Emotional & Behavioral Disorders

IDEA  uses the term emotional disturbance to refer to a condition that is accompanied bu one or more of the following characteristics over a long time and to a marked degree and that adversely affect a child’s educational performance; an inability to learn that cannot be explained by intellectual, sensory, or health factors; an inability to build or maintain satisfactory interpersonal relationships with peers and teachers; inappropriate types of behavior or feelings under normal circumstances; a general, pervasive mood of unhappiness or depression; a tendency to develop physical symptoms or fears associated with personal or school problems”. (Turnbull, Turnbull & Wehmeyer, 2010)

Causes of Emotional & Behavioral Disorder

 Biological Causes

The primary cause for emotional and behavioral disorder lies in brain functioning and heredity. For example in people with schizophrenia, research shows that there are less volume of gray matter as well as in the brains of children with schizophrenia, there are evidence of chemical imbalance in the activity of neurotransmitters, the chemicals that influence how the brain’s neuron’s communicate with each other. Another biological factor is genetics; a person’s genes may affect their temperament (character, personality). A person’s temperament is influenced by their environment; family, neighborhood, school, community, etc    and this interaction can either produce more positive behaviors or more negative behaviors. (Turnbull et al, 2010)

Environmental Factors

Family, school, neighborhood and community are all environmental factors that can contribute to emotional or behavioral disorders.

School factors

A study showed that most teachers who teach students with emotional and behavioral disorders were less qualified compared to teachers who were certified in special education. Teachers themselves felt that were not adequately trained for teaching students with emotional or behavioral disorders. (Turnbull et al, 2010). At school teachers are one of the most influential person in a student’s live, presenting situations that can either trigger or calm emotional and behavioral challenges. Students spend more time at school than at home in a given week, yet the majority of our teachers working with students with these disorders feel they are not adequately trained. Not only that, but about one half to three fourths of students with emotional and behavioral plan, more than 40% of these students do not receive any behavioral intervention or mental health services( Turnbull et al, 2010). These students are also twice as likely to be excluded from school as students with other disabilities.  It is clear that students with emotional and behavioral disorders are not receiving the services needed. One of the factors that can trigger emotional and behavior disorders is environmental factors, such as school. Therefore if the environment is challenging ( lack of resources and trained individuals to work with and support these students) then these students are more likely to have emotional and behavioral challenges.

Family factors

Families of students with emotional or behavioral problems are faced with a lot of challenges to include; single-parent household, unemployment, poverty, uneducated parent, and other siblings with a disability. Most students with emotional and behavioral problems live in uncertainty, which also contributes to their emotional or behavioral problems.

Family considerations

 Many parents feel like they are being blames for their child’s disorder, and with this blame, whether genetics of environmental effects. And because as parents, we see our children as reflections of ourselves, we can easily take on their troubles as a result of our wrong doing. This is an important reason for teachers to build partnerships with the family. Parents of students with emotional or behavioral disorders are more likely to be unsatisfied with their child’s school, teachers and special services being provided. They are also more likely to help their child with homework and attend parent-teacher conferences than students of other disabilities as well as students in the general population as well. However they are less likely to attend class or school events. 

Studies have shown that (1)” maternal depression, marital problems are associated with an increase in child adjustment problems. (2)The parents own  family history and emotional expression and regulation affect how children learn to express and regulate their own emotions.(3) Conflict between child’s temperament and parents temperament are related to each other” (Turnbull et al, 2010).

The fact is the family( genetics and environment) can affect children’s emotional and behavioral actions.

Characteristics of Emotional & Behavioral Disorder

According to the Diagnostics and Statistical Manual of Mental Disorders, there are 5 causes for children and adolescents being classified as having emotional or behavioral disorders: (1) anxiety disorder, (2) mood disorder, (3) oppositional defiant disorder, (4) conduct disorder, and (5) schizophrenia.

According to Turnbull et al, 2010, Anxiety Disorder is the most common childhood disorder. It is characterized by excessive fear, worry, or uneasiness. Students with anxiety disorder experience:

• Separation anxiety disorder- excessive and intense fear associated with separating from home, family, and others with whom a child has close attachment.
• Generalized anxiety disorder- excessive, overwhelming worry not caused by any recent experience.
• Phobia- unrealistic, overwhelming fear of an object or situation
• Panic disorder- overwhelming panic attacks resulting in rapid heartbeat, dizziness, and/or other physical symptoms.
• Obsessive-compulsive disorder- obsession manifesting as repetitive, persistent and intrusive impulses, images or thoughts.
• Post-traumatic stress disorder- flashbacks and other recurring symptoms following exposure to an extremely distressing or dangerous event such as witnessing violence or a hurricane.

Medication for anxiety disorders shows promise, but an intervention known as cognitive behavioral therapy (CBT) teaches students about how their feelings affect their behavior, being aware of their symptoms and developing coping strategies.

Mood Disorder

 A mood disorder can be characterized as having extreme feelings leading to a depressed state or an elevated state or sometimes feelings of both at different times. Experiences of major depression my experience changes in

Emotion: feeling sad or worthless, crying often, or appearing tearful; motivation

Motivation: losing interest in play, friends, and schoolwork, with a resulting decline in grades.

Physical well-being:  eating or sleeping too much or too little, disregarding hygienic or making vague physical complaints.

Thoughts: believing he or she is ugly and unable to do anything right and that life is hopeless

Bipolar disorder is a type of mood disorder characterized by exaggerated mood swings.(Turnbull, et al, 2010)  Student’s mood can go from extreme happiness to a state of depression.  Students with this disorder may also have ADHD.

Oppositional defiant disorder

Oppositional defiant disorder “causes a pattern of negativistic, hostile, disobedient, and defiant behaviors”. According to DSM-IV-TR students must have some of the following: loss of temper, arguments with adults, refusal to cooperate with adult requests, misbehavior, low self-esteem, easily annoyed, expressed resentfulness and anger, and tendency for vindictiveness. Occurrences must last for at least six months, and is usually a precursor to conduct disorder. (Turnbull et al, 2010)

Conduct Disorder

Conduct behavior is a persistent pattern of antisocial behavior that significantly interferes with the rights of others or with school’s and community behavior expectations. The DSM-IV-TR identified 4 categories for conduct disorder: aggressive conduct, property destruction, deceitfulness or theft, and serious rule violations. (Turnbull et al, 2010). Students with this disorder usually have ADHD and are often placed in juvenile correction programs.

Schizophrenia

To be classified as having schizophrenia, according to the MSM-IV-TR, one must display three qualities;

• At least one of the following qualities: highly unusual delusions; an auditory hallucination of one voice that provides commentary on the individual characteristics, behavior, and/ or feelings; auditory hallucinations with multiple voice conversations.
•  At least two of the following qualities: delusions, hallucinations, disorganized expressive language, disorganized or catatonic behavior(behavior that lacks typical movement, activity, and/or expression)
• Other negative symptoms characterized by a loss of contact with reality.

(Turnbull et al, 2010)

Behavioral Characteristics

Students with emotional or behavioral disorders can be identified through two characteristics; internalizing behaviors and externalizing behaviors. Students that internalize displays aggressive behaviors, or behaviors that are non-compliant. These students can also engage in high-intensity behaviors such as setting fires, assault or cruelty towards others. Students internalizing behaviors include withdrawal, depression, anxiety, obsession and compulsion. These students tend to have poor social skills, sometimes so withdrawn that one may not notice or remember that they are present.  Students with internalized behaviors are less likely to be identified for special education services because they are not as disruptive as students with externalized behaviors.

Cognitive and Academic Characteristics

Students with emotional disorder tend to have low-average IQ’s, however some may be gifted. Almost two thirds of students with this disability had expressive and/or receptive language disorder, higher rate of being held back, and low social skills.

Inclusion Ideas

Some ways to include students in the general classroom environment includes allowing classmates to work constructively with each other to solve conflicts, partnering students that can model good social skills, provide positive feedback to students and encourage them to use positive feedback with each other. To accommodate student’s disabilities, allow extended time during testing, allow breaks throughout the test and provide opportunities for one individual to administer the test.

Disability support/Information

Sedgwick County, KS COMCARE Children Services

A licensed Community Mental Health Center

7701 E. Kellogg, Suite 300, Wichita, KS 67207
(316) 660-9600
(316) 660-9660 (Fax)
Contact: Jody Patterson, LCP, director

National Dissemination Center for Children with Disabilities

NICHCY
1825 Connecticut Ave NW, Suite 700
Washington, DC 20009

1.800.695.0285 (Toll-free, Voice/TTY)
202.884.8200 (Voice/TTY)
202.884.8441 (Fax)

Email: nichcy@fhi360.org
Website in English: nichcy.org
Website in Spanish: nichcy.org/espanol/