Emotional

Disturbance
Overview

IDEA Definition
Serious Emotional Disturbance: A

condition exhibiting one or more of the

following characteristics, displayed over a
long period of time and to a marked
degree that adversely affects a child's
educational performance:
* An inability to learn that cannot be
explained by intellectual, sensory, or
health factors

IDEA Definition
An inability to build or maintain

satisfactory interpersonal relationships

with peers or teachers
* Inappropriate types of behavior or
feelings under normal circumstances
* A general pervasive mood of
unhappiness or depression

IDEA Definition
A tendency to develop physical

symptoms or fears associated with

personal or school problems.
This term includes schizophrenia, but
does not include students who are
socially maladjusted, unless they
have a serious emotional disturbance.

Incidence
In the 1999-2000 school year,

470,111 children and youth with

an emotional disturbance were
provided special education and
related services in the public
schools (Twenty-third Annual
Report to Congress, U.S.
Department of Education, 2001).

Characteristics
Hyperactivity (short attention span,

impulsiveness);
Aggression/self-injurious behavior
(acting out, fighting);

Characteristics
Withdrawal (failure to initiate interaction

with others; retreat from exchanges of

social interaction, excessive fear or
anxiety);
Immaturity (inappropriate crying, temper
tantrums, poor coping skills); and
Learning difficulties (academically
performing below grade level).

Characteristics
Children with the most serious emotional

disturbances may exhibit distorted

thinking, excessive anxiety, and
abnormal mood swings and are
sometimes identified as children who
have a severe psychosis or
schizophrenia.

Characteristics
Males are identified as

having emotional
disturbances more
frequently than females,
especially in elementary
years

Characteristics
Students with

emotional disturbances
often use inappropriate
ways to get attention,
such as talking back to
adults, refusing to do
work, or making jokes.

Characteristics
Students with

emotional
disturbances may
have low selfesteem and poor
social skills.

Characteristics
Students with emotional

disturbances can benefit

from classes that are
highly structured and
have clear rules that are
consistently enforced.

Academic Symptoms
Disruptive to classroom

activity.
Impulsive.
Inattentive, distractible.
Appears pre-occupied.

Academic Symptoms
Disregards all

classroom rules.
Poor concentration.
Extreme resistance to
change and transitions.
Speaks out, repeatedly.

Academic Symptoms
Is aggressive.
Bullies and

intimidates others.
Regular truancy
from school.

Academic Symptoms
Dishonest,

consistently blames
others.
Low self esteem.
Unable to work in
groups.

Academic Symptoms
Engages in self injurious

behavior.
Has no regard for
personal space and
belongings.
Persistently tries to
manipulate situations.

Management
Behavior Contracts
A behavior contract is
an agreement between
the child and teacher
and often includes the
student's parent(s).

Management
The behavior contract

is a written agreement
about how the
individual will behave.

Management
It will indicate the

appropriate
consequence should
the student neglect to
behave according to
the contract and

Management
it also states the

reinforcer to be used for

successful compliance.
The behavior contract
provides the student with
structure and selfmanagement.

Functional Behavioral
Assessment
A functional behavioral assessment, or

analysis, is a process which seeks to

identify the problem behavior a child or
adolescent may exhibit, particularly in
school, to determine the function or
purpose of the behavior, and to develop
interventions to teach acceptable
alternatives to the behavior. The process
is as follows:

Functional Behavioral
Assessment
1. Identify the behavior that needs to

change,
2. Collect data on the behavior,
3. Develop a "hypothesis" (best guess)
about the reason for the behavior,
4. Develop an intervention to help
change the behavior,
5. Evaluate the effectiveness of the
intervention,
6. Have patience.

Token Economy
A token economy is an

intensive, in-class positive

reinforcement program
for building up and
maintaining appropriate
classroom performance
and behavior.

Token Economy
Sometimes a tangible

reward program, managed

by the teacher, may be
needed. Tangible rewards
can be conveniently
managed through a token
reinforcement program.

Token Economy
Token programs involve

the distribution of tokens

(for example, stickers,
stars, smiley faces, etc) or
points following
appropriate behavior.

Token Economy
The tokens or points can

be accumulated
throughout the day and
exchanged for designated
rewards at a specified
time.

Token Economy
a predetermined goal is set

for the number of tokens or

points require to earn a
reward. The teacher or
classroom aide is
responsible for distributing
the tokens and providing the
reward.

Conduct Disorders
This condition is

characterized by a persistent
pattern of behavior, which
intrudes and violates the
basic rights of others without
concern or fear of
implications.

Conduct Disorders
This pattern is not selective

and is exhibited in the home,

at school, with peers and in
the child's community.

Conduct Disorders
Other behaviors present with

this condition may include

vandalism, stealing, physical
aggression, cruelty to
animals and fire setting.

Oppositional Defiant
Disorder
This disorder is usually

characterized by patterns
of negativistic, hostile and
defiant behaviors with
peers as well as adults.

Oppositional Defiant Disorder

This disorder is considered

less serious than a conduct

disorder because of the
absence of serious
behaviors, which violate the
basic rights of others.

Oppositional Defiant Disorder

Children with this disorder

usually exhibit argumentative

behaviors towards adults,
which may include swearing
and frequent episodes of
intense anger and
annoyance.

Separation Anxiety Disorder

This disorder is characterized

by extreme anxiety
associated with separation
from someone with whom the
child views as a significant
other

Separation Anxiety Disorder

This separation anxiety is

frequently exhibited at
school and at home.

Anorexia Nervosa
Children with this

condition show a marked

disturbance and
unwillingness to maintain
a minimal body weight for
their age and height.

Anorexia Nervosa
An extreme distorted

sense of body image

exists and intense fears
and worries about gaining
weight become obsessive

Anorexia Nervosa
Children with this disorder

may also exhibit self-induced

vomiting, use of laxatives,
increased reduction of food
intake, preoccupation with
becoming fat, and noticeable
increase in the frequency and
intensity of exercise.

Bulimia Nervosa
A condition characterized by

recurrent episodes of
uncontrolled consumption of
large quantities of food (binging)
followed by self induced
vomiting (purging), use of
laxatives or diuretics over a
period of at least two months.

Bulimia Nervosa
The individual with bulimia nervosa

exhibits symptoms characterized by

binging and purging, use of laxatives and
diuretics, obsessive preoccupation with
body shape and weight and a feeling of
lack of control over food consumption
during binge episodes.

Tourettes Syndrome
This disorder is characterized by

motor and vocal ticing which

may be exhibited in the form of
grunting, coughs, barks,
touching, knee jerking, drastic
head movements, head banging,
squatting and so on.

Tourettes Syndrome
The above symptoms may

change as the child

develops but the course of
the disorder is usually
lifelong

Tourettes Syndrome
The condition is more common

in males and family pattern are

also common. Coprolalia
(vocal tic involving the
expression of obscenities) is
an associated symptom in
about 33% of the cases.

Functional Encopresis
The major symptom of this

disorder is repeated
involuntary or intentional
passage of feces into
clothing or other places
which deem it inappropriate.

Functional Encopresis
The condition is not related to

any physical condition, must

occur for a period of six months
on a regular basis and be
present in a child over the age of
4 for diagnosis to take place.

Functional Enuresis
This disorder is characterized

by repeated involuntary
intentional elimination of
urine during the day or night
into bed or clothes at an age
which bladder control is
expected.

Selective Mutism
This disorder is characterized by

persistent refusal to talk in one

or more major social situations,
including school, despite the
ability to comprehend spoken
language and speak. The
resistance to speak is not a
symptom of any other major
disorder.

Obsessive Compulsive
Disorder
The major characteristics

associated with this disorder are

persistent obsessions
(persistent thoughts) or
compulsions (repetitive acts)
that significantly interfere with
the individuals normal daily
social, educational, occupational
or environmental routines.

Dysthymia
The essential feature of this

disturbance is a chronic
disturbance of the
individual's moods involving
chronic depression or
irritable mood for a period of
one year for children and
adolescents.

Schizoid Personality
Disorder
The child with this disorder

exhibits a restrictive range

of emotional experiences
and expression and
indifference to social
situations.

Antisocial Personality
Disorder
This disorder is characterized by

a pattern of irresponsible and

antisocial behavior. The
condition is usually first seen in
childhood or early adolescence
and continues throughout the
child's development.

Antisocial Personality
Disorder
This diagnosis is usually

made after the age of 18 and

the individual must have had
a history of symptoms before
the age of 15 indicative of a
Conduct Disorder.

Borderline Personality
Disorder
The main features of this

disorder include instability of

self-image, inconsistent and
unfulfilling interpersonal
relationships, instability of
mood, and persistent identity
disturbance.

Post Traumatic Stress

Disorder
Post Traumatic Stress

Disorder (PTSD) is not a

disorder to be
associated solely with
military personnel, as it
has been in the past.

Post Traumatic Stress Disorder

It has been shown that

exposure to traumas such as

a serious accident, a natural
disaster, or criminal assault
can result in PTSD.

Post Traumatic Stress Disorder

When the aftermath of a

traumatic experience
interferes with normal
functioning, the person
may be suffering from
PTSD.

Post Traumatic Stress Disorder

There are three types of generally recognized

stressors:
Threatened death or serious injury to one's

person;
Learning about the death, near death, or
serious injury of a family member or close
friend;
Witnessing the death, near death or serious
injury of another person

Antidepressant Medication
Some of the newest

antidepressants are called selective serot

onin reuptake inhibitors (
SSRIs).

Medications
Antidepressants: Antidepressants work
by changing the level of
neurotransmitters (chemical
messengers) in the brain. Several
neurotransmitters are thought to be in
low supply in depression, including
noradrenaline (sometimes called
norepinephrine) and serotonin.

Examples of Antidepressants
Celexa
Effexor
Lexapro
Wellbutrin
Zoloft
Prozac
Paxil

Antianxiety Medications
Klonopin
Xanax)
Valium)
Ativan).