Transcript Emotional Disturbance

Emotional
Disturbance
Overview
IDEA Definition
 Serious Emotional Disturbance: A
condition exhibiting one or more of the
following characteristics, displayed over
a long period of time and to a marked
degree that adversely affects a child's
educational performance:
 * An inability to learn that cannot be
explained by intellectual, sensory, or
health factors
IDEA Definition
 An inability to build or maintain
satisfactory interpersonal relationships
with peers or teachers
 * Inappropriate types of behavior or
feelings under normal circumstances
 * A general pervasive mood of
unhappiness or depression
IDEA Definition
 A tendency to develop physical
symptoms or fears associated with
personal or school problems.
 This term includes schizophrenia, but
does not include students who are
socially maladjusted, unless they
have a serious emotional disturbance.
Incidence
 In the 1999-2000 school year,
470,111 children and youth with
an emotional disturbance were
provided special education and
related services in the public
schools (Twenty-third Annual
Report to Congress, U.S.
Department of Education, 2001).
Characteristics
 Hyperactivity (short attention span,
impulsiveness);
 Aggression/self-injurious behavior
(acting out, fighting);
Characteristics
 Withdrawal (failure to initiate interaction
with others; retreat from exchanges of
social interaction, excessive fear or
anxiety);
 Immaturity (inappropriate crying, temper
tantrums, poor coping skills); and
 Learning difficulties (academically
performing below grade level).
Characteristics
 Children with the most serious emotional
disturbances may exhibit distorted
thinking, excessive anxiety, and
abnormal mood swings and are
sometimes identified as children who
have a severe psychosis or
schizophrenia.
Characteristics
Males are identified as
having emotional
disturbances more
frequently than females,
especially in elementary
years
Characteristics
Students with emotional
disturbances often use
inappropriate ways to
get attention, such as
talking back to adults,
refusing to do work, or
making jokes.
Characteristics
Students with
emotional
disturbances may have
low self-esteem and
poor social skills.
Characteristics
Students with emotional
disturbances can benefit
from classes that are
highly structured and
have clear rules that are
consistently enforced.
Academic Symptoms
Disruptive to classroom
activity.
Impulsive.
Inattentive, distractible.
Appears pre-occupied.
Academic Symptoms
Disregards all classroom
rules.
Poor concentration.
Extreme resistance to
change and transitions.
Speaks out, repeatedly.
Academic Symptoms
Is aggressive.
Bullies and intimidates
others.
Regular truancy from
school.
Academic Symptoms
Dishonest, consistently
blames others.
Low self esteem.
Unable to work in
groups.
Academic Symptoms
Engages in self injurious
behavior.
Has no regard for personal
space and belongings.
Persistently tries to
manipulate situations.
Management
Behavior Contracts
A behavior contract is an
agreement between the
child and teacher and
often includes the
student's parent(s).
Management
The behavior contract
is a written agreement
about how the
individual will behave.
Management
It will indicate the
appropriate consequence
should the student
neglect to behave
according to the contract
and
Management
it also states the
reinforcer to be used for
successful compliance.
The behavior contract
provides the student with
structure and selfmanagement.
Functional Behavioral
Assessment
 A functional behavioral assessment, or
analysis, is a process which seeks to
identify the problem behavior a child or
adolescent may exhibit, particularly in
school, to determine the function or
purpose of the behavior, and to develop
interventions to teach acceptable
alternatives to the behavior. The process
is as follows:
Functional Behavioral
Assessment
 1. Identify the behavior that needs to
change,
2. Collect data on the behavior,
3. Develop a "hypothesis" (best guess)
about the reason for the behavior,
4. Develop an intervention to help
change the behavior,
5. Evaluate the effectiveness of the
intervention,
6. Have patience.
Token Economy
A token economy is an
intensive, in-class positive
reinforcement program for
building up and maintaining
appropriate classroom
performance and behavior.
Token Economy
Sometimes a tangible
reward program, managed
by the teacher, may be
needed. Tangible rewards
can be conveniently
managed through a token
reinforcement program.
Token Economy
Token programs involve
the distribution of tokens
(for example, stickers,
stars, smiley faces, etc) or
points following
appropriate behavior.
Token Economy
The tokens or points can
be accumulated
throughout the day and
exchanged for designated
rewards at a specified
time.
Token Economy
a predetermined goal is set
for the number of tokens or
points require to earn a
reward. The teacher or
classroom aide is
responsible for distributing
the tokens and providing the
reward.
Conduct Disorders
This condition is
characterized by a persistent
pattern of behavior, which
intrudes and violates the
basic rights of others without
concern or fear of
implications.
Conduct Disorders
This pattern is not selective
and is exhibited in the home,
at school, with peers and in
the child's community.
Conduct Disorders
Other behaviors present with
this condition may include
vandalism, stealing, physical
aggression, cruelty to
animals and fire setting.
Oppositional Defiant
Disorder
This disorder is usually
characterized by patterns
of negativistic, hostile and
defiant behaviors with
peers as well as adults.
Oppositional Defiant Disorder
This disorder is considered
less serious than a conduct
disorder because of the
absence of serious
behaviors, which violate the
basic rights of others.
Oppositional Defiant Disorder
Children with this disorder
usually exhibit argumentative
behaviors towards adults,
which may include swearing
and frequent episodes of
intense anger and
annoyance.
Separation Anxiety Disorder
This disorder is characterized
by extreme anxiety
associated with separation
from someone with whom the
child views as a significant
other
Separation Anxiety Disorder
This separation anxiety is
frequently exhibited at
school and at home.
Anorexia Nervosa
Children with this
condition show a marked
disturbance and
unwillingness to maintain
a minimal body weight for
their age and height.
Anorexia Nervosa
An extreme distorted
sense of body image
exists and intense fears
and worries about gaining
weight become obsessive
Anorexia Nervosa
Children with this disorder
may also exhibit self-induced
vomiting, use of laxatives,
increased reduction of food
intake, preoccupation with
becoming fat, and noticeable
increase in the frequency and
intensity of exercise.
Bulimia Nervosa
 A condition characterized by
recurrent episodes of
uncontrolled consumption of
large quantities of food (binging)
followed by self induced
vomiting (purging), use of
laxatives or diuretics over a
period of at least two months.
Bulimia Nervosa
 The individual with bulimia nervosa
exhibits symptoms characterized by
binging and purging, use of laxatives and
diuretics, obsessive preoccupation with
body shape and weight and a feeling of
lack of control over food consumption
during binge episodes.
Tourette’s Syndrome
 This disorder is characterized by
motor and vocal ticing which
may be exhibited in the form of
grunting, coughs, barks,
touching, knee jerking, drastic
head movements, head banging,
squatting and so on.
Tourette’s Syndrome
The above symptoms may
change as the child
develops but the course of
the disorder is usually
lifelong
Tourette’s Syndrome
The condition is more
common in males and family
pattern are also common.
Coprolalia (vocal tic involving
the expression of
obscenities) is an associated
symptom in about 33% of the
cases.
Functional Encopresis
The major symptom of this
disorder is repeated
involuntary or intentional
passage of feces into
clothing or other places
which deem it inappropriate.
Functional Encopresis
 The condition is not related to
any physical condition, must
occur for a period of six months
on a regular basis and be present
in a child over the age of 4 for
diagnosis to take place.
Functional Enuresis
This disorder is characterized
by repeated involuntary
intentional elimination of
urine during the day or night
into bed or clothes at an age
which bladder control is
expected.
Selective Mutism
 This disorder is characterized by
persistent refusal to talk in one
or more major social situations,
including school, despite the
ability to comprehend spoken
language and speak. The
resistance to speak is not a
symptom of any other major
disorder.
Obsessive Compulsive
Disorder
 The major characteristics
associated with this disorder are
persistent obsessions (persistent
thoughts) or compulsions
(repetitive acts) that significantly
interfere with the individual’s
normal daily social, educational,
occupational or environmental
routines.
Dysthymia
The essential feature of this
disturbance is a chronic
disturbance of the
individual's moods involving
chronic depression or
irritable mood for a period of
one year for children and
adolescents.
Schizoid Personality
Disorder
The child with this
disorder exhibits a
restrictive range of
emotional experiences
and expression and
indifference to social
situations.
Antisocial Personality
Disorder
 This disorder is characterized by
a pattern of irresponsible and
antisocial behavior. The
condition is usually first seen in
childhood or early adolescence
and continues throughout the
child's development.
Antisocial Personality
Disorder
This diagnosis is usually
made after the age of 18 and
the individual must have had
a history of symptoms before
the age of 15 indicative of a
Conduct Disorder.
Borderline Personality
Disorder
The main features of this
disorder include instability of
self-image, inconsistent and
unfulfilling interpersonal
relationships, instability of
mood, and persistent identity
disturbance.
Post Traumatic Stress
Disorder
Post Traumatic Stress
Disorder (PTSD) is not a
disorder to be
associated solely with
military personnel, as it
has been in the past.
Post Traumatic Stress Disorder
It has been shown that
exposure to traumas such as
a serious accident, a natural
disaster, or criminal assault
can result in PTSD.
Post Traumatic Stress Disorder
When the aftermath of a
traumatic experience
interferes with normal
functioning, the person
may be suffering from
PTSD.
Post Traumatic Stress Disorder
 There are three types of generally recognized
stressors:
 Threatened death or serious injury to one's
person;
 Learning about the death, near death, or
serious injury of a family member or close
friend;
 Witnessing the death, near death or serious
injury of another person
Antidepressant Medication
 Some of the newest antidepressants are
called selective serotonin reuptake
inhibitors (SSRIs).
Medications
Antidepressants: Antidepressants work
by changing the level of
neurotransmitters (chemical
messengers) in the brain. Several
neurotransmitters are thought to be in
low supply in depression, including
noradrenaline (sometimes called
norepinephrine) and serotonin.
Examples of Antidepressants
 Celexa
 Effexor
 Lexapro
 Wellbutrin
 Zoloft
 Prozac
 Paxil
Antianxiety Medications
Klonopin
Xanax)
Valium)
Ativan).