Wednesday, July 9, 2008

Emotional and Behavioral Disorders of Children

This summer I taught a class entitled “Emotional and Behavior Disorders of Children.” One of the activities in the class was for the students to pick a topic and write a blog entry. The following several articles were written by the students in my class:

  • Attention Disorders – Allison Babcock
  • Mood Disorders in Middle School – Stephanie Ballard
  • Autism – Stephanie Brown
  • Functional Behavior Assessments – Ashley Brunette
  • Separation Anxiety Disorders, Therapy, & Interventions – Holly Fidler & Jennifer Jackson
  • Emotional Disturbance vs. Social Maladjustment – Jessica Leddy & Andrea Zanchuck
  • Conduct Disorders – Sindy McLain
  • Emotional Disturbance versus Social Maladjustment – Marissa Murphy
  • Prevention of Emotional and Behavioral Disorders – Jenny Robinson
  • Schizophrenia – Sadie Weaver

Schizophrenia - Sadie Weaver

Schizophrenia
By Sadie Weaver

“Schizophrenia is a chronic, severe, and disabling brain disorder that affects about 1.1 percent of the U.S. population. People with schizophrenia sometimes hear voices others don’t hear, believe that others are broadcasting their thoughts to the world, or become convinced that others are plotting to harm them. The symptoms of schizophrenia develop in men and women in their late teens or early twenties. Some cases include hallucinations, delusions, disordered thinking, movement disorders, flat affect, social withdrawal and cognitive defects. Medications can eliminate many of the symptoms and allow people with schizophrenia to live independent and fulfilling lives.” I got all this information from the National Institute of Mental Health website. Now let me tell you what schizophrenia is to me.
I was adopted when I was 4 years old into a loving house in West Texas. I had an adoring big brother (who was also adopted from a different family when he was 4 months old), who told me secrets and taught me how to burp and pass gas, how to climb the tree in the back yard, and how to eat blueberry pancakes! He was the best big brother! He stuck up for me at school and taught me that words people said shouldn’t hurt me. He changed, however, the year he turned 16. I was only 12 at the time and just knew he and our parents fought a lot! They had him tested for drugs and put locks on his windows to keep him from leaving the house at night. At 21 my parents had him evaluated at the hospital in Big Spring and he was diagnosed with schizophrenia. I didn’t know what that meant at the time, I just know our relationship had changed.
He is a grown man now with a wife and son. He holds a job and does a great job to boot! He speaks to middle scholars and high scholars about mental illness and is taking Closeral to control his illness. He has been symptom free since 1992. He is a hero to me. Sure he has hard times and I am sure his life is not easy. I bet people look at him funny and maybe even try to take advantage of him. But let those people walk a mile in his shoes. He has not let his disorder take control of him. He has fought back and fought for control of his life.
We as future teachers need to realize we just might encounter a child like my brother someday in our classrooms. We need to fill our classrooms with compassion and acceptance and remember that these children we encounter everyday might not be in control of their lives. The things they do, the things they see, and the things they say. We need to be a source of stability and love in their crazy lives for the time they are ours in the classroom. We have but a small time to mold and touch lives. I am glad for the teachers and adults that touched my brother’s life through the years; the ones that didn’t give up. I’m glad to have my brother back again!

Prevention of Emotional and Behavioral Disorders - Jenny Robinson

Prevention of Emotional and Behavioral Disorders
By Jenny Robinson

The key to preventing emotional and behavioral disorders in children is early detection. Because of this, two U.S. Presidential commissions (U.S. Surgeon General report in 2000 and the President’s Freedom Commission on Mental Heath in 2003) have called for the “transformation of the mental health system emphasizing the early identification and intervention of children at risk…within school…settings.” (Reddy, 2006) An effective early detection program for children who are considered high-risk should focus, not only in the early school years, but also in preschool settings such as Head Start. Effective tools for screening preschool children for emotional and behavioral disorders are not in common use and universal mental heath interventions for preschool children are not established. A preschool curriculum that is based on following directions, sharing, making appropriate decisions, and other social or behavioral skills seems to be critical as a prevention strategy because it builds the children’s range of behavioral tools that they have available to them. (Forness, 2000)

Special education often involves “early identification rather than early detection and secondary prevention rather than primary prevention” (Forness, 2000). According to James Kauffmann in his article entitled, “How We Prevent the Prevention of Emotional and Behavioral Disorders,” he says, “We often find ways to avoid taking primary or secondary preventive action, regardless of our acknowledgment that such prevention is a good idea. Other concerns take precedence, and as a result we are most successful in preventing prevention itself.” (1999) Early detection involves a systematic screening of all children in the general education setting in order to determine which children may be at risk for behavior disorders so that problems can be detected even before parents or teachers identify them.

Therefore, the most effective early detection program should begin in preschools where children can be screened annually for behavioral problems. Also, incorporated with this should be a primary prevention program in which all children receive universal interventions such as direct instruction in social and behavioral skills, and activities to increase parent involvement. In order to implement this plan, general education teachers need to be trained in effective classroom-wide interventions (Forness, 2000). Parents also need to be trained in effective parenting skills, as well as made aware of how to cooperate with the school in the best interest of their children. Children who do not respond to universal interventions would then go on to prereferral interventions in order to determine their response to intervention. Another early detection and intervention program that is in place is the program known as Triple P-Positive Parenting Program, which is a multilevel system of family intervention. This program provides five levels of intervention, each level increasing in strength. The first level includes a universal media campaign targeting all parents, the second and third levels consist of brief primary care consultations which target mild behavior problems, and then the last two levels consist of intensive parent training and family intervention programs for children at risk for severe behavioral problems (Sanders, 1999).

Forness, S., Hale, M.J., Kavale, K., Lambros, K., Nielsen, E., & L. Serna. (2000). A Model for Early Detection and Primary Prevention of Emotional or Behavioral Disorders. Education & Treatment of Children, 23.3, 325-346.
Kauffmann, J. (1999). How We Prevent the Prevention of Emotional and Behavioral Disorders. Exceptional Children, 65.
Reddy, L, & L. Richardson. (2006). School-Based Prevention and Intervention Programs for Children with Emotional Disturbance. Education & Treatment of Children, 29.2, 379-404.
Sanders, M. (1999). Triple P-Positive Parenting Program: Towards an Empirically
Validated Multilevel Parenting and Family Support Strategy for the
Prevention of Behavior and Emotional Problems in Children. Clinical Child and Family Psychology Review, 2.2, 71-90.

Emotional Disturbance vs. Social Maladjustment- Marissa Murphy

Emotional Disturbance versus Social Maladjustment
By Marissa Murphy

A vast amount of controversy and debate generated when Public Law 94-142 came into effect due to the vague and incomplete federal definition of emotional disturbance. The lack of resolution among educators and administrators attempting to clarify the distinction between emotional disturbance and social maladjustment has resulted in continued conflict.
Individuals with Disabilities Education Act (IDEA) vaguely defines emotional disturbance (ED) as:
A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance: (a) an inability to learn that cannot be explained by intellectual, sensory, or 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, (d) a general pervasive mood of unhappiness or depression, and/or (e) a tendency to develop physical symptoms of fears associated with personal or school problems. Emotional disability includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance (Cavitt, 2007).
IDEA’s definition is criticized because it leads to under-identification, narrowly interprets school performance as academic, emphasizes emotional problems, and underemphasizes behavioral problems (Smith, 2007). But IDEA’s definition for emotional disturbance (ED) causes confusion amongst educators primarily due to its failure to include a definition of socially maladjusted (SM).
Despite federal or state laws inability to fully define socially maladjusted (SM), two separate court cases offer a definition for social maladjustment. According to Doe v. Board of Education of the State of Connecticut, social maladjustment can be defined as “a child who has a persistent pattern of violating societal norms with truancy, substance abuse, a perpetual struggle with authority, is easily frustrated, impulsive, and manipulative” (Whitted, 2008, para. 4). Springer by Springer v. Fairfax County School Board, on the other hand, defined social maladjustment as “a child who is incapable of fully profiting from general educational programs of the public schools because of some serious social or emotion handicap but who is not expected to profit from special education” (Whitted, 2008, para. 5). Although some educators and administrators within individual school districts have turned to court cases for assistance in an attempt to gain a definition of social maladjustment, others have simply devised their own definition. Wayne County Regional Educational Service Agency defined social maladjustment as:
…a conduct problem, whereby maladjusted students choose not to conform to socially acceptable rules and norms…students demonstrate knowledge of school/social norms and expectations and consistently demonstrate a pattern of intentionally choosing to break rules and violate norms of acceptable behavior (2004, p. 8).
With educators and administrators establishing definitions of social maladjustment for their school districts, they are enabling themselves the ability to see the differences between a child suffering from emotional disturbance (ED) and social maladjustment (SM).
For instance, a child with an emotional disturbance is unable to comply with teacher requests while a child who is socially maladjusted is unwilling to comply with teacher requests. A child with emotional disturbance misses school due to emotional or psychosomatic issues while a child who is socially maladjusted misses school due to choice. Thus, intentionality is the distinguishing feature between social maladjustment and emotional disturbance.


References
Cavitt, Dennis. (2007). Chapter 7: Emotional or Behavioral Disorders [PowerPoint slides].
Smith, D.D. (2007). Introduction to Special Education: Making a Difference: Sixth Edition. Boston: Allyn and Bacon.
Wayne County Regional Educational Services. Social Maladjustment: A Guide to Differential Diagnosis and Educational Options. Retrieved from http://www.resa.net/sped/guidelines/social_mal.pdf
Whitted, Brooke R., Cleary, Lara A., & Takiff, Neal E. (2008). Socially Maladjusted Children and Special Eudcation Services. Retrieved July 4, 2008, from http://www.wct-law.com/CM/Publications/publications37.asp.

Conduct Disorder - Sindy McLain

Conduct Disorders
By Sindy McClain

Why has conduct disorders escalated over the years? Could it be some of the circumstances that didn’t exist in days gone by? Mothers are no longer at home for their children. Drugs, alcohol and unemployment are all factors that play to the stressors of family. Sadly, these stressors often bleed over into the lives of children. Latch key kids are common place and divorce places children in a volatile situation. These are surface factors, but too often they are the first things that are blamed for conduct disorders. All too often internal factors are overlooked.
Before we look at internal factors for conduct disorders we should give you the definition of conduct disorders. Conduct disorder is a repetitive and persistent pattern of behavior in children and adolescents in which the rights of others or basic social rules are violated.¹
Children who have conduct disorders all too often do not realize that they have a problem. Adolescence is a time of increased emotional instability and intensity. That could be one of the reasons that children, as well as adults, fail to acknowledge the disorder. Sadly, additional problems can occur if a child does not receive the proper treatment for conduct disorders.
Physicians and families should be knowledgeable about this disorder for several reasons. After being diagnosed with conduct disorder the clinician is then able to refer the student to the appropriate specialists. Also and possibly the most serious, conduct disorders increase the risk of several public health problems, including violence, weapon use, teenage pregnancy, substance abuse and dropping out of school.² If conduct disorder is not identified, intervention is impossible.
According to Officer Long at the Abilene Police Department a large number of adolescents, approximately 75 to 80 percent who are arrested for weapons charges, do have a history of inappropriate conduct at home and at school. This is a tangible sign that children who go untreated for conduct disorders are at risk of that behavior escalating.
Knowledge is key for any medical condition. As a society we cannot just assume that life’s circumstances are the problem. As parents and teachers, when students begin to cross the normal lines of adolescents, we should be there to provide proper assistance to the student and their family. In order to provide proper assistance you should be aware of the signs of conduct disorder.
According to the Diagnostic and Statistical Manual of Mental Disorders, some symptoms for conduct disorders typically include aggression, frequent lying, running away from home overnight and deliberately sets fires and causes destruction of property. These children may also be cruel to animals, show deceitfulness or theft and demonstrate serious violations to rules.³
As you can see conduct disorders are not just from not having a parent at home or having an alcoholic or drug addicted parent. These factors give any child to be angry and act out, however, students with Conduct Disorder will take their behavior to level that is socially inappropriate.
Today is the day we need to reach out and make a difference. We need to not only be educated on what our children need academically, but we need to be aware of their emotional needs as well.
References
Mental Health America. (2006). Factsheet: Conduct Disorder. Retrieved July 1,
2008 from http://www.mentalhealthamerica.net/go/conduct-disorder/

Searight, Russell H., & Rotinek, Fred & Abby, Stacey L. (2001). American Family Physician. Conduct Disorder: Diagnosis and Treatment in Primary Care. Retrieved July 1, 2008 from http://www.aafp.org/afp/20010415/1579.html

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. DSM-IV Conduct Disorder. Retrieved July 1, 2008 from http://www.behavenet.com/capsules/disorders/cndctd.htm

Emotional Disturbance vs. Social Maladjustment- Andrea Zanchuck & Jessica Leddy

Emotional Disturbance vs. Social Maladjustment
Andrea Zanchuk and Jessica Leddy

Introduction
Students with emotional disturbances and social maladjustment propose a unique challenge to educators. Although similar in their behaviors, student needs are quite different. In order to meet their needs we must be highly qualified, and use research based instructional methods. Moreover, to effectively serve this population, it is crucial to know how to implement appropriate prevention and intervention strategies, as well as, instructional strategies.
Differences and Similarities
The main difference between emotional disturbance and social maladjusted is that one exhibits internalized behaviors whereas the other projects externalized behaviors. Social maladjustment has a locus of control that is externally motivated producing a conduct disorder. Their behavior is a direct result of the choices they make. Emotional disturbed students have a locus that is internally controlled concluding in an affective disorder. Although the contributing factors are different both emotional disturbance and social maladjustment require appropriate social skills intervention (School Psychologist, 2008).
Social Skills Intervention
It is widely regarded among educators that children with disabilities are challenged in the area of social competence. Social competence defined is “the ability to interact successfully with peers and adults (Hill, Coufal, 2005).” Part of the emotional well-being of every child is the ability to form and maintain friendships. The need for social acceptance has a direct impact on self-concept, school performance, and cognitive development. Ideally, social skills should be taught in the context of the natural environment.
Students must develop competence in the areas of social tasks, such as joining in, giving a compliment, and expressing feelings. Pragmatics also plays a large role in successful communication. Indeed, pragmatics encompasses assumptions about the use of language in a social context (Hill & Coufal, 2005). Students with disabilities have a hard time generalizing, thus the need for authentic real world experiences to cultivate a thriving tool kit for the social scene.
From the ages of six to twelve, children learn critical social skills necessary for a healthy lifestyle. These skills include: how to negotiate conflict, understand jokes and sarcasm, express forms of politeness, receive and give affection, and be able to recognize
the emotions of hostility, anger, and pride (Hill & Coufal, 2005). Conclusively, a most effective intervention for social competence is to use a comprehensive cross-disciplinary
approach in the school, and community setting for students with emotional disturbances and social maladjustment (Reddy, Richardson, 2006).
Conclusion
Research has previously stated that: “Historically, children with ED have received fragmented inadequate interventions and services that often yielded unfavorable school and community outcomes (Reddy, 2006).” Both emotional disturbance and social maladjustment require appropriate intervention to positively affect the well-being of individuals. Social skills programs actively engage students to positively affect both their academic and social performance. Intervention implementations used concurrently with effective instructional strategies promote a holistic education; therefore, affecting the overall well-being of an individual.

References
Hill, John W., Coufal, Kathy L., (2005). Emotional/Behavioral Disorders: A Retrospective examination of social skills, linguistics, and student outcomes. Communication Disorders Quarterly, 27(1), 33-46.
Reddy, Linda A. (2006).School-based prevention and intervention programs for children with emotional disturbance. Education and Treatment of Children, 29 (2), 370-404.
Social Maladustment: A guide to differential diagnosis and educational options.
http://www.schoolpsychologistfiles.com/EMDisability.html

Functional Behavioral Assessment - Ashley Brunette

Functional Behavior Assessments
By Ashley Brunette

Its fourth period, the class has just been assigned independent work. Everything seems to be going smoothly until Johnny starts acting out again. He does this every time independent work is given, he immediately begins tapping his pencil and throwing paper balls at the other students, Mrs. Johnson has about had it with Johnny and has given up. What should she do? Where does she go from here? Mrs. Johnson in desperate need of assistance would meet with a behavior intervention team to discuss possible intervention strategies to aide in Johnny’s success. The team would first begin by completing a Functional Behavior Assessment or FBA. The goal of the FBA is to determine what activities are associated with the problem behaviors and to identify the student’s preferences. (Smith, 2007) The three basic steps involved in accurately completing a FBA are to describe the behavior, uncover the function of the behavior and discuss the interventions that could be used to change that behavior. (CATIES, 2006)
In describing the problem behavior the teacher or staff member needs to use operational language. This ensures that when another teacher or staff member is observing the child they can accurately measure and identify the problem behavior for future recording. (Crone and Horner, 2003) When initially observing Johnny one would state that Johnny is rude and annoying. This type of language is emotionally driven and difficult to measure and identify. Different behaviors can be annoying and rude to different people and this fact can make things confusing. When describing his behavior for an FBA the individual should instead state that Johnny when placed in an independent work setting throws paper and makes distracting noises and refuses to do his work.
The next step is to uncover the function of the behavior. To do this the behavior intervention team must first take a look at the antecedent situation before the behavior, the behavior itself and the consequence of the behavior. (Crone and Horner, 2003) In Johnny’s case the antecedent is the independent work. He does well in groups but refuses to do his work in an independent work setting. Next the team should look at the consequence of this behavior. What happens when Johnny does this? When looking at this piece the team notes that Mrs. Johnson sends Johnny to the office when he engages in the inappropriate behavior. This information plays a valuable role in the function of the behavior. There are only two functions of behavior, to obtain or to avoid. (Crone and Horner, 2003) In this example Johnny’s behavior appears to be avoidance. He engages in the behavior to avoid doing the work and is then positively reinforced by being sent to the office and therefore escaping the work. The function is then deemed avoidance behavior and the team pursues an intervention plan.
The final step is to create an intervention plan that will result in an elimination of the behavior. (CATIES, 2006) The function of the behaviors should be the same but instead of avoiding doing the work he will have one on one instruction with the teacher to help him understand the concepts he is weakest in and help him to avoid feeling self conscious and frustrated with the work. The team could also add in the behavior plan that Mrs. Johnson needs to pair the students with buddies so that if Johnny has any questions he can ask his buddy and feel confident to work on his assignment again. The antecedent in the intervention plan will now be one on one instruction and a buddy system. The replacement behavior is Johnny working successfully on his assignment and the consequence is that he now feels confident with his skills. He now receives an intrinsic reward for completing his work.
In this scenario the teacher is overwhelmed with the problem behavior in her classroom but with the help of a behavior intervention plan and a simple FBA she now feels confident to take care of the behavior and maintain control of her classroom.

References:

CATIES (2006) FBA. http://www.tcnj.edu/~caties/FunctionalBehaviorAssessments.htm.

Crone, D, & Horner, R (2003). Building positive behavior support systems in schools. New York: Gulford

Functional behavior assessments. Retrieved June 30 , 2008, from Center for assistive technologies and inclusive education studies Web site: http://www.tcnj.edu/~caties/FunctionalBehaviorAssessments.htm

Smith, Deborah D. (2007). Introduction to special education. Boston, MA: Pearson.