communities it has resulted in a preponderant allocation of funds earmarked exclusively for academic purposes. Therefore, children with mental health needs often do not receive the support and services they require. The combination of the exclusive focus on academic enhancement and the absence of accountability indicators for social and emotional growth and development among students is likely to hinder efforts aimed at academie achievement. For example, the National Institute of Mental Health reports that between 5% and 9% of children (2.5-5.0 million) are not learning and achieving in school because of emotional and behavioral barriers.9 Current research indicates that over one-half of the adolescents in the United States who fail to complete their secondary education have a diagnosable psychiatric disorder and that the proportion of failure to complete school that is attributable to psychiatric disorder is estimated to be 46%.10 These findings underscore the need for integrated efforts that reduce both academic and nonacademic barriers, and participants in the critical issues meeting agreed that thus far, No Child Left Behind is not promoting these integrated efforts.
Beyond the lack of funds earmarked for addressing nonacademic barriers to learning, another feature of the No Child Left Behind Act is that it does not mandate funding for specific programs per se. This lack of specificity in directing how and where funds should be allocated can result in confusion and further diversion of funds away from school mental health services. Further, the No Child Left Behind Act does not provide clear guidelines to assist families, schools, and organizations in determining how best to utilize the designated funds for issues related to school mental health needs. This lack of direction represents a major challenge in articulating common interpretations for allocating funds, which again should reflect an integrated agenda to reduce academic and nonacademic barriers to learning.
A major challenge to enhancing the No Child Left Behind-school mental health connection is that the American public is generally not knowledgeable about either. When community members are knowledgeable about the legislation, the focus is usually on its academic and performance pressures. Few community members recognize the numerous mental health issues and opportunities in No Child Left Behind (reviewed in the next section), pointing to the need for education and activities to raise awareness of this interface.
Role of Teachers
Barriers to teacher participation in mental health promotion for students represent another significant challenge. Teachers often are the first persons outside of the family who encounter students in need of mental health services. However, such early identification followed by timely and appropriate referral to mental health professionals remains very much the exception not the rule. Overall, prekindergarten through 12th grade public school teachers, especially those in general education classrooms, represent a vast, yet untapped, resource in the field of integrated mental health/ education. Unfortunately, one of the major barriers to teacher participation in the advancement of school mental health is the lack of training teachers receive regarding child/adolescent mental health issues. For example, other than professional preparation programs in certain special education certification areas (eg, behavioral disorders, emotional disturbance), preservice teacher education is generally devoid of curricular content related to child/ adolescent mental health. If teachers do receive such content, it tends to be minimal and/or very general, as in taking a Psychology 101 class in college. If teachers were more knowledgeable about mental health, they would be in a better position to advocate for integrated approaches that capitalize on No Child Left Behind opportunities.
The lack of longevity in the teaching profession represents another obstacle. For example, among the ranks of those teachers beginning their careers in education, data indicate that the rate of attrition is alarming; currently, about 10% of all new teachers resign prior to the end of the first year, about 35% do so by the end of their third year of full-time employment in schools, and nearly 50% leave the profession within the first 5 years." Thus, the mental health of teachers is another glaring unmet need that might serve as an entry point for school mental health programs to assist in responding to the No Child Left Behind mandate for highly qualified teachers in every classroom.
Staff and interdisciplinary collaboration also proves difficult in the school setting. Specifically, 2 major factors make the work of system and staff integration in schools challenging and complex. First, long-standing patterns of territoriality and separate or competing agendas by individuals, agencies, and professional organizations perpetuate the current fragmentation that exists within and among the professional education and mental health communities. For example, educators and mental health staff have distinct separate professional preparation, generally participate in discipline-specific professional training, and often have job descriptions that do not promote interdisciplinary collaboration. This pattern of systemic organizational structure and functioning is a major impediment to advancing an integrated education/mental health agenda. Further, this pattern disables efforts to provide a seamless continuum of mental health promotion and intervention services that are seen as essential precursors to actualization of educational opportunities for children.
Within the field of mental health, there is a high degree of overspecialization, which impedes collaboration. For example, within psychology there is often considerable separation, and at times turf issues, between the specialties of school, clinical, and counseling psychology; yet in reality, these practicing psychologists often are serving the same youth and performing similar functions in schools.12 second, there are diverse knowledge bases in education, special education, child mental health, community development, and advocacy that should be mastered for effective interdisciplinary practice in the schools. These issues highlight a compelling need to enhance interdisciplinary training for educators, mental health and other child system staff, and families on effective school mental health promotion and intervention, needs that are being overshadowed by realities in implementing No Child Left Behind.
In response to the multiple challenges resulting from the implementation of the No Child Left Behind Act, we propose opportunities available through focusing on changing perspectives, available service provisions and funding streams, community and family outreach, school and teacher outreach, and professional collaboration.
OPPORTUNITIES AND STRATEGIES
In order for large-scale progress to occur in integrating education and mental health needs and overcoming an exclusive focus on academic enhancement, a holistic ecological perspective must be adopted. In short, any changes made within the schools will be of marginal consequence unless parallel changes are enacted in the local, state, and national policy-making communities. The President's New Freedom Commission on Mental Health Report, Achieving the Promise: Transforming Mental Health Care in America specifically recommends increasing access to mental health services through schools.'1 The report states that "to fulfill the promise of [the No Child Left Behind Act], schools must work to remove the emotional, behavioral, and academic barriers that interfere with students' success in school" and that "growing evidence shows that school mental health programs improve educational outcomes by decreasing absences, decreasing discipline referrals, and improving test scores ..." (p. 62). Specifically, the commission made several compelling recommendations in support of school mental health, with 1 of 19 recommendations, 4.2 to "improve and expand school mental health programs."
As mentioned, a focus on academic enhancement designed to meet adequate yearly progress requirements will not achieve its desired goals unless an integrated approach to the reduction of academic and nonacademic barriers to learning is taken, as emphasized by the New Freedom Commission in recommendation 4.2. A comprehensive goal such as 4.2 can be accomplished only through school community collaborations to expand and improve the range of school mental health programs and services available to youth.14,16 An additional critical dimension is advocacy for school mental health that must be framed in relation to promoting outcomes valued by communities including improved school performance, student behavior, school climate, achievement of adequate yearly progress by the schools, and improved school safety. To increase the pace of the work, channels for communication/collaboration should be enhanced between national organizations and resources, including federal resources, focusing on mental health in schools, state-level coalitions and initiatives (as in the Ohio Mental Health Network for School Success, http:// www.units.muohio.edu/csbmhp/network.html),17 and local communities. This work is beginning to happen through the important leadership of federal agencies, national centers, and broad collaborates such as the Individuals with Disabilities Education Act (IDEA) Partnership supported by the Office of Special Education Programs and housed at the National Association of State Directors of Special Education (see http://www.ideapartnership.org).
Available Service Provisions and Funding Streams
Anglin's analysis of No Child Left Behind in the context of other federal support for school mental health concludes that:
Full implementation of the multiple components of this legislation can help schools to identify larger numbers of students with mental health needs, build the service capacity for meeting these needs, and encourage schools to work collaboratively with their communities. Programs developed by the education sector under the auspices of the No Child Left Behind Act have the potential to implement the school-based action steps recommended by the Report of the Surgeon General's Conference on Children's Mental Health. Most importantly, they have the potential to increase children's and adolescents' access to mental health services and reduce the unmet need for them.2
Additionally, through No Child Left Behind's connection to the IDEA, there are other funding streams that can be used to support school mental health.18 For example, in IDEA, as reauthorized in 2004 with final regulations pending, there is a strong emphasis on effective intervention prior to referring a student to special education. Quality school mental health programs serve this prereferral function, and there also is evidence to suggest that these programs effectively divert youth from special education placement resulting in, among other benefits, significant cost savings to school systems.19
Community and Family Outreach
Outreach to, and empowerment of, families to better understand and advocate for the interface between No Child Left Behind and school mental health also is needed. Such outreach is beginning to occur in conjunction with national conferences in education that have focused on No Child Left Behind; however, in general these meetings would benefit from an informed and expanded focus on the academic achievement/mental health interface. School mental health conferences, family-focused conferences, and other relevant meetings in education and child mental health should be used as vehicles to empower families to become more involved in planning, advocacy, and decision making related to the mental health dimensions of the No Child Left Behind Act.20,21 Beyond training conferences and meetings, mechanisms are needed for states and communities to reach out effectively to families and involve them in education-mental health system integration and improvement as in the Shared Agenda Initiative of the IDEA Partnership and federal and national collaborators (see http://www.ideapartnership.org).22,23
School and Teacher Outreach
At the level of the school building, an important reprioritization is the enhancement of the mental health focus of school improvement activities. One possible avenue to achieve this goal is for school mental health professionals to make school leaders aware of the mental health services provided and demonstrate how such services can help both address students' needs and improve academic achievement. These kinds of services must be integrated into overall school improvement efforts so that mental health is regarded as an essential dimension of schools and schooling.
The promotion of expanded teacher training, including in-service presentations, represents a strategic opportunity to help better prepare teachers to identify mental health issues relevant for their students and make appropriate referrals. Given the intensified pressures on teachers and school administrators resulting from the academic performance standards of the No Child Left Behind Act, roles for school mental health programs in providing support to staff members also should be expanded. Such support is consistent with national models of school health such as the coordinated school health approach and is consistent with the increasing ecological and contextual focus of school mental health programs in the United States and, more prominently, in other countries.24,25 Further, as previously stated, teacher retention is a growing and critical concern. The availability of school mental health professionals and programs represents an important building-level support system for teachers and other school staff in the many challenges they face.
One initiative attempting to address the issue of barriers to teacher participation in mental health is the Mental Health Education Integration Consortium, which, through an interdisciplinary and integrated approach, is seeking to enhance training for teachers and mental health professionals in order to enhance professional collaboration. A beginning task to promote collaboration, which the Mental Health Education Integration Consortium is pursuing, is to develop a common language of key terms and concepts in the school-based mental health-No Child Left Behind interface. For example, defining key terms with explanations in the No Child Left Behind legislation, including descriptions of the specific ways in which school mental health programs can enhance implementation and promote the achievement of desired outcomes. Beyond language, venues are needed for the diverse stakeholders in the No Child Left Behind-school mental health interface to come together at national, state, and local levels. Additional strategies to enhance efforts to improve collaboration and system integration in the advancement of school mental health include (a) ensuring that programs are indeed based on empirically supported approaches and (b) monitoring their effectiveness and documenting positive impacts in realms important for families and schools, such as improved grades, attendance, and student behavior. While there is some literature to suggest that these outcomes are attained when programs and services are implemented in the correct manner (ie, collaborative, with school and family input, empirically supported, emphasizing quality), this is an area in need of critical inquiry and enhancement. A number of groups including the IDEA Partnership, the Mental Health Education Integration Consortium, the Center for School Mental Health Assistance, and the Collaborative for Academic, Social, and Emotional Learning are pursuing this agenda.26-28
RECOMMENDATIONS AND FUTURE DIRECTIONS
Over the past 2 decades, school mental health has grown progressively in the United States. The pace of this growth is likely to increase related to a number of factors, including (a) advancing technical assistance, training, and advocacy; (b) a growing research literature underscoring advantages and benefits; (c) support provided through the President's New Freedom Initiative; and finally (d) increasing international effort and collaboration.25,29,30
Promote Technical Assistance, Training, and Advocacy
No Child Left Behind can, and should, be framed as federal legislation that provides additional support for the development of school mental health in the United States. Given the growth of the field, its interdisciplinary nature reflecting knowledge bases of diverse disciplines, and much activity at the federal, state, and local levels, there is a need for a single source of information on stateof-the-art developments and resources in the field. In essence, this would serve as a map of the field, answering questions of who (eg, person, agency, organization) is doing what work (eg, policy, research, clinical) at what level (eg, local, state, national) and in what settings (eg, prekindergarten-12 public schools, juvenile justice).
Research- and evidence-based practices must be more closely examined and more widely distributed. Any effort to market and build support for school mental health programs rests on evidence that the programs are indeed leading to the achievement of No Child Left Behind-related and other outcomes desired by schools and communities. Advocacy, policy improvement, and resource enhancement are critical to provide school-based programs with adequate training, technical assistance, and ongoing support to ensure that empirically supported and evidencebased practices can be implemented and adequate training, resources, and uninterrupted support to conduct ongoing program evaluation, with findings contributing to continuous quality improvement actions. As more programs become increasingly grounded in empirically supported practices and more evidence of positive outcomes is accumulated, fuel to advance the pace of advocacy, policy improvement, and resource enhancement will be provided.31 Already, sufficient data exist to provide a strong position statement on the importance and power of schoolbased mental health to achieve critically valued outcomes. The emerging School Mental Health Alliance, a consortium of organizations supported by a number of foundations, has developed a brief and powerful consensus statement on school-based mental health that is being used to educate and involve others in school-based mental health (http:// www.kidsmentalhealth.org).
Disseminate Research Literature
A related activity under this opportunity would be to organize literature and resources on empirically supported and effective school-based mental health and to make this information broadly accessible to diverse school and community stakeholders. For example, manuscripts, reports, and newsletters should be written for distinct categories of professionals such as principals and teachers in general education classrooms, whose work is impacted by No Child Left Behind. In the advocacy arena, the research literature could be recast in the form of abstracts, briefing papers, etc and disseminated to legislators and other policy makers in ways driven by the best knowledge in social marketing.
Given the interdisciplinary nature of school mental health, there is a need to develop a "metalevel community of practice." Such a community of practice would bring together diverse groups including federal agencies, national centers, professional organizations, coalitions, state and regional centers, family and youth advocacy organizations, and organizations of legislators and others. Together, this community of practice could share information on goals and activities; engage in collaborative planning, training, and research; and pursue the development of a unified information source as recommended above. Importantly, it could advance multiscale learning systems,32,33 involving the sharing of information and collaboration to advance training, practice, research, and policy in school mental health at local, state, and national levels. In this system, learning and collaboration occur at all levels, for example, between national and federal, between national and state, between local and local, between local and state, between local and national. In essence, this community of practice would move toward a coordinated agenda to integrate education, mental health, and other child-serving systems in the advancement of effective school mental health promotion nationwide. Such an initiative also would help to address the policy impediments associated with federalism and would connect to similar initiatives involving school mental health promotion in other countries.30 Fortunately, at the time of this writing this community of practice in school mental health is being developed, through the participation of over 60 organizations, many states, and numerous federal agencies, with convening and supportive functions to the community being provided by the IDEA Partnership and the Center for School Mental Health Assistance.
In conclusion, working to enhance the interface between No Child Left Behind and school mental health offers the chance to improve responsiveness to the legislation, propel the growth and improvement of field, and, most importantly, improve the academic achievement and life success of students, the primary aim of the No Child Left Behind Act and of the school mental health movement.
1. No Child Left Behind Act of 2001. Available at: http://www/ed/ gov/legislation/ESEA02. Accessed August 30, 2004.
2. Anglin T. Mental health in schools: programs of the federal government. In: Weist MD, Evans SW. Lever NA, eds. Handbook of School Mental Health Programs: Advancing Practice and Research. New York, NY: Kluwer Academic/Plenum Publishers; 2003:89-106.
3. Learning First Alliance. Every child learning: safe and supportive schools, 2001. Available at: http:// www.learningfirst.org/publications/safeschools/. Accessed August 30, 2004.
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9. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General-Executive Summary. Rockville, Md: U.S. Department of Health and Human Services; 1999.
10. Stoep AV, Weiss NS, Kuo ES, Cheney D, Cohen P. What proportion of failure to complete secondary school in the US population is attributable to adolescent psychiatric disorder? J Behav Health Serv Res. 2003;30:119-124.
11. Burke RW, Myers BK. Our crisis in children's mental health: frameworks for understanding and action. Special Theme Issue of Childhood Education. 2002;78:258-260.
12. Waxman RP, Weist MD, Benson DM. Toward collaboration in the growing education-mental health interface. Clin Psychol Rev 1999;19:239-253.
13. New Freedom Commission on Mental Health. Achieving the Promise: Transforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, Md: New Freedom Commission on Mental Health; 2003.
14. Adelman HS, Taylor L. School-community relations: policy and practice. In: Fishbaugh MSE, Berkeley TR, Schroth G, eds. Ensuring Safe School Environments: Exploring Issues-seeking Solutions. Mahwah, NJ: Lawrence Erlbaum; 2003:23-43.
15. Weist MD, Evans SW, Lever NA. Advancing mental health practice and research in schools. In: Weist MD, Evans SW, Lever NA, eds. Handbook of School Mental Health: Advancing Practice and Research. New York, NY: Kluwer Academic/Plenum Publishers; 2003:1- 8.
16. New Freedom Initiative. Available at: www.mentalhealthcommission.gov. Accessed September 12, 2004.
17. Ohio Mental Health Network for School Success. Available at: www.mh.state.ohio.us. Accessed September 15, 2004.
18. Weist MD, Goldstein J, Evans SW, et al. Funding a full continuum of mental health promotion and intervention programs in the schools. J Adolesc Health. 2003;32:70-78.
19. Bruns EJ, Walrath C, Siegel MG, Weist MD. School-based mental health services in Baltimore: association with school climate and special education referrals. Behav Modif. 2004;28:430-439.
20. Center for School Mental Health Assistance (CSMHA). Available at: http://csmha.umaryland.edu. Accessed August 30, 2004.
21. Federation of Families for Children's Mental Health. Available at: http://www.ffcmh.org. Accessed September 12, 2004.
22. Shared Agenda Initiative of the National Association of State Directors in Special Education. Available at: http:// www.nasdse.org. Accessed September 12, 2004.
23. National Association of State Mental Health Program Directors. Available at: http://www.nasmhpd.org. Accessed August 30, 2004.
24. The Coordinated School Health Approach. Available at: http:// www.cdc.gov, http://www.ashaweb.org. Accessed August 30, 2004.
25. International Alliance for Child and Adolescent Mental Health and Schools. Available at: http://www.intercamhs.org. Accessed September 12, 2004.
26. IDEA Partnership. Available at: http://www.nasdse.org. Accessed September 15, 2004.
27. Mental Health Education Integration Consortium (MHEDIC). Available at: http://csmha.umaryland.edu. Accessed August 30, 2004.
28. Collaborative for Academic, Social, and Emotional Learning. Available at: www.casel.org. Accessed September 12,2004.
29. World Health Organization. Available at: www.who.org. Accessed September 12, 2004.
30. Rowling L, Weist M. Promoting the growth and sustainability of school health programs worldwide. Int J Ment Health Prvmol 2004; 6:3-11.
31. Weist MD, Paternite CE, Adelsheim S. School-Based Mental Health Services. Paper commissioned by the Institute of Medicine Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders; 2005. Available from the Institute of Medicine.
32. Cashman J. Communities of practice: the human side of implementation. Presentation at the National Monitoring Academies for the Office of Special Education Programs. Baltimore, Md, July, 2003.
33. Wenger E, McDermott R, Snyder W. Cultivating Communities of Practice. Boston, Mass: Harvard Business School Press; 2002.
Brian P. Daly, PhD, Post-Doctoral Fellow (firstname.lastname@example.org). College of Health Professions, Temple University, 3307 North Broad St, 622-Jones Hall. Philadelphia, PA 19140; Robert Burke, PhD, Assistant Professor (email@example.com). Education and Allied Professions, Miami University of Ohio. Teacher Education, McGuffey Hall. 401, Oxford. OH 45056; Isadora Hare, MSW, (firstname.lastname@example.org), U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Adolescent Health. 11509 Parkedge Drive. Rockville, MD 20852; Carrie Mills, MA. Professor (email@example.com); Celeste Owens, PhD, Professor (cowens@ psych.umaryland. edu); and Elizabeth Moore, Professor (firstname.lastname@example.org). Center for School Mental Health Analysis and Action, Department of Psychiatry, University of Maryland School of Medicine. 680 West Lexington St, 10th Floor, Baltimore. MD 21201; and Mark D. Weist, PhD, (email@example.com). Director, Center for School Mental Health Analysis and Action, and Professor, Department of Psychiatry, University of Maryland School of Medicine, 737 West Uimbard St, 4th Floor, Baltimore, MD 21201.
Copyright American School Health Association Nov 2006
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Source: Journal of School Health, The
Daly, Brian P; Burke, Robert; Hare, Isadora; Mills, Carrie; Et al
J Sch Health. 2006;76(9):446-451
INDEX OF NCLB OUTRAGES