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Understanding Students with Emotional or Behavioral Disorders Chapter 7.

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Presentation on theme: "Understanding Students with Emotional or Behavioral Disorders Chapter 7."— Presentation transcript:

1 Understanding Students with Emotional or Behavioral Disorders Chapter 7

2 Defining EBD Inability to learn (cannot be explained by intellectual, sensory, or health factors) Inability to develop or maintain interpersonal relationships Inappropriate types of behaviors or feelings Pervasive mood of unhappiness or depression Physical symptoms or fears associated with personal or school problems Inability to learn (cannot be explained by intellectual, sensory, or health factors) Inability to develop or maintain interpersonal relationships Inappropriate types of behaviors or feelings Pervasive mood of unhappiness or depression Physical symptoms or fears associated with personal or school problems

3 Diagnostic Information in Children’s Mental Health DSM-IV is the accepted guide to psychiatric diagnosis Many disorders show similar symptoms Some tend to occur together in the same child It may take years to reach an accurate diagnosis as symptoms change with time and development DSM-IV is the accepted guide to psychiatric diagnosis Many disorders show similar symptoms Some tend to occur together in the same child It may take years to reach an accurate diagnosis as symptoms change with time and development

4 Educational Classifications Most children with a diagnosable mental health disorder will need special education assistance Usual classifications will be EBD (Emotional or Behavioral Disorders) or OHD (Other Health Disorders) Classification does NOT dictate classroom placement; many of these students succeed in a regular education classroom Most children with a diagnosable mental health disorder will need special education assistance Usual classifications will be EBD (Emotional or Behavioral Disorders) or OHD (Other Health Disorders) Classification does NOT dictate classroom placement; many of these students succeed in a regular education classroom

5 Emotional or Behavioral Disorders An established pattern of one or more: Withdrawal or anxiety, depression, problems with mood, or feelings of self- worth defined by behaviors Disordered thought processes with unusual behavior patterns and atypical communication styles Aggression, hyperactivity, or impulsivity that is developmentally inappropriate An established pattern of one or more: Withdrawal or anxiety, depression, problems with mood, or feelings of self- worth defined by behaviors Disordered thought processes with unusual behavior patterns and atypical communication styles Aggression, hyperactivity, or impulsivity that is developmentally inappropriate

6 EBD Responses must adversely effect educational or developmental performance and be seen in at least three settings including two educational settings (for instance - classroom and lunchroom) Behaviors seen must be significantly different from appropriate age, cultural or ethnic norms; and must not be primarily the result of intellectual, sensory, or acute or chronic health conditions Responses must adversely effect educational or developmental performance and be seen in at least three settings including two educational settings (for instance - classroom and lunchroom) Behaviors seen must be significantly different from appropriate age, cultural or ethnic norms; and must not be primarily the result of intellectual, sensory, or acute or chronic health conditions

7 Characteristics Internalizing Externalizing Cognitive Academic Internalizing Externalizing Cognitive Academic

8 Internalizing Disorders Anxiety - Withdrawal Separation anxiety disorder Generalized anxiety Phobias OCD Panic disorder Anorexia, bulimia Depression Post-traumatic stress disorder Anxiety - Withdrawal Separation anxiety disorder Generalized anxiety Phobias OCD Panic disorder Anorexia, bulimia Depression Post-traumatic stress disorder

9 Anxiety Disorders Frequent absences Isolating behaviors Many physical complaints Excessive worry Frequent bouts of tears Frustration Frequent absences Isolating behaviors Many physical complaints Excessive worry Frequent bouts of tears Frustration Fear of separation School avoidance Fear of new situations Drug or alcohol abuse See also: OCD, PTSD Fear of separation School avoidance Fear of new situations Drug or alcohol abuse See also: OCD, PTSD

10 Depression Affects thoughts, feelings, behavior, relationships, physical health Irritability In early childhood, may appear as irritability, defiance, restlessness, or clinging Affects thoughts, feelings, behavior, relationships, physical health Irritability In early childhood, may appear as irritability, defiance, restlessness, or clinging Continuing sadness Hopelessness, self- deprecating remarks School avoidance Changed eating or sleeping patterns Frequent physical complaints Isolation, nonparticipation Continuing sadness Hopelessness, self- deprecating remarks School avoidance Changed eating or sleeping patterns Frequent physical complaints Isolation, nonparticipation

11 Internalizing Behavior Psychotic behavior hallucinations delusions schizophrenia schizotypal (personality disorder) Psychotic behavior hallucinations delusions schizophrenia schizotypal (personality disorder)

12 Schizophrenia Commonly appears in late teens or early adulthood May come on gradually; may appear in teens with other mental health diagnoses. Early diagnosis and treatment is imperative; 50 percent or more may attempt suicide Commonly appears in late teens or early adulthood May come on gradually; may appear in teens with other mental health diagnoses. Early diagnosis and treatment is imperative; 50 percent or more may attempt suicide Withdrawn, lack motivation Vivid and bizarre thoughts or speech Confusion between fantasy and reality Hallucinations (visual) or delusions (auditory) Severe fearfulness Odd, regressive behavior Disorganized speech Withdrawn, lack motivation Vivid and bizarre thoughts or speech Confusion between fantasy and reality Hallucinations (visual) or delusions (auditory) Severe fearfulness Odd, regressive behavior Disorganized speech

13 External Disorders Undersocialized Aggressive CD CD Attention Problems - Immaturity Motor Excess unaware of behavioral expectations Undersocialized Aggressive CD CD Attention Problems - Immaturity Motor Excess unaware of behavioral expectations Socialized Aggressive CD Socialized delinquency gang involvement truancy “looks up to other rule violators aware of behavioral expectations; covert attempts Socialized Aggressive CD Socialized delinquency gang involvement truancy “looks up to other rule violators aware of behavioral expectations; covert attempts

14 Oppositional Defiant Disorder Above average level of anger, blaming, hostile, or vindictive behavior May be a reaction to frustration, depression, inconsistent structure, or constant failure due to undiagnosed ADHD, learning disabilities, etc. Above average level of anger, blaming, hostile, or vindictive behavior May be a reaction to frustration, depression, inconsistent structure, or constant failure due to undiagnosed ADHD, learning disabilities, etc. Frequent angry outbursts Noncompliant and argumentative Easily annoyed Rejects praise, may sabotage activity that was praised Deliberately annoys, provokes others Frequent angry outbursts Noncompliant and argumentative Easily annoyed Rejects praise, may sabotage activity that was praised Deliberately annoys, provokes others

15 Conduct Disorder Serious, repetitive, and persistent misbehavior Aggression toward people or animals Property destruction Deceitfulness, theft Three or more incidents in last year; one during last six months Serious, repetitive, and persistent misbehavior Aggression toward people or animals Property destruction Deceitfulness, theft Three or more incidents in last year; one during last six months Problem must be persistent, not a reaction to stress, crisis, cultural, or social life context Co-occurs with ADHD, learning disabilities, depression See also: Oppositional Defiant Disorder Problem must be persistent, not a reaction to stress, crisis, cultural, or social life context Co-occurs with ADHD, learning disabilities, depression See also: Oppositional Defiant Disorder

16 Reactive Attachment Disorder Disturbed and developmentally inappropriate social relatedness in most contexts Begins before age five, usually after a period of grossly inadequate care or multiple caretaker changes Disturbed and developmentally inappropriate social relatedness in most contexts Begins before age five, usually after a period of grossly inadequate care or multiple caretaker changes Destructive, self- injurious Absence of guilt or remorse Extreme defiance, provokes power struggles, manipulative Mood swings, rages Inappropriately demanding or clinging Destructive, self- injurious Absence of guilt or remorse Extreme defiance, provokes power struggles, manipulative Mood swings, rages Inappropriately demanding or clinging

17 Bipolar Disorder Frequent, intense shifts in mood, energy, motivation Shifts in children are very fast and unpredictable “Mania” phase may appear as intense irritability or rages Frequent, intense shifts in mood, energy, motivation Shifts in children are very fast and unpredictable “Mania” phase may appear as intense irritability or rages Anxiety, defiance may be seen Strong craving for carbohydrates Impaired judgment, impulsivity Delusions, grandiosity, possibly hallucinations High risk for suicide and accidents Anxiety, defiance may be seen Strong craving for carbohydrates Impaired judgment, impulsivity Delusions, grandiosity, possibly hallucinations High risk for suicide and accidents

18 Obsessive-Compulsive Disorder Intrusive, repeated thoughts Senseless repeated actions or rituals Frequently co-occurs with substance abuse, ADHD, eating disorders, Tourette Syndrome, other anxiety disorders Intrusive, repeated thoughts Senseless repeated actions or rituals Frequently co-occurs with substance abuse, ADHD, eating disorders, Tourette Syndrome, other anxiety disorders Difficulty finishing work on time due to perfectionism or ritual rewriting, erasing, etc. Counting rituals, rearranging objects Poor concentration School avoidance Anxiety or depression Difficulty finishing work on time due to perfectionism or ritual rewriting, erasing, etc. Counting rituals, rearranging objects Poor concentration School avoidance Anxiety or depression

19 Post-Traumatic Stress Disorder Affects children who are involved in or witness a traumatic event A concern with refugee populations Intense fear and helplessness predominate at event and during flashbacks Affects children who are involved in or witness a traumatic event A concern with refugee populations Intense fear and helplessness predominate at event and during flashbacks Flashbacks, nightmares, repetitive play re-enactments Emotional distress when reminded of incident(s) Fear of similar places, people, events Easily startled, irritable, hostile Physical symptoms such as headaches, dizziness Flashbacks, nightmares, repetitive play re-enactments Emotional distress when reminded of incident(s) Fear of similar places, people, events Easily startled, irritable, hostile Physical symptoms such as headaches, dizziness

20 Eating Disorders Anorexia, Bulimia Now at earlier ages, 10-20% boys Perfectionists, over- achievers, athletes at highest risk High risk for depression, alcohol, and drug abuse Anorexia, Bulimia Now at earlier ages, 10-20% boys Perfectionists, over- achievers, athletes at highest risk High risk for depression, alcohol, and drug abuse Impaired concentration Withdrawn, preoccupied, anxious Depressed or mood swings Irritability, lethargy Fainting spells, headaches Impaired concentration Withdrawn, preoccupied, anxious Depressed or mood swings Irritability, lethargy Fainting spells, headaches

21 Cognitive Most have IQ in low range More than half have learning disabilities Relationship between academic and social behaviors are connected Most have IQ in low range More than half have learning disabilities Relationship between academic and social behaviors are connected

22 Academic Achieve below grade level in reading, math, and written expression Drop out of school at a higher rate than any other students Mean achievement level at the 25th percentile More academic problems with externalizing behaviors Less likely to attend post-secondary school Achieve below grade level in reading, math, and written expression Drop out of school at a higher rate than any other students Mean achievement level at the 25th percentile More academic problems with externalizing behaviors Less likely to attend post-secondary school

23 On Any Given Day… Three million American children meet the clinical criteria for mood disorders 21% of children and adolescents have a behavioral, emotional, or mental health problem One out of every 20 Minnesota children is identified with Severe Emotional Disturbance Suicide is the second leading cause of death for ages 15-34 in Minnesota. The overall suicide rate is double the homicide rate in the state Three million American children meet the clinical criteria for mood disorders 21% of children and adolescents have a behavioral, emotional, or mental health problem One out of every 20 Minnesota children is identified with Severe Emotional Disturbance Suicide is the second leading cause of death for ages 15-34 in Minnesota. The overall suicide rate is double the homicide rate in the state

24 Risk Factors Research shows both biological and psychosocial factors influence the development of the brain, and brain disorders Many brain disorders cluster in families, showing a genetic component or predisposition Some symptoms relate to damage due to injury, infection, poor nutrition, or exposure to toxins Stressful life events, malnutrition, childhood maltreatment, and aggression may lead to short or long-term symptoms and increase the likelihood of adverse outcomes Research shows both biological and psychosocial factors influence the development of the brain, and brain disorders Many brain disorders cluster in families, showing a genetic component or predisposition Some symptoms relate to damage due to injury, infection, poor nutrition, or exposure to toxins Stressful life events, malnutrition, childhood maltreatment, and aggression may lead to short or long-term symptoms and increase the likelihood of adverse outcomes

25 Causes Biological Genetics Environmental Stressful living conditions Child maltreatment School factors Biological Genetics Environmental Stressful living conditions Child maltreatment School factors

26 Stressful Living Conditions 38% youth with EBD come from households with annual income under $12,000 32% come from households with income $12,000 - $24,999 44% single parent households 1/2 to 3/4 children in foster care have EBD Homeless children experience EBD 3 to 4 times more frequently 38% youth with EBD come from households with annual income under $12,000 32% come from households with income $12,000 - $24,999 44% single parent households 1/2 to 3/4 children in foster care have EBD Homeless children experience EBD 3 to 4 times more frequently

27 Child Maltreatment Neglect Physical abuse Sexual abuse Emotional abuse Neglect Physical abuse Sexual abuse Emotional abuse

28 School Factors Students do not receive research-based interventions in reading 2/3 of teachers are not certified in EBD Teachers working with students with EBD experience burnout and job stress more than other teachers Students do not receive research-based interventions in reading 2/3 of teachers are not certified in EBD Teachers working with students with EBD experience burnout and job stress more than other teachers

29 Nondiscriminatory Evaluation (see pg.166) Observation Screening Prereferral Referral Nondiscriminatory evaluation procedures Determination Observation Screening Prereferral Referral Nondiscriminatory evaluation procedures Determination

30 Interventions/Techniques Positive Reinforcement Response Cost Proximity Control Attention to Compliance Ignoring Group Consequences Self Management Contracts Service Learning Positive Reinforcement Response Cost Proximity Control Attention to Compliance Ignoring Group Consequences Self Management Contracts Service Learning

31 Group Activity Get into your group Read Partnership Tips - Box 7-4 pg. 173 Answer the 3 questions at the end Get into your group Read Partnership Tips - Box 7-4 pg. 173 Answer the 3 questions at the end

32 Wraparound Supports Family driven Collaborative Individualized Culturally competent Community and strength-based Involves community, school, family, mental health, and other services Family driven Collaborative Individualized Culturally competent Community and strength-based Involves community, school, family, mental health, and other services


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