Emotional Disturbance

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Emotional Disturbance

• Overview

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IDEA Definition

• Serious Emotional Disturbance A condition
  exhibiting one or more of the following
  characteristics, displayed over a long period of
  time and to a marked degree that adversely
  affects a child's educational performance
• An inability to learn that cannot be explained
  by intellectual, sensory, or health factors

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IDEA Definition

• An inability to build or maintain satisfactory
  interpersonal relationships with peers or
  teachers
• Inappropriate types of behavior or feelings
  under normal circumstances
• A general pervasive mood of unhappiness or
  depression

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IDEA Definition

• A tendency to develop physical symptoms or fears
  associated with personal or school problems.
• This term includes schizophrenia, but does not
  include students who are socially maladjusted,
  unless they have a serious emotional disturbance.

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Incidence

• In the 1999-2000 school year, 470,111 children
  and youth with an emotional disturbance were
  provided special education and related services
  in the public schools (Twenty-third Annual Report
  to Congress, U.S. Department of Education, 2001).

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Characteristics

• Hyperactivity (short attention span,
  impulsiveness)
• Aggression/self-injurious behavior (acting out,
  fighting)

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Characteristics

• Withdrawal (failure to initiate interaction with
  others retreat from exchanges of social
  interaction, excessive fear or anxiety)
• Immaturity (inappropriate crying, temper
  tantrums, poor coping skills) and
• Learning difficulties (academically performing
  below grade level).

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Characteristics

• Children with the most serious emotional
  disturbances may exhibit distorted thinking,
  excessive anxiety, and abnormal mood swings and
  are sometimes identified as children who have a
  severe psychosis or schizophrenia.

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Characteristics

• Males are identified as having emotional
• disturbances more frequently than females,
• especially in elementary years

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Characteristics

• Students with emotional disturbances often use
  inappropriate ways to get attention, such as
  talking back to adults, refusing to do work, or
  making jokes.

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Characteristics

• Students with emotional disturbances may have low
  self-esteem and poor social skills.

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Characteristics

• Students with emotional disturbances can benefit
  from classes that are highly structured and have
  clear rules that are consistently enforced.

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Academic Symptoms

• Disruptive to classroom activity.
• Impulsive.
• Inattentive, distractible.
• Appears pre-occupied.

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Academic Symptoms

• Disregards all classroom rules.
• Poor concentration.
• Extreme resistance to change and transitions.
• Speaks out, repeatedly.

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Academic Symptoms

• Is aggressive.
• Bullies and intimidates others.
• Regular truancy from school.

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Academic Symptoms

• Dishonest, consistently blames others.
• Low self esteem.
• Unable to work in groups.

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Academic Symptoms

• Engages in self injurious behavior.
• Has no regard for personal space and belongings.
• Persistently tries to manipulate situations.

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Management

• Behavior Contracts
• A behavior contract is an agreement between the
  child and teacher and often includes the
  student's parent(s).

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Management

• The behavior contract is a written agreement
  about how the individual will behave.

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Management

• It will indicate the appropriate consequence
  should the student neglect to behave according to
  the contract and

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Management

• it also states the reinforcer to be used for
  successful compliance. The behavior contract
  provides the student with structure and
  self-management.

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Functional Behavioral Assessment

• A functional behavioral assessment, or analysis,
  is a process which seeks to identify the problem
  behavior a child or adolescent may exhibit,
  particularly in school, to determine the function
  or purpose of the behavior, and to develop
  interventions to teach acceptable alternatives to
  the behavior. The process is as follows

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Functional Behavioral Assessment

• 1. Identify the behavior that needs to change,2.
  Collect data on the behavior,3. Develop a
  "hypothesis" (best guess) about the reason for
  the behavior,4. Develop an intervention to help
  change the behavior,5. Evaluate the
  effectiveness of the intervention,6. Have
  patience.

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Token Economy

• A token economy is an intensive, in-class
  positive reinforcement program for building up
  and maintaining appropriate classroom performance
  and behavior. 

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Token Economy

• Sometimes a tangible reward program, managed by
  the teacher, may be needed.  Tangible rewards can
  be conveniently managed through a token
  reinforcement program.

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Token Economy

• Token programs involve the distribution of tokens
  (for example, stickers, stars, smiley faces, etc)
  or points following appropriate behavior. 

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Token Economy

• The tokens or points can be accumulated
  throughout the day and exchanged for designated
  rewards at a specified time.

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Token Economy

• a predetermined goal is set for the number of
  tokens or points require to earn a reward.  The
  teacher or classroom aide is responsible for
  distributing the tokens and providing the reward.

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Conduct Disorders

• This condition is characterized by a persistent
  pattern of behavior, which intrudes and violates
  the basic rights of others without concern or
  fear of implications.

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Conduct Disorders

• This pattern is not selective and is exhibited in
  the home, at school, with peers and in the
  child's community.

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Conduct Disorders

• Other behaviors present with this condition may
  include vandalism, stealing, physical aggression,
  cruelty to animals and fire setting.

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Oppositional Defiant Disorder

• This disorder is usually characterized by
  patterns of negativistic, hostile and defiant
  behaviors with peers as well as adults.

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Oppositional Defiant Disorder

• This disorder is considered less serious than a
  conduct disorder because of the absence of
  serious behaviors, which violate the basic rights
  of others.

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Oppositional Defiant Disorder

• Children with this disorder usually exhibit
  argumentative behaviors towards adults, which may
  include swearing and frequent episodes of intense
  anger and annoyance.

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Separation Anxiety Disorder

• This disorder is characterized by extreme anxiety
  associated with separation from someone with whom
  the child views as a significant other

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Separation Anxiety Disorder

• This separation anxiety is frequently exhibited
  at school and at home.

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Anorexia Nervosa

• Children with this condition show a marked
  disturbance and unwillingness to maintain a
  minimal body weight for their age and height.

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Anorexia Nervosa

• An extreme distorted sense of body image exists
  and intense fears and worries about gaining
  weight become obsessive

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Anorexia Nervosa

• Children with this disorder may also exhibit
  self-induced vomiting, use of laxatives,
  increased reduction of food intake, preoccupation
  with becoming fat, and noticeable increase in the
  frequency and intensity of exercise.

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Bulimia Nervosa

• A condition characterized by recurrent episodes
  of uncontrolled consumption of large quantities
  of food (binging) followed by self induced
  vomiting (purging), use of laxatives or diuretics
  over a period of at least two months.

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Bulimia Nervosa

• The individual with bulimia nervosa exhibits
  symptoms characterized by binging and purging,
  use of laxatives and diuretics, obsessive
  preoccupation with body shape and weight and a
  feeling of lack of control over food consumption
  during binge episodes.

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Tourettes Syndrome

• This disorder is characterized by motor and vocal
  ticing which may be exhibited in the form of
  grunting, coughs, barks, touching, knee jerking,
  drastic head movements, head banging, squatting
  and so on.

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Tourettes Syndrome

• The above symptoms may change as the child
  develops but the course of the disorder is
  usually lifelong

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Tourettes Syndrome

• The condition is more common in males and family
  pattern are also common. Coprolalia (vocal tic
  involving the expression of obscenities) is an
  associated symptom in about 33 of the cases.

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Functional Encopresis

• The major symptom of this disorder is repeated
  involuntary or intentional passage of feces into
  clothing or other places which deem it
  inappropriate.

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Functional Encopresis

• The condition is not related to any physical
  condition, must occur for a period of six months
  on a regular basis and be present in a child over
  the age of 4 for diagnosis to take place.

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Functional Enuresis

• This disorder is characterized by repeated
  involuntary intentional elimination of urine
  during the day or night into bed or clothes at an
  age which bladder control is expected.

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Selective Mutism

• This disorder is characterized by persistent
  refusal to talk in one or more major social
  situations, including school, despite the ability
  to comprehend spoken language and speak. The
  resistance to speak is not a symptom of any other
  major disorder.

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Obsessive Compulsive Disorder

• The major characteristics associated with this
  disorder are persistent obsessions (persistent
  thoughts) or compulsions (repetitive acts) that
  significantly interfere with the individuals
  normal daily social, educational, occupational or
  environmental routines.

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Dysthymia

• The essential feature of this disturbance is a
  chronic disturbance of the individual's moods
  involving chronic depression or irritable mood
  for a period of one year for children and
  adolescents.

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Schizoid Personality Disorder

• The child with this disorder exhibits a
  restrictive range of emotional experiences and
  expression and indifference to social situations.

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Antisocial Personality Disorder

• This disorder is characterized by a pattern of
  irresponsible and antisocial behavior. The
  condition is usually first seen in childhood or
  early adolescence and continues throughout the
  child's development.

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Antisocial Personality Disorder

• This diagnosis is usually made after the age of
  18 and the individual must have had a history of
  symptoms before the age of 15 indicative of a
  Conduct Disorder.

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Borderline Personality Disorder

• The main features of this disorder include
  instability of self-image, inconsistent and
  unfulfilling interpersonal relationships,
  instability of mood, and persistent identity
  disturbance.

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Post Traumatic Stress Disorder

• Post Traumatic Stress Disorder (PTSD) is not a
  disorder to be associated solely with military
  personnel, as it has been in the past.

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Post Traumatic Stress Disorder

• It has been shown that exposure to traumas such
  as a serious accident, a natural disaster, or
  criminal assault can result in PTSD.

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Post Traumatic Stress Disorder

• When the aftermath of a traumatic experience
  interferes with normal functioning, the person
  may be suffering from PTSD.

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Post Traumatic Stress Disorder

• There are three types of generally recognized
  stressors
• Threatened death or serious injury to one's
  person
• Learning about the death, near death, or serious
  injury of a family member or close friend
• Witnessing the death, near death or serious
  injury of another person

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Antidepressant Medication

• Some of the newest antidepressants are called
  selective serotonin reuptake inhibitors (SSRIs).

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Medications

• Antidepressants Antidepressants work by changing
  the level of neurotransmitters (chemical
  messengers) in the brain. Several
  neurotransmitters are thought to be in low supply
  in depression, including noradrenaline (sometimes
  called norepinephrine) and serotonin.

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Examples of Antidepressants

• Celexa
• Effexor
• Lexapro
• Wellbutrin
• Zoloft
• Prozac
• Paxil

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Antianxiety Medications

• Klonopin
• Xanax)
• Valium)
• Ativan).