Emotional, Behavioral, and Communication Disorders
Teachers are going to see students with emotional, behavioral and communication disorders within their general education classrooms. It is important for teachers to be able to observe and help identify students with these potential disorders so students can be evaluated to determine if they need additional special education or other resources. Just like students with disabilities, students with disorders need a safe, structured, and predictable environment and schedule. It is important for teachers to be aware that students may have multiple disability or disorder diagnoses.
What are Emotional and Behavioral Disorders? (Part I)
Theodore (2004) states that IDEA’s definition of serious emotional disturbances is “vague and incomplete” and has caused “a great deal of controversy and debate.” Consequently, a task force was created which represented “30 professional and advocacy organizations” (Taylor, Smiley, Richard, 2015). The National Mental Health and Special Education Coalition (NMHSEC) proposed a “new term, emotional or behavioral disorder (EBD)” (Taylor, Smiley, Richard, 2015), to replace serious emotional disturbances used by IDEA. This proposed definition of EBD is as follows:
- The term emotional or behavioral disorders means a disability that is characterized by emotional or behavioral responses in school programs so different from appropriate age, culture, or ethnic norms that they adversely affect educational performance, including academic, social, vocational, or personal skills, and which: (a) is more than a temporary, expected response to stressful events in the environment; (b) is consistently exhibited in two different settings, at least one of which is school-related; and (c) is unresponsive to direct intervention applied in general education, or the child’s condition is such that general education interventions would be insufficient. Emotional and behavioral disorders coexist with other disabilities.
- This category may include children or youth with schizophrenic disorders, affective disorders, anxiety disorders, or other sustained disorders of conduct or adjustment when they adversely affect educational performance in accordance with section I (Forness, Knitzer, 1992).
Depending on if students have internalized or externalized characteristics will determine if they are “disturbed” or “disturbing to others.” The internalized would include: depression, anxiety, bipolar, and even schizophrenia. The externalized would include: acting out, disobedience, and aggression.
It is difficult to identify all students with internalized EBD unless they show extreme obvious clues of withdrawal, violent drawings, writings or comments. Externalized EBD often is easier to identify, with disruptions in the classroom and hallways more common. Even when students act out, are aggressive or disobedient, they will not be immediately identified but will need to be observed and evaluated. According to Cullinan and Epstein (1995) they propose a “rule of one-third” of the students in any one-year will display emotional behavior problems. “Of that third, about one-third – approximately 10% of all students” will need a “modification of the educational program” (Taylor, Smiley, Richard, 2015). According to the U.S. Department of Education, only .7 percent of public school students are being provided services in special education (2018). This discrepancy would be due to the stigma associated with emotional and behavior disorders, especially with emotional.
The biggest potential causes are environmental, genetics, or a combination. Those that are in poverty are more at risk of having an EBD but poverty cannot be a deciding factor. Are there unrealistic expectations at home or at school? Is the student experiencing extreme or inconsistent punishment or neglect at home? Is the student experiencing discourse or even traumatic events with little or no emotional support? It is believed by most professionals that it is a combination of genetic and environmental causes that determine if a student will develop an EBD. Of course, one cannot discount diet. Eating nutrient-poor foods can have an impact on students’ development. These are all possible factors that can cause EBD.
Characteristics of students
There is no “typical” list of characteristics. Often boys tend to have more of the externalized behavior whereas girls tend to have more internalized but clearly that is not a rule. There are various things to keep in mind: what are the typical thoughts and behaviors of that age, gender, or culture? Is the student aggressive, when and why? Is the student withdrawn, and for how long? Does the student have a lot of anxiety, and why?
Internalized characteristics. When a student has internalized characteristics they may be withdrawn, angry without acting out, sad, excessively anxious or even have abnormal mood swings. Unless these symptoms are debilitating they are harder to identify than externalized problems. These are the students that may be at risk for suicide if they are not identified or helped.
Externalized characteristics. When students are acting out, openly disobeying, refusing to comply, destroying things, fighting or hurting themselves; it is easier to observe and determine that a student may need evaluation and help. Often students with externalized EBD have difficulties with impulse control, hyperactivity or poor coping skills. They may even have difficulties with social situations or with peers.
IDEA identification requirements of students
There are several main requirements looked at to determine if a student qualifies for services based on EBD or defined by the Individual with Disabilities Education Act of 2004 (IDEA) with emotional disturbance:
(1). A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance. (a). An inability to learn which cannot be explained by intellectual, sensory, or health factors. (b). An inability to build or maintain satisfactory interpersonal relationships with peers and teachers. (c). Inappropriate types of behavior or feelings under normal circumstances. (d). A general pervasive mood of unhappiness or depression. (e). A tendency to develop physical symptoms or fears associated with personal or school problems.
(2). Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted unless it is determined that they have an emotional disturbance.
Students are identified using a variety of tools: observations, behavior rating scales, behavior assessment systems, personality inventories, and projective tests (Ink Blot Test).
Best-practice instructional strategies for students
Like other students with disabilities, students with EBD need a consistent and predictable environment and schedule. These students need to learn: behavior skills, self-control, social interaction skills, and emotional regulation. “Service-learning activities can be very effectively used to meet both academic and social needs for these students” (Taylor, Smiley, Richard, 2015). Instruction needs to be effective, engaging, and positive. These students need to be taught “how to think rather than what to think” (Taylor, Smiley, Richard, 2015) and why it applies to them.
What are Communication Disorders?
A student who has difficulty with one or more processes of communication may have a communication disorder. The definition of communication is “the process by which one individual relates to another. It includes, among other aspects, language and speech” (Taylor, Smiley, Richard, 2015). There are both expressive and receptive language. Speech is broken down into four systems: respiration, voicing, resonance, and articulation. “Spoken languages are generally considered to have five components: phonology, morphology, syntax, semantics, and pragmatics” (Taylor, Smiley, Richard, 2015). If a student has difficulties with any one of the areas with language or speech they may also have issues communicating/processing their ideas, feelings, opinions or receiving them from others. Without communication one can be isolated, have difficulties reading, writing, learning or socializing. “IDEA defines a speech or language impairment as a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, which adversely affects a child’s educational performance” (Taylor, Smiley, Richard, 2015).
According to the United States Department of Education (2018) 2.6% of students enrolled in public education from preschool to 12th grade receive services for some communication disorder. This is lower than the amount that actually receives services since many students who have communication disorders have a primary disorder which they are categorized under. “IDEA counts students only once” (Taylor, Smiley, Richard, 2015). As many as “half of students receiving services under IDEA for another primary disability also have speech-language disabilities; thus the overall prevalence of students with communication disorders is higher than reported by IDEA” (Taylor, Smiley, Richard, 2015).
A student can have a congenital reason such as cerebral palsy, an organic reason like cleft palate, or even a functional reason that is “presumed to be the result of learning, psychological, or environmental factors” (Hulit, Howard, & Fahey, 2011). So prenatal, postnatal, genetics, or environmental factors can have an impact. Also, some students’ culture, first languages or regional dialect can affect how they listen, speak, and communicate; these do not mean the student has a communication disorder because they may be communicating according to their culture or language which may not translate to English easily. Consequently, a student’s potential communication disorder needs to be taken in context, they may need to learn some rules or processes for English but they may not have an actual communication disorder.
Characteristics of students
If a student has issues with a phonological process, then they will have difficulty learning the rules for using speech sounds. If a student has a morphological disorder they may misuse or omit morphemes. A syntactic issue is where a student may utilize overly simplistic sentences over more complex sentences. A student with semantic issues may have a very limited vocabulary. Whereas, a student with pragmatic issues may have difficulties in social situations: like staying on topic, using humor or understanding another perspective. If a student has a voice issue they may produce atypical “voice quality, pitch, or loudness” (Taylor, Smiley, Richard, 2015). A student with an articulation issue may produce atypical “speech sounds” (Taylor, Smiley, Richard, 2015). A student with a fluency issue may have an erratic “flow of verbal expression” (Taylor, Smiley, Richard, 2015).
IDEA identification requirements of students
The identification of a communication disorder usually requires the speech-language pathologist (SLP). The SLP will utilize norm-forming tests, observations, standardized tests, informal measures, and include the perceptions of those like parents or teachers that are concerned. It is crucial for a family history to be included in the evaluation process. Tests will evaluate both expressive and receptive language skills.
Best-practice instructional strategies for students
Students with communication disorders need social behavior skills and problem-solving skills. The most successful instructional strategies for students with communication disorders are for them to have speech and language modeled to them from teachers, specialists and even peers. Ideally the speech and language lessons are incorporated into the curriculum, such as: an “interactive use of language, modeling, guided practice, active engagement, and feedback in the procedures” (Taylor, Smiley, Richard, 2015).
Teaching a Student with an Emotional or Behavior Disorder (Part II)
Rickie is a ten year old in fifth grade; he often resorts to aggression, excrementing in the middle of class when upset, throwing chairs or other objects, yelling and hitting his teachers or even peers if they are nearby. He has difficulty in regulating his emotions and communicating what he is feeling. He has been in a self-contained classroom for the last six months; when he goes to specials, lunch or recess, a Special Education Instructional Assistant goes with him. He is known for taking off, so there has to be an adult with him at all times. He is unpredictable, explosive and the teachers and assistants had to be trained in CPI to help manage him. He starts the day making negative comments. Miss Melissa will have him chill out on the side while the rest of his class comes in. We go in and go to our self-contained classroom where we start our morning off with breakfast. After breakfast and clean up, the students work on independent morning work, and Rickie prefers puzzles or building. If he is having a difficult day he may end up throwing things instead of creating. Miss Melissa runs the room on the TEACCH method, so the students have a visual personalized schedule that they can take off the completed tasks. The students work for selected rewards, such as a sensory break, reading in book corner, listening to a book, computer time, iPad and some work for snacks. Rickie usually works for computer or iPad. When Rickie has an outburst we usually have to have the other students in our self-contained class exit to the sensory room for a safe sensory break, otherwise his behavior will set off other students. Miss Melissa has been documenting his behavior the entire six months. Recently, we had our IEP reevaluation and have recommended Rickie be seen by the school system’s psychologist and to transfer to the behavioral program so he can have more success and learn skills with some service-learning projects.
Teaching a Student with a Communication Disorder
Ella is a six-year-old kindergarten student who moved to her new hometown from Russia just two years ago. Her family had fled for persecution reasons and Ella does not know much English since her family’s home speaks Russian. Ella had participated in the Preschool program at the school but is having difficulties fitting in due to the delay in learning English and not being able to communicate sufficiently with her peers. She has been evaluated to have a pragmatic disorder but she also has difficulty staying focused and is hyperactive. The teacher has the general education room setup with ample social interaction opportunities. The students start the day with building or drawing. Afterwards, they have calendar where they sing songs, dance, do call-and-response songs, count the days of the year, talk about the day, month, weather and class rules. Then they work in whole group on math with a smart board and manipulatives. Often, the students are partnered or grouped together to work a problem. After the math lesson, the students clean up and have a brain break with GoNoodle. Then they work in small groups for their language arts. These groups rotate daily and often work with the teacher, a speech pathologist, a parent volunteer, or an instructional assistant. Ella spends the majority of her day with her peers having English modeled, being able to practice, and there is a lot of active engagement. The school is fortunate that they have several students from Russia and are able to afford an interpreter to help translate any confusion.
Students with emotional, behavioral and communication disorders have their own special requirements and challenges. They also require many of the same things as their peers with and without disabilities. These students can learn, and can learn to overcome their disorders with support, encouragement and being taught how to do it correctly.
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