Externalizing behavior disorders in child welfare settings: Definition, prevalence, and implications for assessment and treatment

The literature examining the externalizing behavior disorders of youth in child welfare settings reveals a general consensus regarding the severity and nature of these problems. Unfortunately, there is not agreement as to the operational definition of externalizing problems. The authors propose an operational definition in light of the existing literature and DSM-IV-TR criteria and then summarize the prevalence rates of externalizing problems in child welfare settings found across several investigations. The authors assert that this population is difficult to target for assessment and treatment due in part to the heterogeneity of the specific types of behavior problems exhibited by this group. A variety of behavior rating scales, diagnostic interviews, and instruments used for subtyping externalizing behavior disorders are reviewed with a discussion of their psychometric properties and practical utility in child welfare settings. The heterogeneity found among these youth suggests the need for a more comprehensive and dynamic assessment and treatment model, such as the multi-gating approach used by The Conduct Problems Prevention Research Group.