Fall 2021 Social-Emotional Screening Tool and Opt-Out Information

  • In order to address the social and emotional well-being of children and youth in ACPS amid the current coronavirus (COVID-19) pandemic, ACPS plans to survey students in grades three through twelve between September 7, 2021, and October 15, 2021. The information will be used by ACPS schools solely to implement universal and targeted supports and interventions addressing the social-emotional well-being of students.

    ACPS will be using the core components of the UCLA Brief COVID-19 Screen for Child/Adolescent Post-Traumatic Stress Disorder (PTSD), developed by the Regents of the University of California. This is a self-report survey that collects data on the impact of the coronavirus pandemic on children and adolescents. The screening instrument is used widely by a range of professionals in child-serving systems such as behavioral health, pediatrics, schools, and child welfare. The survey will take about 15 minutes for students to complete. The survey will be delivered through SchoolNet, an online assessment platform with which ACPS students are familiar.

    It is important for parents or guardians to know:

    • The screening instrument does not formally diagnose PTSD in children and adolescents.
    • The instrument screens a child and adolescent’s risk level given displayed information.
    • All of the questions have been reviewed by the division and are deemed appropriate for use with students in grades three through twelve.
    • You have the right to opt-out your child. Your child may also opt out on the day the survey is given.

    You may review the questions below. There are no foreseeable risks associated with your student completing the survey. Per the Code of Virginia § 22.1-79.3., please note the following:

    • Access to the results of the survey will be limited to those who directly serve the student (e.g. classroom teacher, school counselor, nurse, psychologist, or social worker, principal)
    • The data will only be used to inform programming and identify students who may need more targeted social-emotional supports. Parents or guardians will be notified if students are identified for small-group or individualized interventions per ACPS Policy JR: School Counseling Program (PDF).
    • Parents or guardians will be able to review their child’s results in the PowerSchool Parent Portal during the 2020-21 school year
    • The results will remain in SchoolNet until five years after the student has graduated or is withdrawn from ACPS per the Virginia Records Retention and Disposition Schedule (PDF).

    If you do not wish to have your student participate, please click on the link below to complete an Opt-Out form. Families who chose to opt-out their child in the fall of 2020 will need to complete the opt-out form again for the fall of 2021. On the day the survey is given, your student may also elect to not participate. There will be no rewards or penalties associated with you or your student’s decision to participate.

    Opt-out of the ACPS UCLA Brief COVID-19 Screening Tool

    The ACPS Strategic Plan, Equity for All 2025: Student Accessibility and Support, states that “ACPS will ensure students have equitable access to and engagement with programs and supports that reduce barriers to learning.” ACPS firmly believes that students who are socially and emotionally well are more able to focus on learning and academics. As such, this survey is critical for ACPS’ timely and efficient response to students’ emotional needs during this time. Moreover, the collected information will assist ACPS schools in identifying and supporting the well-being of our youth, promoting student academic and life success.

    If you have any questions or concerns about the survey, contact Dr. John Baker, Director of School Psychology, at john.baker@acps.k12.va.us.

    Thank you for your consideration as we endeavor to provide comprehensive social-emotional supports to our students during these unprecedented times.

    ACPS UCLA Brief COVID-19 Screen Questions

    Prompt: For your reactions to what’s happening because of the coronavirus illness, select a number (0, 1, 2, 3, or 4) that shows how often the problem happened to you in the past month.

    1. I try to stay away from people, places, or things that remind me about what happened or what is still happening.
    2. I get upset easily or get into arguments or physical fights.
    3. I have trouble concentrating or paying attention.
    4. When something reminds me of what happened or is still happening, I get very upset, afraid, or sad.
    5. I have trouble feeling happiness or love.
    6. I try not to think about or have feelings about what happened or is still happening.
    7. When something reminds me of what happened, I have strong feelings in my body like my heart beats fast, my head aches or my stomach aches.
    8. I have thoughts like “I will never be able to trust other people.”
    9. I feel alone even when I am around other people.
    10. I have upsetting thoughts, pictures or sounds of what happened or is still happening come into my mind when I don’t want them to.
    11. I have trouble going to sleep, wake up often, or have trouble getting back to sleep.

    Response rubric:

    • 0 - None/Never
    • 1 - Little (two times a month)
    • 2 - Some (1-2 times a week)
    • 3 - Much (2-3 times a week)
    • 4 - Most (almost every day)