Essentials PEPSI Elementary Adolescence Advanced CD
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ESE504 : The Class : Advanced CD : EBD

Emotional &

Behavioral Issues

This is a tough subject. Of all the service categories, this is the most filled with:

Religious Ramifications

Social Significance

Cultural Conditioning

What is misbehavior?

How do various theories explain human behaviors - and what do they feel will support change?

How are "being bad" and emotionally disturbed different?

Do some people choose to be bad while others are compelled to do things that are inappropriate?

Are some things wrong, no matter the time, culture, religion?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), of the 33 million children and adolescents age nine to 17, between 3.5 million and four million suffer from "a serious emotional disturbance" (SED), which refers to a range of diagnosable emotional, behavioral, and mental disorders that severely disrupt the youth’s daily functioning in home, school, or community.

Between nine percent and 13 percent of children in that age group have a serious emotional disturbance. Children living in poverty are twice as likely to have a serious emotional disturbance than those living in higher socioeconomic groups.

The National Mental Health Association states: Many children and families are affected by mental health problems. At any given time:

One in five children and adolescents may have a mental health problem.

At least 1 in 10, or as many as 6 million young people, may have a serious emotional disturbance. (Center for Mental Health Services, CMHS)

An estimated two-thirds of all young people with mental health problems are not getting the help they need. (Center for Mental Health Services, CMHS)

About 1% of school children are served - and it is considered one of the most highly underserved category

Externalizing problems are most often recognized and served with

There are 8 boys receiving services for every 1 girl identified and placed in an EBD setting.

Maria is laying out a feast for the dead. There is a festive air surrounding all the goodies she lays on the blanket.

Martin is being put in restraints. He continues to moan and chatter about his dead mother coming to visit him.

One attempt to communicate with the Dead is celebrated annually, the other will likely lead to hospitalization


Jerry is a 14 year old boy who is receiving a medal of valor for shooting a man who was holding up a store.

John is going to jail for shooting a rival gang member.

There is a time and place for violence in some societies. For some of us there are situations when killing is honored, while in other circumstances it is punished.

One of the ways to define emotional disturbance includes determining if a person is a danger to self and others.


Ben has worked for several weeks, following the dictates of his culture and religion and has now entered an altered state that has great religious significance. He is at the threshold of the rites that will help him be ready to take on the challenges and significance of manhood.

Burton is entering treatment for substance abuse. He was caught using an illegal, mind altering drug.

Altered states may be honored in one situation, punished in another.


Miss Marten has a talk with her class and points out how much she honors Jason, who spoke up about injustice in the school.

Mr. Morris sends Jason to detention for disrespecting him by questioning his test.

How a message is received has a great deal to do with decisions about behavior. The power of the speaker and the power position of the recipient may alter how a message is received. That may also include gender, and there may be a difference in how someone responds if the speaker is from a perceived minority.


Luz is raped and begins to be fearful about strangers or walking alone at night.

Lacy gets panicky in situations with no warning. The sense of dread is building, and now, six months later, she is never certain what will trigger intense feelings of dread and anxiety.

Tragic events can create emotional distress. Emotional disturbances may not have an obvious triggering event.

Tracy's father dies and she has no interest in school or interaction with friends.

Tim begins to experience a feeling of dread that he cannot shake. He finds a sense of ominous foreboding is building, and now, six months later, he is not sleeping, has suicidal thoughts and feels hopeless.

Tragic events can create a depressed mood. Clinical depression, with no obvious crisis point may slip into a student's life and create a sense of lethargy and hopelessness.


Lonnie likes to costume himself and often chooses clothes that make him look pretty sexy and feminine. He and his friends get a real kick out of the process and laugh about the good times, the fun and stimulation of playing the part of a woman.

Larry hates being male. He desperately wants to save up the money to have a sex change operation. He often dresses as a girl and the kids have seen him and made him the joke in conversations in the school.

Both students are engaging in cross dressing, but only one is having emotional problems that are related to gender.

If there is so much diversity in how we interpret similar actions,

how will we be able to determine when a student needs exceptional support?

These definitions delineate important points.

Definition Of Emotionally Disturbed - #1

When a student exhibits behaviors that might appear to show emotional disturbance, we can use the definition from IDEA to decide if the behaviors warrant the distinction of Emotionally Disturbed:

The term means a condition exhibiting one or more of the following characteristics over a long time and to a marked degree that adversely affects a student's educational performance.

An inability to learn that cannot be explained by intellectual, sensory or other 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.

Schizophrenia is also included as part of the definition.

Definition Of Emotionally Disturbed - #2

The Mental Health and Special Education Coalition states -

A. The term emotional or behavioral disorder means a a disability that is . . .

(i) characterized by behavioral or emotional responses in school programs so different from appropriate age, cultural or ethnic norms that the responses adversely affect educational performance, including academic, social, vocational or personal skills;

(ii) more than a temporary, expected response to stressful events in the environment;

(iii) consistently exhibited in two different settings, at least one of which is school-related; and

(iv) unresponsive to direct intervention applied in general education, or the condition of a child such that general education interventions would be insufficient

B The term includes such a disability that coexists with other disabilities.

C. The term includes a schizophrenic disorder, affective disorder, anxiety disorder or other sustained disorder of conduct or adjustment, affecting a child if the disorder affects educational performance ....from Individuals with Disabilities Education Law Report, 1993,p.1)

So, there are specific things that suggest intervention. . . How do teachers decide?

This next list shows some of the student behaviors that lead teachers to discipline or punish.

In the past, youngsters were punished for: Common concerns today include:
1. Talking to neighbors

2. Passing notes

3. Chewing gum

4. Walking around the classroom

5. Being off task

6. Not doing homework

7. Pranks on neighbors

8. Taking things that belonged to the classroom

1. Shootings

2. Drug abuse

3.Vandalism and stealing

4. Attacking school personnel

5. Indecent gestures and language

6. Stealing and illegal activities

7. Dishonesty

8. Assault and abuse of fellow students


Questions about Students with Behavior Problems

1. What is behavior or misbehavior?

2. Would it be reasonable to characterize any of the actions teachers find unacceptable as developmental -- meaning age appropriate at some points during maturation?

3. What is the difference between being bad and being considered emotionally disturbed?

a. Could any of these listed behaviors be considered evidence of an emotional disturbance?

b. Are any of the behaviors illegal? Would that make them serious enough to be a disorder?

4. How many are situational issues - things that are related to what is expected at school but not issues in other situations?

5. Are any of these behaviors created by expectations that do not match with normal student behavior, or that are in direct conflict with human needs?

6. Does it make a difference if a youngster chooses to misbehave or is internally compelled? {Feel free to write a paper about these issues. Give yourself 25 points for each authority you read and quote in the paper and an additional 50 points for addressing this issue}.

There are numerous views of human nature or conceptual frameworks for explaining human behavior.

Five will be presented here.

Description of behavior
Behavior is a function of the body
Unconscious desires and needs
Behaviors are learned and come from interactions with environment - no free will
How you process information determines how you see actions
Behavior is combination of need fulfillment conscious thought and drives,
Internal - body
Internal - emotional and experiential
Internal from way we think about experiences and genetic make-up
Combination of inheritance and environment - individual and experience
Cause of behavior
We inherit our personalities and our actions come from that
Combination of nature and nurture
Experience and environment
Way a person thinks about experiences
Need to create personal happiness - self fulfillment
Libido, ego, id, superego, drives
Rewards and punishment
Need to structure experiences
Need to know, to be self, for beauty and self actualization
Measure of Existence
Observation, systemic measurements
Subjective tests, dreams, ideas
Measurable and observable data
Case studies, expressed feelings and needs, personal insights
Therapy or remediation
Medicine, Rx
Play therapy, free association, explore fixations, drives
Manipulate environment, punish, reward, functional analysis and behavior plans
Align perceptions with actual situations; reality therapy
support, love, relationship, nurturance, look for and meet individual needs

These are interesting ideas, since they show that there are many ways of viewing behavior, many ways of explaining another's actions and a wide variety of working to eliminate things that are uncomfortable for us as teachers, parents, adults in society.

Activity: Take a specific behavior problems - for instance a student who is having trouble sitting still or paying attention during class. Suggest the type of intervention that each conceptual framework would sponsor [25 points].

Intervention 1          
Intervention 2          

Intervention 1          
Intervention 2          

Take a student who is violent with others. Suggest the type of intervention for each framework [25 points].

Intervention 1          
Intervention 2          

A student is having auditory hallucinations. Suggest a possible treatment from each framework [25 pts].

Intervention 1          
Intervention 2          

A student is anorexic. Suggest a possible treatment from each framework [25 pts].

Understanding different philosophies or ways of describing human nature tells us a great deal about how people look at the actions of children. It tells us a lot about how our society has matured in our vision of who human beings are. It also provides help in realizing why there are such varied responses to a student act. Each philosophy has a different way of looking at behavior. . . and each philosophy provides a different set of tools for ameliorating uncomfortable, unwanted or dangerous actions. . . getting the child to stop or change the actions.

How Do I Feel?

Each philosophy discusses how others feel about the child.

They do not really help us understand the student or how the student feels.

A student who is distressed really needs our understanding.

SO . . . .

First things first.

I am a wonderful human being first, and a person with a behavior problem second.

If I am self involved it may come from a need to maintain ritual and secure a sense of safety. Until I feel safe, I may not be able to move out of myself to empathize with others.

I have needs, yet I may lose my ability to express those needs.

If I am feeling rage, disappointment or depression, I may behave in ways that express how unfulfilled, thwarted and unhappy I am.

I may not be able to understand myself, to be insightful. If I have been hurt or feel abandoned, I may blame myself, feel thwarted, find myself unable to communicate in rational ways, and I may express needs in ways that oppress others.

I may not be able to get outside myself, and may blame myself for things that I cannot control and did not choose or create. If I have been hurt or feel abandoned, I am likely to believe it is because I am unlikeable. If people are hurting me, I am likely to believe I have done something to cause it and am likely to change my behavior to prevent a repeat, and when the hurt is inflicted again, I may continue to search for my own culpability, rather than understanding that I am not the cause.

I may behave as I do because of biochemical or hereditary influences. No matter what the underlying issues or causes , I will respond best when I feel respected and have a sense of support that includes unconditional positive regard.

I grow best when I feel safe so I can move beyond my own pain and reach out to help others.


Safety is the most important and powerful way to hasten growth.

Help the child feel adequate
Engineer the environment for safety
Provide clear guidelines and expectation Maintain upbeat, hopeful feeling with absence of anger
Describe tasks and practice successful completion Stay away from punishment, retaliation, revenge, grudges
Maintain communications and hear the student Have an adult present during community interaction
Treat the student as an individual and provide opportunities for the student to direct choices Be savvy during times with students, watching for nonverbal signs of trouble - enhance "withitness"
Give the student responsibility for self and behavior, including self monitoring, self rewarding, self control Locate peers- a buddy - with similar interests and support the time spent as a duo or small group as educational
Be proactive and do not reward begging or manipulation Promote a sense of community and willingness to belong
Maintain confidentiality and do not "share" insights about other students when a child is out of the room, and that includes conference times when possible Expect students to share frustrations and keep channels open - allow "telling," sharing feelings of fear, standing up for self and needs
Honor your word and model self control Teach group skills and socialization to all and expect it

We can provide a significant amount of support, structure and nurturance by zooming in to look at whether the problems are INTERNALIZING or EXTERNALIZING.


Exhibits painful shyness or withdrawal

Teased or victimized by peers

Seems to worry excessively

Panics in many situations and seems to have unfounded fears and phobias

Appears to have low esteem

Solves problems by disengaging

Tends to be suicidal or have thoughts of death and retreating from life

May be anorexic or bulimic

Causes or threatens physical harm to people and animals

Uses lewd or obscene gestures frequently

Ignores directions and reprimands

Is verbally hostile, including argumentative

Has tantrums, fits, rages

Damages property and belongings or others

Violates rights of others and societal norms

Recognize and value the student as they are without pressing them to be more, different

Accept student feelings and honor them rather than discounting fear or discomfort

Minimize power struggles - especially since the student is not likely to share needs if this occurs -- "brick wall time"

Keep the classroom safe and supportive for all students; minimizing lecturing as a form of behavior management, punishments, fuming

Stay away from manipulating the student or using them as an example to others

Minimize pressure for perfection

When appropriate, reduce work load for students who are "drawing" their work

Honor individuality and respect a student's request not to speak in front of the class, to go the the bathroom, to work alone

Provide places for the student to express feelings and needs - diary, making up objectives for next class, self pacing, self evaluating

Firmly describe expectations

Anticipate problems and watch for triggers

Model lack of anger and self control

Minimize change and maximize ritual

Explain consequences and resist temptation to use them retroactively - "You did this, now I'm going to do this"

Provide advance notice of change - even expected change -- In five minutes the bell will ring for recess

Provide high intensity outlets for students that are solitary pursuits, increase endorphins, decrease adrenalin

Expect student to work on self control, to self monitor and sense emotional fluctuations, then to adjust to them

Maximize opportunities for students to gain second person perspective

Set up interactions that are likely to be successful and monitor them the whole time

Provide choices and defer control. "The clock shows the bell is about to ring. Would you like help cleaning up or do you want to do it yourself?"

Behavior disorders may also be categorized as having four clusters of traits, including conduct disorders, anxiety-withdrawl, immaturity, and socialized aggression. - Quay, H. C. (1986) Classification. Psychopathological disorders of childhood (3rd ed.).New York: John Wiley &Sons.

Anxiety involves intense feelings of worry and tension when there is no real danger. The symptoms include significant distress and interfere with daily activities and learning. Sufferers of anxiety disorders usually take extreme measures to avoid situations that provoke anxiety. The physical signs of anxiety are restlessness, irritability, disturbed sleep, muscle aches and pains, gastrointestinal distress, and difficulty concentrating. Anxiety disorders are often accompanied by the symptoms of depression and can lead to chronic anxiety.

Conduct disorder is a persistent pattern of behavior that involves violating the rights and ignoring or failing to recognize the needs of others (disobedience, destructiveness). The pattern is seen at home, school, and in the community. Verbal and physical aggression are key features of conduct disorder.

Immaturity is characterized by daydreaming, passiveness, a short attention span, preference for younger playmates, clumsiness, general appearance of being younger than years.

Socialized aggression refers to youth who build or join a community of peers who are involved in delinquent act, "wilding" truancy, tagging, theft, bullying others with acts of violence or threats to life or property

DSM-IV Categories that apply to youth -copyright 1994 by APA
Mental Retardation mild, moderate, severe, profound
Learning Disorders in reading, mathematics, and written expression
Communication Disorders expressive, mixed, receptive-expressive, phonological, and stuttering
Pervasive Developmental Delay childhood-onset schizophrenia, Rett's disorder, Asperger's disorder
Attention Deficit and Disruptive Disorders Attention deficit/hyperactivity, conduct, oppositional defiant
Feeding and eating disorders of Infancy or Early Childhood Pica, rumination, feeding disorder of infancy or early childhood
Elimination Disorders Encopresis (problems with solid waste), enuresis (wetting)
Other Separation anxiety, selective mutism, reactive attachment disorder of infancy or early childhood, stereotypic movement disorder
DSM-IV Categories that are not listed separately as applying solely to youth -copyright 1994 by APA
Mood Disorders depressive disorders, bipolar disorders
Anxiety Disorders specific phobia, social phobia, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), acute stress disorder, generalized anxiety disorder, anxiety disorder due to a general medical condition
Eating Disorders anorexia nervosa, bulimia nervosa
Sleep disorders dyssomnias, parasomnias

Making Accommodations

1. Observe the student in several settings and look for triggers, feelings of others, feelings of the student.

2. Look into the history of the child's behaviors and things that have been tried and failed, things that have helped.

3. Collaborate with others to create a plan that will focus on student needs and provide school wide consistency

4. Communicate carefully and at times/in ways that are most likely to result in understanding.

5. Enhance the amount of structure and safety, including the student in developing the boundaries so they do not look like restraints and do not insight power struggles.

6. Increase the amount of stimulation that will reduce boredom and frustration, balancing that with ways that the student can quiet self.

7. Stay under self control, avoiding feelings of frustration, anger, rage - since these seem to telegraph into student misbehavior.

8. Do not allow self or staff members to be manipulated into misbehaving.

9. Stay clear of value judgments and statements that ask the student to be self insightful.

10. Work to stay away from punishment, using natural and logical outcomes or consequences as much as possible. If punishment is used, have it correlate as closely as possible to the behavior, keep it brief and have no holdovers to the next class, hour, subject, day, week, etc.

Read a few of the links that follow. When finished, list some of the things you feel may contribute to emotional wellness. [15 points each-- 5 for locating a link, 10 more for reading and personally considering each one].

Personal notes

Intensive behavioral interventions - articles,techniques and links

Dr. Koop's site on Mental Illness

Child and Family studies regarding serious emotional issues

Multicultural supports and training in mental health

Glossary of mental health

Web links on Emotional Disturbance

Tourettes Syndrome

APA American Psychological Association

General information from NICHCY

Transition from adolescence to adulthood when EBD

Bullies and violence a book about stopping bullies



Tips and Strategies

Educational Interventions
Personal Notes

Links for sites about interventions

On line book on assisting adolescents in transition to adulthood

Program for youth who are SED

Respite care information for children who are SED

CECP site

CECP extensive links to information and treatment

Youth resource net with extensive links


Basic Needs

I need to be valued for who I am and what I do. I need to feel wanted and I need to feel a sense of belonging - a bond. On the one side, I need to feel good about myself - like myself and at the same time, I need to feel like I really matter to others.

SO . . . .Just as you would with anyone you care for, pay attention to the needs - the real, pressing, desperate needs. When a youth needs space or stimulation, instead of becoming involved in a power struggle such as - "You may want that now, but now is not the time and this is not the place" kind of response, engage in problem solving. This chart gives an example of a positive and supportive way to approach this.

Student action


Creative solution
Breaking rules or interrupting the teaching and learning flow

Student - to be soothed - Safety

Teacher - to teach and have peace - Safety, self actualize

Class - to learn, concentrate - Safety, need to know

Increase the level of comfort and safety for the student who is acting out and make a place where actions will not disturb others; help class to increase tolerance by helping them understand the actions in a positive frame - ways they self soothe,etc. Teacher - observe time of day and check to see if this is a pattern and if so what sets it off. While student is being soothed by others, move forward with the lesson.
Student becomes agitated

Student - to be soothed, to know what is coming next and be ready

Teacher - to make transitions easily

Class - to know that all are safe

Set up a system that communicates that the teacher has the intelligence and foresight to see issues coming and help with solutions. Let the student feel in control of self and clear about what is about to happen - to have time to adjust and cope with the next task and the resultant expectations.

Fill in the next three cell rows, using the ideas you gain from experience, from materials in the text and in your web searches. Identify a likely student behavior that may hamper learning and then go through the process of defining needs, then finding a solution that allows everyone to get needs met [25 points have been allotted for this activity].

Behavior modification can help, particularly with youngsters who need to be trained. In fact, training that recognizes the need to "gentle" the person first and then work on compliance can shorten the youth's frustration, since we are limiting and focusing responses to a few behaviors.

List the recommended steps for setting up a functional analysis and a behavior contract with a youngster. This activity is worth 25 points. [For a review of the steps in the process, go to ese502a and review some of the materials in the module on behavior modification. If the material is new to you, give yourself 100 points for a thorough review]


Activity List

1. Read a book written by a family member, telling about their personal insights and challenges. Make a list of the ways a teacher might support the parent experiences. Make a second list of things parents might tell an educator about a child. [50 points]. Remember, many parents are finding few answers and many recriminations when a child misbehaves.

2. Locate a parent who will allow you to visit the child at home and spend a minimum of 4 hours observing the youngster. As part of the observation experience, identify at least three student strengths. Look for the youngster's interests and determine some of the contact points or areas of interest that could be used to engage the student. Watch for power struggles, flash points, and antecedents to the loss of control. [25 points per hour for observing].

3. Watch Twelve Monkeys, the movie for 50 points and send a review of the characterization of autism for another 25 points. Another movie is Sybil or Bell Jar. You may watch and report on any of the movies listed below.

4. Learn about behavior modification programs. Try to find an opportunity to watch someone use it with a child. After looking at the pros and cons, develop a paragraph stating your personal feelings about the technique and its usefulness. [25 points]

5. Identify three commonly held fallacies about emotional disturbance in youth and then provide three fact based beliefs about youth with behavioral or emotional disturbances. [15 points]

6. Locate and review one of the diagnostic instruments used to evaluate youngsters who are acting out, have attention deficit disorder, or a conduct disorder. Describe your sense of their value in recognizing those who are SED and more transitory times or situation forms of distress in a brief essay[25 points].

7. Find out what services are available in your community to help with suicide issues.

8. There are several very different kinds of emotional disturbance. Choose one of the categories that you find interesting and find at least 10 articles or discussions about the characteristics of the condition. Feel free to use materials off the web, as well. Then write a paper of 500-1000 words, discussing the challenges these young people have and provide a set of methods or materials that might address strengths and diminish barriers to education. [100 points each]

Book List

Aiken, C. (1983). Silent snow, secret snow. MN: Creative Education.

Atwood, M. (1996). Alias Grace. NY: Doubleday

Axline, V. (1964). Dibs: In search of self. Boston: Houghton Mifflin.

Beers, C.W. (1908). The mind that found itself: An autobiography. NY: Longmans, Green.

Bettleheim, B. (1950). Love is not enough. NY: Macmillan

Bettleheim, B. (1967). The empty fortress. NY: Free Press.

Duke, P. (1987). Call me Anna: The autobiography of Patty Duke. NY: Bantam.

Green. H. (1964).I never promised you a rose garden. NY: Holt, Rinehart & Winston.

Greenan, R. (1949). The secret life of Algernon Pendleton. NY: Alfred A. Knopf.

Greenfeld, J. (1986). A client called Noah. NY: Henry Holt & Co.

Grossman, H. (1972). Nine rotten lousy kids. NY: Holt, Rinehart & Winston.

Holm, M.F. (1986). Shall the circle be unbroken? CO: Bookmakers Guild Inc.

Kaysen, S. (1993). Girl interrupted. NY: Random House.

Kesey, K. (1977). One flew over the cuckoo's nest. NY: Penguin.

Neufeld, J. (1969). Lisa, bright and dark. NY: Phillip

Plath, S. (1971). The bell jar. NY: Harper.

Rapport, J. (1989). The boy who couldn't stop washing: The explanation and treatment of obsessive-compulsive disorders. NY: Dutton.

Richette, L.A. (1969). The throw away children. PA: Lippincott.

Rubin,T. I. (1962). Jordi: Lisa and David. NY: Ballentine.

Sheehan, S. (1982). Is there no place on earth for me? MA: Houghton Mifflin.

Stowe, R. (1991). Not the end of the world. NY: Random House.

Styron, W. (1990). Darkness visible: A memoir of madness. NY: Random House.

Vonnegut, M. (1949). The Eden express. NY: Farrar, Straus.


Boy's Town The Bad Seed Shine Compulsion
Bedlam Birdman of Alcatraz Primal Fear David and Lisa
Harvey The Collector Twelve Monkeys The Piano
Fisher King The Prince of Tides Camille Claudel Zelly and Me
Deathtrap The Breakfast Club Full of Sound and Fury The Bell Jar
Harry Days of Heaven David and Lisa Outrageous
Sybil Outrageous Equus A Clockwork Orange
Titicut Follies The Collector One Flew over the Cuckoo's Nest  


You should now:

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Course developed by J'Anne Ellsworth


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