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
• Pervasive mood of unhappiness or depression
• Physical symptoms or fears associated with
personal or school problems
 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
 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
• 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
 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
• Internalizing
• Externalizing
• Cognitive
• Academic
 Internalizing Disorders
• Anxiety - Withdrawal
• Separation anxiety disorder
• Generalized anxiety
• Phobias
• OCD
• Panic disorder
• Anorexia, bulimia
• Depression
• Post-traumatic stress disorder
 Anxiety Disorders
• Frequent absences • Fear of separation
• Isolating behaviors • School avoidance
• Many physical • Fear of new
complaints situations
• Excessive worry • Drug or alcohol
• Frequent bouts of tears abuse
• Frustration • See also: OCD, PTSD
 Depression
• Affects thoughts, • Continuing sadness
feelings, behavior, • Hopelessness, self-
relationships, physical deprecating remarks
health • School avoidance
• Irritability • Changed eating or
• In early childhood, may sleeping patterns
appear as irritability, • Frequent physical
defiance, restlessness, complaints
or clinging • Isolation,
nonparticipation
 Internalizing Behavior
• Psychotic behavior
• hallucinations
• delusions
• schizophrenia
• schizotypal (personality disorder)
 Schizophrenia
• Commonly appears in • Withdrawn, lack
late teens or early motivation
adulthood • Vivid and bizarre
• May come on gradually; thoughts or speech
may appear in teens • Confusion between
with other mental fantasy and reality
health diagnoses. • Hallucinations (visual)
• Early diagnosis and or delusions (auditory)
treatment is • Severe fearfulness
imperative; 50
percent or more may • Odd, regressive
attempt suicide behavior
• Disorganized speech
 External Disorders
• Undersocialized • Socialized
Aggressive CD Aggressive CD
• CD • Socialized
delinquency
• Attention Problems - • gang involvement
Immaturity • truancy
• Motor Excess • “looks up to other
rule violators
• unaware of • aware of
behavioral behavioral
expectations expectations;
covert attempts
 Oppositional Defiant Disorder

• Above average level of • Frequent angry

anger, blaming, hostile, outbursts
or vindictive behavior • Noncompliant and
• May be a reaction to argumentative
frustration, depression, • Easily annoyed
inconsistent structure, • Rejects praise, may
or constant failure due sabotage activity that
to undiagnosed ADHD, was praised
learning disabilities,
etc. • Deliberately annoys,
provokes others
 Conduct Disorder
• Serious, repetitive, and • Problem must be
persistent misbehavior persistent, not a
• Aggression toward reaction to stress,
people or animals crisis, cultural, or
• Property destruction social life context
• Deceitfulness, theft • Co-occurs with ADHD,
learning disabilities,
• Three or more depression
incidents in last year;
one during last six • See also: Oppositional
months Defiant Disorder
 Reactive Attachment
Disorder
• Disturbed and • Destructive, self-
developmentally injurious
inappropriate social • Absence of guilt or
relatedness in most remorse
contexts • Extreme defiance,
• Begins before age five, provokes power
usually after a period struggles, manipulative
of grossly inadequate • Mood swings, rages
care or multiple
caretaker changes • Inappropriately
demanding or clinging
 Bipolar Disorder
• Frequent, intense shifts • Anxiety, defiance may
in mood, energy, be seen
motivation • Strong craving for
• Shifts in children are carbohydrates
very fast and • Impaired judgment,
unpredictable impulsivity
• Delusions, grandiosity,
• “Mania” phase may possibly hallucinations
appear as intense
• High risk for suicide
irritability or rages and accidents
 Obsessive-Compulsive
Disorder
• Intrusive, repeated • Difficulty finishing work
thoughts on time due to
• Senseless repeated perfectionism or ritual
actions or rituals rewriting, erasing, etc.
• Frequently co-occurs • Counting rituals,
with substance abuse, rearranging objects
ADHD, eating disorders, • Poor concentration
Tourette Syndrome, • School avoidance
other anxiety disorders • Anxiety or depression
 Post-Traumatic Stress
Disorder
• Affects children who • Flashbacks,
are involved in or nightmares, repetitive
witness a traumatic play re-enactments
event • Emotional distress
• A concern with refugee when reminded of
populations incident(s)
• Intense fear and • Fear of similar places,
helplessness people, events
predominate at event • Easily startled,
and during flashbacks irritable, hostile
• Physical symptoms such
as headaches, dizziness
 Eating Disorders
• Anorexia, Bulimia • Impaired concentration
• Now at earlier ages, • Withdrawn,
10-20% boys preoccupied, anxious
• Perfectionists, over- • Depressed or mood
achievers, athletes at swings
highest risk • Irritability, lethargy
• High risk for • Fainting spells,
depression, alcohol, headaches
and drug abuse
 Cognitive
• Most have IQ in low range
• More than half have learning
disabilities
• Relationship between academic and
social behaviors are connected
 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…
• 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
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
 Causes
• Biological
• Genetics
• Environmental
• Stressful living conditions
• Child maltreatment
• School factors
 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
• Neglect
• Physical abuse
• Sexual abuse
• Emotional abuse
 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)
• Observation
• Screening
• Prereferral
• Referral
• Nondiscriminatory evaluation
procedures
• Determination
 Interventions/Techniques
• Positive Reinforcement
• Response Cost
• Proximity Control
• Attention to Compliance
• Ignoring
• Group Consequences
• Self Management
• Contracts
• Service Learning
 Group Activity
• Get into your group
• Read Partnership Tips - Box 7-4 pg. 173
• Answer the 3 questions at the end
 Wraparound Supports
• Family driven
• Collaborative
• Individualized
• Culturally competent
• Community and strength-based
• Involves community, school, family,
mental health, and other services