10.1177/1049732304268784 QUALITATIVE HEALTH RESEARCH / November 2004 Arcia et al. / MODES OF ENTRY Modes of Entry Into Services for Young Children With Disruptive Behaviors Emily Arcia María C. Fernández Marisela Jáquez Héctor Castillo María Ruiz The authors undertook this study to describe Latina mothers’ professional help seeking for their young children’s disruptive behaviors. They interviewed 62 Cuban, Puerto Rican, and Dominican first-time help seekers and found four modes of entry: (a) coercion, (b) acceptance of offered referral, (c) responsive and resourceful help seeking subsequent to school reports of behavior problems, and (d) a laborious and convoluted path that was characteristic of 52% of the sample. Schools, maternal and child characteristics, and social network forces played sig- nificant roles for all mothers, but the final determinants of service entry varied by the mode of entry followed. Findings suggest that problem labeling is not a necessary precursor to ser- vice entry and that direct referrals might effectively shortcut the help-seeking process. Finally, the process that underlies service entry would be described more aptly as a Theory of Affective Action than a Theory of Reasoned Action. Keywords: service pathways; children; disruptive behaviors; Latino A ttention Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems of children in the early elementary grades (American Psychiatric Association, 1994), and, if left untreated, the prognosis is typically quite poor (Hechtman & Weiss, 1983). Notwithstanding the importance of services, this population is commonly underserved (Pavuluri, Luk, & McGee, 1996; Verhulst & van der Ende, 1997). It is difficult for parents to recognize that their children’s behavior is atypical and in need of specialized services (Arcia & Fernández, 2003), and there is a dearth of appropriate and easily identified and accessed services (Hoagwood, Kelleher, Feil, & Comer, 2000). In addition, the ethnic minorities are particularly likely to underuse mental health services (McMiller & Weisz, 1996). 1211 AUTHORS’ NOTE: This study was supported by NIMH R03MH60462. It was also made possible by the assistance of numerous mental health care providers who referred mothers to the study and by the sup- port of Miami Behavioral Health Center and Miami-Dade County Public Schools. Most of all, we are indebted to the mothers who shared their stories with us and let us look into their hearts and minds. A copy of the interview protocol is available. Correspondence concerning this article should be addressed to Emily Arcia, Ph.D., 5333 Collins Avenue, #1401, Miami Beach, FL 33140; telephone: 305-995-7585, fax: 305-995-2047; e-mail: earcia@sbab.dade.k12.fl.us. QUALITATIVE HEALTH RESEARCH, Vol. 14 No. 9, November 2004 1211-1226 DOI: 10.1177/1049732304268784 © 2004 Sage Publications