Presented by Rance L. Harbor, Ph.D., School Psychologist Hillsborough County Public Schools Leto High School Email: ran

1. Working with English Language Learner Secondary Students Presented by Rance L. Harbor, Ph.D., School Psychologist Hillsborough County Public Schools Leto High School Email: rance.harbor@sdhc.k12.fl.us

2. Learning Objectives • How to identify and assess academic, acculturation, and emotional factors that may impact English Language Learner students. • Specifically, we will discuss characteristics often present with ELL students at risk for school failure including • language acquisition • Acculturation • school bonding • and family factors.

3. Learning Objectives • How to develop Tier 1, 2, and 3 interventions based on the students’ needs at each level. • Assessment and outcome measurement techniques and materials will be presented for each level.

4. Identification and Assessment of Academic, Acculturation, and Emotional Factors

5. ELLs in Florida by Country of Birth • United States 149,327 • Mexico 10,232 • Cuba 18,864 • Puerto Rico 5,384 • Colombia 4,556 • Dominican Republic 2,945 FL DOE, 2009-2010

6. Latinos are the most numerous and fastest growing ethnic minority group in the United States, and approximately 15.4 million are under the age of 18 years (U.S. Department of Commerce, Bureau of the Census 2009).

7. Selection of Assessment Tools and Identification of Appropriate Treatment Goals

8. Tier 1, 2, & 3 Identification • Make sure you know the Referral Question! • Harbor Student Survey (Spanish & English) • Support Service Intake Form • Background Information- Parent Form (Spanish & English) • Teacher Feedback Form (English only, but Spanish in 2011) • Student Feedback Form (Spanish & English) • Classroom Observations • Behavior Rating Scales (CBCL or BASC)

9. Tier 1, 2, & 3 Identification Cella Testing IPT Testing FAIR Testing Math Formative FCAT Writing, Reading, Math Algebra 1 Grades Intensive Reading Grades Discipline Reports Attendance Reports

10. Student Survey Please rate how much the following questions apply to you by circling the appropriate number.

11. Student Survey

12. Student Survey • Who do you feel comfortable going to for help if another student, or an adult at school, was harassing or bullying you? • (Check all that apply and write a specific name of the person if you want.) •  Teacher(s) _________________  Administrator _________________  School Resource Officer • School Psychologist  School Social Worker  Guidance Counselor  School Nurse • A Friend  Parent (s) ______________ Nobody What things about school worry you the most? ___________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ What things could we do to help you do better in school? ____________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________

13. Teacher Survey Please rate this student’s behavior by circling the appropriate number. Current Grade (estimate): A B C D F Academic Concerns, if any: __________________________________________ Behavior Concerns, if any: __________________________________________

22. Academic Needs .

23. What about ELL? • For those students who: • have not passed FCAT Reading Benchmark • Who took the FAIR Assessment • Examine by Grade • ELL Status x Success Zone AP2 • Compare: • Developmental Score 2008-09 for FCAT Reading • FSP Score AP1 • FSP Score AP2

24. Academic Interventions Going to develop a FUSE model to coteach regular education classes with ELL Paraprofessionals. This will allow LYCs who are stuggling to also have additional ELL resources as well as allow small group pullout/Tier 2 instruction for LYAs and LYBs Newcomer Academy will consist of core language acquisition classes (English, Spanish, Dev LA) with splintering off for Math and Science based on placement test results. Core classes will also allow for delivery of Tier 2 transitional services from psych, guidance, and social work (similar to work already being done in acculturation group) since students are already grouped together.

25. Academic Interventions For all Level 1 FCAT students, an intensive reading program is required. Developmental LA course counts for LYAs + LYBs. Academy of Reading is not recommended as it is not at an appropriate reading level for them. Suggested Math + Science placement tests for newcomers. Math department has Algebra materials in Spanish to create a "screener". Note: Geometry is too language intensive for Lys.

26. Acculturation Mental Health

27. The Importance to Address Culture What is culture? Worldview that a group has which allows members of that group to interpret the world. Culture cannot be interpreted to just mean individuals from a particular ethnic group. Culture and Pathology A group’s values determine how a problem will be expressed. College students express problems overwhelmingly as “being tired”, or “being burnt out”; this is not common among individuals who are not currently in college.

28. Why do different cultural groups look at pathology different? Reason is because of their worldview. Rejection of mind-body duality. A disease of one person is, by default, a disease of the group and of the whole (Kirmayer & Young, 1998). This shared responsibility can, in many instances, relieve the stress that is normally experienced by an individual living in a Western society.

29. Introduction to Depression Depression is a disorder characterized by persistent depressed (sad) mood which may last months or even years. About 2% of school-age children (i.e. children 6-12 years of age) appear to have a major depression at any one time. Puberty - the rate of depression increase to about 4% major depression overall. Overall, approximately 20% of youth will have one or more episodes of major depression by the time they become adults.

30. Prevalence of Depression Lifetime prevalence for Major Depressive Disorder 17% for men 21.3% for women. (Garber 2000) Prevalence Rates of depression: Adolescence: 0.4%  6.4%.

31. Prevalence of Depression • Latina women are at a higher risk of having a depressive episode. • Women seem to be affected more in general, but as many as 46% of Latina women were depressed. • Opposed to men, the prevalence of depression in Latino men is 19.6% (NAMI).

32. Differential Issues in Diagnosis Much stigma and negative connotation associated with depression or any mental related issues in the Latino Culture. Often associated as being “crazy” or “ataque de nervios”. In order to receive help, Latinos may complain and express somatic symptoms. Seeking medical attention is a more valid and socially acceptable way to receive services and avoid embarrassment.

33. Differential Issues in Diagnosis • Rather than seeking professional help, many rely on spiritual belief or other folk tale particular to their culture. • Latinos may seek treatment from general doctors which may result in misdiagnosing or missing the root of the problem all together.

34. Differential Issues in Diagnosis Other factors that can play a role is the on-going stress of issues such as: Poverty Racism Social stratification Legal status Pre-existing mental health issues in native country Assimilation and Acculturation (student and parents) Acculturation - individuals are able to find value and meaning in both cultures and identify with both. Assimilation: The student’s home cultural values and beliefs are replaced by the new culture, leaving behind the parents’ culture .

35. Barriers One big barrier is the shortage of Latinos in the health force to adequately serve these communities. 1.7% of all school psychologists are Latino. Not knowing where to receive help can pose a barrier especially because many Latino families are of low to middle income families

36. Barriers Increase the awareness of Latino issues concerning depression including, cultural traditions among non-Latino groups and individuals. Realizing that although Latinos are very interdependent as a family, the sense of “space” to communicate feelings of depression is not easily available and can pose a great barrier if a child is experiencing such feelings.

37. Barriers By learning how to reach the Latino communities includes everyone that is involved in the child’s life. That may be parents, brothers and sister and as a whole come up with better interventions. Making resources available for parents is of great step to help their children receive medical treatment if needed. Lack of information regarding the intensity and severity of depression. Not informing Latinos of the severity of depression as well as the treatment available can further hinder in receiving the adequate treatment.

38. A Tier 2 Intervention:ELL Transition Group 5 students 3 females (1 from Cuba, 2 from Dominican Republic) 2 males (both from Cuba Primarily 9th and 10th graders/Spanish first language Met bi-weekly for 50 mintues Referred primarily by Guidance Counselor Served as a reference point/bridge between them and the school

39. Adjustment Issues Barriers Transition Family support Group support as a means for navigating school Legal status A Tier 2 Intervention:ELL Transition Group

40. ELL Transition Group/Tier 3 Individual Students Larger issues than just transition Socio-emotional Behavioral

41. Anxiety • Anxiety involves constant, excessive, and unrealistic worry • Generalized Anxiety Disorder • Obsessive Compulsive Disorder • Panic Disorder • Posttraumatic Stress Disorder • Separation Anxiety • Social Anxiety • Specific Phobias

42. Culture & Anxiety “Cultural differences in perceptions and approaches to illness have an impact in the experience of disease, interpretation of symptoms, symptom expression, and the manner in which one copes” Salman et al. (1997)

43. Cultural influences in defining Anxiety • Social stigma and family shame linked to psychological disorders in Latino culture • Influence descriptions and interpretations of psychological symptoms Salman et al. (1997)

44. Cultural influences in defining Anxiety • Culturally accepted terms when referring to symptoms • Widely used term to communicate a wide range of symptoms is “nervios” • Anxiety • Somatic symptoms • Panic attacks • Misbehavior • Emotional distress • Schizophrenia • “Nervios” translates to nerves

45. Prevalence of Anxiety • Latinos meet criteria for separation anxiety disorder more often than Caucasians • 6-17 years old • Mainly Central American origin • More reported general anxiety, social anxiety and somatic symptoms • Secondary school students • Females report more social anxiety and somatic symptoms • Related to absences & visits to school nurse? Ginsburg & Silverman (1996), Glover et al. (1999), McLaughlin et al. (2007)

46. Prevalence of Anxiety • Latinos report more worries than Caucasian youth • Research included Mexican youth residing in Mexico and America as well as European American youth residing in the United States • A later study added youth residing in the United States from Central American origins. Similar results were found. Varela et al. (2004, 2008)

47. “Beyond developing explicatory models of psychopathology with Latino youth, our understanding of how relevant cultural and contextual variables may serve to protect or place such children at greater risk will facilitate the development of psychosocial and cognitive interventions and preventive measures for anxiety disorders with this population.” Varela & Hensley-Maloney, 2009

48. Cognitive-Behavioral Therapy for Anxiety • Balance of cultural sensitivity and evidence-based practices • Flexibility necessary • Be a reflective practitioner • How may my own biases affect treatment? • What is working/not working? • Get to know the student within family and cultural context • Involve the family • Extended family also valuable • Establish goals that are culturally valued and relevant Wood et al. (2008)

49. Barriers to Mental Health Therapy • Language proficiency of therapists • Miscommunication • Misdiagnosis/treatment • Cultural barrier • Cultural context of information • Cultural competence necessary Suzuki & Ponterotto, 2008

50. Transition Group 2010-2011 9 students • 4 Females (2 from Cuba, 1 from Puerto Rico, 1 from Dominican Republic) • 5 Males (3 from Cuba, 2 from Colombia) 9th-12th graders Spanish is primary language Met bi-weekly