Emotional+Disturbances

Emotional and Behavioral Disturbances: A Teacher’s Great Opportunity Krajewski Tara Benedictine College

Abstract It can be said that all people struggle at some point in their lives, or for some, at many points. It truly is a natural part of the way humans live and how we interpret the life that has been handed to us. To parallel the struggles there are successes. Perhaps successes are only reached through struggle. When thinking about this concept one can schematically apply it to their own personal growth. Can it be argued that intuitively growth is the sensation of accomplishment after struggling or overcoming something, whether it is a complicated or effortless? How does one gain the passion to overcome again and again? Whether it is intrinsic or extrinsic motivation, society grows. That is how people, no matter their differences, gain the skills and values to contribute to society and the desire to do exactly that. Behavior and emotional disturbances are differences that, if they continue over an extended period of time, can negatively impact the motivation centers for learning, problem solving, judging, and many other aspects of everyday growth. In the educational definition, stated under the Individuals with Disabilities Educational Act, there are several criteria to fit in the “emotional disturbance (official term)” realm. These include a list of inabilities, behaviors, moods, physical symptoms, and fears associated with everyday interaction (Turnbull et al. 158). Gender, socioeconomic, and ethnicity also impact the individual with an emotional disturbance (Turnbull chap 7). The Diagnostic and Statistical Manual of Disorders IV (1994) lists over three-hundred emotional disturbances. It categorizes the disorders in axis‘. Clinical syndromes are axis one. These include anxiety disorders, mood disorders, dissociative disorders, substance abuse disorders, and schizophrenia. Axis two consists of developmental and personality disorders. These are the internal aspects that are likely to affect how a person is treated and how they are to live. Notice that the DSM-IV is used for doctor-patient diagnosis. The next axis is for physical disorders and conditions. It focuses on medical conditions that are relevant to the disorder. Axis four discusses the severity of psychosocial stressors. These are environmental or interactive stressors that cause the disorder to worsen or heighten. The next axis is “Global assessment of functioning.” At this level the doctor would ask his patient what their overall level of functioning was/is at their certain daily interactions. So, one can see the encompassing factors that lead to the identification, assessment, and aid that is needed for these individuals. As previously stated there are over three-hundred. Under the DSM-IV, “the conditions of childhood and adolescence that cause some children to be classified as having emotional or behavioral disorders are anxiety disorder, mood disorder, oppositional defiant disorder, conduct disorder, and schizophrenia. Does this mean that the education system is strictly limiting the amount of students to be served for their abilities or are these “categories” open ended enough? Is there any possible way to make sure that all the students that need services are getting them? There are many factors that can be seen as causes of emotional and behavioral disturbances. There is evidence that biological influences, environmental stressors, stressful living conditions, abuse, and school factors all impact the child’s unique disability scaffolding. These can be applied to the school setting as well as in the life of an adult with a behavioral or emotional difference. One can also infer this by interpreting and adapting the axis system. There is a recent study that is not usually included in the aforementioned causes because of its recent publishing date. According to Pediatrics of July, 2009, the amount of sleep a child gets can be a leading contributor to whether he/she has a behavior disorder. Children that averaged a minimal amount of sleep time, also had worse scores on several subcategories of the BPI including externalizing behavior (acting out), internalizing behavior, antisocial behavior, hyperactivity, anxiety and depression and peer conflict (July, 2009), all of which are the typical symptoms of those that experience a behavioral disorder. Another peer reviewed article has discussed another interesting attribute that can be seen as important to the educator. An article entitled “Gross Motor Performance and Self-Perceived Motor Competence in Children with Emotional, Behavioral, and Pervasive Developmental Disorders: A Review,“ states that more that often times children that have emotional disturbances have retarded motor skills. Children with emotional differences tend to have balance problems and self-perceived motor incompetence. Children with behavioral problems tend to have poor ball skills, and often times they tend to overestimate their motor abilities (Beek et al. 1). So, how do we apply all of these facts into our current educational pedagogy and even more specifically in the special education classroom? First of all, it is important to remember that an Individualized Education Program is merely the “ticket in” for students to get Special Education services. Each child would then need to be taught individually to meet their own special needs. There are many pedagogical steps that have been used in the past that may be helpful for those professionals seeking advice. Ed Keller describes several options to adapt your classroom to the needs of all of your students. More specifically, he has listed strategies to help the regular education and special education teacher create an environment where students that have emotional disturbances can maximize their educational potential. He says, in his web quest, that the teacher should usually use direct teaching strategies when giving directions. Clear rules, consequences, and assessments should be explained to the child. They should always be complimented on their contributions to the class when they are given. After reading the entire web quest one can concur that Keller emphasized mainly on how to make the child feel loved, important, intelligent, special, and equal. He used those common words when stressing the importance of equity. He also said that the special education teacher should spend less time “teaching” and more time “caring.” As one can see there is an alarming need for special educators and regular educators to learn about emotional and behavioral disorders, and understand why they occur. More importantly, however, one can see that it is more important to get to know each student and cope, adapt, teach, and accept. There are over three-hundred different emotional and behavioral disturbances. There is no efficient way for an educator to narrow a child to one in the three-hundred. If that did occur so many students would be left behind un-equitably. Disability is a natural part of the human experience, and educators are called to be above the average human when experiencing those with an emotional or behavioral disturbance. It has been proven with the information given that those who struggle need positive resources that encourage learning and the learner. Resources Beek, Peter et al. (July 2009). Gross Motor Performance and Self-Perceived Motor Competence in Children with Emotional, Behavioral, and Pervasive Developmental Disorders: A Review. Developmental Medicine & Child Neurology, v51 n7 p501-517. Retrieved from http://www.eric.ed.gov/ERICWebPortal/Home.portal?_nfpb=true&_pageLabel=E

Keller, Ed. (2007). Strategies for Teaching Students with Behavioral Disorders. Inclusion in Science for Students with Disabilities. Retrieved from http://www.as.wvu.edu/~scidis/behavior.html. Reuters Health. (July 2009). Sleep Disorder Linked to Behavior Woes in Some Kids. Pediatrics. Turnbull, Ann et al. (2007). Exceptional Lives: Special Education in Today’s Schools. New Jersey: Pearson Merrill/Prentice Hall.

Tara Krajewski 11-23-09 Part two Introduction There is only so much one can learn from a text book or medical journal about the attributes, traits, elements, and people that have emotional and behavioral disturbances. I have been given the opportunity to step outside that textual ‘box’ and into the real world with real people. This paper is a compilation of five interviews. Each interviewee has an emotional or behavioral difference, or has worked directly with someone that does. I have learned, first hand, about those people and their day to day lives. I now have a pluralistic knowledge of what it means to have anxiety, depression, and so many other emotional differences, and how they impact their finances, family and non-family social interactions, everyday agendas, medical statuses/health, religion, and education. This can be seen as a more genuine, well-rounded, and accurate form of presenting information to those that want or need to learn about special education, more specifically, emotional and behavioral disorders. Often times there are negative stigmas that correlate with the mere hearing of those words, emotional and behavioral disturbances. Whether or not that “judgement” can be supported by ethical factors is usually somewhat overlooked by people outside of the medical and educational realms of society. More often than less, as seen from these five interviews, even those close to the person with the emotional/behavior difference negatively stereotype their own loved ones. Their were several instances when their families were reluctant to accommodate for those suffering. Family Interaction One respondent said that her Dad “thinks of mental illness as a hurdle to be overcome, not something to accept or live with” (TK/NH/Emotional/10-5-09/2AB). She also said that, “their (her parents’) reaction (to her emotions) is rarely appropriate” (TK/NH/Emotional/10-5-09/2AJ). The same respondent said that her Father denies her having her disorder to other people when they ask. He makes up stories on how she’s doing. She went on to say that it was hard for him to accept it (TK/NH/Emotional/10-5-09/2AA). She also said she couldn’t live with her father because he’s a “trigger.“ So, there is limited visitation with him. She said, “He’s only capable of what he’s capable of.“ She also said that she couldn’t have long conversations with him (TK/NH/Emotional/10-5-09/2AG). She lives with her aunt in Georgia (TK/NH/Emotional/10-5-09/2AC). When she has dinner with her parents she only stays a minimum of twenty-four hours (TK/NH/Emotional/10-5-09/2AH). When they ask how she’s doing she said, “I share, but usually I don’t share.” She doesn’t want to get into an argument or inconvenient conversation for them (TK/NH/Emotional/10-5-09/2AI). Another respondent diverged away from communication about the topic of her having anxiety. She said she was hesitant to tell her parents about her anxiety for fear of their reaction. She said, “My family doesn’t know I have it (anxiety)” (TK/YH/Emotional/11-20-09/5B).” However, having anxiety does not impact how she talks to her family (TK/YH/Emotional/11-20-09/5C). Another respondent had a tighter knit relationship with his family. He said that his disorder was his family secret.“ If he had an “episode” he would use the excuse of being sick (TK/EB/Emotional/9-28-09/1G). It seems that he was ashamed of something he could not control. The educator that was interviewed said, in regards to parent-child relationship, that, “Some parents are so involved, some don’t even know if their kids were at school. It varies with each kid” (TK/JN/Emotional/10-9-09/3R/teacher). She brought up a point that can be seen in the comments of the other interviewees. I have found that those interviewees with family members that also have emotional or behavioral disturbances are more supportive of the their struggling loved ones. For instance, one of the student respondents has two parents, both paternal grandparents, and all of his father’s siblings that have depression along with him (TK/MR/Emotional/11-16-09/4K). He said that “when my family found out, they were more careful how they said things to me” (TK/MR/Emotional/11-16-09/4A). Their (his parents’ support) can also be seen from his response that said, “When they give me things to do, they give one thing at a time as opposed to giving lists.” Lists stress him out more (TK/MR/Emotional/11-16-09/4C). Another respondent had two brothers with learning disabilities. One had five learning disabilities including anxiety disorders (TK/NH/Emotional/10-5-09/2Y). She said, “My brother is very supportive because of his disabilities” (TK/NH/Emotional/10-5-09/2Z). Another respondent has two sisters that are bi-polar like him (TK/EB/Emotional/9-28-09/1D). He did not say that he had any problems with his family when I asked him. Therefore, I assumed that they were supportive and accepting. He did say, however, that it “really takes a toll on my marriage” (TK/EB/Emotional/9-28-09/1E). He said that “we really don’t know what to expect…we argue…walk on eggshells”(TK/EB/Emotional/9-28-09/1F). The family lives, of four out of the five interviewees, are obviously impacted by their emotional and behavioral disturbances. Day to Day Life Family interaction was only a small part of the explanations of the interviewees’ day-to-day lives though. One respondent described her days as a circular abyss of stress. She said, “I get stressed out everyday because I can’t do everything I’ve got to do” (TK/YH/Emotional/11-20-09/5A). She told me that she has anxiety. Why she gets stressed is related to what she does all day long. She exclaimed, “When I have homework, and I’m not doing it, I feel useless because I feel I could have done it before” (TK/YH/Emotional/11-20-09/5F). Then, “I skip class because I don’t want to do anything and that makes me stressed out too” (TK/YH/Emotional/11-20-09/5K). The respondent with depression said that he deals with things a bit differently. “When I get depressed I buy lots of things…CD’s for me,” and that is a conscientious expense that causes a greater sense of depression (TK/MR/Emotional/11-16-09/4E). The respondent with bipolar disorder said, “my mood has a lot to do with the day I’m having (manic or depressed)” (TK/EB/Emotional/9-28-09/1B). He either isolates himself or on manic days he makes grandiose plans that aren’t accomplishable (TK/EB/Emotional/9-28-09/1E). Another respondent said, “I try to avoid stress, I constantly have to check with my life” (TK/NH/Emotional/10-5-09/2N). “My whole life revolves around the effort not to relapse…” (TK/NH/Emotional/10-5-09/2G). Keeping their attitudes in check is an important task for all of those interviewed. Their mood, whether or not they are triggered negatively or positively can effect the dealings of their regular day. It can be seen that these individuals, with emotional and behavioral disorders, have triggers, or things that make them irritable or upset. For one it was her father. Other respondents didn’t go into details. They did talk about how do deal with their stress though. One respondent said, “ I have to step back and ask if I really care” (TK/MR/Emotional/11-16-09/4H). He was referring to what triggers him to become depressed or angry. This can be understood as him attempting to interpret his emotions as realistic, or as an outcome of merely being depressed. This causes him to be “straightforward with how I feel. Sometimes blunt, too blunt” (TK/MR/Emotional/11-16-09/4N). It can also be understood that his emotional/behavioral difference effects his sleep, which effects his mood. He said, “A lot of my stress was enhanced by the fact that I didn’t sleep” (TK/MR/Emotional/11-16-09/4J). Education So, how do these individuals interact and contribute in the classroom with triggers and sporadic emotions? The special educator that was interviewed said, “When they are little its okay, but when they get older the harder it is on them” (TK/JN/Emotional/10-9-09/3V/teacher). It can be inferred that those students with emotional/behavioral disturbances are more accepted when they are younger. She said, “the older they get the more they stand out” (TK/JN/Emotional/10-9-09/3S/teacher). So, what happens when they start to “stand out?” I learned of how some educators acted. However, I learned the outcomes with extreme disappointment. One respondent was treated inappropriately because she was “different.” She had the “indicators of anxiousness, unexplainable fevers, weird medical problems, fainting, and paralysis” (TK/NH/Emotional/10-5-09/2R). One teacher used her as a class example of “what not to do” everyday (TK/NH/Emotional/10-5-09/2AL). She also said, “my first grade teacher tried to choke me” (TK/NH/Emotional/10-5-09/2AK). She was also disciplined by “sitting in a coat closet,” because she asked too many questions (TK/NH/Emotional/10-5-09/2AN). This particular individual was very open about sharing her educational past. After years of being treated unfairly she was finally placed in a special education class. However, that endeavor was also an unfortunate one. She was “unfocused and annoyed in the ’slow room” (TK/NH/Emotional/10-5-09/2AM). So, her mom arranged a meeting with her teachers. They decided to give her an IQ test (TK/NH/Emotional/10-5-09/2AP). After the test she was put on the gifted track, she was there until graduation (TK/NH/Emotional/10-5-09/2AQ). After hearing that I thought I would hear positive stories about the program. I was wrong. She said the gifted program wasn’t good (TK/NH/Emotional/10-5-09/2AR). She felt more accepted and the teachers were more sensitive but she thought it was a bureaucracy where they were tested all the time (TK/NH/Emotional/10-5-09/2AS). Her gifted program lost funding so she had to return to “regular school.“ She was not impressed with their system (TK/NH/Emotional/10-5-09/2AX). Her brother was also placed on the gifted track, and he was placed in a resource room (TK/NH/Emotional/10-5-09/2AT). He also ended up going back to the regular public school classroom. She said, “That (the gifted program) was a confidence lift for him, and then he went back to public school and graduated (TK/NH/Emotional/10-5-09/2AU). In the course of flopping from classroom to classroom their IEP’s floated with them. However, her mother felt like her and her brother were constantly fighting their IEP teams (TK/NH/Emotional/10-5-09/2AW). She went on to college. She said that it was a task. It caused a lot of anxiety. She did well in spite of herself (TK/NH/Emotional/10-5-09/2AY). Her final opinion of the programs, she was in, was not a gleeful one. She said, “the help, cost, and structure of both programs was not effective” (TK/NH/Emotional/10-5-09/2AV). I took all of her accounts very personally. I became eager to learn more about the perspective of the educator trying to accommodate. With this eagerness, I interviewed an educator with teaching strategies drastically different when compared to the last account. Her opinions on educating individuals with emotional and behavioral differences were kind, understanding, and appropriate. She would not have singled the last interviewee out (TK/JN/Emotional/10-9-09/3C/teacher). She would not have put her in the closet either. She believes that a teacher should only discipline “if there is a problem or if something happens” (TK/JN/Emotional/10-9-09/3B/teacher). It can be assumed that this respondent supported the ideal that all students are equal and should be treated equitably. She thought that teachers should accommodate for all students. Obviously, some of her students had IEP’s, but she didn’t think of her teaching accommodations to be “just for them“, she saw them as normal adaptations that all teachers should make/do for all students (TK/JN/Emotional/10-9-09/3E/teacher). She always “broke the objectives down to meet benchmarks,” because she knew that she wanted to meet the goals with each of her students (TK/JN/Emotional/10-9-09/3L/teacher). She said that ED was under OHI in Nebraska, so all of those individuals have IEP’s (TK/JN/Emotional/10-9-09/3J/teacher). I liked this. At least with this parents would know that actions are being made to accommodate for their kids with emotional and behavioral disorders, hopefully. This is important because some educators, as I have learned, do not teach students appropriately, in the regular education classroom, even if they should. It has been implied that students with IEP’s are more likely to be accommodated for, more authentically. Remember, it has been said that students struggle more as they get older. This idea has been supported with the respondents’ accounts discussing their social interactions beyond family and school. The teacher that was interviewed discussed her life outside of the classroom. She often struggled with the other professionals because of their perceptions of the “special kids.” She did say that “most teachers want to help students as much as possible” (TK/JNEmotional/10-9-09/3G/teacher). However, she said that educators need to be prepared for those “brick wall” people. One should not let them waver “how you feel.” One should help them see truth and goodness in all people (TK/JN/Emotional/10-9-09/3H/teacher). She described another struggle that many teachers endure. The dealings in her special education classroom wear on her (TK/JN/Emotional/10-9-09/3M/teacher). “You get caught up in it, but you have to deal with it too” (TK/JN/Emotional/10-9-09/3N/teacher). “Sometimes I’m a basket case and I can’t bring it home”(TK/JN/Emotional/10-9-09/3O/teacher). She then described how she does “deal with it.” She talks to professionals she trusts. It helps her cope (TK/JN/Emotional/10-9-09/3Q/teacher). Emotional and behavioral disturbances impact the lives of the educators, positively and negatively. Many of the other respondents cope by verbal communication also. One respondent tells her boyfriend about her stress levels. He cheers her up. Sometimes though he gets “pissed off…do it too much” (TK/YH/Emotional/11-20-09/5I). She told me that she is “picky” on her stressed days(TK/YH/Emotional/11-20-09/5E). Another respondent has a girlfriend with “similar issues…(so they are) on a level playing field” (TK/MR/Emotional/11-16-09/4I). He said that he tries not to get angry at them usually, referring to other people he communicates with (TK/MR/Emotional/11-16-09/4M). This is usually when he would check his attitude with reality. This seemed to be a common communicative attribute for the respondents. All five of them were very careful to explain their symptoms in a way that could be understood by a non-doctor. Each of the respondents that personally had an emotional/behavioral difference had so many other elements to be factored in. Symptoms(for lack of a better word) One respondent had an extremely unusual disorder, as she would call it. She described it as a “psychological disorder with neurological links (conversion disorder)”(TK/NH/Emotional/10-5-09/2J). This pertains a variety things. She explained that she has seizures, paralysis, and that her body mimics other illnesses (TK/NH/Emotional/10-5-09/2L). This means that her brain tells her she has an illness, she gets those symptoms, but she doesn’t have them in actuality (TK/NH/Emotional/10-5-09/2M). This is onset by stress, or triggers. For instance, she lost her voice for nine and a half weeks. Doctors couldn’t map brain activity because of stress which shut her vocal cords off (TK/NH/Emotional/10-5-09/2K). Also, in middle school she had a “huge panic attack” which in turn did not allow her to go to school (TK/NH/Emotional/10-5-09/2AO). Later on in life she began having severe seizures (TK/NH/Emotional/10-5-09/2U). In the same month she had a nervous breakdown. She became agoraphobic. She didn’t remember any of the episode for ten days (TK/NH/Emotional/10-5-09/2T). Another respondent claimed that he gets “mad easy” (TK/MR/Emotional/11-16-09/4L). The final respondent elucidated that she eats “a lot” when stressed out (TK/YH/Emotional/11-20-09/5H). To summarize, those that have an emotional or behavioral disturbance may suffer from other physical ailments, anger, stress, dietary changes, and episodes of panic. These aspects can be, and are most often, directly related to diagnoses and medication prescription which correlate with doctor visits, therapy, and hospitalization. Medication/Diagnoses Each respondent had exclusive versions of how they sought and received medical care. One respondent, was given her official diagnosis after being hospitalized after being inflicted with severe seizures (TK/NH/Emotional/10-5-09/2U). Her primary diagnosis was conversion disorder. This disorder only effects .001% of people (TK/NH/Emotional/10-5-09/2I), many doctors don‘t even know it existed (TK/NH/Emotional/10-5-09/2W). She has also been put in the mental illness category with diagnoses of attention deficit hyperactivity disorder, generalized anxiety disorder, panic disorder, borderline personality disorder, major depression, and obsessive compulsive disorder (TK/NH/Emotional/10-5-09/2A). Another respondent told me that he has anxiety and depression (TK/MR/Emotional/11-16-09/4B). Another has bi-polar disorder, and the final person has anxiety. Some see psychologists/therapists (TK/NH/Emotional/10-5-09/2Q, TK/MR/Emotional/11-16-09/4F). One respondent has been in the hospital three times within a year (TK/NH/Emotional/10-5-09/2H), and that she has group therapy everyday, she sees a therapist two times a month, and a psychologist once a month (TK/NH/Emotional/10-5-09/2E). One can only imagine that these individuals would need to have a prescription also, because that is common. That has been proven among these individuals. One respondent said that she was prescribed two medications and taken off of them shortly after only to be re-prescribed (TK/NH/Emotional/10-5-09/2S). If she forgets her now six prescriptions her mind is put into “emergency mode.” which leads to other problems (TK/NH/Emotional/10-5-09/2B). Another respondent goes through each morning with remnants of his Seroquel (a medication given to those who suffer from manic depression)(TK/EB/Emotional/9-28-09/1A). The teacher that was interviewed emphasized that educators need to know those prescriptions that their students are on (TK/JN/Emotional/10-9-09/3F/teacher). It is obvious that medications are an asset in maintaining a stable mental state for those that have emotional and behavioral disorders. It can also be seen that those that have an emotional and behavioral disorder do not always plainly have characteristics of one disorder, or that they do not have just one disorder. It can be inferred that those individuals that communicate, work, live with, and educate persons that have emotional or behavioral disorders should take into account that possibility. Finances Financially there may also be a burden for those that suffer from emotional and behavioral disorders. Two respondents were not as impacted in the financial realm. The medication either don’t exist or they don’t cost very much (TK/MR/Emotional/11-16-09/4D, TK/YH/Emotional/11-20-09/5G). This was for the interviewees with depression and anxiety. However, that does not mean that all persons with these disorders have the same experiences. Some experience financial strain in other facets of expenditures. It was previously stated that one respondent spends his money on compact discs when stressed. Another exclaimed that she ate a lot when anxious. These things would also have financial impacts. One respondent said he is absent from work approximately one day a month due to mood fluctuation (TK/EB/Emotional/9-28-09/IC). It was also previously cited that he spends his money on manic days. He did say however that his medication costs about eighty dollars a month. Another respondent claimed that she would not be able to pay her medical costs without her disability insurance (TK/NH/Emotional/10-5-09/2D)which is called, “cobra insurance” It costs three-hundred and ninety-six dollars a month (TK/NH/Emotional/10-5-09/2O). She is not able to work without doctor permission so finances are always tight(TK/NH/Emotional/10-5-09/2D). Therefore, her disability insurance is her primary income (TK/NH/Emotional/10-5-09/2C). Interviewee Advice One really never knows what a person is truly going through. Some individuals with emotional and behavioral disorders suffer mood swings, depression, anxiety fluctuations, differences in communication and social interaction, health risks, and financial burdens. Others go about their days undetected and not helped or recognized. Some face serious life changes on an abnormal basis. A few interviewees took into account their own situations and felt the need to give advice to others in education, and simple ethics. Ultimately, they have experienced situations that they have critiqued. I thought it would be appropriate to give them an outlet to discuss those remarks, and to conclude this compilation of information with them. Three respondents chose to give educators advice based from their own experiences. Most of these comments can be compared to the ideals of the Individuals with Disabilities Education Act. A graduated adult respondent said, “Make sure that students are appropriately placed.” If not it’s hard on a child (TK/NH/Emotional/10-5-09/2BB). She also spoke of inclusion and FAPE in schools. She said, “there’s a fine balance of separating and including kids in reality…School is a good representation of life” (TK/NH/Emotional/10-5-09/2BC). A student interviewee said, “Don’t diagnose the student, but when they say ‘this is what I got,’ the teacher needs to accommodate to that kid’s needs”(TK/MR/Emotional/11-16-09/4O). This comment parallels with the idea that each child deserves a non-discriminatory evaluation. The teacher that was interviewed said these two comments that can be seen as a correlation to the IEP process. She said, “try to keep it (the classroom) as mellow as you possibly can”(TK/JN/Emotional/10-9-09/3A/teacher), and “look where they (students) are at and where they want them to be in a year” (TK/JN/Emotional/10-9-09/3K/teacher). In the ethics grouping of advice, one respondent said, “when you’re dealing with people you’re dealing with their emotion…There’s no getting past it” (TK/JN/Emotional/10-9-09/3Y/teacher). She also made this comment in regard for her students, “Just be there for them. Be there so they can trust you and count on you. Be real (TK/JN/Emotional/10-9-09/3X/teacher). Another respondent was discouraged by those that call her “crazy” because of her differences. She said, “those who stereotype shun” (TK/NH/Emotional/10-5-09/2AE). Another respondent said that she wanted to be treated the same by others with her own set limitations (TK/YH/Emotional/11-20-09/5J). It can be concluded, by the evidence included, that people need to socially interact with others in a virtuous and politically correct way. This has been shown in these accounts, by those that have emotional and behavioral disturbances. I hope its true what one respondent said, because I have learned much more than a text book could tell me. She said that when people have “knowledge and information they are usually supportive,” (TK/NH/Emotional/10-5-09/2AD) because, “everyone deserves a chance“(TK/JN/Emotional/10-9-09/3I/teacher). //Resources TK/EB/Emotional/9-28-09/1A TK/EB/Emotional/9-28-09/1B TK/EB/Emotional/9-28-09/IC TK/EB/Emotional/9-28-09/1D TK/EB/Emotional/9-28-09/1E TK/EB/Emotional/9-28-09/1F TK/EB/Emotional/9-28-09/1G TK/NH/Emotional/10-5-09/2A TK/NH/Emotional/10-5-09/2B TK/NH/Emotional/10-5-09/2C TK/NH/Emotional/10-5-09/2D TK/NH/Emotional/10-5-09/2E TK/NH/Emotional/10-5-09/2G TK/NH/Emotional/10-5-09/2H TK/NH/Emotional/10-5-09/2I TK/NH/Emotional/10-5-09/2J TK/NH/Emotional/10-5-09/2K TK/NH/Emotional/10-5-09/2L TK/NH/Emotional/10-5-09/2M TK/NH/Emotional/10-5-09/2N TK/NH/Emotional/10-5-09/2O TK/NH/Emotional/10-5-09/2Q TK/NH/Emotional/10-5-09/2R TK/NH/Emotional/10-5-09/2S TK/NH/Emotional/10-5-09/2T TK/NH/Emotional/10-5-09/2U TK/NH/Emotional/10-5-09/2W TK/NH/Emotional/10-5-09/2Y TK/NH/Emotional/10-5-09/2Z TK/NH/Emotional/10-5-09/2AA TK/NH/Emotional/10-5-09/2AB TK/NH/Emotional/10-5-09/2AC TK/NH/Emotional/10-5-09/2AE TK/NH/Emotional/10-5-09/2AD TK/NH/Emotional/10-5-09/2AG TK/NH/Emotional/10-5-09/2AH TK/NH/Emotional/10-5-09/2AI TK/NH/Emotional/10-5-09/2AJ TK/NH/Emotional/10-5-09/2AK TK/NH/Emotional/10-5-09/2AL TK/NH/Emotional/10-5-09/2AM TK/NH/Emotional/10-5-09/2AN TK/NH/Emotional/10-5-09/2AO TK/NH/Emotional/10-5-09/2AP TK/NH/Emotional/10-5-09/2AQ TK/NH/Emotional/10-5-09/2AR TK/NH/Emotional/10-5-09/2AS TK/NH/Emotional/10-5-09/2AT TK/NH/Emotional/10-5-09/2AU TK/NH/Emotional/10-5-09/2AV TK/NH/Emotional/10-5-09/2AW TK/NH/Emotional/10-5-09/2AX TK/NH/Emotional/10-5-09/2AY TK/NH/Emotional/10-5-09/2BB TK/NH/Emotional/10-5-09/2BC TK/JN/Emotional/10-9-09/3A/teacher TK/JN/Emotional/10-9-09/3B/teacher TK/JN/Emotional/10-9-09/3C/teacher TK/JN/Emotional/10-9-09/3E/teacher TK/JN/Emotional/10-9-09/3F/teacher TK/JN//Emotional/10-9-09/3G/teacher TK/JN/Emotional/10-9-09/3H/teacher TK/JN/Emotional/10-9-09/3I/teacher TK/JN/Emotional/10-9-09/3J/teacher TK/JN/Emotional/10-9-09/3K/teacher TK/JN/Emotional/10-9-09/3L/teacher TK/JN/Emotional/10-9-09/3M/teacher TK/JN/Emotional/10-9-09/3N/teacher TK/JN/Emotional/10-9-09/3O/teacher TK/JN/Emotional/10-9-09/3O/teacher TK/JN/Emotional/10-9-09/3R/teacher TK/JN/Emotional/10-9-09/3S/teacher TK/JN/Emotional/10-9-09/3V/teacher TK/JN/Emotional/10-9-09/3X/teacher TK/JN/Emotional/10-9-09/3Y/teacher TK/MR/Emotional/11-16-09/4A TK/MR/Emotional/11-16-09/4B TK/MR/Emotional/11-16-09/4C TK/MR/Emotional/11-16-09/4D TK/MR/Emotional/11-16-09/4E TK/MR/Emotional/11-16-09/4F TK/MR/Emotional/11-16-09/4H TK/MR/Emotional/11-16-09/4I TK/MR/Emotional/11-16-09/4J TK/MR/Emotional/11-16-09/4L TK/MR/Emotional/11-16-09/4K TK/MR/Emotional/11-16-09/4M TK/MR/Emotional/11-16-09/4N TK/MR/Emotional/11-16-09/4O TK/YH/Emotional/11-20-09/5A TK/YH/Emotional/11-20-09/5B TK/YH/Emotional/11-20-09/5C TK/YH/Emotional/11-20-09/5E TK/YH/Emotional/11-20-09/5F TK/YH/Emotional/11-20-09/5G TK/YH/Emotional/11-20-09/5H TK/YH/Emotional/11-20-09/5I TK/YH/Emotional/11-20-09/5J TK/YH/Emotional/11-20-09/5K

Emotional and Behavioral Disorders Karissa M. O’Hearn Benedictine College

Abstract

The purpose of this paper is to provide the reader with a general understanding of both emotional disturbance, and behavior disorders. It provides the reader with a brief overview of the history of the disorders. It goes in depth about the different disorders that fall into this category. It continues by lightly brushing the correlation between ED/BD and environment and biological influence.

In 2003-2004, approximately 0.7 percent of all students in the nations’ schools received special education because they had emotional or behavioral disorders (Turnbull, Turnbull, Wehmeyer). This was not always the case. Ideals of taking a proactive approach to these disorders began as early as the 1960’s. Two authors, C. Michael Nelson, and James M. Kauffman, reminisce about their beginning days of their doctoral studies in Special Education in the field of emotional disturbance, and behavior disorders that they began in 1967 in an article titled The Past is a Prologue: Suggestions for moving forward in Emotional and behavioral disorders. In this article they speak of many publications beginning in 1962 that they still see as valuable in the education of students with emotional disturbances and behavioral disorders today. One milestone that they recognized in the movement toward teaching students with these types of disorders was the publication of the first three volumes of the conceptual models project led by Bill Rhodes in 1970. They talk about being awash in alternative views for working with emotional disturbance or behavior disorders. They explain the excitement they felt, and point out that this was still before the 1975 Handicap act. From 1960 on research in behavioral studies was something that was progressively moving the ideals of educators who were interested, forward. Much of the research came from the desire to understand the multiple causes of defiant behavior. It wasn’t until the 1980’s that these ideals finally began to come to fruition in the school setting. At this time there were a lot of federally funded training programs for teachers of students with Emotional or Behavior Disorders. Since this time, these types of federally funded programs are not as prevalent. But now thanks to IDEA, these disorders, if interfering with the student’s educational well-being can make a student eligible to receive special services (Nelson, Kauffman, 2009) IDEA, along with many professionals, uses the terminology emotional disturbance. Others refer to this same thing by calling it an emotional disorder. Generally this is because a disorder sounds much less severe than a disturbance. According to IDEA, emotional disturbance is a condition that is accompanied by one or more of the following characteristics over a long time, and to a marked degree adversely effects a child’s educational performance. These characteristics are: An inability to learn that can not be explained by intellectual, sensory or health factors; An inability to maintain satisfactory interpersonal relationships with peers and teachers; Inappropriate types of behavior or feelings under normal circumstances; A general pervasive mood of unhappiness; and a tendency to develop physical symptoms or fears associated with personal or school problems (Turnbull, Turnbull, Wehmeyer, 2007). Under the American Psychiatric association there are five conditions that identify children and adolescence as having emotional or behavior disorders. These conditions are anxiety disorder, mood disorder, oppositional defiant disorder, conduct disorder, and schizophrenia. These conditions each include multiple disorders. Anxiety disorders include anything from separation anxiety disorder to general phobias to obsessive-compulsive disorders. A mood disorder can be recognized through a students’ display of sadness and frequent crying. Another indicator is if the student shows a severe decline in motivation, doesn’t want to play with friends, or shows a significant decline in grades. Mood disorders also include all types of depression, including manic depression. Another disorder that qualifies under emotional disturbance or behavior disorder is oppositional defiant disorder. This can be characterized by patterns of negativistic, hostile, disobedient, and defiant behaviors (Turnbull, Turnbull, Wehmeyer, 2007) Oppositional defiant disorder can be easily confused, or coupled with conduct disorder. Signs of conduct disorder include a constant antisocial behavior that often interferes with others rights. This can be a problem especially if it is endangering other students in the classroom, and if it becomes an obsession with destruction of property. Finally schizophrenia is also a disorder included in emotional and behavior disorders. People who have schizophrenia often times experience two or more of the following characteristics, withdrawal, delusion, hallucination, loss of contact with reality, and disorganized speech. No matter the disorder, children with emotional disturbances or behavior disorders either act in an outward motion, affecting those around them, or they experience the effects of their disorder inwardly. These are through externalizing and internalizing behaviors. When a student shows externalizing behaviors, he or she is outwardly violent, defiant, and seems to sometimes be aware of the disruption that he or she is causing. It is often times easier to recognize a need for intervention when a student externalizes in the way that he or she experiences their disorder. It is important to recognize that a person may experience depression, but also exhibit externalizing behavior. This is not to be confused with adults who often times internalize their feelings through withdrawal. Often times externalizing behavior is met with some form of zero tolerance policy. This can lead to expulsion among other things. Consequently in the past this has led to less education for those who have an emotional disturbance or behavior disorder. IDEA does protect the rights to the education of those students, and requires the school to work with the student, to ensure that he or she does not end up falling through the cracks. Internalizing behavior is much less obvious. When a student internalizes, a lot of what he or she may be going through stays with the student, and may show up little to no times in the classroom through the students immediate behavior. For these students, a good indicator of struggles with internalized behavior may be a drop in the student’s average grade performance. Another thing that may commonly be observed is a severe lack of motivation within the student when it comes to playing with friends, and doing normal classroom activities. Externalizing and internalizing behavior can occur simultaneously (Turnbull, Turnbull, Wehmeyer, 2007). You might experience this in a student who outwardly displays defiance, but at the same time is going through depression. The effects of emotional disturbance or behavior disorders on the student come with an extraneous list of effects on their education. Students with emotional disturbance or behavior disorders may be gifted, or have mental retardation, but most have IQ’s in the low average range. Unfortunately emotional disturbance or behavior disorder often times is concurrent with learning disabilities. Students with emotional disturbances or behavior disorders drop out of school more often then other students who have disabilities. Often times they do not go on to post- secondary schools, and frequently students with emotional disturbance or behavior disorders perform academically in the 25th percentile. Determining the direct cause of emotional and behavioral disorders is an ambiguous feat. Regardless, it has become clear that two major influences on emotional disturbance and behavior disorders are environmental and biological. Hallowell (1996) concluded, “All behavior and all personality are in some way genetically influenced, and to a greater degree than most of us take into account (Turnbull, Turnbull, Wehmeyer, 2007). Things that can be biological or inherited include schizophrenia, depression, oppositional defiant disorder, anxiety disorder, certain behaviors, and conduct disorders. Many different types of environments can be stressful for children. This is especially so for students who live in a home that is considered a low socio-economic status home. There are many families who live in poverty and are emotionally healthy, but a child who lives in a high socio-economic situation is less likely to develop an emotional disturbance or behavior disorder. Homeless students experience behavioral disorders three to four times more frequently than do children in the general school population (Turnbull, Turnbull, Wehmeyer, 2007). Another correlated environmental stressor is child maltreatment. There are four types of child maltreatment. These are neglect, physical abuse, sexual abuse and emotional abuse. The shocking news is that, on every day in 2001, approximately 2,500 children were victims of child abuse (Turnbull, Turnbull, Wehmeyer, 2007). These are phenomenal numbers. Not so surprising, there too are school factors that feed in to a student’s emotional disturbance or behavior disorder. Low academic achievement tends to result in behavior problems. Another factor is that not all teachers are well trained for their position. Whether it is a lack of knowledge on how to work with students who have emotional disturbances or behavioral problems, or a lack of knowledge in the realm of multiple teaching methods, teachers do affect their children who have these disorders. Since the 1960’s America has come a long way in recognizing students with emotional disturbances and behavior disorders. There are many disorders that fall into the category of emotional disturbance and behavior disorders, but the most important thing to remember is that emotionally disturbed, or behavior disorder serves only as a classification, not as a label. Students with emotional disturbances and behavioral disorders can either experience their disorders externally or internally, and sometimes both. Emotional disturbance and behavioral disorders are directly correlated with biological influence, as well as environmental influence. As awareness of the disorder category grows, together we can give kids a chance.

References Turnbull, A., Turnbull, R., Wehmeyer, M.L., (2007). Exceptional Lives: Special Education in Today’s Schools. Columbus, OH: Pearson Merrill Prentice Hall. Hulahan, D., Kauffman, J., (1994). Exceptional Children. Sydney, Australia: Allyn and Bacon

Part two: Interviews “Generally a good day would be one where I am constantly analyzing what I might get in trouble for.” (KO/SL/Behaviors/Anxiety disorder/11-23-09/5B) These are the words of one female who struggles with an Anxiety Disorder. She recalls that patterns of anxiety began to immerge for her in the fourth grade. For her, along with others who struggle with different types of emotional disturbances and behavior disorders, school as well as daily family endeavors can become more then just menial tasks. However, before we begin to unravel this sometimes-overlooked disability, let us begin with its origins. A mother of three tells about seeing depression in her family; “The entire family has depression. I remember when my grandma would have mental breakdowns. She would just lay down on the couch staring blankly at the ceiling. Later, I found out that my grandpa committed suicide (KO/CE/Behavior/9-23-09/2B). For most who have Emotional Disturbances and Behavior Disorders it is likely that it has been genetically inherited. One teacher who works primarily with students within this category said, “Once you get to know the family you usually find out that mom or dad has anger issues, or has similar issues that the child is dealing with.” (KO/CW/Behaviors/Teacher/10-20-09/3D) Others, like a mother of four, just simply said, “It runs in the family.” (KE/TK/Depression/10-4-09) While some are quick to identify Behavior Disorders and Emotional Disturbances within their families others, particularly parents have troubles admitting that their child may have a problem. A teacher explains, “Sometimes you encounter parents who think their child doesn’t have behavior problems. It’s just about showing them that it’s okay, I’m just here to help.” (K/O/Behaviors/Teacher/10-20-09/3E) These types of disorders don’t just run in the family, but they also affect the family in a very deep way. Emotional Disturbances and Behavior Disorders, for some, create a distance between who it is that is struggling and other members of the family. One mother, when speaking of her daughter said, “The family doesn’t understand her.” (KO/TK/Depression/10-4-09/1H) She continued by explaining that because others in the family do not experience life in the same way, they tend to shy away from her, and sometimes view her behaviors as frustrating and annoying. A sibling speaks of her brother who struggles with depression and anxiety saying, “We would normally wake up to him fighting over things like forgetting to set his alarm, or not being able to find his wallet.” (KO/BL/Depression/Anxiety/Sisterof/11-20-09/4A) She continues to describe a sort of disconnect, “Our family never really got to know him.” (KO/BL/Depression/Anxiety/Sisterof/11-20-09) she continued by explaining the emotions of the family, “The family experienced a lot of stress because of dad being upset with the things that my brother was doing.” (KO/BL/Depression/Anxiety/ Sisterof/11-20-09/4H) She further explains her experience. “When you experience someone in the family with a disorder as always having it, you don’t think about the persons affect on the family, you just think that it is normal.” (KO/BL/Depression/Anxiety/Sisterof/11-20-09/4P4) On a quite different note a young girl describes how in some ways her anxiety brought her closer to her family, “I also think I’ve gotten closer to my family because of the hard things we’ve experienced together, they’ve seen me at my worst.” (KO/SL/Behaviors/Anxiety Disorder/11-23-09/5N) Beyond experiencing changes in family relationships, the general interaction outside the boundaries of the home for many of the participants has been affected as well. A young girl explains, “I become very anxious and sometimes obsessive about little things.” (KO/SL/Behaviors/Anxiety Disorder/11-23-09/SF) She continued by speaking of how this affected her time with her family, “Sometimes weird routines would make me miss out on family things.” (KO/SL/Behaviors/Anxiety Disorder/11-23-09/5L) A teacher describes how parents may hesitate about where they might take their child who has an Emotional Disturbance or Behavior Disorder; “The biggest affect on what the family does is usually that the mom and dad try to avoid taking their child out in public, for fear of an outburst.”(KO/CW/Behaviors/Teacher/10-20-09/4B) One mother describes how it is difficult for her family to interact and sometimes spend time together, “Anger and anxiety affects your entire day, and everyone around you.”(KO/CE/Behavior/Depression/9-23-09/2J) And yet another describes how time together wasn’t the best thing for her family, “Some days were hard just because of the tension between him and dad.” (KO/BL/Depression/Anxiety/Sister of/11-20-09/4B) Beyond playing a part in relationships, there is a bit of a financial affect for those with Emotional Disturbances or Behavior Disorders. For some families the financial affect can be relatively minimal. When working with a disorder such as Behavior Disorder or Emotional Disturbance, you avoid numerous expenses that may come with other disabilities or illnesses. Some people though, must pay for their Emotional Disturbance or Behavior Disorder, literally. In reference to her brother who struggles with anxiety and depression, a young female says, “(My Brother) Doesn’t understand financial stress.” (KO/BL/Depression/Anxiety/Sisterof/11-20-09/4E) She continues with, “Financial impacts basically are just having to feed his bank account due to constant overdrawing.” (KO/BL/Depression/Anxiety/Sisterof/11-20-09/4D) and she finishes with an empathetic sigh, “My parents have had to make a lot of sacrifices due to his withdrawals.” (KO/BL/Depression/Anxiety/Sisterof/11-20-09/4F) For some, the only financial impact is having to pay for medication, this too can be minimal, due to the fact that most health insurance plans will cover this expense. This is not true for everyone, “Our Health Insurance doesn’t cover mental illnesses.”(KE/TK/Depression/10-4-09) Still for others the financial affects can come in different forms, “Financial impacts would be doctors appointments, mostly because with my anxiety, I need to know what is wrong with me when something is up.” There are multiple steps to intervene when you or a loved one sees an Emotional or Behavioral issue. One that is commonly used, and deemed effective is medication. “No medication triggers mood swings.” (KE/TK/Depression/10-4-09/1B) a mother explains about the way her daughter acts when she is without medication. There are a lot of positive effects that people experience when they take the right kind of medicine. One mother recalls the first time she began to take medicine for her depression. “My spouse saw an immediate change once I took medication.” (KO/CE/Behavior/Depression/9-23-09/2Q) She continues, “I can tell when I don’t take my medicine. I am fine for a few days, but then it comes back worse then ever.” (KO/CE/Behavior/Depression/9-23-09/2T) For the participants who were on medication, or knew someone that was, they all seemed to point more toward the negative affects of the times they did not take their medicine. “If you don’t take medication then your upset and you upset the entire family.” (KO/CE/Behavior/Depression/9-23-09) Some notice other side effects, “Without medication you are exhausted and you can’t sleep. (KO/CE/Behavior/Depression/9-23-09/2H), and yet another, “When (she) doesn’t take medication, she sleeps a lot.” (KE/TK/Depression/10-4-09) Another sought out intervention, is through counseling. Very few of the participants had any experience with this. “She never had counseling.” (KE/TK/Depression/10-4-09/1G) Not every type of counseling is for everyone, “I tried counseling and didn’t like it, but spiritual direction is totally necessary.” (KO/SL/Behaviors/Anxiety Disorder/11-23-09/5K) Spiritual direction is a type of counseling focused on ones spiritual life. A healthy mix of counseling and medication can truly be beneficial, but it is difficult to find those who participate in both. Even though there are really great interventions out there, children and adults alike continue to struggle with Emotional Disturbances and Behavioral Disorders, “People confuse it with being crazy, but that has nothing to do with it.” (KO/CE/Behavior/Depression/9-23-09/2R) Describes a mother whose family was mentioned above. She continues to advocate for how common it is, “When friends mention that they know someone is going through it, I just tell them that I am taking medicine for it.” (KO/CE/Behavior/Depression/9-23-09/2S) She concludes the interview with, “There is so much more that you kids have to deal with that we never did.” (KO/CE/Behavior/Depression/9-23-09) Emotional Disturbances and Behavioral Disorders continue to affect many on a day-to-day basis. Our greatest gain is knowledge. The more we come to understand others, their disabilities, and how these things change reality around them, the closer we come to accepting and knowing others beyond their disabilities.