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Understanding Students with Emotional or Behavioral Disorders. Chapter 7. 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

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Understanding Students with Emotional or Behavioral Disorders


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defining ebd
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
diagnostic information in children s mental health
Diagnostic Informationin 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
educational classifications
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
emotional or behavioral disorders
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
slide6
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
characteristics
Characteristics
  • Internalizing
  • Externalizing
  • Cognitive
  • Academic
internalizing disorders
Internalizing Disorders
  • Anxiety - Withdrawal
    • Separation anxiety disorder
    • Generalized anxiety
    • Phobias
    • OCD
    • Panic disorder
    • Anorexia, bulimia
    • Depression
    • Post-traumatic stress disorder
anxiety disorders
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

Anxiety Disorders
depression
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

Depression
internalizing behavior
Internalizing Behavior
  • Psychotic behavior
    • hallucinations
    • delusions
      • schizophrenia
      • schizotypal (personality disorder)
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

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

Schizophrenia
external disorders
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

External Disorders
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.

Frequent angry outbursts

Noncompliant and argumentative

Easily annoyed

Rejects praise, may sabotage activity that was praised

Deliberately annoys, provokes others

Oppositional Defiant Disorder
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

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

Conduct Disorder
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

Destructive, self-injurious

Absence of guilt or remorse

Extreme defiance, provokes power struggles, manipulative

Mood swings, rages

Inappropriately demanding or clinging

Reactive Attachment Disorder
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

Anxiety, defiance may be seen

Strong craving for carbohydrates

Impaired judgment, impulsivity

Delusions, grandiosity, possibly hallucinations

High risk for suicide and accidents

Bipolar Disorder
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

Difficulty finishing work on time due to perfectionism or ritual rewriting, erasing, etc.

Counting rituals, rearranging objects

Poor concentration

School avoidance

Anxiety or depression

Obsessive-Compulsive Disorder
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

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

Post-Traumatic Stress Disorder
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

Impaired concentration

Withdrawn, preoccupied, anxious

Depressed or mood swings

Irritability, lethargy

Fainting spells, headaches

Eating Disorders
cognitive
Cognitive
  • Most have IQ in low range
  • More than half have learning disabilities
  • Relationship between academic and social behaviors are connected
academic
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
on any given day
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
risk factors
Risk Factors

Research shows both biological and psychosocialfactors 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
causes
Causes
  • Biological
    • Genetics
  • Environmental
    • Stressful living conditions
    • Child maltreatment
    • School factors
stressful living conditions
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
child maltreatment
Child Maltreatment
  • Neglect
  • Physical abuse
  • Sexual abuse
  • Emotional abuse
school factors
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
nondiscriminatory evaluation see pg 166
Nondiscriminatory Evaluation (see pg.166)
  • Observation
  • Screening
  • Prereferral
  • Referral
  • Nondiscriminatory evaluation procedures
  • Determination
interventions techniques
Interventions/Techniques
  • Positive Reinforcement
  • Response Cost
  • Proximity Control
  • Attention to Compliance
  • Ignoring
  • Group Consequences
  • Self Management
  • Contracts
  • Service Learning
group activity
Group Activity
  • Get into your group
  • Read Partnership Tips - Box 7-4 pg. 173
  • Answer the 3 questions at the end
wraparound supports
Wraparound Supports
  • Family driven
  • Collaborative
  • Individualized
  • Culturally competent
  • Community and strength-based
  • Involves community, school, family, mental health, and other services