Child mental health researchers often focus on interventions that improve externalizing problems (i.e., disruptive, aggressive, and impulsive behaviors), due to the relationship between children's externalizing behaviors and social, emotional, and academic disparities. School-based mental health counselors work to reduce externalizing problems due to the relationship between these behaviors and school-based problems, such as bullying victimization, school adjustment difficulties, and suspension. Children with complex trauma histories often exhibit externalizing problems. Unfortunately, limited research examines school trauma screening and guidelines for schools to effectively distinguish behavioral and trauma-related symptoms. As a result, we examined whether children's trauma symptoms predicted their externalizing problems that prompted referrals for school-based mental health counseling interventions at three Title-I elementary schools.
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