Under what circumstances should an aggressive or disruptive student be evaluated for a possible behavior disorder?
A day hardly passes in many schools without at least a few students becoming involved in a fight or disrupting class. There is little reason to evaluate every student who is charged with such misconduct for a possible behavior disorder. In some cases, however, school authorities may need to consider the possibility that a student's behavior is the result of psychological or medical problems requiring the assistance of specialists. What guidelines should be used in determining when students should undergo a formal assessment?
As a diagnostic category, "behavior disordered" is relatively recent. Coleman (1992, p. 22) explains that the preferred term for years was "emotionally disturbed." In the wake of Public Law 94-142, some states replaced this term with behavior disordered because it sounded less threatening and more compatible with the educational mission of the school. Presumably, teachers could observe and attempt to correct inappropriate behavior. Emotions, on the other hand, seemed to belong more in the domain of clinical psychology.
It should be noted that consensus regarding terminology in this area does not exist. Depending on the state, special education teachers may use behavior disordered or emotionally disturbed. "Conduct disorder" is frequently employed as a diagnostic category by mental health professionals working in residential treatment centers. Conduct disorders are indicated by the presence of multiple antisocial behaviors, such as fighting and physical cruelty, over an extended period of time. Walker, Colvin, and Ramsey (1995, p. 4) note that educators sometimes refer to conduct disorders and antisocial behavior as "social maladjustment." Representatives of law enforcement agencies and the courts may use the term "sociopathic" to describe behavior patterns that pose a danger to others.
Public Law 94-142 specified that "seriously emotionally disturbed" was a condition characterized by one or more of the following aspects (Federal Register, 1981):
- an inability to learn which cannot be explained by intellectual, sensory, or 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
Serious behavior problems requiring clinical intervention may be divided into two general categories: internalizing behaviors and externalizing behaviors (Coleman, 1992, pp. 26–28). Internalizing behaviors, such as social withdrawal and apathy, generally pose no immediate safety problem for others. Externalizing behaviors, on the other hand, may place others at risk. These behaviors include defiance, disobedience, vandalism, aggression toward others, temper tantrums, and swearing. In the most extreme cases, young people lack the ability to distinguish right from wrong. They appear to have no conscience or respect for societal rules. These individuals may be referred to as psychopathic, sociopathic, or "solitary aggressive type" (Coleman, 1992, p. 159).
In determining whether aggressive behavior should be treated as disordered behavior, it is necessary to take into account its frequency and severity. When aggressive behavior has been present for a long period of time, when it results in serious harm to people and property, and when it is coupled with other externalizing behaviors, psychological assessment by trained personnel is justified. Teachers and administrators should be prepared to provide evidence of the frequency of behaviors and their effects on others.
To help resolve some of the confusion surrounding terminology and provide guidance concerning when to assess individuals manifesting problem behavior, the National Mental Health and Special Education Coalition created a working group to develop a new definition of behavioral disorder. The result of their efforts is the following statement (Forness and Knitzer, 1992, p. 13):
The term emotional or behavioral disorder means a disability characterized by behavioral or emotional responses in school programs so different from appropriate age, cultural, or ethnic norms that they adversely affect educational performance, including academic, social, vocational or personal skills, and which:
- is more than a temporary, expected response to stressful events in the environment;
- is consistently exhibited in two different settings, at least one of which is school-related; and
- persists despite individualized interventions within the education program, unless, in the judgment of the team, the child's or youth's history indicates that such interventions would not be effective.
Labeling young people as seriously emotionally disturbed and behavior disordered, of course, can have negative consequences. The potential for misdiagnosis and the "self-fulfilling prophecy" effect is always present. To protect the interests of young people, guidelines have been established for evaluating students for special education services. As specified in Public Law 94-142, evaluations must involve nondiscriminatory testing, parental participation, multiple criteria, team decisions, and test validity. Estimates of U.S. students who meet the criteria for behavior disordered range from less than 1% to more than 10% (Coleman, 1992, pp. 30–31).
Should drugs be used to control the behaviors of students with behavior disorders?
Deciding that a student should be labeled behavior disordered does not mean that the appropriate course of action is necessarily clear. Considerable controversy exists regarding the extent to which students who are seriously emotionally disturbed and behavior disordered should be medicated when they are in school.
Three main categories of drugs are used in conjunction with IEPs involving behavior disorders. Antipsychotic drugs (tranquilizers) are reserved for the most serious cases. They do not cure disorders, but they are helpful in controlling the symptoms of psychosis, including hallucinations and delusions. Coleman (1992, p. 54) reports that, when used in small doses, these drugs can relieve tension, anxiety, and agitation as well as control aggression and self-injurious behavior.
A second category of drug that has gained popularity with therapists in recent years is antidepressants. Although their use in educational settings is not widespread, antidepressants are occasionally prescribed for school phobia and extreme sadness. Stimulants, the third type of drug, are used to treat attention deficit disorder. There are indications that drugs such as Ritalin and Dexedrine can improve attention and reduce impulsivity in many young people.
Some child psychologists and physicians have raised serious questions about the use of drug therapy with young people. Breggin (2000, p. 61), a physician, has taken the extreme position of counseling parents never to permit their children to be placed on psychoactive drugs for the control of behavior or emotions. Not only does prescribing drugs send the wrong message to young people who we want to avoid drug dependency, but some evidence exists that drugs may have the opposite effect of that which we desire. Breggin (2000, pp. 127–146) notes that some of the boys involved in school shootings were taking drugs prescribed by physicians and psychologists. He points out that antidepressants can induce a manic reaction in which a young person feels invincible and godlike, feelings that can lead to violence. Interestingly, antidepressants also can cause depression, the very condition they are supposed to alleviate (Breggin, 2000, pp. 137–138). Stimulants do not escape Breggin's broadside. He refers to research that has traced violent and psychotic behavior to the use of stimulants such as Ritalin (Breggin, 2000, pp. 138–140).
There is no question that, despite its risks, drug therapy has an appeal for many people. Parents naturally want to see their children avoid getting into trouble in school. Educators want to reduce disorderly and dangerous behavior so that teaching and learning can take place. Prescribing antipsychotics, antidepressants, and stimulants for millions of students, however, is unlikely to provide long-term solutions to either unsafe schools or the psychological problems of young people. Drug therapy may be justified as a last resort in the most serious cases, but parents and educators must be apprised of the potential for harmful side effects.
What can schools do to reduce the harmful effects of drugs and alcohol?
Protecting young people from the negative effects of drugs and alcohol is not easy in a society that often glamorizes these substances. Young people frequently see adults, including their own parents, consuming alcoholic beverages in the course of relaxing and having a good time. They watch movies and television shows in which young people experiment with drugs in order to achieve heightened awareness and to cope with stress and anxiety. They read of admired athletes who take performance-enhancing drugs. Despite these impediments, there still is much schools can do to discourage students from using drugs and alcohol. Five strategies are particularly important:
- Develop school cultures that discourage the use of drugs and alcohol.
- Recognize when students might be using drugs and alcohol.
- Provide instruction related to the harmful effects of drugs and alcohol and how to resist them.
- Enforce school rules related to the possession, use, and distribution of drugs and alcohol.
- Provide interventions and referrals for students involved in the abuse of drugs and alcohol.
In some schools, young people pick up the message that educators do not feel it is their responsibility to oversee drug and alcohol use. Other schools, meanwhile, are characterized by cultures that strongly oppose the use and distribution of dangerous substances. Young people are encouraged to develop sound health practices and play an active role in discouraging friends and siblings from using drugs and alcohol. School cultures that reinforce healthy behavior and warn against substance abuse have been found to have lower levels of drug problems than schools with cultures that do not take an active stand against such behavior (Gottfredson, 1997, p. 5-19).
A second responsibility of schools is to identify students who may be using drugs and alcohol. Educators must be alert to signs of drug and alcohol use, both at school and elsewhere. They should know the factors that can lead young people to experiment with controlled substances and recognize the signs and symptoms of drug and alcohol abuse. The latter include personality changes, changes in appearance, changes in behavior, and physical evidence.
Besides developing familiarity with the signs and symptoms of drug and alcohol use, educators need to help parents and students recognize these indicators. Students should be encouraged to report when classmates may be abusing drugs and alcohol. Students, understandably, are more likely to inform school authorities if their identity can be concealed. Several court cases indicate that school authorities are not compelled to disclose who provided them with information related to drugs and alcohol (Johnson, 1989).
Providing all students with instruction related to the harmful effects of drugs and alcohol is another important responsibility of all schools. Instruction should cover such issues as the consequences—physical, psychological, social and legal—of drug and alcohol abuse and how to handle situations in which there is pressure to use illegal substances. The latter often is referred to as "resistance training." Competency in self-control, stress management, social problem-solving, conflict resolution, and communications are additional useful goals of instruction. Gottfredson (1997, pp. 5-28 to 5-38) reported that instruction of the kind noted above can be an effective approach to curtailing substance abuse. Two instructional programs with demonstrated effectiveness for secondary students are ALERT (Ellickson & Bell, 1990) and Life-Skills Training (Botvin, Baker, Filazzola, & Botvin, 1990).
Enforcing school rules related to the possession, use, and distribution of drugs and alcohol is the fourth responsibility of schools that are committed to curtailing substance abuse. It is of little value to have rules if they are not enforced consistently. Many school systems in the United States operate with zero tolerance policies in matters of drugs and alcohol. Consistent enforcement of these policies sends a potent message to young people thinking about bringing illegal substances to school.
Enforcing school rules related to controlled substances may entail periodic locker searches, drug testing, and "sweeps" by drug-sniffing dogs. The preceding discussion regarding student rights and privacy issues should be reviewed before adopting these measures. Surveillance cameras in isolated parts of the school can help to discourage students from transacting drug sales on campus. Some school systems provide a hot line so that students can provide school administrators with anonymous tips concerning drug deals, local parties where alcohol and drugs may be present, and classmates who are abusing these substances.
Blauvelt (1999, pp. 33–34) offers several guidelines concerning enforcement of rules related to drugs. When a school administrator comes across a suspicious substance, the individual should place it in a clean plastic bag and then place the bag in a clean envelope and seal it. The date and time when the substance was found should be indicated on the envelope along with where it was found and from whom it was received (if another person was involved). The police should be contacted and asked to pick up the envelope and run a test on its contents. When a police officer picks up the envelope, she should be asked to provide a written receipt.
Schools should be prepared to assist students who have been discovered to be abusing drugs and alcohol. Where zero tolerance policies are in place, such assistance, of course, may need to be provided outside of the regular school setting. Special counseling, behavior modification programs, and direct instruction can be useful, as can participation in a support group consisting of students with similar problems. Parents, too, may benefit from these interventions under certain circumstances. Alternative schools have proven to be effective settings for some young people in need of help overcoming substance abuse (Gottfredson, 1997, pp. 5-28).
Although schools alone may be unable to prevent all young people from experimenting with and abusing drugs and alcohol, they can play a vital role in community-based efforts to reduce these problems. The inability to control many of the factors that lead young people to use drugs and alcohol is not an acceptable reason for ignoring the problem.
What can schools do to combat the negative influence of gangs?
Gangs have long been a feature of U.S. social structure. There are indications that their influence, particularly in schools, is growing. A government report published in 1998 (U.S. Department of Education and U.S. Department of Justice, 1998, p. 34) indicated that the percentage of students reporting that street gangs were present at their schools rose from 15% in 1989 to 28% in 1995.
Gangs come in all shapes and sizes. Huff (1989), in studying Ohio gangs, identified three basic types of gangs. Informal hedonistic gangs concentrate primarily on partying and committing minor crimes, mostly against property. Instrumental gangs commit property crimes for economic reasons and engage in the sale of drugs. Predatory gangs are involved in violent crime. Gangs are a concern for educators because gang activity sometimes spills over onto campuses, resulting in fights, "get even" acts, and vandalism. Gang members, many of whom are no longer in school, also may recruit students and enlist them in efforts to distribute drugs and commit other crimes at school.
Efforts to eliminate gangs have not proven particularly effective (Sherman, 1997, pp. 3-10 to 3-19). Besides, educators alone are not in a position to take the lead in such endeavors. Educators, however, can work to reduce the underlying factors that lead to gang involvement and to discourage young people from turning to gangs as a way to resolve difficulties in their lives. Among the actions that schools can take to combat the negative influence of gangs are the following:
- Monitor students for indications of gang involvement
- Cooperate with local law enforcement in addressing gang-related problems
- Develop early intervention programs to deal with academic problems and antisocial behavior
- Support the development of after-school and weekend activities
- Promote mentoring programs
As in the case of drug and alcohol prevention efforts, there are various signs that suggest students may be involved in gangs. These signs include graffiti on school property, unusual attire, and fights involving groups of students. Educators need to be alert to such indicators. In some cases, students may not be actual gang members, but they may be emulating these individuals. In other instances, gang activities are occurring at school. By monitoring students for signs of gang involvement, educators can warn parents and the police as well as take a public stand against gang involvement. School officials should take immediate steps to remove graffiti and other symbols of gangs and to prohibit students from wearing gang-related attire to school.
If gangs have formed in a community, efforts to deal with them must involve local law enforcement agencies. Educators need to establish close ties with these agencies, informing them of suspicious activities at school and receiving advanced warnings of possible gang-related incidents in or around school. In the event that rival gangs become involved in a fight at school, the police should be contacted immediately and the appropriate crisis management plan put into effect. School personnel should not attempt to handle such incidents on their own.
The key to school-based efforts to deal with gangs is early intervention. Once adolescents have joined a gang, it is quite difficult to convince them to leave. Elementary school interventions should focus on assisting students who are experiencing academic problems and manifesting antisocial behavior. Antisocial behavior causes youngsters to be rejected by peers and teachers, thereby making them receptive to invitations from gangs. Many of the programs that have proven effective in preventing drug and alcohol use, such as training in resistance skills and effective problem solving, also may help young people cope with the lure of gang membership.
One school-based program that has shown promise in discouraging young people from becoming involved in gangs is Gang Resistance Education and Training (G.R.E.A.T.). Developed by the Phoenix Police Department, G.R.E.A.T. is a nine-week instructional program aimed at middle school students. Students learn about the impact of crime on victims and the community in general and how to meet their needs without joining a gang. Goal-setting is a key component of the training. A study that compared students who had and had not received G.R.E.A.T. instruction found that the former reported lower rates of delinquency and drug use (Gottfredson, 1997, pp. 5-39 to 5-40).
Because unstructured time opens the door to possible gang involvement, programs that offer young people interesting things to do after school, on weekends, and in the summer also may serve as antidotes to gang involvement (Sherman, 1997, pp. 3-26 to 3-28). Educators should create programs that use school facilities during nonschool hours and work with other groups to develop opportunities for involvement elsewhere in the community. Howell (1995, p. 95) concluded that
Afterschool recreation programs can address the risk factors of alienation and association with delinquent and violent peers. Protective factors may include opportunities for involvement with prosocial youth and adults, skills for leisure activities, and bonding to prosocial others.
Some young people are drawn to gangs because they lack positive role models. To address this deficit, schools and communities can develop mentoring programs that place at-risk young people in contact with responsible and caring adults. There is substantial evidence that mentoring can be an effective intervention to prevent young people from joining gangs (Sherman, 1997, pp. 3-20 to 3-25). Mentors meet with their young charges several times each month as well as speaking with them over the phone on a regular basis. Young people share problems with mentors and join them in recreational activities.
The overall message for educators interested in reducing the harmful effects of gangs is identical to that for school-based efforts to confront drugs and alcohol. Though educators alone do not control the factors that give rise to gangs, it is crucial that they play an active role in discouraging gang involvement and providing constructive alternatives for young people.
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