Students with Emotional and Behavior Disorders

Chapter 7

IDEA Definition of Emotional DisturbanceOne or more of the following characteristics, over a long period of

time, to a marked degree, which adversely affects a child’s educational performance –

inability to learn that can’t be otherwise explained

inability to build or maintain relationships with peers and teachers

inappropriate types of behavior or expression of feelings

pervasive mood of unhappiness or depression

physical symptoms or fears associated with personal/school problems

Includes schizophrenia but excludes social maladjustment

National Coalition on Mental Health and Special Education Definition

A disability characterized by behavioral or emotional responses so different from appropriate age, cultural, or ethnic norms that they adversely affect educational performance (academic, social, vocational, and personal skills)

more than a temporary, expected response to stressful events

consistently exhibited in two different settings, one of which is school

unresponsive to direct intervention in general education

Emotional and behavioral disorders can co-exist with other disabilities.

May include schizophrenia, affective disorders, anxiety disorder, or conduct disorders

Prevalence of Emotional and Behavior Disorders

• About 8% of all students• African American students are over-

represented• Far more males than females

Factors that May Contribute to Emotional and Behavior Disorders

Biological Heredity Brain injury pre/post birth Nutrition Accident or illness

Psychosocial Chronic stress at home Stressful life events Childhood maltreatment Other family factors

Behavioral Characteristics

Internalizing behaviors

Withdrawal Easy to overlook

Externalizing behaviors

Aggression, acting out Readily identified

Emotional and Social Characteristics

• Anxiety, fears• Anger, aggression• Low self-esteem• Depression• Problems with social relationships • May need to be taught social skills

Classification

– Feeding and eating disorders• Pica• Rumination• Anorexia• Bulimia

– Elimination disorders in older children.

• soiling (encopresis)• wetting (enuresis)

– Tourette’s syndrome - stereotyped movements or vocalizations that are involuntary, rapid, and recurring over time.

– http://www.youtube.com/watch?v=aDipNAuZuZI

Other disorders of infancy, childhood, or adolescence

– Anxiety disorders – GAD, OCD, Separation Anxiety, phobias– Selective mutism– Traumatic Disorders: PTSD, Reactive attachment disorder– Depression, bipolar disorder– Schizophrenia

Conduct Disorder• A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal

norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months:

• Aggression to people and animals • (1) often bullies, threatens, or intimidates others

(2) often initiates physical fights (3) has used a weapon that can cause serious physical harm to others (e.g., abat, brick, broken bottle, knife, gun) (4) has been physically cruel to people (5) has been physically cruel to animals (6) has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery) (7) has forced someone into sexual activity

• Destruction of property • (8) has deliberately engaged in fire setting with the intention of causing serious damage

(9) has deliberately destroyed others' property (other than by fire setting)• Deceitfulness or theft • (10) has broken into someone else's house, building, or car

(11) often lies to obtain goods or favors or to avoid obligations (i.e., "cons" others) (12) has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)

• Serious violations of rules • (13) often stays out at night despite parental prohibitions, beginning before age 13 years

(14) has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period) (15) is often truant from school, beginning before age 13 years

• B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. • C. If the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder.

Oppositional Defiant Disorder• A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months,

during which four (or more) of the following are present: • (1) often loses temper

(2) often argues with adults (3) often actively defies or refuses to comply with adults' requests or rules (4) often deliberately annoys people (5) often blames others for his or her mistakes or misbehavior (6) is often touchy or easily annoyed by others (7) is often angry and resentful (8) is often spiteful or vindictive Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.

• B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

• C. The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.

• D. Criteria are not met for Conduct Disorder, and, if the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder.

What are the Symptoms of ODD?

No! I will not #?!*& smile!!!!!!!!!!!

Cognitive and Academic Characteristics

• Low average to average cognitive ability• Significant academic difficulties• Highest dropout rates of any disability

category

Do emotional and behavior disorders cause academic problems, or vice versa?

Copyright © Allyn & Bacon 2006

AssessmentIDEA requires assessment teams to conduct

functional behavioral assessments.

– Identify the functions of a behavior in relationship to various settings.

– Behavior intervention plans to assist the child or youth in developing new more adaptive behaviors.

Antecedent (A) Behavior (B) Consequence (C)

Types of Assessment

FormalScales for Assessing Emotional Disturbance

Behavior Assessment System for Children

Behavior Rating Profile

Cognitive and Achievement Assessments

Classroom Assessments

Other AssessmentsFamily and developmental history

Student interviews

Medical information

Early Childhood Education

• Reduce risk factors by– Educating young women about the effects of

prenatal alcohol, nicotine, and drug use– Teaching parenting skills

• Provide early intervention services–e.g., First Steps to Success program

Elementary and Secondary Education

• 28 % of students are in general education• 30 % are in self-contained special education

classes• 18 % in separate schools or facilities

Types of services vary by setting

MULTIDISCIPLINARY COLLABORATION SYSTEMS OF CARE

• Based on several core values and guiding principle

• Cognitive-behavioral therapy

Copyright © Allyn & Bacon 2006

Early Childhood Years

• Interventions for young children are directed at lessening and preventing the impact of behavior disorders. – Building positive replacement behaviors.– Promoting appropriate social interactions.– Creating positive behavioral supports across

environments.– Providing respite care.– Parent training and foster services.– Counseling. – Communication skills. – Supporting inclusion.

Concerns about Inclusive Practices

• Curriculum in general education

–Pressure of high expectations

–No social skills or anger management training

• Social rejection

• Lack of mental health treatment options

Inclusion Can Work

• Welcome all students to the learning community

• Teach professionals techniques for supporting students in general education

• Successful inclusion requires

– Strong administrative support

–A plan for implementation

– Enhanced knowledge and skills for teachers

Transition and Adulthood• Outcomes are disappointing– High dropout rate– Problems finding and keeping jobs

• Improved outcomes result from– Family centered practices– Better access to mental health services– Teaching skills that enhance postschool outcomes– Focused transition programs

Best Practices

• Prevention through early intervention• Schoolwide positive behavior supports• Effective interagency collaborations• Wraparound services• Functional behavior assessments• Behavior intervention plans

“Copyright© Allyn & Bacon 2006”

Behavior Modification

Effective Classroom Interventions

Strategies to enhance student learning (e.g., Personal digital assistants – PDAs)

Peer tutoring

Cooperative learning

Teacher-led instruction

Parent and Family Perspectives

• Generally low income and single parent families• Parents may have negative interactions with

school professionals• Little advocacy exists for families

Trends and Issues

• Many youth who need services remain unidentified

• Better access to services through health care coverage for children is needed

• Better professional development on best practices is needed by school personnel