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emotional and behavioral disorders educational classification medical classification special education

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This report provides an overview of emotional and behavioral disorders (EBD). It details different classifications, causes, characteristics, and identification methods. It includes aspects of educational and medical classifications, and the report highlights different types of EBD such as internalizing and externalizing disorders.

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1. Understand the Definition of Emotional or Behavioral Disorders (EBD) 2.Identify the Categories of EBD 3.Analyze EBD’s Causes 4. Familiarize with its Characteristics 5.Explore its Identification Methods The IDEA 04 Definition of Emotional Disturbance: 1.) A condition exhibiting one or more o...

1. Understand the Definition of Emotional or Behavioral Disorders (EBD) 2.Identify the Categories of EBD 3.Analyze EBD’s Causes 4. Familiarize with its Characteristics 5.Explore its Identification Methods The IDEA 04 Definition of Emotional Disturbance: 1.) A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance: (A) An inability to learn that cannot be explained by intellectual, sensory, or health factors. (B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers. (C) Inappropriate types of behavior or feelings under normal circumstances. (D) A general pervasive mood of unhappiness or depression. (E) A tendency to develop physical symptoms or fears associated with personal or school problems. 2.) Emotional Disturbance includes schizophrenia.The term does not apply to children who are socially maladjusted unless it is determined that they have an emotional disturbance. Alternative Definition Forness & Knitzer (1992) proposed a new term emotional or behavioral disorder (EBD), replacing the term serious emotional disturbance used in IDEA. I) 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 norm that the responses adversely affect educational performance, including academic, social, vocational, and personal skills. Such a disability: (A) is more than a temporary, expected response to stressful events in the environment. (B) is consistently exhibited in two different settings, at least one of which is school- related; and (C) is unresponsive to direct intervention in general education, or the child’s condition is such that general education interventions would be insufficient. (II) Emotional and behavioral disorders can co-exist with other disabilities. (III) This category may include children or youth with schizophrenic disorders, affective disorder, anxiety disorder, or other sustained disorders of conduct or adjustment where they adversely affect educational performance in accordance with section I. (p. 13) 1. Educational Classification 2.Medical Classification 1. Internalizing Disorders Can be harder to notice. Directly affect the individual with emotional or behavioral problems. 2. Externalizing Disorders Can be easily observable. Students with these behaviors often lash out at others. This system includes 6 Dimensions of Behavior Problems: 1. Conduct Disorder Mental health condition that involves a consistent pattern of aggressive and disobedient behaviors. 4 key symptoms: Aggression towards people and animals or violating others' rights, Damaging property, Deceiving, lying, or stealing, and Serious violation of rules. 2. Socialized Aggression Aggression that people learn and adapt based on their social environment and cultural influences. Typically involves gang activities, cooperative stealing, truancy, and other manifestations of participation in a delinquent subculture. 3. Attention problems- immaturity Characteristically involves preoccupation, short attention span, passivity, daydreaming, sluggishness, and other behaviors not consistent with developmental expectations. 4. Anxiety- withdrawal A Refers to a behavior where a student becomes less active or engaged due to feelings of anxiety. Contrasts sharply with conduct disorder. Avoidance of social interaction, becoming more hesitant or disengaged compared to usual behavior, lack of interest, etc 5. Psychotic Behavior A A group of serious mental illnesses that can make people lose touch with reality and struggle with daily life. Examples include Hallucinations, Delusions, Illogical thinking, Self- injurious behavior, etc 6. Motor tension excess A Another term for this is "Psychomotor Agitation“. Refers to excessive physical restlessness or tension in students. This can include symptoms like muscle tightness, fidgeting, or an inability to relax. It often occurs in response to stress or anxiety and can make a person feel physically uneasy or agitated. The primary medical classification system for individuals with EBD is based on the Diagnostic and Statistical Manual of Mental Disorders, currently in its Fifth Edition, Text Revision (DSM-5-TR). It includes the latest criteria for diagnosing mental disorders and detailed descriptions, offering a standardized language for clinicians to discuss their patients. Another medical classification system is provided by the International Classification of Diseases (ICD), now in its 11th revision (World Health Organization, 2019). ICD- 11 is the basis for identifying and analyzing global health trends and statistics, providing a universal language (code set and rules) that allows health professionals around the world to share information. A The US Department of Education reports a 2% increase in EBD over the past 2 decades. Estimates suggest that 3% to 6% of students have significant emotional or behavioral issues requiring special education (Kauffman, 2005) Rubin and Balow (1978) found that over 7% of students had significant behavior problems. A Cullinan and Epstein's (1995) proposed "Rule of One Third”. It is a guideline for identifying and addressing emotional or behavioral problems in students. According to their proposal: One-third of students in a class might show behavioral or emotional problems that teachers notice. Out of that one-third, 10% might need some changes in their educational program to help them. Finally, 3-4% of the total students will need special education or additional services to address their issues. A However, the actual number of students identified with emotional disturbance under IDEA 04 is much lower than some estimates. Specifically: 0.72% of students ages 6-21 are identified with emotional disturbance. This is less than the 2% estimated by the U.S. Department of Education and lower than other estimates. Despite this, emotional disturbance remains the 4th largest category of disability under IDEA 04, affecting 8% of students with disabilities. (US Dept. of Education, 2006) A Possible Reasons for Under-Identification: Stigma: The label of "emotional disturbance" can carry stigma, which might discourage identification and support, especially for younger children. Social Maladjustment: Students who are socially maladjusted (but not emotionally disturbed) might be excluded from the category, leading to fewer students being identified. A Boys are more frequently identified with emotional or behavioral problems. They are more likely to exhibit externalizing disorders like aggression or antisocial behavior. Girls tend to be identified with internalizing disorders, such as anxiety or depression. Teachers are more likely to notice and refer students with externalizing behaviors because these behaviors are more visible. Older students are more frequently identified with emotional or behavioral problems than younger ones. Possible Reasons: 1. Parents and teachers might be hesitant to formally label a younger child as having emotional or behavioral disorders. 2. Nature of the problem changes with age. A Poverty doubles the risk of being identified (Costello, Messer, Bird, Cohen, 7 Reinherz, 1998). Further, even when sociodemographic variables, such as poverty, are controlled, gender and ethnicity make a big difference (Coutinho, Oswald, Best & Forness, 2002). 1. Environmental 2.Genetics 3.Combined Although controversial factors, such as exposure to television violence, suggested as direct cause of emotional and behavioral disorders (Huesmann, Moise, & Freedman, 2005), there is more consensus about the effect of Family, School, and Community factors. a. Family Factors Family factors could include parental discord, inconsistent or extreme punishment, and lack of emotional support (Reid & Eddy, 1997). Becvar & Becvar (1988) identified several characteristics of emotionally healthy families. The absence of these characteristics increases the risk of a child developing problems. According to Becvar & Becvar (1988), Emotionally Healthy families typically exhibit several Key Traits. These families are characterized by: 1. A legitimate source of authority, established and supported over time 2.A consistent enforce rule system 3.Stable and consistent nurturing behavior 4.Effective child- rearing practices 5.Common family goals 6.Flexibility to adapt 2. School Factors School factors, such as negative experiences like bullying and the systematic oppression of specific racial or ethnic groups, as well as unrealistic teacher expectations, can contribute to the development of emotional or behavioral disorders. 3. Community Factors Exposure to violence in the community, such as gang activity or frequent witnessing of violent incidents can also play a role in the development of an emotional or behavioral disorder. Research indicates that some emotional or behavioral problems , particularly more severe problems, have a genetic basis. Rutter & Silberg (2002) stated “Any dispassionate review of the evidence indicates that there are substantial genetic effects on psychopathology, including emotional and behavioral disturbances” (p. 464). In a study by Loeber, Novak, and Lynam (2000), parents of both identical and fraternal twins assessed their children's problematic behaviors. The findings indicated that just over a third of these behaviors were linked to genetics, while slightly more than half were attributed to the shared environment. Other research based on the investigations of the degree of mental illness occuring within the families suggest that schizophrenia, in particular, has a genetic basis (Gottesman & Reilly, 2003; Sawa & Kamiya, 2003). Sanjuan et al. (2006) found that a mutation of a specific gene was highly associated with individuals with schizophrenia who had auditory hallucinations. The professional concensus is that causes of EBD are both environmentally and genetically influenced, particularly considering the wide range of individuals who fall into this category. Rutter & Silberg (2002) contend that an emotional or behavioral problem may be due to an environmental factors, to genetic factors, or perhaps to a combination of the two. 3 Points should be considered when discussing the characteristics of EBD: 1. Students in this category have a wide variety of characteristics, making it difficult to create a “typical” list of characteristics. 2.There is evidence that problem behaviors are both related to gender and age (Achenbach & Edelbrock, 1991). 3.There is evidence that problem behaviors are related to ethnicity. Students with higher level of aggression have more intense and more frequent episodes. In addition, they have more difficulty in identifying the cause of their aggression (Bohnert, Crnic, & Lim, 2003). Students with externalizing behaviors are typically more offered to special education because of their effects on others. In the DSM-IV-TR classification, a category considered externalizing is Conduct Disorder. Individuals with this disorder exhibit a repetitive and persistent pattern of behavior that violates age-appropriate societal norms or rules, or the basic rights of others. 4 Major Behaviors of Conduct Disorders: 1. Aggressive behavior that causes or threatens physical harm to people or animals 2.Non aggressive behavior that causes property loss or damage. 3.Deceitfulness or theft 4.Serious rule violations One of the most common internalizing problem is Anxiety. Another example that affects students is Social Withdrawal. Withdrawal varies from disinterest in making friends and engaging to conversations to severe withdrawal. Mood disorders is another category of internalizing problems. This category includes manic disorder, depressive disorder, and bipolar disorder, characterized by periods of fluctuating manic and depressive states. The IDEA 04 definition of emotional disturbance specifically states that individuals with schizophrenia are considered to have an emotional disturbance. Schizophrenia is a psychotic disorder characterized by delusions, hallucinations, disorganized speech, and disorganized or catatonic behavior. Another characteristics include a lack of emotional expression and lack of goal directed behavior (American Psychiatric Association, 2000). The severity of emotional or behavioral problem is show to influence IQ. Those with more severe problems tend to also have lower IQs. A related area is Language. Students with emotional or behavioral problems are much more likely to have language deficits than those students without it. Benner, Nelson, and Eipstein (2002), reported that approximately three out of four students with emotional or behavioral problems also have language deficits. Nelson, Benner and Chenney (2005), also reported moderate to large language deficits, particularly related to externalizing behaviors. Although some early research indicated that more children with emotional disturbance were above average academically than below - average (Tamkin, 1960), this does not appear to be the case. Most students with emotional or behavioral problems also have academic difficulty (Trout, Nordness, Pierce & Eipstein, 2003) and IDEA 04 indicates that a student’s educational performance must be adversely affected to be identified as having an emotional disturbance. There are many characteristics and possible causes of emotional or behavioral disorders. Acknowledgment of the wide variety of characteristics has important implications for general and special education teachers. 1. Observation 2.Behavior Rating Scales 3.Behavior Assessment Systems 4. Personality Inventories 5.Projective Tests Used primarily by teachers to initially identify a student and to provide objective information to help make eligible decision. One attempt to address this issue focuses on the comparison of observational data between the target student and a control student. Observation can be used to help document the type, frequency, and duration of the problem behaviors. Observation is also useful in conducting a Functional Behavior Assessment (FBA). FBA are integral tools in behavioral analysis, widely used to address and manage behaviors of concern (challenging behaviors) in the home, at school or community settings. FBA is a step by step process which typically starts with the identification of the challenging behaviors and concludes with an evaluation to see if the interventions designed as a result of the behavior assessment have worked. FBA are integral tools in behavioral analysis, widely used to address and manage behaviors of concern (challenging behaviors) in the home, at school or community settings. FBA is a step by step process which typically starts with the identification of the challenging behaviors and concludes with an evaluation to see if the interventions designed as a result of the behavior assessment have worked. The 7 steps from FBA to PBS are: 1. Identify the behavior of concern 2. Gather Information (data collection) 3. Analyze the Information 4. Formulate a Hypothesis 5. Develop a Positive Behavior Support Plan (or Behavior Intervention Plan) 6. Implement the Plan / Intervention 7. Monitor and Evaluate Used to document the presence and degree of certain behavior characteristics. Use of Behavior Rating Scales has been shown to reliably differentiate students with and without behavior patterns (Hinshaw & Nigg, 1999) , although some problems of agreement has arise when more than one informant is used (Synhorst, Buckley, Reid, Eipstein, & Ryser, 2005). One example is the Devereux Behavior Rating Scales Form (DBRS- SF; Naglieri, Lebuffe, & Pfeiffer, 1993). It has 2 forms, one for ages 5-12 and one for ages 13-18. It is designed to be used by either general education or special education teacher. It includes 40 items that are grouped according to 4 factors: 1. Interpersonal Problems 2.Inappropriate Behaviors/Feelings 3.Depression 4.Physical Symptoms/Fears Devereux Behavior Rating Scales Form Major Purposes: 1. To identify children and adolescents who are at risk of emotional or behavioral problems and warrant in-depth evaluation. 2.To determine atypical aspects of behavior as well as specific behavior difficulties. 3.To monitor and evaluate changes behavior over time. Have multiple components, including behavior rating scales. For instance, they might include a teacher rating scale, a parent rating scale, peer rating scale, a self report scale, an observational component, and an interview component. Its advantage is that they provide ratings of the student from multiple informants in multiple settings. Examples of Behavior Assessment Systems: 1. Achenbach System of Empirically Based Assessment (ASEBA; Achenbach, 1991, 1997, 2000, 2003) It measures areas such as anxious/depressed, thought problems, and aggression. 2. Behavior Assessment Sytem for Children - III (BASC- III; Reynolds and Kamphaus, 2015) It measures areas such as depression, interpersonal relations, and attention problems. Most Personality Inventories have the following Characteristics in common: 1. They are designed primarily for use with adolescents and adults. 2.They typically use a True/False Format. 3.They measure a large number of personality characteristics or factors such as paranoia, reality distortion, and psychological discomfort. Personality Inventories have been criticized for different reasons: 1. Their use of most school-age children is limited, although some attempts have been made to develop appropriate objective inventories for younger students(Taylor, 2009). 2.Self Report format. 3.Instruments primarily used medical rather than educational terminology. 2 popular examples are the Minnesota Multiphasic Personality Inventory - 3 ( Ben-Porath & Tellegen, 2020) and the Personality Inventory for Children - 2 (Lachar & Gruber, 2001) Based on Psychoanalytic theory, assume that a student will “project” his or her feelings, emotions, and personality characteristics when a relatively abstract stimulus is presented. School psychologists reported that they are the least useful assessment technique to evaluate students with emotional disturbance (Cheramie, Griffen, & Morgan, 2000). Examples of Projective tests are: Rorschach Ink Blot Test (Rorschach, 1932) Thematic picture tests such as Thematic Apperception Test (Murray & Bellak, 1973) and Children’s Apperception Test (Beillak & Bellak, 1991) Draw-a-Person Screening Procedure for Emotional Disturbance (Naglieri, McNiesh, & Bardos, 1991) or Kinetic Drawing System for School(Knoff & Prout, 1985) However, Projective Tests, in general , have been criticized for being time-consuming and lacking adequate psychometric properties (Petot, 2000) There is also a great deal of subjectivity in the scoring and interpretation of these tests (Salvia, Ysseldyke, & Bolt, 2007; Taylor, 2009). Although some identification procedures, such as Personality Inventories and Projective Testing, are administered by psychologists or psychiatrists, teachers still play an important role in identification process of students with Emotional or Behavioral Disorders. 1. Observation 2.Behavior Rating Scales 3.Behavior Assessment Systems 4. Personality Inventories 5.Projective Tests 1. Heward, W. L. (2009). Exceptional children: An Introduction to Special Education. Prentice Hall. 2. Conduct Disorder. (2024, May 1). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23924-conduct-disorder 3. Bandura, A. (1973). Aggression: A social learning analysis. Prentice-Hall. 4. King, L. M., PhD. (2024, August 20). Psychotic Disorders: Types, symptoms, diagnosis, treatment. WebMD. https://www.webmd.com/schizophrenia/mental-health-psychotic-disorders 5. Psychomotor Agitation: What Is It, Causes, Diagnosis, and More | Osmosis. (n.d.).Www.osmosis.org. https://www.osmosis.org/answers/psychomotor-agitation 6. About DSM-5-TR. (n.d.).https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm 7. Team, T. L. (2024, February 5). What is ICD-11? AAPC. https://www.aapc.com/resources/what-is-icd-11 8. Goh, D. S. (1995). Book Review: Devereux Behavior Rating Scale-School Form. Journal of Psychoeducational Assessment, 13(3), 326-331. https://doi.org/10.1177/073428299501300312 9. Seven steps of functional... | Behaviour Help. (n.d.-b). Behaviour Help. https://behaviourhelp.com/functional-behaviour-assessment/seven-steps-of-functional-behaviour- assessment 10.Seven steps of functional... | Behaviour Help. (n.d.). Behaviour Help. https://behaviourhelp.com/functional-behaviour-assessment/seven-steps-of-functional-behaviour- assessment

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