Marie Poulsen - Academia.edu (original) (raw)

Papers by Marie Poulsen

Journal of the American Academy of Child & Adolescent Psychiatry, 2007

A quality-improvement study evaluated the feasibility of training mental health providers to prov... more A quality-improvement study evaluated the feasibility of training mental health providers to provide mental health screening and relationship-based intervention to expand services for children 0 to 5 years of age in eight California county mental health systems from November 2002 to June 2003. State-level training was provided to more than 582 participants and county-level training to more than 5425 participants, including ongoing supervision. Direct services and use of collateral services were tracked. Psychiatric symptoms were screened with new Mental Health Screening and Risk Assessment tools for 388 children (mean age, 34 months). At intake and after intervention (mean of 22 visits), an index sample (93 children) were further characterized by the Diagnostic Classification for Zero to Three and DSM-IV, and parent-child relationship was characterized by the Diagnostic Classification for Zero to Three Parent-Infant Relationship Global Assessment Scale. Providers reported that 41% of their service time was directed to the parent and child together, 35% to the parent alone, and 24% to the child alone. The 93 index children and 295 children in a clinic reference sample were comparable, supporting generalizability. After intervention, Mental Health Screening and Risk Assessment scores were significantly lower. Global Assessment of Functioning scores improved (effect size, 0.35), as did the relationship (Parent-Infant Relationship Global Assessment Scale effect size, 0.16). Training mental health staff to provide treatment to infants and preschool children and families in public mental health settings is feasible and leads to an increase in numbers of children served.

ICAN: Infant, Child, & Adolescent Nutrition, 2009

... DOI: 10.1177/1941406409341077 2009 1: 197 ICAN: Infant, Child, & Adolescent Nutrition... more ... DOI: 10.1177/1941406409341077 2009 1: 197 ICAN: Infant, Child, & Adolescent Nutrition Larry Yin, Hope Wills, Noreen Clarke, Janice Shacks, Christine Bottrell and Marie K. Poulsen Cardiovascular Risk in Preschool Children Published by: http://www.sagepublications.com ...

The Journal of School Nursing, 2008

Early detection and treatment of vision disorders in children are important to avoid lifelong vis... more Early detection and treatment of vision disorders in children are important to avoid lifelong visual impairment; however, preschool vision-screening rates are low. Traditional methods of screening lack the precision of objective tests and are difficult to administer in preschoolers. This study adopted a method using school nurses to conduct vision screening in preschoolers with a portable autorefractor. In addition, the effectiveness of the school nurse in conducting follow-up was evaluated. In a sample of 600 children, more than 98% completed the screening, and 7% were referred for follow-up evaluation. Seventeen percent of parents had plans to follow-up after receiving a brochure indicating that their child would benefit from a comprehensive eye exam. However, after a conversation with the school nurse, 86% had plans to schedule an evaluation with an eye care professional. Of the 15 students with known follow-up, 10 received glasses. The described method is effective in identifying young children with potential vision problems and facilitating their correction after contact made by the school nurse.

Journal of School Health, 2009

Normal hearing during the preschool years is essential for speech, language, social, emotional, a... more Normal hearing during the preschool years is essential for speech, language, social, emotional, and preacademic development. Children of low socioeconomic status may be particularly vulnerable to the negative effects of late identification and intervention. While a mass-screening effort focused on preschool children does not have broad support, focused screening remains important to identify children at risk. This project was conducted to address 3 primary aims: develop and implement an initial hearing screen using transient evoked otoacoustic emissions (TEOAEs) for at-risk preschoolers, verify speed and tolerability of the screen, and assess the test performance of TEOAEs screening compared to pure tone audiometry in a group of 142 preschool children. A total of 744 preschool children attending preschools in an underserved, urban community completed TEOAEs screening by a school nurse. A secondary cohort of 142 children was screened first by TEOAEs and then followed by pure tone audiometry and results compared. A total of 680 children passed screening. Forty-one children (5.5%) had a "refer" result. Two-year-olds had the highest refusal rate (10.5%). Mean testing time was 43 seconds per ear. Secondary cohort analysis revealed 1 subject did not pass either TEOAEs or pure tone screening; no subject passed TEOAEs and then did not pass pure tone audiometry. TEOAEs screening test sensitivity was 1.00 (95% confidence interval 0.054-1.00) and specificity 0.94 (0.88-0.97). TEOAEs screening performed by school nurses is a fast, efficient, and feasible model. Children who pass TEOAEs screening have a very high likelihood of being free from hearing impairment. Application may be particularly relevant in underserved communities.

Issues in Comprehensive Pediatric Nursing, 2004

Children and youths with developmental disabilities (DD) have needs for more community-based serv... more Children and youths with developmental disabilities (DD) have needs for more community-based services to address ongoing health, educational, employment, housing, transportation, and recreational concerns. Secondary data analysis was conducted to examine the array of services accessed and service obstacles to primary, preventive and special health care services of 102 children and youths with developmental disabilities. The two services most frequently reported as being used by families were SSI (29.4%) and MediCal (California's Medicaid program) (27.8%). Speech therapy was the most frequently identified support service accessed by respondents (51%). Respondents identified a number of unaddressed concerns and perceived barriers to having these concerns addressed as it related to service referrals for speech therapy, nutrition services, dental services, and behavior management services.

Infant Behavior and Development, 1996

American Journal of Community Psychology, 2012

This article addresses the primary modifications necessary for system change to better meet the m... more This article addresses the primary modifications necessary for system change to better meet the mental health needs of children under the age of three. The role of risk and resiliency factors in the young child, family and community and the necessity for a comprehensive community infant-family mental health system with a focus on the whole family are addressed. Barriers to care within early childhood systems of care are examined, including stigma, community referral and collaboration, diagnostic concerns during infancy, issues around family engagement, empowerment and partnership, funding of comprehensive and well coordinated infant-family services, workforce capacity and evaluation. Recommendations for implementation of system changes at the community and federal levels are proposed.

Journal of the American Academy of Child & Adolescent Psychiatry, 2007

A quality-improvement study evaluated the feasibility of training mental health providers to prov... more A quality-improvement study evaluated the feasibility of training mental health providers to provide mental health screening and relationship-based intervention to expand services for children 0 to 5 years of age in eight California county mental health systems from November 2002 to June 2003. State-level training was provided to more than 582 participants and county-level training to more than 5425 participants, including ongoing supervision. Direct services and use of collateral services were tracked. Psychiatric symptoms were screened with new Mental Health Screening and Risk Assessment tools for 388 children (mean age, 34 months). At intake and after intervention (mean of 22 visits), an index sample (93 children) were further characterized by the Diagnostic Classification for Zero to Three and DSM-IV, and parent-child relationship was characterized by the Diagnostic Classification for Zero to Three Parent-Infant Relationship Global Assessment Scale. Providers reported that 41% of their service time was directed to the parent and child together, 35% to the parent alone, and 24% to the child alone. The 93 index children and 295 children in a clinic reference sample were comparable, supporting generalizability. After intervention, Mental Health Screening and Risk Assessment scores were significantly lower. Global Assessment of Functioning scores improved (effect size, 0.35), as did the relationship (Parent-Infant Relationship Global Assessment Scale effect size, 0.16). Training mental health staff to provide treatment to infants and preschool children and families in public mental health settings is feasible and leads to an increase in numbers of children served.

Journal of the American Academy of Child & Adolescent Psychiatry, 2007

A quality-improvement study evaluated the feasibility of training mental health providers to prov... more A quality-improvement study evaluated the feasibility of training mental health providers to provide mental health screening and relationship-based intervention to expand services for children 0 to 5 years of age in eight California county mental health systems from November 2002 to June 2003. State-level training was provided to more than 582 participants and county-level training to more than 5425 participants, including ongoing supervision. Direct services and use of collateral services were tracked. Psychiatric symptoms were screened with new Mental Health Screening and Risk Assessment tools for 388 children (mean age, 34 months). At intake and after intervention (mean of 22 visits), an index sample (93 children) were further characterized by the Diagnostic Classification for Zero to Three and DSM-IV, and parent-child relationship was characterized by the Diagnostic Classification for Zero to Three Parent-Infant Relationship Global Assessment Scale. Providers reported that 41% of their service time was directed to the parent and child together, 35% to the parent alone, and 24% to the child alone. The 93 index children and 295 children in a clinic reference sample were comparable, supporting generalizability. After intervention, Mental Health Screening and Risk Assessment scores were significantly lower. Global Assessment of Functioning scores improved (effect size, 0.35), as did the relationship (Parent-Infant Relationship Global Assessment Scale effect size, 0.16). Training mental health staff to provide treatment to infants and preschool children and families in public mental health settings is feasible and leads to an increase in numbers of children served.

ICAN: Infant, Child, & Adolescent Nutrition, 2009

... DOI: 10.1177/1941406409341077 2009 1: 197 ICAN: Infant, Child, & Adolescent Nutrition... more ... DOI: 10.1177/1941406409341077 2009 1: 197 ICAN: Infant, Child, & Adolescent Nutrition Larry Yin, Hope Wills, Noreen Clarke, Janice Shacks, Christine Bottrell and Marie K. Poulsen Cardiovascular Risk in Preschool Children Published by: http://www.sagepublications.com ...

The Journal of School Nursing, 2008

Early detection and treatment of vision disorders in children are important to avoid lifelong vis... more Early detection and treatment of vision disorders in children are important to avoid lifelong visual impairment; however, preschool vision-screening rates are low. Traditional methods of screening lack the precision of objective tests and are difficult to administer in preschoolers. This study adopted a method using school nurses to conduct vision screening in preschoolers with a portable autorefractor. In addition, the effectiveness of the school nurse in conducting follow-up was evaluated. In a sample of 600 children, more than 98% completed the screening, and 7% were referred for follow-up evaluation. Seventeen percent of parents had plans to follow-up after receiving a brochure indicating that their child would benefit from a comprehensive eye exam. However, after a conversation with the school nurse, 86% had plans to schedule an evaluation with an eye care professional. Of the 15 students with known follow-up, 10 received glasses. The described method is effective in identifying young children with potential vision problems and facilitating their correction after contact made by the school nurse.

Journal of School Health, 2009

Normal hearing during the preschool years is essential for speech, language, social, emotional, a... more Normal hearing during the preschool years is essential for speech, language, social, emotional, and preacademic development. Children of low socioeconomic status may be particularly vulnerable to the negative effects of late identification and intervention. While a mass-screening effort focused on preschool children does not have broad support, focused screening remains important to identify children at risk. This project was conducted to address 3 primary aims: develop and implement an initial hearing screen using transient evoked otoacoustic emissions (TEOAEs) for at-risk preschoolers, verify speed and tolerability of the screen, and assess the test performance of TEOAEs screening compared to pure tone audiometry in a group of 142 preschool children. A total of 744 preschool children attending preschools in an underserved, urban community completed TEOAEs screening by a school nurse. A secondary cohort of 142 children was screened first by TEOAEs and then followed by pure tone audiometry and results compared. A total of 680 children passed screening. Forty-one children (5.5%) had a "refer" result. Two-year-olds had the highest refusal rate (10.5%). Mean testing time was 43 seconds per ear. Secondary cohort analysis revealed 1 subject did not pass either TEOAEs or pure tone screening; no subject passed TEOAEs and then did not pass pure tone audiometry. TEOAEs screening test sensitivity was 1.00 (95% confidence interval 0.054-1.00) and specificity 0.94 (0.88-0.97). TEOAEs screening performed by school nurses is a fast, efficient, and feasible model. Children who pass TEOAEs screening have a very high likelihood of being free from hearing impairment. Application may be particularly relevant in underserved communities.

Issues in Comprehensive Pediatric Nursing, 2004

Children and youths with developmental disabilities (DD) have needs for more community-based serv... more Children and youths with developmental disabilities (DD) have needs for more community-based services to address ongoing health, educational, employment, housing, transportation, and recreational concerns. Secondary data analysis was conducted to examine the array of services accessed and service obstacles to primary, preventive and special health care services of 102 children and youths with developmental disabilities. The two services most frequently reported as being used by families were SSI (29.4%) and MediCal (California's Medicaid program) (27.8%). Speech therapy was the most frequently identified support service accessed by respondents (51%). Respondents identified a number of unaddressed concerns and perceived barriers to having these concerns addressed as it related to service referrals for speech therapy, nutrition services, dental services, and behavior management services.

Infant Behavior and Development, 1996

American Journal of Community Psychology, 2012

This article addresses the primary modifications necessary for system change to better meet the m... more This article addresses the primary modifications necessary for system change to better meet the mental health needs of children under the age of three. The role of risk and resiliency factors in the young child, family and community and the necessity for a comprehensive community infant-family mental health system with a focus on the whole family are addressed. Barriers to care within early childhood systems of care are examined, including stigma, community referral and collaboration, diagnostic concerns during infancy, issues around family engagement, empowerment and partnership, funding of comprehensive and well coordinated infant-family services, workforce capacity and evaluation. Recommendations for implementation of system changes at the community and federal levels are proposed.

Journal of the American Academy of Child & Adolescent Psychiatry, 2007

A quality-improvement study evaluated the feasibility of training mental health providers to prov... more A quality-improvement study evaluated the feasibility of training mental health providers to provide mental health screening and relationship-based intervention to expand services for children 0 to 5 years of age in eight California county mental health systems from November 2002 to June 2003. State-level training was provided to more than 582 participants and county-level training to more than 5425 participants, including ongoing supervision. Direct services and use of collateral services were tracked. Psychiatric symptoms were screened with new Mental Health Screening and Risk Assessment tools for 388 children (mean age, 34 months). At intake and after intervention (mean of 22 visits), an index sample (93 children) were further characterized by the Diagnostic Classification for Zero to Three and DSM-IV, and parent-child relationship was characterized by the Diagnostic Classification for Zero to Three Parent-Infant Relationship Global Assessment Scale. Providers reported that 41% of their service time was directed to the parent and child together, 35% to the parent alone, and 24% to the child alone. The 93 index children and 295 children in a clinic reference sample were comparable, supporting generalizability. After intervention, Mental Health Screening and Risk Assessment scores were significantly lower. Global Assessment of Functioning scores improved (effect size, 0.35), as did the relationship (Parent-Infant Relationship Global Assessment Scale effect size, 0.16). Training mental health staff to provide treatment to infants and preschool children and families in public mental health settings is feasible and leads to an increase in numbers of children served.