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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?
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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
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.
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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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Definition Of Emotionally Disturbed
- #2
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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)
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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
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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
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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.
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Biophysical
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Psychodynamic
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Behavioral
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Cognitive
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Humanistic
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Description of behavior
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Behavior is a function of the
body
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Unconscious desires and needs
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Behaviors are learned and come
from interactions with environment - no free will
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How you process information
determines how you see actions
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Behavior is combination of need
fulfillment conscious thought and drives,
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Control
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Internal - body
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Internal - emotional and experiential
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External
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Internal from way we think about
experiences and genetic make-up
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Combination of inheritance and
environment - individual and experience
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Cause of behavior
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We inherit our personalities
and our actions come from that
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Combination of nature and nurture
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Experience and environment
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Way a person thinks about experiences
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Need to create personal happiness
- self fulfillment
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Motivation
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Internal
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Libido, ego, id, superego, drives
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Rewards and punishment
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Need to structure experiences
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Need to know, to be self, for
beauty and self actualization
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Measure of Existence
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Observation, systemic measurements
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Subjective tests, dreams, ideas
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Observation
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Measurable and observable data
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Case studies, expressed feelings
and needs, personal insights
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Therapy or remediation
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Medicine, Rx
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Play therapy, free association,
explore fixations, drives
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Manipulate environment, punish,
reward, functional analysis and behavior plans
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Align perceptions with actual
situations; reality therapy
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support, love, relationship,
nurturance, look for and meet individual needs
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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].
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Biophysical
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Psychodynamic
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Behavioral
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Cognitive
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Humanistic
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Intervention 1 |
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Intervention 2 |
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Biophysical
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Psychodynamic
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Behavioral
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Cognitive
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Humanistic
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Intervention 1 |
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Intervention 2 |
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Take a student who is violent with others. Suggest
the type of intervention for each framework [25 points].
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Biophysical
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Psychodynamic
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Behavioral
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Cognitive
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Humanistic
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Intervention 1 |
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Intervention 2 |
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A student is having auditory hallucinations. Suggest
a possible treatment from each framework [25 pts].
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Biophysical
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Psychodynamic
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Behavioral
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Cognitive
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Humanistic
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Intervention 1 |
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Intervention 2 |
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A student is anorexic. Suggest a possible treatment
from each framework.
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
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Engineer the environment for safety
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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.
INTERNALIZING
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EXTERNALIZING
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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
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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
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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
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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?"
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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
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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
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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.
Tips and Strategies
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.
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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
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Needs
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Creative solution
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Breaking rules or interrupting the teaching
and learning flow
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Student - to be soothed - Safety
Teacher - to teach and have peace - Safety, self actualize
Class - to learn, concentrate - Safety, need to know
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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
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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
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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. |
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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
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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.
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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.
Movies
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 |
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E-mail J'Anne Affeld at Janne.Affeld@nau.edu
Course developed by J'Anne
Affeld
Copyright © 1999 Northern Arizona
University
ALL RIGHTS RESERVED
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