Emotional and Behaviour Disorders in Children - Assignment Example

Emotional and Behaviour Disorders (EBD) in Children and Adolescents Introduction Young people can have mental, emotional, and behaviour problems that are real, painful, and costly. These problems, often called "disorders," are a source of stress for the child as well as the family, school, community, and larger society. Children who are emotionally and behaviourally disordered (EBD) have always challenged and frustrated experts. These children are unpredictable and impulsive; abusive and destructive. They either defy authority and lash out with resentment and aggression or become isolated and are rejected by their peers. These are the children who are troubled, cause trouble, disrupt routines, and often make life difficult for themselves, for their parents, for other children, and for their teacher. The number of families and children who are affected by mental, emotional and behaviour disorders in young people is shocking. Mental health disorders in children and adolescents are caused by biology, environment, or a mix of both. Examples of biological factors are genetics, chemical imbalances in the body, and damage to the central nervous system, such as a head injury. Many factors in a young person's environment can affect his or her mental health, such as exposure to violence, extreme stress, and loss of an important person in their lives. Some EBD children are curable while others are not, all due to the severity of the disorder and when it is spotted. Different Disorders of Emotionally and Behaviourally Disordered Following are descriptions of some of the mental, emotional, and behaviour problems that can occur during childhood and adolescence. All of these disorders can have a serious impact on a child's overall health. Some disorders are more common than others, and conditions can range from mild to severe. Often, a child has more than one disorder. Anxiety disorders the most common of childhood disorder. These young people experience excessive fear, worry, or uneasiness that interferes with their daily lives. Anxiety disorders include: 1. phobia - an unrealistic and overwhelming fear of some object or situation 2. generalized anxiety disorder - a pattern of excessive, unrealistic worry not attributable to any recent experience; 3. panic disorder - terrifying panic attacks that include physical symptoms such as rapid heartbeat and dizziness 4. Obsessive-compulsive disorder - being trapped in a pattern of repeated thoughts and behaviours such as counting or hand washing. 5. Post-traumatic stress disorder - a pattern of flashbacks and other symptoms that occurs in children who have experienced a psychologically distressing event such as physical or sexual abuse, being a victim or witness of violence, or exposure to some other traumatic event such as a bombing or hurricane. Major depression is recognized more and more in young people. The disorder is marked by changes in: 1. emotion - the child often feels sad, cries, looks tearful, feels worthless; 2. motivation - schoolwork declines, the child shows no interest in play; 3. physical well-being - there may be changes in appetite or sleep patterns and vague physical complaints; and 4. Thoughts - the child believes that he or she is ugly, that he or she is unable to do anything right, or that the world or life is hopeless. Bipolar disorder (manic-depressive illness): This is exaggerated mood swings between extreme lows (depression) and highs (excitement or manic phases). Periods of reasonable mood occur in between. During a manic phase, the child or adolescent may talk nonstop, need very little sleep, and show unusually poor judgment. Attention-deficit/hyperactivity disorder is when a young person with attention-deficit/hyperactivity disorder is unable to focus attention and is often impulsive and easily distracted. Most children with this disorder have great difficulty remaining still, taking turns, and keeping quiet. Learning disorders affect the ability of children and adolescents to receive or express information. These problems can show up as difficulties with spoken and written language, coordination, attention, or self-control. Such difficulties can make it harder for a child to learn to read, write, or do math. Conduct disorder causes children to act out their feelings or impulses toward others in destructive ways. The offenses that these children commit get more serious over time. Examples include lying, theft, aggression, truancy, fire setting, and vandalism. Children and adolescents with conduct disorder usually have little care or concern for others. Eating disorders can be life threatening. This child or adolescent is intensely afraid of gaining weight and doesn't believe that he or she is underweight. Bulimia nervosa victims feel compelled to eat huge amounts of food at a time. Afterward, to prevent weight gain, they rid their bodies of the food by vomiting, abusing laxatives, taking enemas, or exercising obsessively Schizophrenia can be a devastating mental disorder. Young people with schizophrenia have psychotic periods when they may have hallucinations (sense things that do not exist, such as hearing voices), withdraw from others, and lose contact with reality. Other symptoms include delusional or disordered thoughts and an inability to experience pleasure. SoWhat Caused All Of This Some causes of EBD include: 1. Biological Factors: There is evidence that EBD appears to be partial by genetic, neurological, or biochemical factors, singly or in combination. However no one has been able to say with certainty whether the physiological abnormality actually causes the behaviour problem or is just associated with it in some unknown way. 2. Environmental Factors: Environmental factors are considered important in the development of emotional and behavioural disorders in all conceptual models. Dodge (1993) has identified three primary causal factors that contribute to the development of conduct disorder and antisocial behaviour: (a) An adverse early rearing environment, (b) An aggressive pattern of behaviour displayed on entering school, and (c) Social rejection by peers. The family or home, school, and society environments have major influence on the behaviour of individuals. 3. Family - The relationship children have with their parents, particularly during the early years, is critical to the way they learn to act. An interaction between parents and their child influences the child's opinions, behaviours, and emotions. One factor associated with emotional problems is child abuse. Child abuse may result in poor impulse control and poor self-concepts. Aggression and anger are often noticed in children who have been abused. 4. School - School is where children spend the largest portion of their time outside the home. Teacher expectations and actions greatly affect a student's life and behaviour. 5. Society - Societal problems can impact on a student's emotional and behavioural status. An impoverished environment, including poor nutrition, a disrupted family, and a sense of frustration and hopelessness may lead to aggressive, acting-out behaviours. Education of the Emotionally and Behaviourally Disordered Children "Troubled and troubling" children (Hobbs, 1982) have been labeled throughout the years as: "seriously emotionally disturbed, behaviourally disordered, deviant, socially maladjusted, emotionally maladjusted, psychologically impaired, or emotionally handicapped." Regardless of the terminology, children with behavioural disorders, over a prolonged period of time, are not rare, are demanding of teacher time, and are ultimately referred to school district special education personnel. Programs for behaviourally disordered children and youth are typically described at the classroom level, with a focus on the individual teacher's methods and intervention practices. (Jones, 1987). They may also be examined from a broader perspective, where the focus is placed on describing the entire range of services school districts offer for the behaviourally disordered student population (Grosenick, George, & George, 1988). One example of such is Outdoor education. It offers special benefits to behaviour disordered students. Programs range from simple, near-school activities to lengthy, more expensive wilderness camping experiences. Outdoor education enables students and teachers to interact in an environment free from the limitations of the classroom. The change in environment can facilitate learning by removing behaviour disordered students from the classroom setting which they may already identify with failure. Outdoor education programs for behaviour disordered students shows improvement in self-concept, social adjustment, academic achievement, and group cohesion. Relationships with peers, parents, teachers, and counselors were also improved in some of the programs. Teachers also reported greater ability to teach specific skills and academic behaviours, and to lessen disruptive behaviour when programs were conducted out of doors. Lane and others (1983) found increases in peer relationships and group unity in their counseling-oriented "Group Walk-Talk" program, which combined hiking and counseling in a public school program for adolescents. It revealed significant improvement in self-concept, personality adjustment, and academic skill level. Inclusion or Segregation - Mainstream or Special When the Green Paper Excellence for All Children: Meeting Special Educational Needs (DfEE 1997) recommended that all children, irrespective of the nature of their behaviour, should be considered as viable candidates for inclusion, a debate that had been going on for many years reached a seriously high level. A child should attend a special school must be an extremely careful process. Some children will have experienced enormous problems and failing situations in one or more mainstream schools. Some will have refused to attend local schools as a result of extremely low self-esteem; others will have been involved in confrontations and even offending in their local neighborhood, giving rise to intolerable levels of stress in school. There is little doubt that special schools will have a continuing and vital role to play within an inclusive education system. However, the decision to place a child in such a school should only be made after all the benefits of an ever-increasing range of provisions have been investigated. Increased academic performance comes from: 1) actual time teaching (time spent on instruction) and, 2) student on-task behaviour. When teaching is interrupted by inappropriate behaviour or students are not on task, the question is how do we manage behaviour The teacher has two overall goals: First, to stop inappropriate behaviour, and second, to increase appropriate behaviour. To do so, a teacher must: 1. Define teacher expectations: Problems occur where there is a disagreement between what the teacher expects and what students do. Thus, we are dealing with two dimensions: teacher expectations and student behaviour. If we want to increase appropriate behaviour, a necessary first step is for the teacher to explicitly, clearly, and fairly define behavioural expectations. Such expectations evolve from the teacher's values and beliefs about how students should behave in the classroom. It is important to note that the same behaviour can be seen differently in different situations and by different people. 2. Set Rules: Clear rule setting is helpful for all students. Expectations should be explicit, fair, and within the student's range of achievement. Rules should be reasonable, objective and little in number. Being consistent with consequences for breaking rules is a great idea. A teacher should use positive reinforcement for obedience with rules and use negative consequences for breaking rules. 3. Preventive Discipline: Experience tells us that the most effective means of working with students who display emotional or behavioural disorders is preventive in nature. Rather than responding to inappropriate behaviours, use positive interactive approaches that remove the need for inappropriate behaviours. A teacher can do this by: i. Inform pupils of what is expected of them ii. Establish a positive learning climate iii. Provide a meaningful learning experience iv. Avoid threats v. Demonstrate fairness vi. Build and exhibit self-confidence vii. Recognize positive student attributes viii. Time the recognition of student attributes ix. Use positive modelling x. Structure the curriculum & classroom environment Like anyone else, students with emotional disorders usually respond to positive, corrective feedback when they make an error. Teachers need to communicate care and concern rather than punish when reacting to inappropriate behaviours. Other ways of teaching social skills include direct instruction, prompting, and role-playing. Recently, there has been rising interest in the explanation on their schooling. This point of view has called the client-orient perspective (Wade & Moore, 1993) or consumer's view (Guterman, 1995; Habel, Bloom, Ray, and Bacon, 1999). These researchers are mainly interested in the students' perceptions, preferences and experiences instead of using only teacher evaluations of the meaning of the education. This kind of perspective is especially valuable in considering special education, in which the children are traditionally considered as having a disability or a handicap. The consumer's view could serve as a tool for empowerment and a small step toward broader acceptance of individuals with diverse skills and abilities in our society experienced most difficulties with teachers. However the results of these studies are somewhat contradictory. For example, according to Guterman "the general education teachers had rarely adjusted curricula or requirements to accommodate their individual needs, but a majority also said that their special education placement had not helped them academically very much, because of a low level, irrelevant and repetitive curriculum" (Guterman, 1995). "The paradox is that special education students might value the special education services because they are trying to avoid an unresponsive general education system" (Guterman, 1995). In some studies of special education the purpose has been to find answers to certain specific questions using open-ended questions like "I like teachers who..." or "what I dislike most about school is..."However, in studies where older pupils are interviewed, the results give us a broader picture of being a pupil considered as maladjusted behaviourally disordered or learning disabled (Guterman, 1995). Social constructivism and phenomenology are therefore underlying theories. The major finding of these studies concerning school experiences of pupils of special education seems to be that the separate special education placement is not at all so bad Conclusion Many of the symptoms and much of the distress associated with childhood and adolescent mental, emotional, and behaviour problems may be alleviated with timely and appropriate treatment and support services. A child who is in need of treatment or services, his family needs to a plan of care based on the severity and duration of symptoms. This plan is developed with the family, service providers, and a service coordinator, who is referred to as a case manager. Whenever possible, the child or adolescent is involved in decisions. Tying together all the various supports and services in a plan of care for a particular child and family is commonly referred to as a "system of care." A system of care is designed to improve the child's ability to function in all areas of life-at home, at school, and in the community. Researchers are working to produce new knowledge and understanding about mental, emotional, and behaviour disorders. Studies are also exploring ways to prevent and treat mental, emotional, and behaviour problems, including the range of services that may be required. Currently in existence are many types of programs that utilize the out-of-doors in treating behaviour disordered children. Many are long-term residential camps that offer wilderness camping as therapy, while others are wilderness camping programs of shorter duration. The latter include summer programs, month-long programs, and day camps. Another type of program is the public school class that integrates outdoor education into the curriculum areas or combines the academic programs with high-adventure programming. Behaviour-disordered students benefit from activities that offer a challenge to the students. Camping, hiking, rock climbing, rappelling, canoeing, rafting, and backpacking are all activities that can be adapted to the novice and do not require exceptional physical ability. A patient and knowledgeable instructor can make these high-adventure activities success experiences for the behaviour disordered student. Other activities that benefit students include ropes courses, initiative games, cross-country skiing, snowshoeing, orienteering, cycling, skin diving, tubing, and sailing. Not all schools can provide these activities, so there are near-school activities available such as field trips that emphasize nature study, environmental education, conservation of nature, awareness of the outside world, local history, community services, nutrition, physical education, and health education can also be learning experiences for behaviour disordered students. References Mental, Emotional, and Behaviour Disorders in Children and Adolescents. 1996. Accessed: April 26, 2006. http://www.parentinginformation.org/MEBDisorders.htm Lappin, Edward. 2000, April 20.Outdoor Education for Behaviour Disordered Students. Accessed: April 26, 2006. http://www.kidsource.com/kidsource/content2/outdoor.education.ld.k12.3.html Child, Adolescent & Family. Accessed: April 26, 2006. http://www.mentalhealth.samhsa.gov/cmhs/ChildrensCampaign/1998execsum3.asp 2000, April 20. Strategies For Teaching Students With Behavioural Disorders. Accessed: April 26, 2006.http://www.as.wvu.edu/scidis/behaviour.html Emotional & Behavioural Disorders. Accessed: April 26, 2006 http://www.slc.sevier.org/emoclass.htm Medscape, 2004-2006. Accessed: April 26, 2006 http://www.medscape.com/viewarticle/514172_print Mental Health in the United States: Health Care and Well Being of Children with Chronic Emotional, Behavioural, or Developmental Problems. 2005, October 5. Accessed: April 26, 2006. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5439a3.htm Special Education (SPE). 2003. Accessed: April 26, 2006. http://www.register.siue.edu/2003-2005catalog-updated/courses/specialeducation.htm Grosenick, J. K., George, N. L. & George, M. P. (1988). The Availability Of Program Descriptions Among Program For Seriously Emotionally Disturbed Students. Behavioural Disorders, 13, 108-115. Hobbs, N. (1982). The Troubled And Troubling Child. San Fransisco: Jossey-Bass. Jones, V. F. (1987). Major Components In A Comprehensive Program For Seriously Emotionally Disturbed Children. In R. B. Rutherford, Jr., C. M. Nelson, & S. R. Forness (Eds.), Severe behavioural disorders of children and youth: Vol. 9 (pp. 94-121). Lane, B., J. Bonic, and N. Wallgren-Bonic. "The Group Walk-Talk: A Therapeutic Challenge for Secondary Students with Social/Emotional Problems." TEACHING EXCEPTIONAL CHILDREN 16 (1983): 12-17. Guterman, B. R. (1995). The Validity of Categorical Learning Disabilities Services: the Consumer View. Exceptional Children, 62, 111-124. Wade B. & Moore, M. (1993). Experiencing Special Education. What Young People with Special Educational Needs Can Tell Us. Buckingham: Open University Press. DfEE (1997) Excellence for All Children: Meeting Special Educational Needs, DfEE, London. Read More