School Psychology

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School Psychology

• Meredith M. Goldman, Ph.D.

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What is School Psychology?

• Help children succeed academically, socially, and
  emotionally
• Work together with educators, parents, and other
  professionals to create safe, healthy, and
  supportive learning environments

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What School Psychologists Do

• Work to find solutions to address student needs
• Develop strategies for addressing student needs
• Educate parents and teachers regarding strategies

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How Services are Provided

• Consultation
• Evaluation
• Intervention
• Prevention
• Research and Planning

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Why It is Important

• Role of School in Childrens Lives
• Time Spent
• Different Perspectives
• Long-term Effects of School Experiences

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Developmental Psychopathology

• ADHD
• Depression/Anxiety
• Conduct Disorder
• Autism/Aspergers Disorder
• Intellectual Disabilities
• Learning Disabilities

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Case Study

• Gilderoy Lockhart is a 7-year-old boy
  referred for testing by the Student Support Team
  at his school. Referral concerns primarily focus
  on his behavior in the classroom. His teacher,
  Ms. Umbridge, believes he is very capable of
  doing his schoolwork, but notes that he is
  becoming angry and frustrated often during the
  school day. She describes him as often roaming
  the classroom rather than completing his school
  work and picking fights with other children
  during group activities. His grades range from
  Fs to some low Bs. Ms. Umbridge and Gilderoys
  student support team want more information in
  order to determine how to best work with Gilderoy
  during the rest of the school year.

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Differential Abilities Scale (DAS) Area Assessed
Standard Score 95 Conf. Interval
Verbal Cluster 72
63-84 3 Nonverbal Cluster
83 75-93 13 Spatial Cluster
78 70-87 7 General
Conceptual Ability 74 68-81
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Scales of Independent Behavior-Revised
(SIB-R) Cluster
Standard Score Conf. Interval
Social Interaction/Communication Skills 89
84-94 22 Personal Living
Skills 73 69-77 4 Community
Living Skills 76 72-80 6
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Woodcock Johnson III Tests of Achievement
(WJ-III Achievement) Area Assessed Standard
Score BROAD READING 76 Reading
Fluency 81 Letter Word Identification 79
Passage Comprehension 74 BROAD MATH
81 Calculation 89 Math Fluency
78 Applied Problems 78
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Behavior Assessment System for Children- Parent
Rating Sales Clinical Scales
T-Scores Hyperactivity 41 Aggression
39 Conduct Problems 49 Anxiety 46 Depres
sion 43 Somatization 44 Atypicality 50 Wi
thdrawal 54 Attention Problems 60 Adaptive
Scales T-Scores Adaptability 64 Social
Skills 40 Leadership 39
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Behavior Assessment System for Children- Teacher
Rating Sales Clinical Scales
T-Scores Hyperactivity 63 Aggression
60 Conduct Problems 60 Anxiety 49 Depres
sion 61 Somatization 64 Attention
Problems 60 Learning Problems 59 Atypicality
47 Withdrawal 51 Adaptive Scales
T-Scores Adaptability 51 Social
Skills 38 Leadership 41 Study Skills 35
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Case Study 2

• Draco Malfoy is an eight-year-old boy in the
  third grade. His teacher, Professor Snape, has
  referred him to the schools student support team
  due to Dracos failure to complete school
  assignments and declining grades. Draco is
  described as very irritable, becoming angry with
  his friends and impatient with his teachers. H e
  also notes that Draco appears inattentive in the
  classroom, staring into space and failing to
  follow directions. Professor Snape reported that
  Draco has not had such difficulties during the
  previous school year and he is worried about his
  academic progress. Dracos student support team
  would like to gather more information in order to
  determine how to best address Dracos
  difficulties.

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Differential Abilities Scale (DAS) Area Assessed
Standard Score Verbal Cluster
91 27 Nonverbal Cluster 135 99 Spatial
Cluster 106 66 General Conceptual
Ability 113 81
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Woodcock Johnson III Tests of Achievement Area
Assessed Standard Score BROAD READING 103
Reading Fluency 110 Letter Word
Identification 99 Passage Comprehension
97 BROAD MATH 123 Calculation 119 Math
Fluency 132 Applied Problems 115 BROAD
WRITTEN LANGUAGE 118 Writing Samples 123
Spelling 108 Writing Fluency 117
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Behavior Assessment System for Children- Parent
Rating Sales Clinical Scales
T-Scores Hyperactivity 55 Aggression
53 Conduct Problems 52 Anxiety 50 Depres
sion 53 Somatization 39 Atypicality 42 Wi
thdrawal 47 Attention Problems 63 Adaptive
Scales Adaptability 53 Social
Skills 45 Leadership 44
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Behavior Assessment System for Children- Teacher
Rating Sales Clinical Scales
T-Scores Hyperactivity 51 Aggression
41 Conduct Problems 43 Anxiety 52 Depres
sion 46 Somatization 42 Attention
Problems 48 Learning Problems 69 Atypicality
47 Withdrawal 64 Adaptive Scales
Adaptability 43 Social Skills 36 Leadership
39 Study Skills 50
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Behavior Assessment System for Children-Self-Repor
t of Personality Area Assessed
T-Score Attitude Toward School 64
Attitude Toward Teachers 53 Atypicality
63 Locus of Control
59 Social Stress
64 Anxiety
62 Depression 71 Sense
of Inadequacy 67 Adaptive Scales
Relations with
Parents 57 Interpersonal Relations
40 Self-Esteem
46 Self-Reliance 51
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Typical Day

• Assessment
• Report Writing
• Consultation
• Student Support Team
• Individualized Education Plan

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History of ADHD

• References to hyperactive individuals occur as
  early as Shakespeare
• Characteristics referenced in Principles of
  Psychology (1890)
• Became focus of clinical attention in England in
  1902

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History of ADHD (cont.)

• Interest in North America increased after great
  encephalitis epidemics in 1917-1918
• During 1950s, focus on the behavior of
  hyperactivity and poor impulse control, with
  labels such as hyperkinetic impulse disorder.

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History of ADHD (cont.)

• In 1968, given the name hyperkinetic reaction of
  childhood (DSM-II)
• In 1980, given the name Attention Deficit
  Disorder (DSM-III)
• In 1987, renamed Attention-Deficit Hyperactivity
  Disorder and Attention Deficit Disorder without
  hyperactivity (DSM-III-R)

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History of ADHD (cont.)

• In 1994, named Attention Deficit Hyperactivity
  Disorder, including three subtypes (DSM-IV)
• Primarily Inattentive
• Primarily Hyperactive
• Combined Type

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Prevalence Rates

• Prevalence 3-9
• Inattentive subtype more prevalent in the general
  population
• Combined subtype more prevalent in clinically
  referred populations
• More prevalent in males than girls on both
  general and clinically referred population
  (3.51)
• Approximately 2/3 will no longer evidence
  symptoms once they enter adulthood

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Incidence

• Occurs across all socioeconomic levels, but may
  be more prevalent in lower SES
• Arises in all ethnic groups studied so far,
  including countries such as Holland, China,
  Brazil, Colombia, United Arab Emirates, and the
  Ukraine.

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Associated Deficits

• Decreased performance on tests of academic
  achievement
• Increased risk for grade retention
• Increased risk of Learning Disabilities
• Impaired interpersonal functioning
• More likely to be rated liked least by their
  classroom peers
• Positively-distorted self-perceptions in domains
  of weakness

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Associated Deficits (cont.)

• Associated risks if superior IQ
• If evidencing the disorder in adulthood, have
  deficits including less formal schooling and
  lower ranking in occupational functioning
• 42 dropped out of post-secondary school at
  least once
• 40 were underemployed at evaluation

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Comorbidity

• 54-64 may have oppositional behaviors
• 12-24 develop substance abuse disorders
  (research indicates stimulant medication serves
  as a protective factor to reduce the likelihood
  of substance abuse)
• 25 may have an anxiety disorder
• Those with ADHD are 6x more likely to have
  another disorder in their lifetime that those
  without ADHD

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Comorbidity (cont).

• 20-30 may develop a mood disorder
• 19-26 may have learning disabilities
• 5 - 10 have tic disorders
• 50 - 70 of those with Tourettes have ADHD
• 20 of epileptic children have ADHD

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Models of ADHD

• Russel Barkleys (2000) model of behavioral
  inhibition
• Sergeants (2000) cognitive-energetic model
• Sonuga-Barkes (2003)dual pathway model
• Browns (2001) model of executive functioning

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Barkleys Model of Behavioral Inhibition
Motor Control, Fluency, and Syntax
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Cognitive-Energetic Model (Sergeant, 2000)
Management/Executive Functioning
Effort
Arousal
Activation
Encoding
Central
Motor
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Dual Pathway Model(Sonuga-Barke, 2002)
CHOICE
NO CHOICE
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Dual Pathway Model (cont.)
Executive Circuit
Reward Circuit
Neuro-biological basis
Inhibitory Deficits
Shortened Delay Reward Gradient
Parental Response
Executive Dysfunction
Delay Aversion
Psychological Processes
ADHD
Behavioral Expression
Engagement
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Browns Model of Executive Functions Impaired in
ADHD
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Treatment Lacking Empirical Support

• Relaxation Training
• Dietary Treatments
• Cognitive-Behavioral Treatment
• Social Skills Training

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NIMH Treatment Study of ADHD (1999)

• 597 children
• 7-9.9 years of age
• Combined type
• Treatment Conditions
• Medication Management
• Behavior Modification
• Combined
• Community Care

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NIMH Treatment Study of ADHDMajor Findings
(Whalen, 2001)

• Outcomes for the combined treatment, which were
  not detectably different from those of the
  medication-only condition, were achieved with
  significantly lower medication doses
• Only the combined treatment condition was
  superior to community care in problem domains
  beyond the core ADHD symptoms

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NIMH Treatment Study of ADHDMajor Findings
(Whalen, 2001)

• Parents were more satisfied with treatment when
  it included a behavioral component that when it
  involved medication only
• For children with comorbid ADHD and anxiety, the
  behavioral treatment was superior to community
  care and did not differ from medication

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NIMH Treatment Study of ADHDMajor Findings
(Whalen, 2001)

• Medication management in the MTA proved superior
  to the use of medication in the community care
  condition
• Positive-parent child interchanges, as reported
  by parents, decreased for those in the medication
  condition but either increased or remained the
  same in all other conditions

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NIMH Treatment Study of ADHD (1999) 14 Months

• Improvement in ADHD symptoms was significantly
  higher for children receiving Combined treatment
  or Medication.
• Some specific symptoms showed superior
  improvement for Combined only
• Combined treatment was superior to Community Care
  (even when medication was used)

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NIMH Treatment Study of ADHD (1999) 14 Months

• Combined treatment greater than medication for
  positive functioning and greater levels of parent
  satisfaction

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NIMH Treatment Study of ADHD (1999) 24 Months

• Combined treatment still evidenced superior
  results over behavior management alone or
  community care
• However, effect size was reduced by half
• A significant number of cases in the medication
  and combined group had ceased taking medication

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NIMH Treatment Study of ADHD (1999) 24 Months

• A significant growth suppression was observed in
  the second year for the children that were
  treated continuously with medication
• Smaller growth suppression was observed in
  children without continuous treatment

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Stimulant Medication

• Behavioral improvements in sustained attention,
  impulse control, and reduction of task-irrelevant
  activity
• Some research indicating ADHD children are able
  to perceive the benefits and describe improvement
  in their self-esteem
• Reductions in aggressive behavior in children
  already demonstrating abnormally high levels of
  aggression

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Stimulant Medication

• Some research indicating an improvement in
  handwriting
• Increased academic productivity
• Increased accuracy of work completion

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Antidepressant Medication

• Some research that low doses may produce
  increased sustained attention and decreased
  imulsivity
• Some elevation in mood, particularly in those
  children with pretreatment levels of anxiety and
  depression
• Treatment effects more likely to diminish over
  time

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Academic Interventions

• Contingent reinforcers for reduced activity level
  or increased sustained attention
• Research indicates need for token reinforcer,
  suggesting praise may not be sufficient
• Several studies show that group administered
  rewards are as effective as individually
  administered reward
• However, reinforcing reduced activity level and
  increased attention do not necessarily translate
  into increased productivity or accuracy

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Academic Interventions

• Reinforcing products of classroom behavior (such
  as accuracy) not only increased productivity and
  accuracy, but indirectly produced declines in
  off-task and hyperactive behavior
• Research using punishment contingency has shown
  disruptive behavior to return to baseline after
  one week
• Some support for response cost paired with
  punishment, but sensitive to fading

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Academic InterventionsPeer Tutoring

• Class Wide Peer Tutoring
• Class is dividend into two teams
• Within each team, classmates form tutoring pairs
• Students take turns tutoring each other
• Tutors are provided with academic scripts
• Praise and points are contingent on correct
  answers
• Errors are corrected immediately, and an
  opportunity is provided fro practicing the
  correct answer
• Teacher monitors tutoring pairs and provides
  bonus points for pairs that are following
  prescribed procedures
• Points are tallied by each student at the
  conclusion of each session
• Tutor sessions last 20 minutes, with an
  additional 5 minutes for charting

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Academic InterventionsPeer Tutoring

• Active engagement of students with ADHD
  significantly increases from an average of 22
  during baseline to an average of 82 when CWPT
  was implemented
• Childrens weekly posttest scores increased from
  an average of 55 during baseline to 73 for CWPT
  conditions
• Durability was not assessed

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Academic InterventionsComputer-Assisted
Instruction

• Key features individual instructional levels,
  easily readable display format, self-paced work
  completion, and motivational features
• Students completed almost twice as many problems
• Students spent significantly more time working on
  problems

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Academic InterventionsComputer-Assisted
Instruction-2

• Students used software programs math drill and
  practice, math instructional game, reading drill
  and practice, reading tutorial. Each program
  included a game and nongame format
• Students were more attentive when the CAI
  included a game format with animation
• More nonattending bx observed when CAI only used
  drill and practice
• In drill and practice format, nonattending bx
  increased when the CAI material was too easy or
  too difficult

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Academic InterventionsTask Modifications

• Adding color to relevant cues in a spelling task
• Hyperactive participants demonstrated better
  performance when relevant color was added to
  spelling tasks
• Addition of color to irrelevant aspects of the
  task resulted in decreases in spelling
  performance

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Academic InterventionsTask Modifications

• Alternative writing method including peer
  discussion, brainstorming of ideas, and the use
  of a computer for journal writing
• Clinically significant decreases in off-task bx

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Academic InterventionsTask Modifications

• Choice making- requiring the student to choose
  activities from two or more concurrently
  presented stimuli
• Increase in task engagement
• Concomitant reductions in disruptive behavior

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Academic InterventionsInstructional Modifications

• Allowing participants to respond orally to
  written material
• Oral reading produced fewer comprehension errors

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Academic InterventionsStrategy Training

• Having students administer self-reinforcement
  independently once academic or bx goals are met
• Increased academic performance than medication
  alone

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Teacher Variables

• Teacher knowledge of ADHD was unrelated to their
  knowledge of treatments for ADHD
• Teachers knowledge of ADHD was positively
  related to their ratings of medication
  acceptability but unrelated to their ratings of
  acceptability for behavioral interventions

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Effect of Child Characteristics and Teacher
Acceptability

• Regardless of sex or subtype, teachers preferred
  a daily report card (DRC) intervention
• Teachers considered DRC to be more acceptable and
  effective than any other intervention
• Medication was considered more effective than a
  response cost or classroom lottery
• Medication was rated less acceptable than
  response cost and more acceptable than classroom
  lottery

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Effect of Child Characteristics and Teacher
Acceptability

• Teachers rated medication as less acceptable for
  girls when provided with alternative bx treatment
• Teachers were not as strongly opposed to the use
  of medication with boys