Emotional or Behavioral Disorders

1
Emotional or Behavioral Disorders
2
IDEA 1997

• i)        The term emotional disturbance refers
  to a condition exhibiting one or more of the
  following characteristics over a long time and to
  a marked degree that adversely affects a
  students educational performance
• (a)   An inability to learn that cannot be
  explained by intellectual, sensory, or other
  health factors
• (b)   An inability to build or maintain
  satisfactory interpersonal relationships with
  peers and teachers.
• (c)   Inappropriate types of behavior or feelings
  under normal circumstances

3
IDEA cont.

• (d)   A general pervasive mood of unhappiness or
  school problems
• (e)   A tendency to develop physical symptoms or
  fears associated with personal or school problems
• ii)      The term does not apply to children who
  are socially maladjusted, unless it is determined
  that they have an emotional disturbance.

4

• IDEA definition excludes students with social
  maladjustments, which refers to a student whose
  behavior conflicts with society in general but is
  an adaptive, often peer-approved response to
  their environment (i.e. gangs)
• Implies choice vs. students with ED/BD result of
  disability.

5

• Problems with identification
• Lack of precise definitions of mental health and
  normal behavior
• Differences among conceptual models
• Difficulties in measuring emotions and behavior
• Relationships b/t emotional and behavioral
  disorder and other disabilities
• Differences in the professionals who diagnose and
  serve children and youths
•  

6
Characteristics

• Primarily by behavior that falls significantly
  beyond the norms of their cultural and age group
  on two dimensions. Called externalizing and
  internalizing.
• Externalizing antisocial behaviors may include
  lying, stealing, fighting, yelling, ignoring
  authority, destroying property, temper tantrums,
  noncompliance
• Internalizing too little interaction with
  others which limits their opportunities to be
  successful

7

• Affective Disorder a disorder of mood or
  emotional tone characterized by depression or
  elation
• Anxiety Disorder Most common childhood disorder.
  
• Characterized by excessive fear, worry, or
  uneasiness
• Phobia unrealistic, overwhelming fear of object
  or situation
• Generalized anxiety disorder excessive,
  overwhelming worry not caused by any recent
  experience

8

• Panic disorder overwhelming panic attacks
• Obsessive-compulsive disorder obsessions
  manifesting as repetitive, persistent, and
  intrusive impulses, images, or thoughts and/or
  compulsions manifesting as repetitive
  stereotypical behaviors
• eating disorders anorexia and/or bulimia
• post-traumatic stress disorder flashbacks and
  other recurrent symptoms following exposure to an
  extremely distressing and dangerous event

9

• Mood disorders involves an extreme mood deviation
  in either a depressed or and elevated directions
  or sometimes both directions at different times.
  Depression can onset at any age. Involve
  emotion, motivation, physical well-being, and
  thoughts.

10

• 750,000 young people b/t ages 10-24 attempt
  suicide each year 5,000 succeed. Females 4 x as
  likely to attempt but males 4 x as likely to
  succeed.
• ( page 136)
• Bipolar disorder
• (manic depressive) typically begins in late
  adolescence or early adulthood. Exaggerated mood
  swings.  

11

• Oppositional Defiant Disorder causes a pattern of
  negativistic, hostile, disobedient, and defiant
  behaviors.
• Symptoms, loss of temper, arguing, w/ and defying
  adults, irritability, vindictiveness, swearing,
  and using obscenities, blaming others for
  mistakes and misbehavior and low self-esteem.
  May abuse drugs and alcohol.
•  Tagging telling student I would like to
  discuss this at a later time when both of us are
  calm and ending discussion.
• (p.137)

12

• Conduct disorder persistent pattern of antisocial
  behavior that significantly interferes with
  school, family, and social functioning.
• Students with conduct disorders violate the basic
  rights of others or major age appropriate
  societal norms and rules.

13

• Categories for conduct disorders
• Aggressive conduct,
• physical harm to people or animals
• Non-aggressive conduct,
• property loss or damage
• Deceitfulness or theft
• Serious rule violations
•  
• Low self esteem or overly inflated self esteem

14

• Schizophrenia - disorder in which people
  typically have two or more of the following
  symptoms hallucinations, withdrawal, delusion,
  inability to experience pleasure, loss of contact
  with reality, and disorganized speech
• Generally begins in late adolescence or early
  adulthood, some childhood onset (usually greater
  genetic vulnerability)

15
Behavioral Characteristics

• Externalizing behaviors persistent aggressive
  acting out and noncompliant behaviors
• (p. 139)
•  
• ED/BD students subject to zero tolerance laws
  expel student who exhibits violent behavior or
  brings drugs or weapons to school. IDEA provides
  that no student whose behavior is a manifestation
  of a disability may be expelled from school.

16

• The IEP team must make a manifestation
  determination
• (Did the behavior arise from the disability?)
• Student can be suspended for a short term (never
  more than 10 days in any school year) or placed
  in a more restrictive setting.

17

• 2001 the reauthorization of the Elementary and
  Secondary Education Act (ESEA) allowed local
  school officials to discipline a student with
  disabilities in the same manner as they
  discipline students w/out disabilities when it
  comes to suspension and expulsion.
• ESEA does not require the school to suspend or
  expel children with disabilities as they would
  those without disabilities, but it does allow it.
  
• States and locals have the option of following
  IDEA rules, which have a basic purpose continuing
  the education of a student whose placement is
  changed to an alternative setting.

18
Cognitive and Academic Characteristics

• May be gifted or have mental retardation
• Often perform 1 or more years below grade level
• But most have IQs in the low average range.
• Over half have concurrent LD
• Lowest GPA of any disability
• Highest absenteeism
• 50 ED/BD drop out of school
• 71 ED/BD have expressive and/or receptive
  language disorders

19
Causes

• Biological
• Genetics also influence behavioral
  characteristics
• Precise nature remains unclear
• No real evidence that biological factors alone
  are the root of the problem
• However, evidence that the more severe the
  problem the more tie to genetic factors
  (schizophrenia)
•  

20

• Tourettes syndrome (TS) a neurological disorder
  beginning in childhood ( 3 x boys to girls) in
  which stereotypical, repetitive motor movements
  (tics) are accompanied by multiple vocal outburst
  that may include grunting noises or socially
  inappropriate words or statements (i.e. swearing)

21

• Environmental
• Exposed to trauma and maltreatment are more
  likely to experience emotional and behavioral
  disorders
• Frequent exposure to stressors can have adverse
  effects on the balance of brain chemicals

22

• Stressful living conditions
• 38 of youth with ED/BD from households income
  under 12,000
• Another 32 from households b/t 12 and 24,999
• 44 come from single-parent households

23
Child Abuse

• Teachers reported 38 ED/BD were physically or
  sexually abused
• 41 were neglected
• 51 abused emotionally
• As a teacher, you are legally responsible to
  report suspected child abuse.
• 1-800-4-A-CHILD

24

• Poor self-image
• Inability to depend on and trust others
• Aggressive and destructive, sometimes illegal
  behaviors
• Passive and withdrawn behavior w/ fear of
  entering new relationships and activities
• School failure
• Serious drug and alcohol abuse

25

• School Factors
• experienced peer rejection and aggression may be
  more likely to develop conduct disorders
• especially boys

26
Prevalence

• Very small with serious ED/BD receive mental
  health services
• Estimated numbers vary greatly because of no
  standard and reliable definition or screen
  instrument
• 1 school-age population served 1999-2000
• Most students placed exhibit externalized
  behaviors
• Some experts believe 9-10
• 3 of US youths are referred to juvenile court
  annually (African American males are over
  represented) 

27
Under-Identification

• Reluctance to serve aversive conduct disorders
• Federal regulations regarding disciplinary
  actions
• Costs
• Insensitivity/lack of understanding
• Subjective nature of ID
• Label stigma

28

• African American males are over-represented in
  ED/BD classes
• Unavailability of culturally appropriate
  assessments instruments
• Concern about teacher expectations regarding
  appropriate behavior
• Building respectful family-professional
  partnerships that may prevent ID
•  
• Under ID see page 144 figure 5-6

29
Models That Work

• Systematic, data-based intervention interventions
  that are applied consistently and that are based
  on reliable research data, not unsubstantiated
  theory
• Continuous assessment and monitored of progress
  direct daily assessment of performance, with
  planning based on this monitoring
• Provisions for practice of new skills are not
  taught in isolation but are applied directly in
  everyday situations through modeling, rehearsal,
  and guided practice

30

• Treatment matched to the problem interventions
  that are designed to meet the needs of individual
  students and their particular life circumstances,
  not general formulas that ignore the nature,
  complexity, and severity of the problem
• Multi-component treatment as many different
  interventions as are necessary to meet the
  multiple needs of students (e.g. social skills
  training, academic remediation, medication,
  counseling, or psychotherapy, family treatment or
  parent training)

31

• Programming for transfer and maintenance
  interventions designed to promote transfer of
  learning to new situations, recognizing that
  quick fixes nearly always fail to produce
  generalized change
• Commitment to sustained interventions
  interventions designed with the realization that
  many emotional or behavioral disorders are
  developmental disabilities and will not be
  eliminated entirely or cured.  

32
Service Delivery Models

• More ED/BD students are educated outside of the
  general education classroom
• Even so, the trend is towards inclusion
• Full continuum of services is especially
  important because of the variety of behaviors and
  characteristics