1. CHILDREN WITH EMOTIONAL
& BEHAVIORAL DISORDERS
ANGIE SHULTIS * EDU540

2. MEET BETH
• Beth Thomas, age 6,
subject of 1990 HBO
documentary “Child
of Rage”
• Diagnosed with
Reactive Attachment
Disorder after suffering
early childhood abuse
http://www.youtube.com/watch?v=ME2wmFunCjU

3. HISTORICAL PERSPECTIVES
• Two Centuries Ago
• “Possessed”, “insane” or “retarded”
• Institutionalization
• 1800s
• Greater awareness of genetic factors
• Medical focus
• Special ungraded classes, little attention to individual
needs
• Post WWII
• Greater awareness of the power of ecological and social
factors
• Shift in responsibility for children with exceptionalities, from
medical/mental health communities to educators

4. WHAT IS EBD?
• Federal Definition of Emotional & Behavioral Disorders:
• A condition exhibiting one or more of the following
characteristics over a long period of time and to a marked
degree that adversely affects educational performance:
• An inability to learn that 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
• The term does not apply to children who are socially maladjusted
unless it is determined that they have an emotional disturbance

5. WHAT IS EBD?
• Federal Definition of Emotional & Behavioral Disorders:
• A condition exhibiting one or more of the following
characteristics over a LONG PERIOD OF TIME and to a
marked degree that adversely affects educational
performance:
• An inability to learn that 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
• THE TERM DOES NOT APPLY TO CHILDREN WHO ARE SOCIALLY
MALADJUSTED UNLESS IT IS DETERMINED THAT THEY HAVE AN

6. WHAT IS EBD?
• What separates children with EBD from their more
average peers?
• Intensity of their behavior
• Long-lasting nature of their behavior
• Other problems with the federal definition
• Places all responsibility on the child, none on the
environment, necessitating changes to the child and not
the environment
• The term “behavior disorder” implies the child is causing
trouble for someone else
• Cultural considerations
• “Norms” vary from culture to culture

7. HOW COMMON IS EBD?
• Number of children judged to have either serious
emotional disturbance or behavior disorders: 5-15 %
• Number of children receiving special services for EBD:
About 1%
• Tendency towards longevity
• Longitudinal studies suggest that students at moderate or
high risk for behavior and academic problems tend to
continue to be at risk for poor school outcomes through
middle school

8. DIAGNOSTIC ISSUES
• Subjective judgments, often left to local personnel
• Lack of clear line separating severe from mild
emotional and behavior disorders
• “Diagnostic Fads”
• Over-diagnosis and over-treatment
of certain disorders
• Bipolar Disorder
• ADHD
• Autism Spectrum Disorders

9. CAUSES OF EBD
• Neurology & Genetics
• “The Evil Child” - future behavior is determined at birth?
• Widely considered over-simplistic
• Genetics tells us that some children
ARE predisposed towards:
• Hyperactivity
• Attention problems
• Impulsiveness
• Interaction Between Genetics & Environment
• Data suggests that behavior is a result of integrated contributions
of factors, both internal and external
• The influence of child abuse
• Physical and psychological mistreatment of children is strongly
predictive of EBD, and requires preventative action such as parent
training and support

10. EXTERNALIZING DISORDERS
• Externalizing disorders are
characterized by aggression
and “acting out”
Correlated Constraints That Affect Aggression
Positive Constraints Negative Constraints
•Academic Success •Academic Difficulties
•Positive Peer Relations •Attention Problems
•Athletic Competence •Peer Rejection
•Supportive Adults •Coercive Family Systems
•Sufficient Resources •Poor Parental Monitoring
Operate as a brake on aggression Tend to predict aggression

11. RISK FACTORS –
EXTERNALIZING DISORDERS
• Family Risk Factors
• Family violence, including child
abuse
• Violence against children is a
behavior children are likely to
display when old enough to
inflict violence
• Many believe a child’s
atypical behavior may cause
parents to act in a way that is
inappropriate, causing a
downward spiral

12. RISK FACTORS –
EXTERNALIZING DISORDERS
• School Risk Factors
•While one might think EBD students act out as a reaction to
failure in school, in EBD children aggressive behavior is typically
observable before they enter school
• School Violence & Bullying
•Violence is prevalent in schools, though typically to a lesser
degree than in the community at large
•Children prone to violence can be identified early
•Studies suggest 6-9% of children account for more than 50
percent of discipline referrals and nearly all serious offenses
•Early discipline problems are predictive of later adjustment
problems.

13. RISK FACTORS –
EXTERNALIZING DISORDERS
• Cultural & Ethnic Risk Factors
• Prevalence of culturally and linguistically diverse children
who are identified as having social or emotional
disturbances.
• Conflict between the values of those in authority and of the
child’s culture (honesty vs. loyalty, for example)
• Substance Abuse Risk Factors
• Exceptional children may be overrepresented among those
who use drugs and alcohol
• Predisposition to substance abuse, due to factors such as
prescribed medication, social isolation, depression, family
issues, etc.

14. INTERNALIZING DISORDERS
• Common characteristics:
• Anxious
• Withdrawn
• Fearful
• Children who suffer from internalizing disorders:
• Are usually not disruptive
• Have problems with excessive internal control – aggression
is turned inward rather than outward
• May be rigid and unable to be spontaneous

15. INTERNALIZING DISORDERS –
RISK FACTORS
• Learned Helplessness
• The belief that nothing they do can stop bad things from
happening
• Can result in severe deterioration in performance after
failure
• Pessimism about self and abilities
• Suicide
• Strong feelings of hopelessness can be a predominant
reason for children to think about or attempt suicide
• Countered with explicit instruction in positive coping skills,
building sense of self-control

16. THE INFORMATION PROCESSING
MODEL
• EBD – whether exhibiting external or internal aggression
– has an impact on all aspects of information
processing
• While perceptual abilities may
test as normal, how the child
perceives stimulus may be
altered
• Anxiety and stress can influence
all processing mechanisms
• A team approach is required to
provide appropriate supports to
address externalizing or
internalizing disorders and build
self-confidence

17. RTI & EBD
• Preschool Children With EBD
• Critical to identify children with EBD
as early as possible, to ensure early
intervention
• In one study, for preschool children
identified as having an emotional
disability, only 69 percent were
considered to have the same label by
fourth grade
• Even if academic ability is normal, EBD
can interfere with academic
performance.
• Oppositional (or depressive) behaviors must be “persistent,
pervasive” and “severe” to warrant mental health referral

18. RTI SUPPORT FOR EBD – TIER I
• For students with EBD, Tier I must include:
• A strong core reading program, to address poor academic
performance commonly associated with EBD
• A consensus on school rules and classroom performance
expectations
• Positive behavior approaches.

19. RTI SUPPORT FOR EBD – TIER II
• Positive Behavior Supports
• Proactively creating a positive environment that makes
misbehavior unnecessary
• Creating an environment where personal needs and
interests are being met
• Functional Behavior Assessment (FBA)
• Gathering information about a child’s behavior in order to
attempt to identify causes
• Identifies antecedent behaviors

20. RTI SUPPORT FOR EBD – TIER III
• Applied Behavior Analysis (ABA)
• Focuses on the antecedents to the behavior and the
consequences following it (the Antecedents-Behavior-
Consequence, or “A-B-C” approach)
• Focuses on modifying the antecedent and the
consequences to hopefully modify the behavior.
• Residential Care
• Despite the tendency towards full
Inclusion, other alternatives are being
Investigated
• Programs are expensive but under
the right circumstances might be
beneficial to the student.

21. TEACHER & PROGRAM STRATEGIES
FOR CHILDREN WITH EBD
• Social Skills Training – Developing Social Skills
• Self monitoring
• Self instruction training (SIT)
• Self evaluation
• Self reinforcement
• Two desired outcomes of these methods:
• The child gains self-confidence by exerting control
over his or her behaviors
• The child can participate in the general education
classroom for the maximum time possible

22. TEACHER & PROGRAM STRATEGIES
FOR CHILDREN WITH EBD
• Teacher & Personnel Preparation
• The move to full inclusion requires more teacher
preparation than ever
• Rather than expecting to have “super teachers” a team
approach is critical to ensuring teachers are appropriately
supported
• The Support Teacher (EBD Specialist)
• Understands that even a child with serious behavior
problems is not disturbed all the time
• Is a source of, and requires, direct assistance
• Should be full-time and trained as a special education
teacher, and should be able to help all children with
academic and emotional problems.

23. TEACHER & PROGRAM STRATEGIES
FOR CHILDREN WITH EBD
• The Wraparound Approach
• A multi-disciplinary approach makes extensive use of
agencies outside the school program
• Can include services for not only the student but the family
as well
• Focuses on the strengths of the students
• Peer Tutoring
• Peer-assisted learning strategies with a “player” (student
with disabilities) and a “coach” (student prepared to help)
• Coaches must be prepared appropriately and requires
considerable planning to be successful

24. TEACHER & PROGRAM STRATEGIES
FOR CHILDREN WITH EBD
• Technical assistance
• PBIS (Positive Behavior Interventions & Supports)
• Behavior games, social skills games
• Time Out
• Takes students away from possibly negative interactions
• Allows for a cool-off period
• Assistive Technology
• Effective because computers don’t interact emotionally with a
child, does not allow student to resort to emotional manipulation
• Computer-based support in academic achievement can lead
to enhancement of self-worth
• Students with hyperactivity or concentration issues can be
helped by a computer

25. THE ROLE OF THE FAMILY
• “Partnering of Experts”
• Parents as “experts” on their children, and professionals are
“experts” in their areas, such as special education or
mental health.
• Challenges
• Cultural diversity sometimes leads to view that parents
need to be trained rather than partnered with
• Learned helplessness

26. BETH: PROGRESS?
• http://www.youtube.com/watch?v=g2-Re_Fl_L4