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Identifying Mental Health and Substance Abuse Problems of Children and Youth

Chapter 1: Prevention and Early Identification of Children's and Adolescents’ Mental Health and Substance Use Problems

1. The term "mental health" in this paper addresses:

A. Whether and to what extent children and adolescents are diagnosed with mental disorders

B. How children and adolescents think, feel, and act as they face the challenges of life

C. How well balanced children and adolescents are

2. Almost _____ percent of U.S. children and adolescents have a diagnosable mental health or addictive disorder that affects their ability to function.

A. 12

B. 18

C. 21

D. 26

E. 31

3. According to this paper, some factors that can contribute to a higher risk of developing mental health or substance use problems include:

A. Having family members are living with conditions such as depression or other mental health disorders

B. Having developmental disabilities and chronic medical conditions

C. Questions of sexual orientation or gender identity

D. All of the above

E. A and B above

4. According to this protective factors such as ______________ can help prevent certain kinds of problems from developing in children and adolescents.

A. Family stability

B. Supportive and nurturing relationships

C. A strong community

D. Faith organizations

E. All of the above

5. Children and adolescents in families that have experienced significant losses may face greater challenges to healthy development than those without such losses.

A. True

B. False

6. According to this paper, a few key interventions are used to help children, adolescents, and families cope with mental health and substance use problems.

A. True

B. False

7. Prescribed medication to treat a child’s or adolescent’s mental health problem usually should ___________.

A. be combined with other interventions as part of a comprehensive treatment plan

B. be considered the best form of intervention.

C. always be carefully monitored

D. A and B above

E. A and C above

Chapter 2: Understanding the Identification Process and Tools

8. Caregivers are usually the first to recognize early signs of problems in their children.

A. True

B. False

9. Child-serving organizations must ALWAYS seek informed parental consent to identify or address possible mental health or substance use problems of the children and adolescents participating in their programs.

A. True

B. False

10. Every identification initiative has three elements:

A. Assessment, intervention and treatment

B. Identification, assessment, and intervention and/or treatment

C. Identification, intervention and treatment

11. A screening tool is ___________.

A. A simple psychological exam administered by a licensed psychologist

B. A chemical analysis of saliva or blood that screens for the presence of drugs and/or alcohol

C. A brief list of questions relating to a youth’s behavior, thoughts, and feelings

12. An assessment should be conducted by a qualified, experienced mental health or substance abuse professional.

A. True

B. False

13. The goal of identifying children and adolescents with a high likelihood of having mental health and substance use problems is ____________.

A. To provide early warning of potential problems as the child gets older

B. To provide an appropriate intervention

C. To connect the youths and their families with assessment and treatment resources

D. All of the above

E. B and C above

14. Which of the following is NOT one of the five Principles Guiding Screening for Early Identification of Mental Health and Substance Use Problems in Children and Adolescents discussed in this paper include?

A. First, do no harm.

B. Obtain informed consent.

C. Use a scientifically sound screening process.

D. Alert appropriate authorities such as child protective services.

E. Link to assessment and treatment services.

15. A 2005 randomized controlled trial involving more than 2,000 students found that asking about suicide does not increases the probability that a youth will attempt it.

A. True

B. False

16. Which of the following assertions does this paper make about fears caregivers may have regarding mental health treatment?

A. Caregivers may have fears about mental health treatment and may resist any efforts to identify mental health problems in their children.

B. Caregivers may express concerns about medication.

C. Caregivers may have little accurate information about mental health and substance abuse treatment.

D. All of the above.

E. A and B above.

17. Sometimes the identification of mental health or substance use problems can cause a youth to be excluded from their social group and cultural communities. To help counter this the paper suggests _________.

A. Partnering with representatives from these communities to identify potentially negative consequences that could arise from early identification.

B. Helping the youth find other, more supportive social groups to join.

C. Providing professional counseling for the youth on how do deal with such situations.

18. According to this paper, parents who have given consent for their child or adolescent to be screened do NOT have be informed when the screen indicates a possible problem.

A. True

B. False

19. Information about a youth's mental health or substance use problems is subject to laws regarding confidentiality, even if it was not collected by a mental health or substance abuse professional.

A. True

B. False

20. People who are not mental health or substance abuse professionals can employ two basic methods to identify children and adolescents with a mental health or substance use problem:

A. Requesting an assessment by a qualified individual.

B. Become familiar with signs of mental health and substance use problems.

C. Administering a scientifically validated screening tool.

D. A and B above

E. B and C above

21. When it comes to mental health and substance abuse issues identification is NOT diagnosis.

A. True

B. False

22. A child’s or adolescent’s behavior or appearance can provide signs of a mental health or substance use problem.

A. True

B. False

23. According to this paper, signs of some problems either may be actively concealed from adults or may not be readily apparent. Examples of such problems are:

A. Depression

B. Bulimia

C. Early stages of substance use

D. All of the above

E. B and C above

24. Organizations should clearly define the goals they want to achieve through an identification process ___________.

A. before selecting a method of identification

B. in order to make sure they are on the right path

C. before they design a prevention program

25. According to this paper, tertiary prevention is focused on __________.

A. the entire population of children and adolescents

B. the small percentage of children and adolescents with known problems or whose behavior indicates they are likely to have mental health or substance use problems

C. those children and adolescents who have entered the criminal justice system

26. Secondary prevention is focused on children and adolescents who are in groups known to have an elevated risk for mental health or substance use problems. Which of the following is NOT one of the ways to identify this group?

A. Behavior or functioning

B. High-risk life situations

C. Racial or cultural affiliation

D. Traumatic events

E. Sexual orientation

27. According to this paper, the most common conditions that arise in the birth to age 5 group of children include:

A. Autism

B. Hyperactivity

C. Oppositionality

D. All of the above

E. B and C above

28. For children aged 6-12 the most common conditions that arise include:


B. Psychosis

C. Trauma from neglect

D. A and C above

E. A and B above

29. Which one of the following disorders commonly arises in both adolescents (13-22) and children aged 6-12?

A. Eating disorders

B. Depression and other mood disorders

C. Substance abuse disorders

D. Conduct problems

30. When selecting a screening tool that best supports the goals selected for early identification, which of the following are good questions to ask?

A. What are the ages of the children and adolescents being served?

B. What kinds of problems are being identified, and how will the information be used?

C. What level of validity and reliability is needed?

D. All of the above

E. A and B above

31. When evaluating a screening tool it is important to consider the level of validity and reliability necessary. In this context reliability ______.

A. Is a measure of the consistency in scores for the same youth by different raters using the same tool

B. Describes what the tool measures and how well it does so

C. Both A and B above

D. Neither A or B above

32. Identification tools listed in this paper all have acceptable levels of validity and reliability. Other than these two properties, the most useful dimensions to consider when selecting among them are their

A. Sensitivity

B. Specificity

C. Range

D. Tolerance

E. A and B above

33. Which of the following assertions is made in this paper make regarding who should complete a screen?

A. Parents and caregivers are the most accurate informants for adolescents’ externalizing problems (such as substance use and oppositional behavior).

B. Adolescents themselves more accurately identify internalizing problems (such as depression and anxiety).

C. If the only available informant does not know the youth well, less reliance should be placed on the results of the screen.

D. All of the above

E. A and B above

34. Only mental health or substance abuse professionals should administer a screening tool.

A. True

B. False

35. You can administer more than one tool to provide a more comprehensive screening program, but it is not valid to combine parts of different tools into one screen or omit items from a tool.

A. True

B. False

36. When using a screening tool with a target population other than native English speakers, important questions to consider include:

A. Is there an appropriate translation of the tool into the intended respondent's language?

B. Does the tool accurately account for cultural beliefs, values and norms of the target population?

C. What can be learned from using a screening tool that has not been fully tested with a particular linguistic or cultural group?

D. All of the above

E. A and B above

37. This paper contains two tables listing screening tools identified by experts as meeting best practice criteria. Things to consider when using the tables include:

A. Reading level required

B. Translations available

C. Settings where tool has been studied

D. All of the above

E. B and C above

Chapter 3: Key Steps of Early Identification

38. Which of the following statements accurately reflect what is said in this paper regarding obtaining informed parental consent?

A. A child-serving organization must have in place clearly written procedures for obtaining informed parental consent to screen a child.

B. In health care settings, no additional procedures are necessary.

C. Procedures should identify specific circumstances in which the information will be shared with other service providers.

D. All of the above

E. A and C above

39. In emergency situations involving mental health or substance use problems, it is permissible to identify, assess, and treat a youth without obtaining parental consent.

A. True

B. False

40. When communicating about children’s and adolescents’ mental health and substance use to people from different cultures, program staff and volunteers must _________.

A. always be sure to speak to the father first if he is available

B. be able to convey respect and avoid unintentional disrespect

C. clear about what the issues are from the dominant culture's perspective

41. If your 500 student school is using a screening tool that is known to identify between 5% and 8% of children from a general population and you have limited treatment resources available you best choice is to:

A. Screen all 500 students at once

B. Screen the students in two groups of 250 each

C. Screen two homerooms of students a month during the 9 month school year

42. According to this paper, communicating concerns about warning signs or positive screening results to caregivers is imperative unless adolescents are exercising their rights as mature minors or young adults.

A. True

B. False

43. When a youth meets standards for service as a mature minor or is a young adult, caregivers must NOT be informed of screening results without the express consent of the mature minor or young adult.

A. True

B. False

Chapter 4: Partnering for Resources

44. Examples of people who are qualified to diagnose mental health and substance use problems include:

A. Social worker or counselor (master’s level)

B. Psychologist (master’s level or doctoral level)

C. Physician or psychiatrist

D. Licensed substance abuse counselor

E. All of the above

45. According to this paper, families and youth often feel that peers are the only source of support that comes without blame or shame.

A. True

B. False

46. Potential partners in a program to identify and support children and youth with mental health and drug use problems noted in this paper include:

A. Faith communities

B. Law enforcement agencies

C. Local mental health associations

D. All of the above

E. A and C above

47. Child-serving organizations can work together with mental health and substance abuse providers in a number of ways to link an early identification program to assessment and treatment, including __________.

A. Consultation

B. Collaboration

C. Colocation

D. All of the above

E. A and B above

Supplement 1: Child Welfare

48. According to this paper, an estimated 267,000 children were removed from their homes in 2008 as a result of child maltreatment investigations.

A. True

B. False

49. When working with abused and/or neglected children and adolescents, a best practice is ___________.

A. prompt screening

B. immediate reporting

C. getting the child or youth back into the family setting as soon as possible

50. A joint policy statement of AACAP and CWLA recommends that screenings should occur when a child or adolescent enters foster care and every time there is a change in placement.

A. True

B. False

Supplement 2: Early Care and Education

51. It is estimated that 70 percent to 80 percent of children with significant developmental and behavioral difficulties have already had problems identified by the time they enter kindergarten.

A. True

B. False

52. This paper states that Children in early care and education settings should be screened at minimum _________________.

A. every two years

B. once a year

C. twice a year

53. It can be helpful to use both a parent version and a teacher version of a screening tool to develop a more detailed and multidimensional picture of the child.

A. True

B. False

Supplement 3: Family, Domestic Violence, and Runaway Shelters

54. According to this paper, of children and adolescents ages 6–17 who are homeless __________ compared to about 20% of other youths.

A. almost 33 percent has at least one major mental health disorder that interferes with daily activities

B. close to 50 percent has problems with anxiety, depression, or withdrawal

C. more than 33 percent manifest delinquent and aggressive behavior

D. All of the above

E. A and C above

55. Psychological trauma is one of the most pressing mental health issues for many children and adolescents in shelters.

A. True

B. False

Supplement 4: Juvenile Justice

56. Which of the following information statements is made in this section of the paper regarding youths in the juvenile justice system?

A. Youths from certain racial and ethnic groups are disproportionately represented in the juvenile justice system compared to their representation in the country as a whole.

B. Many of these youths have committed only minor offenses.

C. A small percentage of these youths have not committed any offense.

D. All of the above

E. B and C above

57. Justice facilities should have protections in place so that ________________.

A. Information provided by youths in an intake screen cannot be used in support of current or future charges

B. Facilities do not ask questions by which youths may self-incriminate

C. A and B above

Supplement 5: Mental Health and Substance Abuse

58. Things that can help to identify and treat children and youth with both mental health and substance use problems include:

A. Cross training mental health and substance abuse professionals

B. Using screening tools to help clinicians identify co-occurring disorders efficiently

C. Using screening tools to gather information from informants other than the children and adolescents themselves, particularly regarding externalized problems

D. All of the above

E. A and B above

Supplement 6: Primary Care

59. Primary care providers participating in state Medicaid child health programs through the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program are legally required to provide comprehensive health screening services.

A. True

B. False

Supplement 7: Schools and Out-of-School Programs

60. Schools will have greater success if they obtain consensus and community support for the goals of an identification initiative.

A. True

B. False

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