Emotional/Behavioral Disorders Exceptionality Report Introduction In 1988, the National Mental Health and the Special Education Coalition

approved the term emotional and behavioral disorders (EBD) (Pro Ed, n.d., p. 3) which cause issues with students academic achievement and social development. EBDs are challenging to define and can be linked to biological and environmental causes or a combination of the two. Biological factors include: chemical imbalances in the body, and damage to the central nervous system, such as a head injury, while environmental factors include: exposure to violence, extreme stress, and the loss of an important person, (Pyschology.com, 2011). This report lists information that may be able to help in recognizing problems with your child, so the proper measures can be intergrated. Definition and Prevalence IDEA Emotional disturbance is defined in the Individuals with Disabilities Education Act (IDEA) as: (I) A condition exhibiting one or more characteristics over a long period of time and to a marked degree, which adversely affects educational performance: (A) An inability to learn which cannot be explained by intellectual, sensory, or health factors; (B) An inability to build or maintain satisfactory relationships with peers and teachers; (C) Inappropriate types of behaviors or feelings under normal circumstances; (D) A general pervasive mood of unhappiness or depression; or (E) A tendency to develop physical symptoms or fears associated with personal or school problems. (II) The term does not include children who are socially maladjusted, unless it is determined that they are seriously emotionally disturbed (Hardman, Drew, & Egan, 2011). According to Hardman, Drew, and Egan, the prevalence of emotional and behavioral disorders vary widely from one study to another, with a range of two to twenty percent (2011, p.183). In the United States, roughly one percent of the students in the public school setting obtain special education under the EBD classification. Sadly, a majority of students with EBD remain unidentified and do not receive the therapeutic care or special education they need to succeed (Hardman, Drew, & Egan, 2011, p.183). Characteristics In the chart below is a list of common characteristics that accompany emotional and behavioral disorders: Emotion and Behavior

Internalizing vs. Externalizing Behaviors Same emotions and behaviors typical students have, but are more intense and

more often. Fears and Anxieties associated with coming to school Might have Anger with externalizing behaviors and aggression Might be depressed, internalizing behaviors Hard to establish and maintain peer and adult relationships Lack of social skills and appropriateness Low to average intellectual ability Lowest GPAs and highest dropout rate Many students with EBD also show comorbid or additional disabilities

Social

Cognition and Academics

(School of Psychology, 2012) Classifications In the chart below is a list of some of the most common emotional/behavioral disorders and their signs and symptoms: Disorder Generalized Anxiety Disorder Phobias Panic disorders Obsessive-compulsive disorder Post-traumatic stress disorder Signs & Symptoms Trouble falling or staying asleep Trembling Twitching Muscle tension Headaches Irritability Sweating Hot flashes Lightheadedness and/or difficulty breathing Nausea Frequent urination Feeling as though there is a lump in the throat Fatigue Lack of concentration Being easily startled Prone to irritable bowel syndrome Inability to relax

Severe Depression

(John Hopkins Medicine, n.d.) Fatigue or loss of energy almost every day.

Feelings of worthlessness or guilt almost every day. Impaired concentration, indecisiveness. Insomnia or hypersomnia (excessive sleeping) almost every day. Markedly diminished interest or pleasure in almost all activities nearly every day (called anhedonia, this symptom can be indicated by reports from significant others). Restlessness or feeling slowed down. Recurring thoughts of death or suicide. Significant weight loss or gain (a change of more than 5% of body weight in a month).

Bipolar Disorder

(Web MD, 2012) Feeling hopeless, sad, or empty. Irritability Inability to experience pleasure Fatigue or loss of energy Physical and mental sluggishness Appetite or weight changes Sleep problems Concentration and memory problems Feelings of worthlessness or guilt Thoughts of death or suicide (Smith, & Segal, 2013) Inattention Has difficulty concentrating Has unrelated thoughts Has problems focusing and sustaining attention Appears to not be listening Performance depends on task May have better attention to enjoyed activities Has difficulty planning, organizing, and completing tasks on time Has problems learning new things Demonstrates poor self-regulation of behavior, that is, he or she has difficulty monitoring and modifying behavior to fit different situations and settings Hyperactivity Seems unable to sit still (e.g., squirming in his/her seat, roaming around the room, tapping pencil, wiggling feet, and touching everything) Appears restless and fidgety May bounce from one activity to the next

Attention-deficit/Hyperactivity Disorder

Conduct Disorder

Often tries to do more than one thing at once Impulsivity Difficulty thinking before acting (e.g., hitting a classmate when he/she is upset or frustrated) Problems waiting his/her turn, such as when playing a game (American Speech-Language-Hearing Association, n.d.) Aggressive behavior: These are behaviors that threaten or cause physical harm and may include fighting, bullying, being cruel to others or animals, using weapons, and forcing another into sexual activity. Destructive behavior: This involves intentional destruction of property such as arson (deliberate firesetting) and vandalism (harming another person's property). Deceitful behavior: This may include repeated lying, shoplifting, or breaking into homes or cars in order to steal. Violation of rules: This involves going against accepted rules of society or engaging in behavior that is not appropriate for the person's age. These behaviors may include running away, skipping school, playing pranks, or being sexually active at a very young age. Low self-esteem Tend to throw frequent temper tantrums Possible abuse drugs and alcohol use Unable to appreciate how their behavior can hurt others Little guilt or remorse about hurting others

(Web MD, 2012) Eating Disorder Anorexia Nervosa Bulimia Nervosa Obesity and binge eating

Behavioral symptoms of binge eating and compulsive overeating

Inability to stop eating or control what youre eating Rapidly eating large amounts of food Eating even when you're full Hiding or stockpiling food to eat later in secret Eating normally around others, but gorging when youre alone Eating continuously throughout the day, with no planned mealtimes

Emotional symptoms of binge eating and compulsive overeating

Feeling stress or tension that is only relieved by eating Embarrassment over how much youre eating Feeling numb while bingeinglike youre not really there or youre on auto-pilot. Never feeling satisfied, no matter how much you eat Feeling guilty, disgusted, or depressed after overeating Desperation to control weight and eating habits

Autism

(Smith, & Segal, 2013) Social skills Fails to respond to his or her name Has poor eye contact Appears not to hear you at times Resists cuddling and holding Appears unaware of others' feelings Seems to prefer playing alone retreats into his or her own world Doesn't ask for help or request things Language Doesn't speak or has delayed speech Loses previously acquired ability to say words or sentences Doesn't make eye contact when making requests Speaks with an abnormal tone or rhythm may use a singsong voice or robot-like speech Can't start a conversation or keep one going May repeat words or phrases verbatim, but doesn't understand how to use them Doesn't appear to understand simple questions or directions Behavior Performs repetitive movements, such as rocking, spinning or hand-flapping Develops specific routines or rituals and becomes disturbed at the slightest change Moves constantly May be fascinated by details of an object, such as the spinning wheels of a toy car, but doesn't understand the "big picture" of the subject May be unusually sensitive to light, sound and touch, and yet oblivious to pain

Does not engage in imitative or make-believe play May have odd food preferences, such as eating only a few foods, or craving items that are not food, such as chalk or dirt May perform activities that could cause selfharm, such as head-banging (Mayo Clinic, 2012) Schizophrenia

Distorted perception of reality (for example, difficulty telling dreams from reality) Confused thinking (for example, confusing television with reality) Detailed and bizarre thoughts and ideas Suspiciousness and/or paranoia (fearfulness that someone, or something, is going to harm them) Hallucinations (seeing, hearing, or feeling things that are not real such as hearing voices telling them to do something) Delusions (ideas that seem real but are not based in reality) Extreme moodiness Severe anxiety and/or fearfulness Flat affect (lack of emotional expression when speaking) or inability to manage emotions Difficulty in performing functions at work and/or school Exaggerated self-worth and/or unrealistic sense of superiority of one's self Social withdrawal (severe problems in making and keeping friends ) Disorganized or catatonic behavior (suddenly becoming agitated and confused, or sitting and staring, as if immobilized) Odd behaviors

(John Hopkins Medicine, n.d.) Diagnostic Assessments The following assessments give parents and teachers a base to begin the evaluation process on students that are suspected to have an EBD. Screen procedures a. Systematic screening for behavior disorder (SSBD) identifies young children that need intervention or other services before they are considered for referrals. This is a three step process which involves: i. The student being nominated by a general education teacher,

ii. The students are then grouped by the severity or frequency of the behavior, and iii. Systematic observations in the classroom and other school environments are used to evaluate how the students adapt to their environment. Functional behavioral assessments information that has been collected to obtain knowledge about the possible antecedents, by asking the following questions: a. What does the child do before the behavior? b. What does the child does during the behavior? c. What does the child do after the behavior? Motivational assessments a. Response to Intervention (RtI) this is a program that most states have adopted to help tailor to the needs of students experiencing learning or behavior issues based on the assessments. Teacher/parent interviews Diagnostic academic assessments Behavioral checklists Variety of sociometric devices Use of parent/teacher rating scales (Hardman, Drew, & Egan, 2011, p.191-195) Once an appropriate diagnosis is made then the proper steps can be taken to adequately help your child succeed in his/her educational and social skills. Collaboration between the parents, teachers, physicians, and the student is the best way to get on the right track for success. Eligibility Criteria 511 IAC 7-41-7 Emotional disability Sec. 7. (a) "Emotional disability" means an inability to learn or progress that cannot be explained by cognitive, sensory, or health factors. The student exhibits one (1) or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance: (1) A tendency to develop physical symptoms or fears associated with personal or school problems. (2) A general pervasive mood of unhappiness or depression. (3) An inability to build or maintain satisfactory interpersonal relationships. (4) Inappropriate behaviors or feelings under normal circumstances. (5) Episodes of psychosis. (b) Eligibility for special education as a student with an emotional disability shall be determined by the student's CCC. This determination shall be based on the multidisciplinary team's educational evaluation report described in 511 IAC 7-40-5(e), which includes the following: (1) An assessment of the following: (A) Current academic achievement as defined at 511 IAC 7-32-2. (B) Emotional and behavioral functioning. (2) A social and developmental history that may include, but is not limited to, the following: (A) Communication skills. (B) Social interaction skills.

(C) Responses to sensory experiences. (D) Relevant family and environmental information. (E) Patterns of emotional adjustment. (F) Unusual or atypical behaviors. (3) A functional behavior assessment as defined at 511 IAC 7-32-41 that includes an analysis of any interventions used to address the behaviors leading to the referral for the educational evaluation. (4) Available medical and mental health information that is educationally relevant. (5) Any other assessments and information, collected prior to referral or during the educational evaluation, necessary to: (A) address whether the student's inability to learn or progress is caused by: (i) cognitive; (ii) sensory; or (iii) health factors; (B) determine eligibility for special education and related services; and (C) inform the student's CCC of the student's special education and related services needs. (Indiana State Board of Education-IDEA, 2004). Strategies, Interventions, and Adaptive Materials Structure and consistency can help students overcome the struggles associated with EBD. Below is a list of critical strategies, interventions, and adaptive materials that will help to improve success in individuals with these obstacles.

Behavior Management. Include a point system for appropriate behavior and task completion, wherein good behavior is charted and students earn rewards. Systematic Intervention Plans. Use a hierarchy of tactics, depending on students' behavior. Home-School Communication. Include notes to the home and home-based reward systems. Peer Involvement. Have classmates remind each other of classroom expectations. Classroom Structure. Employ guided practice and well-organized transitions from activity to activity. Supervised Free Periods. Have adults monitor unstructured parts of the school day (recess, hall changes, lunch). Consistent Standards. Be sure all school staff members use the same standards for acceptable behavior and hold high expectations for academic performance. (Smith, 2010)

Support/Services Providers The following organizations can help locate local support systems with the state or community in which you live. These sites can connect you to the following, as well: o Local resources o Support groups that provide connection and understanding o Information

Referrals

Mental Health America | 1.800.969.6642 http://www.mentalhealthamerica.net/farcry/go/searchMHA NAMI | National Alliance on Mental Illness | 1.800.950.NAMI http://www.nami.org/template.cfm?section=Your_Local_Nami National Mental Health Consumers Self-Help Clearinghouse 1.800.553.4539 | http://www.cdsdirectory.org/ (National Dissemination Center for Children with Disabilities, 2013) Resources Website Association for Positive Behavior Support http://www.apbs.org/index.html#.UkJNmBBu0Wc This website has helpful strategies to help reduce behavioral challenges, increasing independence, and ensure the development of constructive behaviors to meet life goals in the areas of social relationships, employment, academic achievement, functional life-skills, selfdetermination, health, and safety (Association for Positive Behavior Support , 2011). National Organization National Institute of Mental Health Mailing Address: 6001 Executive Boulevard Rockville, MD 2085 Email: NIMHinfo@mail.nih.gov Website: http://www.nimh.nih.gov/index.shtml This national organization, through clinical research, are attempting to pave the way to prevention, recovery, and finding a cure of emotional and behavioral disorders. The site contains mental health information and fact sheets, publications, educational resources, statistics, and articles on mental illnesses. State or Local Organization Indiana Federation of Families for Childrens Mental Health State Organization Brenda Hamilton 2205 Costello Drive Anderson IN 46011 Office: 765-622-0601 Toll Free: 866-247-8457 Fax: 765-622-0643 Email: indianafedfam@comcast.net Website: www.indianafamilies.org

This is a state non-profit organization dedicated exclusively to childrens mental health. Their mission is to create and grow networks of support, education, intervention, leadership and advocacy, thereby empowering families to facilitate growth and development for their children who have emotional, behavioral or mental challenges while also creating and maintaining a positive environment for all family members (Indiana Federation of Families for Childrens Mental Health, n.d.). Informational Book for Parents Davis, M. R. (2011). School success for kids with emotional and behavioral disorders. Waco, Tex: Prufrock Press. This book will help parents and teachers of students that struggle with emotional and behavioral disorders. The strategies in this book will help students overcome their struggles and achieve academically. Childrens Book on Learning Disabilities Hamilton, V. (1971). The planet of Junior Brown. New York: Macmillan. Already a leader in New Yorks underground world of homeless children, Buddy Clark takes on the responsibility of protecting the overweight, emotionally disturbed friend with whom he has been playing hooky from eighth grade all semester ("Old Westbury Lib - Full View of Record", n.d).

References American Speech-Language-Hearing Association (n.d.). Attention Deficit/Hyperactivity Disorder (ADHD). Retrieved September 23, 2013, from http://www.asha.org/public/speech/disorders/adhd.htm Association for Positive Behavior Support (2011, June). About APBS. Retrieved September 24, 2013, from http://www.apbs.org/about_APBS.htm#apbsmav Hardman, M.L., Drew, C.J., & Egan, M.W. (2011). Human exceptionality: School, community, and family, 10e. Boston: Houghton Mifflin. Indiana Federation of Families for Childrens Mental Health (n.d.). Indiana Families - Welcome. Retrieved September 25, 2013, from http://indianafamilies.org/page1.php John Hopkins Medicine (n.d.). Generalized Anxiety Disorder | Johns Hopkins Medicine Health Library. Retrieved from http://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/gener alized_anxiety_disorder_85,P00736/ John Hopkins Medicine (n.d.). Schizophrenia | Johns Hopkins Medicine Health Library. Retrieved September 23, 2013, from http://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/schizo phrenia_85,P00762/ Mayo Clinic (2012, October 6). Autism: Symptoms - MayoClinic.com. Retrieved September 23, 2013, from http://www.mayoclinic.com/health/autism/DS00348/DSECTION=symptoms National Dissemination Center for Children with Disabilities (2013, May). Emotional Disturbance National Dissemination Center for Children with Disabilities. Retrieved October 1, 2013, from http://nichcy.org/disability/specific/emotionaldisturbance#freq Old Westbury Lib - Full View of Record. (n.d.). Retrieved September 24, 2013, from http://old.sunyconnect.suny.edu:4450/F/?func=direct&doc_number=181833 Pro Ed (n.d.). Overview of Emotional and Behavioral Disorders. Retrieved October 1, 2013, from http://www.proedinc.com/Downloads/12762Ch01.pdf Psychology.com (2011). Children Behavior Disorders. Retrieved October 1, 2013, from http://www.psychology.com/resources/child_behavior.php School of Psychology (2012). Emotional and Behavioral Disorders | School Psychology. Retrieved September 30, 2013, from http://school-psychology.org/emotional-andbehavioral-disorders

Smith, M., & Segal, J. (2013, August). Bipolar Disorder Signs & Symptoms: Mania & Bipolar Depression. Retrieved September 23, 2013, from http://www.helpguide.org/mental/bipolar_disorder_symptoms_treatment.htm

Smith, M., & Segal, J. (2013, August). Binge Eating Disorder: Symptoms, Causes, Treatment, and Help. (n.d.). Retrieved September 23, 2013, from http://www.helpguide.org/mental/binge_eating_disorder.htm Smith, D. (2010, July 20). Education.com. Retrieved October 1, 2013, from www.education.com/reference/article/emotional-behavioral-disorders-prevention/?page=2 Web MD (2012, February 17). Major Depression (Clinical Depression) Symptoms, Treatments, and More. Retrieved September 30, 2013, from http://www.webmd.com/depression/guide/major-depression Web MD (2012, May 31). Mental Health: Conduct Disorder. Retrieved September 30, 2013, from http://www.webmd.com/mental-health/mental-health-conduct-disorder?page=3