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Emotional or Behavioral Disorders Defined (page 2)

By — Pearson Allyn Bacon Prentice Hall
Updated on Apr 30, 2014

Externalizing Behaviors

When we think about emotional or behavioral disorders, we probably first think of behaviors that are "out of control"—aggressive behaviors expressed outwardly, usually toward other persons. Some typical examples are hyperactivity, a high level of irritating behavior that is impulsive and distractible, and persistent aggression. Young children who have serious challenging behaviors that persist are the mo likely to be referred for psychiatric services (Maag, 2000). Three common problems associated with externalizing behavior are hyperactivity, aggression, and delinquency. Hyperactivity was discussed in Chapter 6 because it is a common characteristic of ADHD. Remember that ADHD and emotional or behavioral disorders often occur in combination. So it shouldn't be surprising to find that hyperactivity is a common problem among these children as well.

Aggression may be turned toward objects, toward the self, or toward others. The DSM-IV-TR does not directly define aggression, but it does include elements of aggression in two of the disorders it describes: conduct disorders and oppositional defiant disorder. Aggressive behavior, particularly when it is observed in very young children, is worrisome. This is not just because of the behavior itself—though its hazards should not be minimized—but also because of its strong correlation with long-term problems (dropping out of school, delinquency, violence). A pattern of early aggressive acts beginning with annoying and bullying, followed by physical fighting, is a clear pathway, especially for boys, to violence in late adolescence (Talbott & Thiede, 1999).

Some 30 to 50 percent of youth in correctional facilities are individuals with disabilities (IDEA Practices, 2002). In this group, learning disabilities and emotional or behavioral disorders are about equally represented (45 and 42 percent, respectively). Delinquency, or juvenile delinquency, is defined by the criminal justice system rather than by the medical or educational establishments. Delinquency consists of the commission by juveniles of illegal acts, which could include crimes such as theft or assault. Remember that although some children who are delinquent have emotional or behavioral disorders, many do not—just as some children with emotional or behavioral disorders are delinquent but many are not. However, it is very important to understand that many of these children are at great risk for being involved with the criminal justice system (Edens & Otto, 1997). Their rates of contact with the authorities are disproportionately high. While still in high school, students with emotional or behavioral disorders are 13 times more likely to be arrested than other students with disabilities (U.S. Department of Education, 2001).

Internalizing Behaviors

Internalizing behaviors are typically expressed by being socially withdrawn. Examples of internalizing behaviors include

  • Anorexia or bulimia
  • Depression
  • Anxiety

Serious eating disorders that usually occur during students' teenage years are anorexia and bulimia (Manley, Rickson, & Standeven, 2000). These disorders occur because of individuals' (typically girls') preoccupation with weight and body image, their drive for thinness, and their fear of becoming fat. Many causes for these problems have been suggested; they include the media's projection of extreme thinness as the image of beauty and health, competition among peers, perfectionism, personal insecurity, and family crisis. Regardless of the cause, teachers can help by spotting these preoccupations early and seeking assistance from the school's support team or school nurse.

It is often difficult to recognize depression in children. Among the components of depression are guilt, self-blame, feelings of rejection, lethargy, low self-esteem, and negative self-image. These tendencies are often overlooked or may be expressed in behaviors that appear to signal a different problem entirely. Because children's behavior when they are depressed often appears so different from the depressed behavior of adults, teachers and parents may have difficulty recognizing the depression. For example, a severely depressed child might attempt to harm himself by running into a busy street or hurling himself off a ledge. Adults might assume that this behavior was normal because many children accidentally do those things, or they might minimize its seriousness. In addition, children usually do not have the vocabulary, personal insight, or experience to recognize and label feelings of depression.

Finally, anxiety disorders may be demonstrated as intense anxiety upon separation from family, friends, or a familiar environment; as excessive shrinking from contact with strangers; or as unfocused, excessive worry and fear. Anxiety disorders are difficult to recognize in children. Because withdrawn children engage in very low levels of positive interactions with their peers, peer rating scales may help educators identify these disorders. Children with internalizing behavior problems, regardless of the type, tend to be underidentified, and this leaves many of them at risk of remaining untreated or receiving needed services later than they should. For those who do receive intervention support, medications such as antidepressants and antianxiety agents may be a component of a more comprehensive intervention plan. If these youngsters are taking medications, it is important for teachers and parents to work collaboratively to ensure that medication is delivered as prescribed, particularly if medication to be taken during the school day.

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