Emotional Disturbance

Definition of Emotional Disturbance

• (i) The term means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which adversely affects educational performance:

• (A) An ability to learn which cannot be explained by intellectual, sensory, or health factors;

Definition of ED (2)

• (B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers;

• (C) Inappropriate types of behavior or feelings under normal circumstances;

• (D) A general pervasive mood of unhappiness or depression; or

Definition of ED (3)

• (E) A tendency to develop physical symptoms or fears assocaited with personal or school problems.

• (ii) The term includes children who are schizophrenic or autistic. The term does not include children who are socially maladjusted unless it is determined that they are seriously emotionally disturbed. (Federal Register, August 23, 1977)

Why the sudden increase in the number of ED students?

• Previously they have been:

• Dropouts• Pushouts• Runways--100,00 on

any given day• Inadequately served as

LD

• Incarcerated• in revolving door

suspensions (see Honig v. Doe)

• Truant• Most of these doors

are substantially now closed

Four dimensions of disordered behavior

• Frequency• Duration• Topography (time, place, setting of behavior)• Magnitude or intensity of behavior

• ED is a psychologist’s opinion and not a measurement

Causes of Emotional Disturbances

• Biological• Psychological,

including the influence of home--quality and quantity of parental and sibling attention

• Influence of school. Quality of behavior management, especially

A Tale of Two Terms

• Neurosis. The neurotic worries too much. This might describe a lot of lives in our contemporary world.

• Psychosis. The psychotic is past worry and is out of touch with reality at least part of the time.

• “The neurotic builds castles in the air; the psychotic goes to live in them.”

Phobias and their treatment

• Phobias are fears that go far beyond evidence. Sometimes fear is wise.

• Acrophobia is a fear of high places.

• Agoraphobia is a fear of open places

• Algophobia is a fear of pain.

• Anthrophobia is a fear of mankind

• Claustrophobia is a fear of closed places.

• Mysophobia is a fear of germs

Phobias (2)

• Monophobia is a fear of being alone.

• Nyctophobia is a fear of night or darkness

• Ochlophobia is a fear of crowds

• Syphilophobia is a fear of syphilis

• Thanatophobia is an exaggerated fear of death

• Zoophobia is a fear of one or all animals

• Phobias are not a problem if they do not prevent the person from enjoying life.

Treatments for phobias

• Exhaustion or flooding method. Advantages: time, simplicity. Disadvantages: real risk to client; spread of phobia if procedure fails. Ethics can be a concern depending upon how things are handled. Best use of flooding: minor phobias, phobias that are not intense or deeply internalized.

Treatments for phobias (2)

• De-sensitization method. Advantages: natural method; less real risk to client; less likelihood of spread of effect if the procedure does not work; usually more comfortable for the client since he is partially in control. Disadvantages: time, possible lack of motivation of client.

• For more deep-seated phobias

Demographics of ED students

• More likely male• Most likely eighth

grade• More likely disruptive

than withdrawn• Decision to drop out

of school is made in the seventh grade, acted upon later

Schizophrenia

• Disorganized schizophrenia is characterized by a flat or incongruous affect. There may be bizarre mannerisms and social isolation. The onset of this type of schizophrenia occurs early in life and tends to be chronic.

• Catatonic schizophrenia is noted by periods of stupor, mutism, and psychomotor agitation, contrasted with periods of almost constant talking and delusions of grandeur.

Schizophrenia (2)

• Paranoid schizophrenia tends to occur in later life (30s) and is characterized by suspiciousness and delusions of persecution and grandeur.

• Most likely schizoid, if the classroom teacher ever has one in class, is the disorganized one. Know where his medicine is.

Characteristics of Autism

If a child has at least half of the symptoms on the following list, he or

she may be diagnosed as autistic:

Autistic characteristics (1)

• Difficulty in socializing with other children

• Acts deaf.• Resists learning• No fear of real

dangers.• Resists changes in

routine

• Indicates needs by gesture rather than speaking or pointing

• Inappropriate laughing or giggling

• Resists cuddling• Marked physical

overactivity

Autistic characteristics (2)

• Avoids eye contact• Inappropriate

attachment to objects• Spins objects• Sustained odd play• Standoffish manner

• Characteristics become noticeable before CA 30 months, The first few months of life seem normal, but then they seem to withdraw from the world.

• Source: Autism Society of America

Indicators of suicide

• Age range 15 to 24

• Depressed or irritable mood

• Loss of enjoyment or interest in normally pleasurable activities

• Change in weight, appetite, or eating habits

• Problems with sleeping, either insomnia or hypersomnia

Indicators of suicide (2)

• Psychomotor agitation or retardation (hyperactivity in children)

• Loss of energy or feelings of fatigue

• Feelings of worthlessness or excessive or inappropriate guilt

• Diminished ability to attend, think, or concentrate (indecisiveness)

• Recurrent thoughts of death or suicide

• “Last will and testament” scenario

Approaches to Teaching Emotionally Disturbed Students

• Psychodynamic strategy. Freudian approach that attempts to bring the id, ego, and superego into balance with each other. Sometimes referred to as the “five year couch” approach. One feature of this approach that is frequently used in schools is the “life space interview” following a crisis. Problem: need something more pro-active in a school situation.

Approaches to ED (2)

• Biogenic approach. Appropriate when problems are more physical than mental. Schizophrenia, substance abuse, glucose, ADHD, and other medically related problems.

• Humanistic approach. Teacher acts as a non-authoritarian “resource and catalyst” rather than being directive. For most ED students this approach is not recommended.

Behavior modification

• Behavior is controlled by its consequences until the student gains self-control.

• BMOD has the strongest research base of any of the approaches for ED.

• Even with BMOD there are some situations that do not always work. ED is the last great frontier of special education teaching.

Approaches for ED

• Ecological approaches. These try to re-arrange key elements in the child’s environment, including his home, to facilitate his adjustment to the world.

• The combination of behavioral and ecological approaches, called Project RE-ED, has been the most effective thus far.

The goal of discipline is self-discipline

The goal is not to find or invent novel ways to punish people

CONTINUUM OF DISCIPLINARY METHODS

________________________________________________________________________________

Looking On Discipline Reality Assertive Behavior Behaviors With Dignity Therapy Discipline Mod.

Disciplinary Continuum

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Simple Discipline Reality Assertive Behavior

Control With Therapy Discipline Modific- Dignity

ation

Looking On Behaviors (Simple Control)

• For classes with a minimum of disciplinary challenge

• “Please,” “Thank you,” and “May I see your eyes”

• Big advantage: Doesn’t quash creativity

Discipline with Dignity

• Long-term behavior changes vs. short-term quick fixes

• Stop doing ineffective things

• I will be fair, and I won’t always treat everyone the same

• Rules must make sense

• Model what you expect

• Responsibility is more important than obedience (??!!)

• Always treat students with dignity

Glasser’s Reality Therapy Approach

• “What am I doing?”

• Is it working?

• Recognition--Give the student the “time of day.”

• What are you doing?

• Is it against the rules?

Glasser’s Reality Therapy Approach (2)

• Work it out (and make a plan), to wit:

• No excuses

• No planning for failure

• No labeling and forgetting

• No exempting from the rule--the student is responsible

• No punishment at this point

Glasser’s Reality Therapy (3)

• Isolate from the class

• OUT to in-school suspension

• Send the student home

• Get professional help

Canter’s Assertive Discipline

Percent | X X

|

Of | X X

|

Students | X X

|

Off | X X

| X X

Task | X X X

__________________________________________

rules 0 1 2 3 4 5 6 7 8 9 10 11 12

If you could have five to seven rules,

What would they be?

Typical Assertive Discipline rules

• Come to class with all of your study materials

• Listen to what the teacher and classmates have to say

• Respect the body and privacy rights of others

• Attempt every assignment

• Speak about others as you would like to be spoken of

Typical consequences in an assertive discipline classroom

• First offense (no warnings given)--name on board, lose 10 minutes of recess or lunch

• Second offense--check mark by name, lose thirty minutes of recess or after school

• Third offense--for schools that operate D-Hall, Saturday D-hall

• Fourth--corporal punishment or suspension

• Severe clause--see principal immediately

Canter’s disciplinary personality types

• Assertive--tells students what is expected and informs them when they have done it

• Non-assertive--opposite of assertive

• Hostile--meets own needs at expense of students

Behavior modification

• For most demanding disciplinary situations

• Fits well with mastery learning, individualized instruction, and contracts

• Very structured

How a token economy works (1)

• Students earn tokens for doing school work. Combined with individualized instruction, this provides a very fair means of assigning work

• Mastery learning is incorporated in that only work done to at least 80 % accuracy gets paid for

How a token economy works (2)

• Work not up to 80% gets returned marked “Not finished.” In BMOD parlance, this is extinction

• Fines can be used to remedy misbehavior

• Time-out can be worked into the system

• Tokens can be charged for pencils and paper, encouraging responsibility

The behavior-modifier’s tools

Positive reinforcement, response cost, timeout, overcorrection, extinction,

ALT-R, negative reinforcement, PAC

Effective positive reinforcement

• Should be something that the STUDENT finds rewarding

• In schools, will likely be tertiary reinforcement

• Beware of satiation

• Timeliness

• Reinforcers can change

Using response cost effectively

• Spell out the rules of the game early

• Allow for buildup of reserve without telling students

• Take fining only so far before mixing it with other techniques such as time out

Using time out effectively

• Remove the person from sources of stimulation immediately

• Timeout situation must be neutral with no reinforcing properties of its own

• Short in duration

Overcorrection (restitution)

• Insure the relevance of the corrective measure to the problem behavior

• Apply the procedure immediately and consistently

• Keep the performance consistent during overcorrection. If the student is having to walk heel-toe, do not allow him to run the last few yards.

Extinction (systematic non-reinforcement)

• Specify the conditions for extinction so that the child knows why these things are happening

• Dispense no reinforcement before its time

• Watch for spontaneous recovery

Reinforcement of alternative behaviors (ALT-R)

• Behavior to be reinforced must be incompatible with that to be extinguished

• Alternative behavior must already be established

• Alternative behavior must be one that is likely to be supported by the natural environment

Negative reinforcement, also called escape conditioning

• Do not allow the noxious stimulus to become aversive or a different set of behaviors will take over.

• Dispense R- immediately• Do not remove the

noxious stimulus prematurely

Using PAC effectively

• Communicate the rules before beginning an episode where PAC might be used

• No escape after announcement that PAC is about to occur

• Consistent and immediate application

• Present at strong intensity

• Combine PAC with extinction so that the student will not attempt the prohibited behavior again.

Differences between negative reinforcement and PAC

• Negative reinforcement uses a noxious stimulus

• NR has an increase in behaviors as its goal

• Presentation of aversive consequences uses an aversive stimulus

• PAC has the elimination of behaviors as its goal

Whatever we do,

Let us remember that helping the student is what we are trying to do.