Emotional Disturbance (page 2)
Prevalence and Definitions
Individuals classified as having emotional disturbance (or behavioral disorders) represent 8.1% of all students ages 6–21 served under IDEA, or .72% of the school population (U.S. Department of Education, 2002a). However, prevalence studies have suggested that the actual percentage may be much higher. Boys outnumber girls in this category by about 3.5 to 1 (Oswald, Best, Coutinho, & Nagle, 2003).
Emotional disturbance refers to a number of different, but related, social-emotional disabilities. Individuals classified as emotionally disturbed meet several criteria established under IDEA, including the following:
- An inability to exhibit appropriate behavior under ordinary circumstances
- An inability to maintain relationships with peers or teachers
- An inappropriate affect such as depression or anxiety
- An inappropriate manifestation of physical symptoms or fears in response to school or personal difficulties
These characteristics must be manifested over an extended time period and have a negative effect on school performance (U.S. Department of Education, 2002a).
Individuals classified as emotionally disturbed represent a range of severity, and the disability itself may be temporary or permanent. Specific emotional disturbance areas include childhood schizophrenia; selective mutism (failure to speak in selected circumstances); seriously aggressive or acting-out behavior; conduct disorders; inappropriate affective disorders such as depression, social withdrawal, psychosomatic disorders, anxiety disorders, self-mutilating behaviors; and excessive fears (or phobias) (Kauffman, 2005). Individuals characterized as socially maladjusted (e.g., juvenile delinquency) are not considered emotionally disturbed according to IDEA, unless they also exhibit other evidence of emotional disturbance (U.S. Department of Education, 2002a). Students with Tourette syndrome may receive services under Other Health Impairments.
Causes of Emotional Disturbance
Most behavioral disorders or emotional disturbances have no known cause. However, possible causes include biological, family, school, and cultural factors (e.g., Hallahan & Kauffman, 2003; Kauffman, 2005).
Biological factors are genetic, biochemical, and neurological influences that interact and result in emotional disabilities. Schizophrenia, autism, attention-deficit/hyperactivity disorder (ADHD), and Tourette syndrome—a tic disorder characterized by involuntary muscular movements, vocalizations, and/or inappropriate verbal outbursts—all appear to have biological bases that interact with other factors and may contribute to emotional disturbances. However, Tourette syndrome and ADHD are not necessarily associated with emotional disturbance. Family factors (such as domestic violence) are also considered to be strong contributing factors to emotional disturbance. School factors (such as failure to accommodate for individual needs, inappropriate expectations, or inconsistency) can also contribute to an emotional disability. Finally, certain cultural environmental factors (including peer group, urbanization, and neighborhood factors) interact with the individual, the home, and the school and may also contribute to emotional disabilities (Kauffman, 2005).
Issues in Identification and Assessment of Emotional Disturbance
Individuals with emotional disabilities are difficult to objectively identify and classify. Moreover, there appears to be a reluctance on the part of school personnel to label a child “emotionally disturbed” (Kauffman, 2005). Traditional measures to identify emotional or behavioral disabilities include teacher checklists; parental checklists; classroom behavioral observations; and tests of intelligence, achievement, and psychological status. Checklists are listings of frequently observed behaviors. Teachers and parents complete checklists by indicating the types and severity of problem behaviors. Direct observations are conducted during classes, on the playground, at lunch, and in other parts of the school.
Characteristics of Emotional Disturbance
As with most students with disabilities, not all individuals with emotional disturbance will exhibit all the characteristics described here.
Most students with emotional disturbance have problems with their social behavior, often manifested as less mature or inappropriate social skills (Kauffman, 2005). Some students may be particularly aggressive with peers and adults and cause harm when playing or interacting with others. These students act out in class, do not appear to respond appropriately to discipline from teachers and may seem oblivious to class and school rules (Furlong, Morrison, & Jimerson, 2004). Students with behavioral disorders are at higher risk for substance abuse (Steele, Forehand, Armistead, & Brody, 1995).
Other students may exhibit social behavior similar to that of younger children and act socially immature. Some students may withdraw from others and appear socially isolated. Although withdrawn students may not call as much attention to themselves as conduct-disordered students they nonetheless may require intensive interventions (Gresham & Kern, 2004). These students may exhibit symptoms of depression. Social isolates do not interact with any peers or adults, and in the most severe cases may exhibit selective (or elective) mutism. Individuals with selective mutism have the physical ability to talk but nevertheless do not speak in appropriate situations (Brigham & Cole, 1999). All of these emotional or behavioral disorders share the characteristic of an inability to interact appropriately with others, including peers, teachers, siblings, and parents, which negatively affects school performance (Cullinan, 2004).
Students with emotional disturbance may also inappropriately attribute their behavioral or social problems to causes outside themselves, saying things such as, “Teachers are out to get me,” or “Other kids always get me into trouble.” By doing this, these students are able to avoid acknowledging or evaluating their own behavior and their own role in behavior problems.
Some students with emotional disturbances have serious affective disorders. Affective disorders can take many forms, but the most commonly recognized forms include depression, severe anxiety disorders, phobias, and psychosomatic disorders (Kauffman, 2005). Individuals with many of these disorders may be treated with different medications.
Research has indicated that students may function two or more years below grade level in reading, math, writing, and spelling (Lane, 2004; Reid, Gonzalez, Nordness, Trout, & Epstein, 2004; see the Research Highlight feature). These deficiencies may be related to the emotional disabilities. For example, if students have severe anxieties, they may be unable to attend, listen, and learn in school. Some students lack social skills that are necessary for school success (Kavale, Mathur, & Mostert, 2004). Others may exhibit severe deficiencies in metacognitive skills, memory skills, and attention, which may in turn lead to academic underachievement (Montague, Fiore, Hocutt, McKinney, & Harris, 1996). Students with emotional disturbance are at risk for dropping out of school, hindering their future life possibilities. Nevertheless, some students with emotional or behavioral disabilities attain average, or even above-average academic achievement.
Classroom Adaptations for Students with Emotional Disabilities
General adaptations can facilitate the inclusion of students with emotional and behavioral disorders into general education classes. Some specific adaptations to promote successful inclusion are presented next.
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