Effectiveness of Day Treatment
EFFECTIVENESS OF DAY TREATMENT WITH PROCTOR CARE
Effectiveness of Day Treatment with Proctor Care for Young Children:
A Four-Year Follow-up
Erin Whitemore
Monica Ford
William H. Sack, M.D.
Morrison Center Child and Family Services
Portland, Oregon
Accepted for publication in the Journal of Community Psychology, April 7th, 2003, to be
published September 2003.
Reprint Requests should be sent to:
Erin Whitemore
Hand In Hand Day Treatment
11456 NE Knott, Portland OR 97220
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Effectiveness of Day Treatment
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Abstract
This study evaluated the immediate and long-term outcomes of a day treatment and proctor care
model for preschool-aged children. Seventy-seven boys and 52 girls completed the program
which combined day treatment, case management, individual and family therapy. Also, 60% of
these clients were placed in proctor care homes which are short-term family placements
providing in-home treatment. Results showed there was increased stabilization in family
placements, with 67% of participants still living in a permanent family placement at the 4 year
follow-up. Also, 69% of participants transitioned to a less restrictive academic placement and
remained in regular classroom placements at follow-up. Participants showed significant
behavioral improvement at discharge and follow-up on the Child Behavior Checklist.
Participants also showed significant developmental improvement on the Battelle Developmental
Inventory and the Expressive One Word Vocabulary Test. The results suggest that this treatment
modality is effective in maintaining these children in the community and in producing positive
long-term outcomes.
Key Indexing Words: behavior disorders, children, day treatment, treatment foster care
Effectiveness of Day Treatment
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Effectiveness of Day Treatment with Proctor Care for Young Children:
A Four-Year Follow-up
A growing body of literature indicates that day treatment can be an effective alternative
to residential treatment for children with serious emotional and behavioral problems (Erker1,
Searight, Amanat & White, 1993; Grizenko2, Papineau & Sayegh, 1993; Grizenko3, Sayegh, &
Papineau, 1994; Sack4, Mason & Collins, 1987). Day treatment as an alternative to institutional
treatment is consistent with the philosophy of providing treatment in the least restrictive
environment appropriate to a child’s needs. In addition, the day treatment approach enables
children to remain living in a family environment, and is more compatible with family
preservation policies. Day treatment (without adjunct “wrap-around” services) is also
considerably less expensive than residential treatment or hospitalization. As managed care and
cost cutting efforts continue to reduce the availability of residential and inpatient resources, the
effectiveness of day treatment is increasingly being challenged by an influx of severely disturbed
children who previously would have been served in institutions.
Placement options for preschool-aged children with behavior problems continue to be
limited. A common misconception is that children typically do not demonstrate severely
disturbed behaviors as early as 3-4 years of age. However, a significant number of young
children have multiple placement failures due to their behavior problems (Dore5 & Eisner, 1993).
Treatment professionals are hesitant to place these children in residential treatment at such a
young age, and the residential placements are simply not available in most systems (Erker et al.,
1993). But these children are difficult to manage in the community and a more restrictive setting
is frequently sought when a child’s needs overwhelm the capacity of the community placement
provider. A child’s ability to remain in the community ultimately rests with the capacity of the
placement resource to provide a safe and stable place to live. Two of the most common sources
Effectiveness of Day Treatment
4
of disruption to a community placement are the child’s aggression and impulsivity (Dore and
Eisner, 1993).
Fortunately, great strides have been made during the past two decades in developing
systems of care to better enable families to maintain seriously disturbed children in community
placements. Treatment foster care has been studied fairly extensively and has been demonstrated
to be an effective treatment model for seriously disturbed children (Friedman6, 1989; Hudson7,
Nutter & Galaway, 1994; Meadowcroft8, Thomlison, & Chamberlain, 1994). The day treatment
combined with treatment foster care has not been studied, but it was also designed to better
maintain seriously disturbed children in community placements. The Hand in Hand program
refers to our treatment foster care program as ‘proctor care’.
The day treatment with treatment foster care model shares many of the features of
treatment foster care programs summarized by Hudson et al. (1990): (1) proctor parents are
recruited specifically to provide treatment to a population of children with special challenges; (2)
proctor parents are compensated at a higher rate than traditional foster parents; (3) proctor
parents receive extensive training and support; (4) proctor parents function as professional
members of the treatment team; and (5) the children served by the day treatment/proctor program
would otherwise be admitted to non-family, institutional settings. One fundamental difference
between a day treatment/proctor program and the treatment foster care only model is that the
proctor home exists to support the day treatment program, which remains the primary treatment
milieu. In treatment foster care programs, the home environment is the primary treatment
milieu.
Children receiving treatment in the Hand in Hand program receive year round day
treatment services and some children also are placed in proctor care. We believe that day
Effectiveness of Day Treatment
5
treatment and proctor care are powerful interventions alone, but the greatest positive effect
occurs when these services are combined. Our placement process is not random and we are
unable to test this assumption directly. The decision to place a child in a proctor home occurs
when a child has had a series of placement failures, has clinical need and there is an opening in
proctor care. Also, the move to a proctor home may occur at the beginning of treatment or
anytime during treatment. This lack of initial equivalence of the day treatment only group and
the day treatment plus proctor care group as well as the heterogeneity in the proportion of time
children spend in proctor care violate the assumptions of most statistical tests making it
impossible to compare the treatment methodologies.
The present study examined the outcome of a day treatment/proctor care treatment
program for preschool-aged children. We compared children’s admission and discharge test
scores on standardized measures of behavior, school functioning, and development. A four-year
follow-up of the same cohort of children examined their long-term adjustment with regard to
living situation, and school functioning.
Method
Participants
The sample consisted of 77 boys and 52 girls ranging in age between 2 and 6 years of age
at admission (M=50 months, SD=9.5 months) served in Hand in Hand between 1988 and 1999.
Sixty-four percent of the sample was European-American, 16% were African-American, 1 %
were Asian-American, 2% were Native-American and 16% were multi-racial. Almost all of the
participants had experienced some form of abuse based on therapist interviews, chart/case
review: 70% had been physically abused, 54% had been sexually abused, with 80% of these
experiencing severe levels of molestation. 91% had been physically neglected and 72% had
Effectiveness of Day Treatment
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experienced multiple forms of abuse. Nearly all of the children had at least one parent with a
history of criminal arrests and 96% were children of chronic substance abusers. Ninety-six
percent of the children had lived in poverty. At intake, 16% of children’s birth parents had had
their parental rights terminated. Most children were wards of the court (72%). Children had an
average of 2.8 foster placements prior to admission and had spent an average of 36% of their
lives in foster care. Participants exhibited both severe behavioral impairments as well as
developmental delays on standardized measures. At 85% had at least 1 score in the clinical range
on the Achenbach Teacher Report Form. Furthermore, 88% of children had at least 1 subscale in
the clinical range on the Achenbach Child Behavior Checklist. On the Battelle Developmental
Inventory 94% of children had one or more subscales in the clinical range, demonstrating
significant delay.
Setting and Treatment
Day Treatment. The Hand in Hand Day Treatment program, located in Portland, Oregon,
provides mulitmodal treatment for young children with severe behavioral problems. The
program consists of four hours of milieu therapy each day (for 230 days per year) that includes
special education, intensive case management, academic and developmental skill building, and
individual and family therapy.
Proctor Care
Proctor Care is a time limited transition living placement that accompanies Day
Treatment for some participants. This service is for children exhibiting extreme behaviors likely
to cause multiple foster care placement failures, or render the child extremely difficult or
unappealing to parent. Proctor homes provide safe, predictable and consistent nurturing
environments where treatment plans are implemented in concert with Day Treatment. Proctor
Effectiveness of Day Treatment
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parents are carefully screened for the presence of certain risk factors, including chemical
dependency and criminal history. Standardized screening instruments are used to screen for
psychopathology (Psychological Screening Index, Lanyon, 1968), risk for child abuse (Child
Abuse Potential Inventory, Milner,1990), and marital discord (Dyadic Adjustment Scale,
Sharpley & Cross, 1982).
Proctor parents are an essential part of the treatment team, participating in developing
and implementing treatment plans. Treatment staff and proctor parents work together in treating
the child, with staff providing support and ongoing training to parents throughout treatment.
Proctor parents work with the staff to monitor progress and adjust treatment and behavior
management as needed. Treatment provided in the milieu is supported and reinforced by
treatment in the home. This ‘hothouse’ approach provides 24 hour care and treatment for clients
requiring this level of intervention.
Funding
Day treatment is funded through state general funds for those children not eligible for
Medicaid. For Medicaid eligible children are funded by a combination of Federal Medicaid
dollars and Oregon general funds. Ten of the day treatment slots are funded by Multnomah
county business and income tax. Proctor care is funded through a blend of federal Medicaid
dollars and Title 4E foster care dollars, in addition to State of Oregon Department of Human
Services placement allocations.
The Hand in Hand Day Treatment and Proctor Care program costs significantly less than
residential treatment. In Oregon, Day treatment costs about $135 per day for 230 days per year.
Proctor care at Hand in Hand is an additional $67 per day for 365 days per year. So one year in
Effectiveness of Day Treatment
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day treatment plus proctor care costs about $55,574. The cost of residential treatment in
Multnomah County is $260 per day. The total then for a year of residential treatment is $95,000.
Measures
Measures included demographic and historical information, behavioral testing,
developmental testing and functioning in the community. A questionnaire concerning the child
and family history was completed, which included abuse and placement history and family
criminal and substance abuse history. Behavior was measured using the Achenbach Teacher
Rating Form (TRF) and the Achenbach Child Behavior Checklist(CBCL). Both instruments are
standardized measures of externalizing and internalizing behaviors. To measure cognitive
development three measures were used. The Battelle Developmental Inventory (BDI) is a
standardized assessment of developmental skills in children. Language skills were measured
using the Peabody Picture Vocabulary Test (PPVT replaced by the Receptive One-Word Picture
Vocabulary Test in 1994). Both are individually administered measures of a child’s ability to
understand spoken language. The Expressive One-Word Picture Vocabulary Test Revised
(EOW) was also used which measures a child’s ability to express in words the content of a
stimulus picture. Both the ROW and the EOW have been normed on a sample of over 1000
English speaking children.
Procedure
At 30 days after admission, therapists completed the questionnaire concerning
participants’ abuse and family history (n=129). The development measures were completed
within 2 months of admission by special education teachers with extensive contact with the
clients and again within 30 days of discharge by the same rater (BDI n=57, EOW n=84, ROW
n=7, PPVT n=60). The TRF was completed 8 weeks after intake by the child therapist and again
Effectiveness of Day Treatment
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at discharge by the same rater (n=94). Neither teachers nor therapists were blind to the clients’
participation in a proctor care. The CBCL was completed by the primary caregiver (that client
was living with) within 30 days of intake and repeated at discharge. Some clients changed living
placement during treatment, but CBCL’s were only used when the same rater completed the
measure at both intake and discharge (n=57).
All graduates received day treatment that included an average of 27 individual therapy
sessions (sd=26.5), 34 speech sessions (sd=52.24) and 17 family therapy sessions (sd=21.4) and
length of treatment averaged 627 days. Additionally, 60% of the participants were placed in
proctor care and the average length of stay there was 567 days, with most proctor clients
spending over 90% of their treatment time in both day treatment and proctor care. During
treatment, 32% of children were prescribed psychiatric medication to help manage impulsivity,
depression, anxiety and psychosis. See Table 1 for medications prescribed at discharge.
Participants’ families were contacted by phone four years after discharge and asked a
series of questions regarding the child’s functioning at home and at school. Families were also
asked to complete the CBCL and the forms were mailed to them. Of the 129 clients completing
the program, 80 had reached the 4 year follow-up at the time of analysis, and 53 (66%) were
found for the 4 year follow-up. Some families were unavailable for follow-up due to relocation
in and out of state. Out of 53 caretakers contacted for the follow-up, 29 completed CBCL’s for
this study.
Results
Three quarters (76%) of children who entered treatment successfully completed the
program (n=99) and 16% (n=21) of participants’ parents initiated early termination, 8% (n=10)
Effectiveness of Day Treatment
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of early transitions were initiated by the program and one client left treatment early due to
placement out of state. Only graduates were included in the following analyses for two reasons.
Pre-post comparisons are designed to assess the effectiveness of treatment, and only graduates
received the complete treatment. Secondly, clients who terminated early were much less likely to
be available for post-testing, so were unlikely to have the same rater for comparison. Analyses
suggest that graduates were no different than non-graduates in terms of risk factors and intensity
of behavior problems at intake.
Children generally experienced increased stabilization in their family placement over
time (Figure 1). While only 2% of children were in adoptive homes at intake, over 40% were in
adoptive placements at graduation. Similarly, despite histories of academic challenges, most
participants transitioned into less restrictive school placements at discharge (Figure 2), with only
15% transitioning to day or residential treatment. Fifty-seven percent of participants changed
family placements during treatment. Additionally, half of birth parents’ rights were terminated
during treatment.
By the end of treatment, children displayed improvement in behaviors at home and in the
treatment milieu. Comparisons were made using the raw scores as is suggested by the CBCL
manual (Achenbach, 1991). A repeated measures MANOVA was performed, comparing intake
and discharge scores on the subscales of the CBCL, revealing a significant interaction of test
point and subscale, F(7,791)=10.746, p<.001. Univariate tests showed significant improvement
on the aggression subscale, externalizing scale and the overall sum (Table 2). Compared to 88%
of children at intake, significantly fewer participants (72%) had at least one subscale score in the
clinical range at graduation (the clinical range for the CBCL and TRF is a subscale t-score
greater than 70 or a scale t-score greater than 63). A repeated measures MANOVA was
Effectiveness of Day Treatment
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performed, comparing intake and discharge scores on the subscales of the TRF also. There was a
significant interaction of test point and subscale, F(9,113)=7.031, p<.01. Univariate contrasts
revealed that participants demonstrated statistically significant improvement at graduation on the
attention subscale of the TRF (Table 3). Seventy-seven percent of participants had at least one
subscale score in the clinical range at graduation, compared with 85% at intake (not a statistically
significant difference).
In addition to behavioral improvements, participants also demonstrated significant
developmental gains. A repeated measures MANOVA was performed, comparing intake and
discharge scores on the subscales of the BDI. There was a significant interaction of test point and
subscale, F(1,56)=25.640, p<.01. Univariate comparisons revealed statistically significant
improvement on the personal-social and adaptive subscales, and on total score (Table 4).
Compared with 94% at intake, significantly fewer participants (74%) had at least one subscale in
the clinical range at graduation (p<.05). Improvement in language skills was demonstrated on
the PPVT, t(59)=5.66, p<.001 and on the EOWPVT, t(84)=11.725, p<.001 (Table 5).
At the 4-year follow-up, functional outcomes and behavior were assessed. Participants
continued to show stability in family and school placements. While only 2% of children were in
adoptive homes at intake, nearly 65% were in adoptive placements at the 4-year follow-up. Of
the clients who had been adopted at discharge, only 12% were no longer at that placement at the
4-year follow-up. Additionally, 75% remained in regular school placements, with 53% in
regular classrooms with no special education services, 16% in regular classrooms with special
education resources and 6% in self-contained special education classrooms at follow-up. Less
than half of the families in the follow-up completed the CBCL preventing a statistical
Effectiveness of Day Treatment
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comparison of posttest and follow-up subscale scores. But only 45% of participants in the
follow-up had at least one CBCL subscale in the clinical range, compared with 85% at intake.
Discussion
The participants treated in the program have extensive histories of abuse and neglect.
Given their experiences of home instability, securing long-term placement for these children is
difficult. The program was successful in assisting state case workers in finding adoptive
placements for two-thirds of participants and decreasing the placement failure rate of this
population. Similarly, although participants showed aggressive behaviors at intake, most were
being maintained in regular classrooms at the 4-year follow-up. Participants demonstrated
significant improvement in behavioral functioning at discharge and behavioral improvement was
maintained at follow-up. Also, significant developmental gains were made over the course of
treatment. Participants’ language skills improved as well, with discharge scores in the average
range.
Unfortunately, the interpretability of these positive outcomes is difficult due to several
weaknesses in the design. The absence of a suitable control group in the current study prevents
ruling out alternative explanations, such as maturation effects. That said, the tremendous
developmental gains shown by clients are extremely unlikely to occur as a result of maturation.
Children entered treatment with language scores in the 25th percentile and graduated significantly
above average. Also, although the day treatment/proctor care model is an alternative to
residential treatment, no comparison between these two treatment models was performed. It is
difficult to know how these outcomes compare with typical outcomes of residential treatment for
preschool age children as so little research exists. That only 7% of participants transitioned to
Effectiveness of Day Treatment
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residential treatment though suggests that the day treatment/proctor care model may be an
effective treatment at a less restrictive level of care. Additionally, the loss of one third of the
participants from the follow-up limits the generalizability of the results, although analyses reveal
that ‘lost’ participants were no different from ‘found’ participants in terms of family risk factors,
behavior and developmental functioning though.
An important limitation of the study is that the active ingredients of the intervention
cannot be deconstructed. Specifically, no comparisons could be made between children receiving
day treatment alone and those receiving day treatment plus proctor care. These two groups are
not initially equivalent, as children in proctor care typically have more extensive abuse histories
and are more likely to have parents whose rights have been terminated. Also, some participants
enter proctor care during treatment due to foster care placement failures. So the effectiveness of
day treatment alone cannot be determined. This methodological limitation is often unavoidable
in ecologically valid studies. Random assignment of living placement or the creation of an
untreated control group are not possible or ethical for this population, for whom placement is
determined by many factors and stakeholders.
In the long-term follow-up, the percentage of children in stable family and school
placements is consistent with the findings of previous research (Erker, Searight, Amanat, &
White, 1993). More thorough and complete long-term follow-up is necessary to determine if
these positive outcomes are maintained through childhood. The use of psychometrically sound
pretest and posttest measures is a strength of the current study. Also, while it could be argued
that behavioral improvements and developmental gains are due to maturation, the fact that
measures are normed for age, controls for this possibility. Regression to the mean may also
Effectiveness of Day Treatment
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account for some of the improvement seen, but the stability of these improvements at the 4 year
follow-up suggests that improvements are the result of treatment interventions.
Clearly much more research is needed with preschool age children which addresses
treatment options that keep children in the community. Emerging research exists that suggests
that residential care may not be best practice with latency-aged children, and there’s reason to
think that these findings apply to preschool-aged children as well. Investigations should focus on
more treatment interventions like the day treatment/proctor care model as alternatives to
residential treatment. Community-based treatment options are sorely needed for these children
for whom securing permanent family placements is so vital.
Effectiveness of Day Treatment
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References
Achenbach, T.M. (1991). Manual for the Teacher’s Report Form and 1991 Profile.
Burlington, VT: University of Vermont Department of Psychiatry.
Erker,G.J., Searight, H.R., Amanat, E., & White, P.D. (1993). Residential versus day
treatment for children: A long-term follow-up study. Child Psychiatry and Human
Development, 24, 31-39.
Grizenko, N, Papineau, D. & Sayegh, L. (1993). Effectiveness of a multimodal day treatment
program for children with disruptive behavior problems. Journal of American
Academy of Child and Adolescent Psychiatry, 32, 127-134.
Grizenko, N.,Sayegh, L., & Papineau, D. (1994). Predicting outcome in a multimodal day
treatment program for children with severe behavior problems. Canadian Journal of
Psychiatry, 39, 557-562.
Sack, W.H., Mason, R., & Collins, R. (1987). A long-term follow-up study of a children’s
psychiatric day treatment center. Child Psychiatry and Human Development, 18, 5868.
Dore, M.M., & Eisner, E. (1993) . Child-related dimensions of placement stability in
treatment foster care. Child and Adolescent Social Work Journal, 10, 301-317.
Friedman, R.M. (1989). The role of therapeutic foster care in an overall system of care:
Issues in service delivery and program evaluation. In R. Hawkins & H. Beiling (Eds.),
Therapeutic foster care: Critical Issues Washington DC: Child Welfare League of
America.
Effectiveness of Day Treatment
16
Hudson, J., Nutter, R. W., & Galaway, B. (1992). Evaluation research on the treatment foster
care programs serving youth: a review and suggested directions. Toronto, Canada;
Laidlaw Foundation.
Meadowcroft, P., Thomlison, B., & Chamberlain, P. (1994). Treatment foster care services:
Research agenda for child welfare. Child Welfare, 73, 565-581.
Lanyon, R.I., (1970). Development of a psychological screening inventory. Journal of
Consulting & Clinical Psychology, 35, 24.
Milner, J.S., (1990). Additional cross-validation of the child abuse potential inventory.
Psychological Assessment, 1, 219-223.
Sharpley, C.F., & Cross, D.G. (1982). A psychometric evaluation of Spanier Dyadic
Adjustment Scale. Journal of Marriage and the Family, 44, 739-741.
Effectiveness of Day Treatment
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Effectiveness of Day Treatment
Questions:
1. include these references.
18
Effectiveness of Day Treatment
Table 1
Percentage of clients prescribed medication during treatment
Medication
Percentage Receiving Medication
Anti-Depressant
8.2%
Anti-Psychotic
5.1%
Stimulant
26.5%
Anti-Anxiety
4.1%
Other Medications
9.2%
Percentage of Clients Receiving Any Medication
32.0%
______________________________________________________________________________
19
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Table 2
Mean and Standard Deviations of CBCL Subscale Raw Scores and T-Scores at Intake and
Discharge (n=59)
______________________________________________________________
Intake
Discharge
Raw Scores
T-Scores
Raw Scores
T-Scores
M
(SD)
M
M
(SD)
M
Withdrawn
5.08
3.66
63.39 10.65
3.68
3.40
59.29 9.94
Somatic Complaints
1.58
2.37
56.47 8.02
.97
1.83
54.10 6.37
Anxious
6.66
5.15
60.56 9.67
5.81
5.18
59.10 9.58
Social Problems
5.34
3.14
65.20 10.65
4.58
3.16
62.37 10.82
Thought Problems
2.86
2.49
64.63 9.92
1.90
2.43
60.03 10.46
Attention Problems
9.14
5.00
67.89 11.90
7.25
4.51
63.76 10.22
Delinquent
4.86
3.33
64.53 9.41
4.12
3.86
61.46 10.44
Aggressive
21.73 8.96
71.85 12.93
17.07 10.11 65.64 13.75
Total Sum
68.24 28.40 69.39 9.23
52.31 31.36 63.36 11.53
Internalizing
12.66 8.74
9.92
(SD)
60.32 11.76
8.54
(SD)
56.17 12.20
Externalizing
26.59 11.51 68.63 10.47
21.19 13.22 63.00 12.72
______________________________________________________________________________
*** Raw scores were used in statistical tests for all subscales and t scores were used in
comparisons for total and scale scores (Achenbach, 1991).
Effectiveness of Day Treatment
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Table 3
Mean and Standard Deviations of TRF Subscale Raw Scores and T-Scores at Intake and
Discharge (n=75)
________________________________________________________________________
Intake
Discharge
Raw Scores
T-Scores
Raw Scores
T-Scores
M
(SD)
M
(SD)
M
(SD)
M
Withdrawn
7.36
4.15
67.8
10.79
6.00
3.21
64.08 8.07
Somatic Complaints
.48
1.03
52.8
5.37
.45
.98
52.55 4.82
Anxious
11.01 5.94
65.52 8.47
11.27 6.59
65.83 9.03
Social Problems
7.83
4.2
66.41 8.44
7.27
4.30
65.71 7.37
Thought Problems
2.35
2.38
63.12 9.66
1.6
2.37
59.23 9.88
Attention Problems
18.44 7.99
62.87 8.15
13.57 8.87
58.4
Delinquent
2.57
59.15 7.07
2.79
59.91 7.45
Aggressive
19.16 12.79 66.09 11.45
19.73 11.95 66.33 10.83
Total Sum
67.97 25.66 67.45 7.13
60.04 28.76
64.97 8.30
Internalizing
17.92 8.35
16.43 8.57
65.12
8.07
Externalizing
21.73 14.40 64.51 9.61
22.52 13.53 64.88
9.23
2.27
66.16 8.02
2.40
(SD)
8.08
_____________________________________________________________________________
*** Raw scores were used in statistical tests for all subscales and t scores were used in comparisons for total and
scale scores (Achenbach, 1991).
Effectiveness of Day Treatment
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Table 4
Mean and Standard Deviations of BDI Subscale Scores at Intake and Discharge
_____________________________________________________________________________
Intake
M
(SD)
Discharge
M
(SD)
Subscales
Personal-Social (N=68)
28.47 4.80
32.53 7.10
Adaptive (N=67)
30.18 6.29
35.96 10.38
Motor (N=67)
38.74 9.60
43.04 11.49
Communication (N=60)
35.88 8.58
40.04 9.00
Cognitive (N=69)
39.02 9.62
43.67 10.37
Total (57)
30.68 5.93
35.91 9.17
_____________________________________________________________________________
Effectiveness of Day Treatment
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Table 5
Mean and Standard Deviations of Language Measures at Intake and Discharge
_____________________________________________________________________________
Intake
Discharge
M
(SD)
M
(SD)
PPVT (n=60)
81.67
14.19
91.02
13.05
ROWPVT (n=7)
92.71
14.95
102.00
6.66
EOWPVT (n=84)
87.96
12.84
102.28
13.24
PPVT- Peabody Picture Vocabulary Test
ROWPVT- Receptive One Word Picture Vocabulary Test
EOWPVT- Expressive One Word Picture Vocabulary Test
Effectiveness of Day Treatment
Figure 1
Family placement at discharge.
90%
80%
70%
Intake
Termination
Follow-up
60%
50%
40%
30%
20%
10%
0%
Living w/Birth
Family
Parent's Rights
Termnated
Living w/Adoptive
Family
24
Effectiveness of Day Treatment
Figure 2
School placement at discharge
Day
Treatment
8%
Res
Treatment
7%
None
6%
Preschool
20%
Spec Ed
37%
Elementary
18%
Other
4%
25