Behavior Disorders/Emotional Disabilityand Educational Implications

Robin M. Fierer-Wilson, EdSRCCSEC School Psychologist

Topics to be covered:IDEA and Emotional

Disturbance/Disability (ED)Characteristics of Students with

Emotional DisabilityED versus “Socially Maladjusted”Specific Emotional DisabilitiesThe Role of SchoolsResponse to Intervention for ED

IDEA and Emotional DisabilityA condition exhibiting ONE or more of the

following FIVE characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:

Inability to learn that cannot be explained by intellectual, sensory, or health factors

Inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

Inappropriate types of behavior or feelings under normal circumstances

A general pervasive mood of sadness or depressionA tendency to develop physical symptoms or fears

associated with personal or school problems

Characteristics of Students with EDTypically exhibit mood disorders (depression, bipolar),

anxiety disorders, or other psychiatric disordersCo-occurrence of emotional disturbance and behavior

disorders is commonParticularly vulnerable to environment changes such

as transitions and to a lack of positive behavior support during transitions

Behavior and intensity is episodic and subject to change over time

Often behavior serves to direct attention away from underlying issues, such as depression

Behavior may be internal or external (e.g. acting out vs. withdrawn)

Behaviors Exhibited by Children with EDHyperactivity (short attention span,

impulsiveness)Aggression or self-injurious behavior

(fighting, throwing things, cutting)Withdrawal (not interacting w/ others,

excessive fear or anxiety)Immaturity (inappropriate crying, temper

tantrums, poor coping skills)Learning difficulties (academically

performing below grade level)

ED versus “Socially Maladjusted”Students who are deemed “Socially

Maladjusted” are NOT eligible for special education services under IDEA

“Socially Maladjusted” has no clear Federal definition, thus no universally recognized agreement of its meaning

Additionally, no clear process for determining ED versus Socially Maladjusted

Body of research exists supporting different definitions of Social Maladjustment (Achenbach, Bower, Clarizio, Forness, Merrell & Walker) – a non-exhaustive list of authors, not specific citations

Traditional View of “Socially Maladjusted” (Merrell & Walker, 2004)

Student meets the Diagnostic & Statistical Manual of Mental Disorders (DSM) criteria for Conduct Disorder or Oppositional-Defiant Disorder

Engages in antisocial and delinquent behavior within the context of a deviant peer group (typically seen by older children)

Maintains social status with deviant peer group by engaging in antisocial and delinquent behavior

Problem behavior is “willful:” child is making a “choice” to do it and could stop if desired

Student with SM does not have internalizing/emotional problems or mental health problems

Student with SM believes that behavioral rules should not apply to them or that they should be able to self-select own rules of conduct

Students with SM are shrewd, callous, streetwise, and lack remorse

Legal Cases of Eligibility and IneligibilityFauqueir County Pub. Sch., 20 IDELR 579 (August 11, 1993)

The parents of a nine-year-old wanted their daughter classified as ED so she could receive special education services. The hearing officer found that the child did exhibit rage and behavioral problems at home and was categorized as “asocial”, but she was making significant progress in school. Eligible or Ineligible

The officer also found her to be well adjusted in the school setting. Therefore, the child was benefitting from the regular education program and, therefore, not eligible for special education services.

Eligibility versus IneligibilityHansen v. Republic R-III School District, No. 10-1514Larry Hansen’s son is a ninth-grade student in the Republic

R-III School District (“Republic”) and has been diagnosed with conduct disorder, bipolar disorder, and attention deficit hyperactivity disorder. Hansen has (1) been suspended numerous times for threatening classmates and teachers, (2) made suicidal comments on multiple occasions, (3) consistently performed poorly in his classes and standardized tests. At the end of his fifth-grade year, Hansen’s father initiated proceedings under the IDEA for sped services for Hansen.

Eligible or Ineligible

Hansen v. Republic cont.

Initially, Republic determined that Hansen did not qualify under IDEA for special education services. Hansen’s father challenged the decision, but the Due Process Panel agreed with Republic that Hansen did not qualify.

Hansen’s father sought judicial review of the panel’s decision, and the district court agreed with Hansen’s father that his son was disabled as defined by the IDEA.

Republic then appealed the matter to the Circuit Court of Appeals, arguing that Hansen did not meet the statutory definition of a “child with a disability”, arguing that he was “Socially Maladjusted”.

The Circuit Court of Appeals agreed with Hansen’s father, stating that the student “…consistently struggled to pass his classes, failed the standardized test for advancement to seventh grade, and suffered academically because of his diagnosed bipolar disorder.”

Specific Emotional DisabilitiesAnxiety Disorders

Umbrella term that refers to distinct disabilities that share core characteristic of irrational fear: generalized anxiety disorder (GAD), Obsessive –compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder (also called social phobia), and specific phobias (heights, insects, etc)

Anxiety disorders are the most common psychiatric illnesses affecting children and adults (Anxiety Disorders Association of America)

Bipolar disorder (formerly referred to as Manic-Depressive Disorder

Causes dramatic mood swings from overly “high” and/or irritable to sad and hopeless and then back again, often with periods of normal mood in between.

Severe changes in energy and behavior go along with these changes in mood.

For most people, mood swings and related symptoms can be stabilized over time with a combination of medication and psychosocial treatment.

Conduct DisorderRefers to a group of behavioral and emotional

problems in children and adolescents.Kids with this disorder have extreme difficulty

following rules and behaving in a socially acceptable way, which may include some of these behaviors: Aggression to people and animals; Destruction of property; Deceitfulness, lying, or stealing Truancy or other serious violations of rules

National Alliance on Mental Illness. (2010). What is mental illness: Mental illness facts. http://tinyurl.com/3ew3d

Reactive Attachment DisorderDisturbed and developmentally inappropriate social

relatedness in most contexts to a marked degree, beginning before age 5 evident by (1) or (2): (1) Persistent failure to respond appropriately to most

social interactions (highly inhibited/ambivalent, hyper vigilant, contradictory responses such as approach-avoidance)

(2) Attachments categorized as inappropriate or indiscriminate, such as excessive familiarity/comfort with strangers or lack of selectivity in choice of attachment figures (indiscriminate).

Not accounted for by developmental delay (e.g. mental retardation) and does not meet criteria for a PDD

Pathogenic care of at least 1 type (neglect, abuse, repeated changes of primary caregiver)

Role of Schools in Children’s Mental HealthSchools provide a logical venue/opportunity to

bring students, educators, families and community together

Building a “System of Care” or a partnership of service providers to support student success with a multidisciplinary team approach or “Wraparound Planning Process”

The Comprehensive Community Mental Health Services Program for Children and Families is a Federally funded program that provides grants to local communities (SAMHSA - http://www.samhsa.gov/)

Wrap-around Planning ProcessProven to be an effective process for designing

individualized service plans for children with ED and their families

Teams include school personnel, family members of student, and other service providers involved with child (e.g. case worker, counselor, clergy)

In the three-tiered model (RtI/PBIS) the Wraparound Planning process can address the complex needs of students in the top of the triangle (RED): the 1% - 5% needing intensive and individualized behavioral interventions

Wrap-around Plan ExampleJustin:Six years old, beginning kindergartenHad been kicked out of several childcare

centers for biting, kicking, and hitting. Also destroyed property and had temper tantrums that would last for hours.

Mother took him to the local medical school, where they diagnosed him and came up with a treatment plan.

Mother also took him to the community mental health clinic, where they provided a different diagnosis and treatment plan.

Justin continued…The school provided a third “diagnosis”

(eligibility determination) and plan.When mother chose ONE plan to follow, the

other two systems labeled her as “resistant”.The Wrap-around Plan promotes a

coordinated, community-based approach to care for children and adolescents with serious mental health challenges and their families.

“A system of care is not a program, it’s a PHILOSOPHY” (Dr. Gary M. Blau, Chief of the Child, Adolescent, and Family Branch at SAMHSA’s Center for Mental Health Services (CMHS)

RtI and Students with E/BDStudents identified as having E/BD may

receive support at any Tier (I, II, or III)It must be determined what level of services

will provide the highest chance of success for the student – both behaviorally and academically

E/BD students will likely receive Tier III behavioral support, including an extensive functional behavioral analysis and interventions

Academic SystemsBehavioral Systems

1-5% 1-5%

5-10% 5-10%

80-90% 80-90%

Intensive, Individual Interventions•Individual Students•Assessment-based•High Intensity

Intensive, Individual Interventions•Individual Students•Assessment-based•Intense, durable procedures

Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response

Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response

Universal Interventions•All students•Preventive, proactive

Universal Interventions•All settings, all students•Preventive, proactive

Council for Children with Behavior Disorders(CCBD): Position statement on RtI and BehaviorAll teachers and school personnel should be provided with the

tools to implement scientifically-based academic and behavioral interventions.

Schools that implement RtI should be committed to providing PBIS and should integrate RtI and PBIS to ensure students’ academic and behavior needs are addressed.

*A functional behavior assessment and behavior intervention plan are suggested for any student exhibiting behavior that leads to restrictive disciplinary actions. RtI interventions should not be substituted for a spec. ed. evaluation referral for a student suspected of having E/BD.

Failure to refer a student suspected of having a disability and continued use of suspension and expulsion in the name of RtI are inappropriate strategies for addressing a students emotional/behavior problems.

CCBD position statement continued…General education teachers should receive

support staff, resources, and training in appropriate scientifically based academic and behavioral interventions regarding RtI. *While collaboration between general and spec. ed

teachers will enhance services at every level of a tiered system, spec. ed teachers should not be expected to reduce services to identified students with disabilities to assist general ed teachers in implementing RtI.

Parents should be actively involved in RtI and informed of the student’s progress or lack of, throughout the process

Please feel free to email me with any comments or

questions!

Robin Fierer-Wilson

fiererrm@rccsec.org