Inclusion and Students with Emotional/Behavioral Disorders

Summary

This article presents a point/counterpoint approach to the issue of full inclusion of all students with emotional/behavioral disorders. To set the stage for the discussion that follows, the academic, social, and behavioral characteristics of these students pertinent to classroom performance are reviewed. The pros and cons of these four issues are then presented: (a) appropriateness of the general education curriculum for students with EBD; (b) social acceptance and other social competence issues; (c) mental health interventions and supports in general education settings; and (d) legality of full inclusion. Under the legality issue, case law on full inclusion pertaining to students with EBD is briefly reviewed. The basic premise of the authors who are full inclusion opponents is that a continuum of placements, including full-time placement in general education classrooms, should be preserved so that decisions about appropriate settings can be made on an individual basis. The basic premise of the author who is a full inclusion proponent is that, rather than maintaining two separate systems, we should direct our energies toward correcting the inadequacies of the general education classroom for the benefit of all students, including those with EBD.     

Academic Performance of Students with Emotional and Behavioral Disorders Served in a Self-Contained Setting

This study describes the academic, social, and behavioral performance of elementary and secondary students with emotional and behavioral disorders (EBD) receiving services in a self-contained school for students with serious behavior problems, with an emphasis on how school adjustment and problem behavior patterns predict academic performance. Results revealed that elementary and secondary group scores were well below the 25th percentile on reading, math, and written expression measures. Further, a seven variable model representing academic, social, and behavioral domains was able to differentiate between age groups explaining 54% of the variance and correctly classifying 78.26% (n = 18) of the elementary students and 84.21% (n = 16) of the secondary students. Findings also suggested that behavioral variables (e.g., school adjustment, externalizing, and internalizing) were predictive of broad reading and broad written expression scores, with school adjustment (a protective factor) accounting for the most variance in the three-variable model. Limitations and recommendations for future research are addressed.     

A Comparison of Quality of Life Variables for Students with Emotional and Behavioral Disorders and Students Without Disabilities

The importance of quality of life has been increasingly recognized in the field of special education. To date, however, there are no studies focusing exclusively on students with emotional and behavioral disorders (EBD). This study examined quality of life differences between students with EBD and their nondisabled peers in four domains: (a) General quality of life; (b) Self; (c) Relationships; and (d) Environment. Additional analyses compared parent and adolescent ratings. Results indicated adolescents with EBD were significantly more dissatisfied with their quality of life in all domains than their non-EBD peers. No significant within group differences were found for gender or age; however, EBD students in self-contained schools rated self and environment significantly higher than their peers with EBD in public schools. Parents of adolescent with EBD rated their adolescent’s quality of life significantly lower than their adolescent did, while parents of non-EBD adolescents rated their adolescent’s quality of life as significantly higher than did their adolescents. This study has several implications for programming to improve the outcomes among this group of students.     

A Comparison of Results and Acceptability of Functional Behavioral Assessment Procedures with a Group of Middle School Students with Emotional/Behavioral Disorders (E/BD)

There is currently controversy over the validity and applicability of functional behavioral assessment (FBA) procedures with students with emotional/behavioral disorders (E/BD). A set of FBA procedures, including teacher and student interviews and direct classroom observations, were carried out with eight students with disabilities (7 classified E/BD, one classified LD). Results indicated that when all three methods (teacher/student interviews, classroom observations) yielded a ranking for a function they agreed 64% of those occasions. For those situations in which there was overall disagreement there was agreement between teacher interview and classroom observations most of the time. Social validity data indicated that both students and teachers felt that the assessment procedures were a useful and productive process.     

Recognition of Facial Expressions of Emotion by Children with Emotional and Behavioral Disorders

Interpreting and responding appropriately to facial expressions of emotion are important aspects of social skills. Some children, adolescents, and adults with various psychological and psychiatric disorders recognize facial expressions less proficiently than their peers in the general population. We wished to determine if such deficits existed in a group of 133 children and adolescents with emotional and behavioral disorders (EBD). The subjects were receiving in-patient psychiatric services for at least one of substance-related disorders, adjustment disorders, anxiety disorders, mood disorders or disruptive behavior disorders. After being read stories describing various emotional reactions, all subjects were tested for their ability to recognize the 6 basic facial expressions of emotion depicted in Ekman and Friesen's (1976) normed photographs. Overall, they performed well on this task at levels comparable to those occurring in the general population. Accuracy increased with age, irrespective of gender, ethnicity, or clinical diagnosis. After adjusting for age effects, the subjects diagnosed with either adjustment disorders, mood disorders, or disruptive behavior disorders were significantly more accurate at identifying anger than those without those diagnoses. In addition, subjects with mood disorders identified sadness significantly more accurately than those without this diagnosis, although the effect was greatest with younger children.     

Applying Utilization Management Principles to a Comprehensive Service System for Children with Emotional and Behavioral Disorders and Their Families: A Feasibility Study

The Comprehensive Services Act for At Risk Youth and Families of Virginia (CSA), is a service, funding, and organizational reform initiative designed to improve the provision of child centered and family focused services within a community setting. We conducted this study in order to assess the feasibility of applying utilization management principles to the CSA in order to improve the appropriateness, quality, and cost effectiveness of this service delivery system. Data were gathered through focus groups, surveys, clinical profiling, and analysis of costs, and service utilization. While overall program costs increased since inception of the program, the costs per child served rose less than the rate of inflation. CSA appeared to be serving children with a high degree of emotional and behavioral difficulties. There was considerable variation among localities in placement patterns. A majority of survey and focus group respondents were willing to consider the application of utilization management principles to the CSA as long as decision making remained within localities. We concluded that there is a constructive role for utilization management approaches to improve the appropriateness and quality of services as well as enhancing efficiency in child mental health.     

Outcomes in a System of Care for Youths with Emotional and Behavioral Disorders: An Examination of Differential Change Across Clinical Profiles

We assessed the utility of an empirically-derived classification system for youths with emotional and behavioral disorders in a system of care with a strong representation of juvenile delinquents. Eighty-seven youths served in a system of care were categorized by variables related to past history, current behavioral functioning, and current psychological functioning into four clinical clusters. We evaluated preliminary clinical outcomes after six months of interagency involvement for youths within each cluster and across the four clusters. Results indicated that youths in different clusters improved significantly in need-specific areas. Trends in our data indicated differential change in clinical outcomes across clusters. We discuss our findings within the context of emerging outcomes of youths involved in comprehensive community-based programs and consider implications for outcome research, treatment of juvenile delinquents, and mental health policy.     

Increasing Anger Log Use During School Among Middle School Students with Emotional/Behavioral Disorders

ABSTRACT

Although anger management programs often promote the use of anger logs as an alternative to aggressive behavior, researchers have not studied whether or not these programs actually increase anger log use. Thus, this study examines the impact of In Control, a classroom-based curriculum with 10 weekly 30-minute sessions, on the frequency of anger log use between sessions. Study participants were all of the students attending a middle school for emotional/behavioral disorders. Twenty-seven students received the In Control program, and 19 equivalent students did not. While anger logs were visibly available in all of the classrooms, the students who received the In Control program completed significantly more logs between sessions than did the nonprogram students. During a 4-month follow-up, the 19 program students who received monthly booster sessions continued to fill out significantly more logs than did the nonprogram students. These findings suggest that In Control can increase the use of a log to record anger-provoking episodes by middle school students with serious emotional/behavioral disorders, both in between training sessions and during follow-up, if booster sessions are provided.     

Social–Emotional Factors and Academic Outcomes Among Elementary‐Aged Children

Social–emotional comprehension involves encoding, interpreting, and reasoning about social–emotional information, and self‐regulating. This study examined the mediating pathways through which social–emotional comprehension and social behaviour are related to academic outcomes in two ethnically and socioeconomically heterogeneous samples totaling 340 elementary‐aged children. In both samples, social–emotional comprehension, teacher report of social behaviour, and academic outcomes were measured in a single school year. In both samples, structural equation models showed that the relationship between social–emotional comprehension and reading was mediated by socially skilled behaviour. In one sample, but not the other, the relationship between social–emotional comprehension and math was mediated by socially skilled behaviour. This paper advances our understanding of the mechanisms through which social–emotional factors are associated with academic outcomes. Copyright © 2015 John Wiley & Sons, Ltd.     

Providing Ongoing Skill Development and Support for Educators and Parents of Students with Emotional and Behavioral Disabilities

Target six of the national agenda to improve outcomes for students with or at risk of emotional disturbance is reviewed. Having discussed this target with multiple stakeholders, the authors present four underlying themes that support ongoing skill development of providers and parents alike. These include building capacity of providers, decreasing isolation of school staff, gaining commitment of all school staff to support students with challenging behavior, and including parents and family members in staff development activities. The four underlying themes are discussed and recommendations given for ensuring ongoing skill development and support in education.     

中学生学业情绪表达策略及其与学业情绪的关系

采用问卷调查法，以3004名初一至高三学生为被试，探讨了中学生学业情绪表达策略的性别和年级差异，并考察了学业情绪与学业情绪表达策略间的关系。结果发现：（1）在调节积极和消极学业情绪时，中学生对表达抑制和表达宣泄策略的使用在不同性别和年级上存在微弱的差异。（2）在调节积极学业情绪时，积极学业情绪显著正向预测表达抑制和表达宣泄策略；在调节消极学业情绪时，消极学业情绪对表达宣泄策略具有正向预测作用。结果表明了情绪效价在学业情绪表达策略使用中的重要性。     

Anger Management Effects on Middle School Students with Emotional/Behavioral Disorders: Anger Log Use,Aggressive and Prosocial Behavior

ABSTRACT

This study examined the impact of a classroom-based, 10-week, cognitive-behavioral, anger management program plus booster sessions on middle school students with emotional disorders attending a therapeutic day school. Forty-five students were in the study; 20 received the program. The program group completed significantly more anger logs compared to the nonprogram group in both program and follow-up periods. Program students were observed to exhibit significantly more prosocial behaviors toward their teachers and showed a trend toward exhibiting fewer negative behaviors toward peers than nonprogram students at the end of the program. Program students also showed a trend toward fewer aggressive incidents than their nonprogram peers during follow-up. Findings may suggest mechanisms of change in anger management.     

A Systematic Review of Student-Mediated Math Interventions for Students with Emotional or Behavior Disorders

Journal of Behavioral Education - Students identified with emotional or behavioral disorders (EBD) display deficits across academic content areas, most notably in mathematics. We reviewed research...     

Reducing Time-Out Assignments for Students with Emotional/Behavioral Disorders in a Self-Contained Classroom

This study assessed the impact of a class-wide time-out/re-directing strategy on (a) the frequency of teacher-assigned time-outs and (b) the time students spent in disciplinary sanctions. Twelve students with emotional/behavioral disorders, enrolled in a self-contained elementary classroom were taught an alternative time-out strategy (Active Response Beads-Time Out), while teachers were taught a re-directing strategy, in an attempt to decrease the amount of student's time spent in time-out (TO) and the number of TO assigned by staff. Using a multiple baseline design across academic classroom periods, results showed that Active Response Beads Time-Out (ARB-TO) and teacher re-directions decreased the total time spent in time-out and number of TO assigned across the three class periods. Results maintained at one, two and four week follow-up sessions.     

Evaluating the vermont system of care: Outcomes associated with community-based wraparound services

Evaluation of innovative community-based interventions is becoming a high priority for child and adolescent mental health service system research. The present study examined outcomes for a sample of Vermont children (N=27) experiencing emotional and behavioral problems and receiving individualized, wraparound services. One year after initiation of wraparound care, incidence of negative behaviors rated as placing a child at risk of removal from the community had decreased significantly, compliance behavior had increased, and a significant decline in Total Problem Behavior scores on the Child Behavior Checklist was observed. In addition, though 70% of the participants had previously required inpatient or residential treatment, 89% were maintained in the community after one year of services, and the total cost of services was less than that of out-of-state residential care. Although further comparative research is needed, this study suggests that for many of these children, wraparound services may be a more efficient intervention than long-term psychiatric hospitalization or residential treatment.     

A Review of Occupation-Based Life Skills Interventions for Adults with Neurodevelopmental Disorders

Adults with neurodevelopmental disorders are at a higher risk for poverty, unemployment, and difficulties in relationships. Instrumental activities of daily living deficits often go unaddressed and minimal research has explored interventions to address them. The purpose of this study was to synthesize findings about occupation-based life skills interventions for adults with neurodevelopmental disorders. Ten articles met inclusion criteria and the American Occupational Therapy Association level of evidence and quality ratings were identified. Results indicate that occupation-based life skills interventions effectively address limitations experienced by adults with neurodevelopmental disorders but the overall quantity and quality of evidence-based interventions are lacking.     

Exploring the Link Between Emotional and Behavioral Dysregulation: A Test of the Emotional Cascade Model

The emotional cascade model (Selby, Anestis, & Joiner, 2008) posits that the link between emotional and behavioral dysregulation may be through emotional cascades, which are repetitive cycles of rumination and negative affect that result in an intensification of emotional distress. Dysregulated behaviors, such as non-suicidal self-injury, are used to reduce aversive emotions and distract the person from ruminative processes. The aim of the present study was to investigate the emotional cascade model in a non-Western sample of Turkish university students. Accordingly, a structural equation model was tested, and the results demonstrated that the emotional cascades were indeed associated to dysregulated behaviors, even when the effect of current symptoms of depression and anxiety on behavioral dysregulation was statistically controlled. Furthermore, thought suppression had a stronger relationship with all symptom patterns as compared to rumination, which may point to a cultural difference. Possible implications of the findings are discussed.     

School-Based Mental Health Services: A Research Review

This paper provides a synthetic review of research on school-based mental health services. Schools play an increasingly important role in providing mental health services to children, yet most school-based programs being provided have no evidence to support their impact. A computerized search of references published between 1985 and 1999 was used to identify studies of school-based mental health services for children. Study inclusion was determined by (i) use of randomized, quasi-experimental, or multiple baseline research design; (ii) inclusion of a control group; (iii) use of standardized outcome measures; and (iv) baseline and postintervention outcome assessment. The application of these criteria yielded a final sample of 47 studies on which this review is based. Results suggest that there are a strong group of school-based mental health programs that have evidence of impact across a range of emotional and behavioral problems. However, there were no programs that specifically targeted particular clinical syndromes. Important features of the implementation process that increase the probability of service sustainability and maintenance were identified. These include (i) consistent program implementation; (ii) inclusion of parents, teachers, or peers; (iii) use of multiple modalities; (iv) integration of program content into general classroom curriculum; and (v) developmentally appropriate program components. Implications of these findings and directions for future research are discussed.     

Literacy Interventions for Secondary Students Formally Identified with Emotional and Behavioral Disorders: Trends and Gaps in the Research

There has historically been much less research on the literacy skills of adolescents with emotional and behavioral disorders (EBD) compared to the amount of intervention research targeting their behavior. Within the limited literacy research available, there are multiple issues that need to be addressed, including (a) a predominant focus on children in elementary school, (b) gender differences in students with EBD, and (c) variation in the labels of research participants. The purpose of this integrative, comprehensive review was to investigate these concerns and provide a summary of the data to guide future research studies. A total of 63 articles targeting the reading and/or writing skills of middle and high school students with EBD were identified, spanning 37 years of research (1980–2016). Analysis of the articles revealed that less than 15% of the participants were female, and the percentage of females included in this research has declined across time; 11 different labels have been used to describe research participants; oral reading fluency, persuasive writing, and reading comprehension were the three most common dependent variables; and less than 5% of studies took place in inclusive general education settings. Recommendations for practitioners serving students with EBD and for researchers are discussed.