Emotional and Behavioral Disorders in Children

1. Emotional and Behavioral Disorders in Children Katie Conn EDN 410 – Fall 2009 November 4th, 2009

2. DESCRIPTION • The descriptor emotional and behavioral disorders is commonly used for students whose behavior falls considerably outside the norm. • The federal government use the term emotional disturbance in its criteria for placement of students in special education. Vaughn, S., Bos, C. S., & Schumm, J. S. (2007). Teaching Students Who Are Expectional, Diverse, and at Risk in the General Education Classroom (4thth ed., pp. 120-141). USA: Pearson Education, Inc.

3. Federal Definition of Emotional Disturbance • The federal government defines “emotionally disturbed” as follows: • The term means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which affects educational performance including: • An inability to learn that cannot be explained by intellectual, sensory, or health factors; • An inability to build or maintain satisfactory interpersonal relationships with peers and teachers; Continued on next slide

4. Federal Definition of Emotional Disturbance Continued • Inappropriate types of behavior or feelings under normal circumstances; • A general pervasive mood of unhappiness or depression; or • A tendency to develop physical symptoms or fears associated with personal or school problems. • The term includes children who are schizophrenic. The term does not include children who are socially maladjusted, unless it is determined that they are emotionally disturbed. Vaughn, S., Bos, C. S., & Schumm, J. S. (2007). Teaching Students Who Are Expectional, Diverse, and at Risk in the General Education Classroom (4thth ed., pp. 120-141). USA: Pearson Education, Inc.

5. Specific Types of Emotional and Behavioral Disorders • The following 6 specific types will each be described within the next couple of slides. • Conduct Disorders and Aggression • Hyperactivity • Socialized Aggression • Immaturity • Depression • Anxiety-Withdrawal Vaughn, S., Bos, C. S., & Schumm, J. S. (2007). Teaching Students Who Are Expectional, Diverse, and at Risk in the General Education Classroom (4thth ed., pp. 120-141). USA: Pearson Education, Inc.

6. Conduct Disorders and Aggression • Children usually have little concern for others and repeatedly violate the basic rights of others and the rules of society. • They act out their feeling or impulses in destructive ways. • Some offenses that these children commit often grow into more serious crimes. • as, theft, lying, aggression, Continued on next slide

7. Characteristics of Conduct Disorders • Some offenses that children with conduct disorders show are: • Lying, • Aggression, • Theft, • Truancy, • Setting of fires, and • Vandalism United States Dept. of Health and Human Services. (2003, April). Children's Mental Health Facts Children and Adolescents with Mental, Emotional, and Behavioral Disorders. Retrieved November 2, 2009, from http://mentalhealth.samhsa.gov/publications/allpubs/CA-0006/default.asp#7

8. Hyperactivity • This can also be referred to as ADHD. • Children with hyperactivity are unable to focus their attention and are often impulsive and easily distracted. • Occurs in up to five of every 100 children. • They have great difficulty remaining still, taking turns, and keeping quiet. Continued on next slide

9. Hyperactivity CONTINUED • The symptoms must be present in two setting for children to be diagnosed as hyperactive. • For example, children would be observed at school, and at home in order to make sure their actions are consistent. United States Dept. of Health and Human Services. (2003, April). Children's Mental Health Facts Children and Adolescents with Mental, Emotional, and Behavioral Disorders. Retrieved November 2, 2009, from http://mentalhealth.samhsa.gov/publications/allpubs/CA-0006/default.asp#7

10. Socialized Aggression • The term socialized aggression is used to refer to students who routinely engage in antisocial behaviors. • Students are categorized as hanging around with the wrong kinds of kids, displaying behaviors that are not typical of others in their age group, harassing others, and stealing and damaging property. Continued on next slide

11. Socialized Aggression CONTINUED • Social aggression is also associated with group behavior. • When one student within the group behaves one way, the rest of their group is assumed to act exactly the same. • They associate gang life as being a part of social aggression in some inner cities as well as in suburban and rural areas. • There is a high rate of overlap between socialized aggression, conduct disorders, and attention problems. Vaughn, S., Bos, C. S., & Schumm, J. S. (2007). Teaching Students Who Are Expectional, Diverse, and at Risk in the General Education Classroom (4thth ed., pp. 120-141). USA: Pearson Education, Inc.

12. Immaturity • Various behaviors are associated with immaturity: • Lack of perseverance, • Failure to finish tasks, • A short attention span, • Poor concentration, and • Frequent daydreaming or preoccupation. • These students come to a teachers attention because they show little interest in school work. Continued on next slide

13. Immaturity CONTINUED • Students often seem dependent on their parents or caretakers and have difficulty being responsible member of a group. • If they have a severe case of immaturity, they have difficulty interacting with other people, using social skills, and playing with children their own age. • These students may retreat into fantasy and develop fears that are out of proportion to the circumstances. Vaughn, S., Bos, C. S., & Schumm, J. S. (2007). Teaching Students Who Are Expectional, Diverse, and at Risk in the General Education Classroom (4thth ed., pp. 120-141). USA: Pearson Education, Inc.

14. Depression • Many people believe that depression does not affect children, but studies today show evidence against this. • Studies show that two of every 100 children may have major depression, and as many as eight of every 100 adolescents may be affected. Continued on next slide

15. Signs of Depression • This disorder is marked by changes in: • Emotions—Children often feel sad, cry, or feel worthless. • Motivation—Children lose interest in play activities, or schoolwork declines. • Physical well-being—Children may experience changes in appetite or sleeping patterns and may have vague physical complaints. • Thoughts—Children believe they are ugly, unable to do anything right, or that the world or life is hopeless. Continued on next slide

16. Key Point on Depression • VERY IMPORTANT for parents and caregivers to be aware that some children and adolescents with depression may not value their lives, which can put them at risk for suicide. United States Dept. of Health and Human Services. (2003, April). Children's Mental Health Facts Children and Adolescents with Mental, Emotional, and Behavioral Disorders. Retrieved November 2, 2009, from http://mentalhealth.samhsa.gov/publications/allpubs/CA-0006/default.asp#7

17. Anxiety-Withdrawal • Children with anxiety disorders may experience excessive fear, worry, or uneasiness. • This is the most common of the childhood disorders. • Based upon one study of 9- to 17-year-olds, as many as 13 of every 100 young people have an anxiety disorder. Continued on next slide

18. Anxiety Disorders • Anxiety disorders include: • Phobias, which are unrealistic and overwhelming fears of objects or situations. • Generalized anxiety disorder, which causes children to demonstrate a pattern of excessive, unrealistic worry that cannot be attributed to any recent experience. • Panic disorder, which causes terrifying "panic attacks" that include physical symptoms, such as a rapid heartbeat and dizziness. • Obsessive-compulsive disorder, which causes children to become "trapped" in a pattern of repeated thoughts and behaviors, such as counting or hand washing. • Post-traumatic stress disorder, which causes a pattern of flashbacks and other symptoms and occurs in children who have experienced a psychologically distressing event, such as abuse, being a victim or witness of violence, or exposure to other types of trauma such as wars or natural disasters. United States Dept. of Health and Human Services. (2003, April). Children's Mental Health Facts Children and Adolescents with Mental, Emotional, and Behavioral Disorders. Retrieved November 2, 2009, from http://mentalhealth.samhsa.gov/publications/allpubs/CA-0006/default.asp#7

19. Other types of disorders • Besides the 6 main types of emotional and behavior disorders that were described in the previous slides, there are others that exist, but don’t really fit into one of the main categories according to our text by Vaughn, Bos & Schumm, such as: • Bi-polar, and • Schizophrenia • Bi-polar is sometimes categorized with depression, and schizophrenia is sort of with the anxiety disorders because it deals with fears and people freaking out. Vaughn, S., Bos, C. S., & Schumm, J. S. (2007). Teaching Students Who Are Expectional, Diverse, and at Risk in the General Education Classroom (4thth ed., pp. 120-141). USA: Pearson Education, Inc.

20. Etiology/Causes of Emotional and Behavioral Disorders • The causes remain elusive. • However, relationships between some causal factors and this disability are becoming clearer. • Children who experience abuse are more likely to have emotional or behavioral disorders. • The reason it is do difficult to have a certain cause for these disorders is because there are likely to be multiple and overlapping factors. Continued on next slide

21. Causes CONTINUED • At least three general areas can contribute to emotional or behavioral disorders: biology, home and community, and school. • Biology: Many biological and genetic factors are causes, such as mood disorders, depression, and schizophrenia. • Home & Community: The child’s environment and culture. Children use the people around them as role models, not matter if they have parental involvement or none. Children mimic the behaviors they see around them. • School: Teachers and schools have a tremendous influence on students. Expectation, feedback, and interaction with peers all play a role in how children behave. This can cause children to act out or begin to internalize issues. Smith, D. D. (2007). Emotional and Behavioral Disorders: Causes and Prevention. Retrieved November 2, 2009, from http://www.education.com/reference/article/emotional-behavioral-disorders-prevention/

22. Prevalence • Higher prevalence rates are reported for mild emotional or behavioral disorders, and lower prevalence rates for more severe disorders. • Current reports show that the prevalence of emotional and behavioral disorders in the general population range from 10 percent to 20 percent of the school-age population. • Fewer than 1 percent of students receive special education services for emotional disturbance, and of those students, less than half are identified in elementary school. Continued on next slide

23. Underidentification • Below are reasons for underidentification of students with emotional and behavioral disorders: • Social Stigma is associated with the label “seriously emotionally disturbed.” • Eligibility for categorization as emotionally disordered is not clearly defined. • The identification process lacks uniformity. • Co-morbidity, or the presence of multiple disabilities, can make identification difficult. • A lack of funding may limit school districts’ willingness to identify and provide services for those students. • There is often a lack of appropriate services when students are identified, and identification limits a school’s ability to take disciplinary action against misbehavior. • Adequate assessment measures to facilitate identification are few. Continued on next slide

24. UnderidentificationCONTINUED • Even though these disorders are underidentified, the majority of students identified are males. • Males outnumber females by a ratio as high as 8 to 1. • Minority populations are also disproportionately represented. • This issue of overrepresentation of minority students is complex, and is viewed in terms of a combination of factors, including cultural bias, poverty, and the historical practice of segregation and discrimination in schools. Vaughn, S., Bos, C. S., & Schumm, J. S. (2007). Teaching Students Who Are Expectional, Diverse, and at Risk in the General Education Classroom (4thth ed., pp. 120-141). USA: Pearson Education, Inc.

25. Strategies for Teaching Students with Emotional and Behavioral Disorders • There are numerous strategies out there for teaching students with emotional and behavioral disorders. • It is important for the teacher to create a community where all students are respectful and encourage others. • Some of those strategies are: • After a week, or so, of observation, try to anticipate classroom situations where the student's emotional state will be vulnerable and be prepared to apply the appropriate mitigative strategies. • Check on the student's basic capacity to communicate and adjust your communications efforts accordingly. Continued on next slide

26. More Strategies! • Use a wide variety of instructional equipment which can be displayed for the students to look at and handle. • Teachers should reward students for good behavior and withhold reinforcement for inappropriate behavior. • Some aggressive students act as they do because of a subconscious desire for attention, and it is possible to modify their behavior by giving them recognition. • Special efforts should be made to encourage and easily facilitate students with behavioral disorders to interact. • Keep an organized classroom learning environment. • Devise a structured behavioral management program. Continued on next slide

27. And MORE Strategies!! • If unstructured activities must occur, you must clearly distinguish them from structured activities in terms of time, place, and expectations. • Do not expect students with behavioral disorders to have immediate success; work for improvement on a overall basis. • Present a sense of positiveness in the learning environment. • Find ways to encourage the student. • Develop a schedule for applying positive reinforcement in all educational environments. • Make sure the discipline fits the "crime," without harshness. Keller, E. (2007, April 20). Strategies for teaching students with behavioral disorders. Retrieved November 2, 2009, from http://www.as.wvu.edu/~scidis/behavior.html

28. Differentiated Instruction (DI) Strategies in an Inclusive Classroom • Differentiated instruction is when we meet the needs of all learners in the classroom by differentiating instruction. • This technique can be applied for students with emotional and behavioral disorders in many ways. • Since students with these disorders are often tied closely to their own emotions and feelings, instruction within the classroom can be designed to help all students. • Some strategies of DI are listed on the following slide. Continued on next slide

29. Differentiated Instruction (DI) Strategies CONTINUED • DI strategies: • Fill out an interest and skill survey • This will allow all students, including those with emotional and behavioral disorders to feel as is their teacher cares about their interests. • Then, create differentiated instruction based upon what the classes interests are. For example: • Create a math lesson/activity • Students work in small groups that they are familiar with so it makes them feel more comfortable. • Hands-on activities that help the students learn. • Give responsibilities to children within each group; recorder, reader, speaker, etc. • Allow students to share their results, but make sure not to give answers, dig deeper to understand their answers • Make children feel appreciated and valuable through letting them come up with their own ways. Franny. (2009, September 15). Differentiating Instruction … One Size Doesn’t Fit All: Effective Strategies to Improve Student Performance!. Retrieved November 2, 2009, from http://www.learnerslink.com/curriculum.htm

30. Differentiated Instruction CONTINUED • DI strategies can vary from subject to subject and from class to class. • Not all students are the same, and students with emotional and behavioral disorders need to know that they are cared for and valued. • Instruction for them needs to allow them to feel that they are wanted and valued within the classroom. • Emotions are strong behind these students, so the more we can show them that we care, the more successful they will hopefully become.

31. Websites for Teachers to Use • Listed below are helpful websites that contain information about emotional and behavioral disorders, along with other disorders, that may help teachers when they need it: • Council for Exceptional Children (CEC): http://www.cec.sped.org • United States Dept. of Health and Human Services- SAMHSA’s National Mental Health Information Center: http://mentalhealth.samhsa.gov/ • National Association of School Psychologists: http://www.nasponline.org • **National Association of Special Education Teachers: http://www.naset.org (I added one more because it was another good resource to know about)

32. Resources • Franny. (2009, September 15). Differentiating Instruction … One Size Doesn’t Fit All: Effective Strategies to Improve Student Performance!. Retrieved November 2, 2009, from http://www.learnerslink.com/curriculum.htm • Keller, E. (2007, April 20). Strategies for teaching students with behavioral disorders. Retrieved November 2, 2009, from http://www.as.wvu.edu/~scidis/behavior.html • Smith, D. D. (2007). Emotional and Behavioral Disorders: Causes and Prevention. Retrieved November 2, 2009, from http://www.education.com/reference/article/emotional-behavioral-disorders-prevention/ • United States Dept. of Health and Human Services. (2003, April). Children's Mental Health Facts Children and Adolescents with Mental, Emotional, and Behavioral Disorders. Retrieved November 2, 2009, from http://mentalhealth.samhsa.gov/publications/allpubs/CA-0006/default.asp#7 • Vaughn, S., Bos, C. S., & Schumm, J. S. (2007). Teaching Students Who Are Expectional, Diverse, and at Risk in the General Education Classroom (4thth ed., pp. 120-141). USA: Pearson Education, Inc.