Published on

  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide


  1. 1. “ No Child Left Behind” A teacher story regarding combined learning and emotional disabilities Sandrine Colson-Inam, Ph.D. Math and Science Teacher Beacon High School (617) 993-5122 * [email_address] * www.sandrine.teach-nology.com ASSET (Association of Science Special Education Teachers) www.spedscience.com
  2. 3. Outline <ul><li>Introduction: </li></ul><ul><ul><li>Who are you as a teacher? </li></ul></ul><ul><ul><li>Why are you interested in this panel? What would like to learn from this discussion? </li></ul></ul><ul><li>Teaching students with ED (Emotional Disabilities) and/or LD (Learning Disabilities) </li></ul><ul><ul><li>Background info + Case studies </li></ul></ul><ul><ul><li>Final case study: the “multi-level” classroom case </li></ul></ul><ul><li>Q/A + discussion: What do you see in your classroom? </li></ul><ul><li>Conclusions </li></ul>
  3. 4. Introduction <ul><li>Who are you as a teacher? </li></ul><ul><ul><li>What grades/subject are you teaching? </li></ul></ul><ul><ul><li>Where are you teaching? </li></ul></ul><ul><ul><li>What do you like about teaching? </li></ul></ul><ul><ul><li>What don’t you like? </li></ul></ul><ul><ul><li>What are your challenges? </li></ul></ul><ul><li>Why are you interested in this panel? What would you like to learn from this discussion? </li></ul>
  4. 5. Teaching students with ED and LD <ul><li>What do you know about ED? </li></ul><ul><li>ED is Emotional Disability </li></ul><ul><li>Examples of EDs </li></ul><ul><li>How does it show in the classroom? </li></ul>
  5. 6. Emotional Disabilities <ul><li>Some disabilities result from behavioral or emotional disturbances such as mental illness, trauma, abuse or else. These are called ED, Emotional Disabilities (or Emotionally Disturbed). </li></ul><ul><li>This mental health condition causes children to have extreme difficulties at home, at school and with peer relations. </li></ul><ul><li>For example: children with mood disorders, anxiety disorders, attention deficit/hyperactivity disorders or who are oppositional defiant. Sometimes eating disorders. </li></ul><ul><li>These children are often very intelligent and have the cognitive skills to complete school work, therefore ED is often called &quot;The Invisible Handicap.&quot; </li></ul><ul><li>Their behavioral concerns are frustrating and confusing to their family members, peers and others in the community.  </li></ul>Source of Information: http://www.ih.k12.oh.us/esspeced/what_are_behavioral_and_emotiona.htm )
  6. 7. Characteristics of Children with ED <ul><li>impulsivity, hyperactivity, or &quot;out of control&quot; behavior </li></ul><ul><li>episodes of extreme irritability, anger and outbursts </li></ul><ul><li>moods that change quickly and seemingly without reason </li></ul><ul><li>poor grades at school due to lack of work completion and behavioral problems  “the lazy child” </li></ul><ul><li>sadness, withdrawal, decreased energy level </li></ul><ul><li>inflexibility and low tolerance for frustration&quot; </li></ul><ul><li>Examples are: anxiety, bipolar, depression, eating disorders, stress and trauma (PTSD for example), abuse and addictions. </li></ul>Examples are: anxiety, bipolar, depression, eating disorders, stress and trauma (PTSD for example), abuse trauma and addictions.
  7. 8. More info about ED <ul><li>http://www.ih.k12.oh.us/esspeced/what_are_behavioral_and_emotiona.htm </li></ul><ul><li>http:// www.helpguide.org/mental/learning_disabilities.htm </li></ul>
  8. 9. Teaching students with ED and LD <ul><li>What do you know about LD? </li></ul><ul><li>LD is Learning Disability </li></ul><ul><li>Examples of LDs </li></ul><ul><li>How does it show in the classroom? </li></ul>
  9. 10. Learning Disabilities <ul><li>&quot;A learning disability is a condition that can either prevent or hinder someone from learning basic academic and life skills. It is a disorder in the basic psychological processes involved in acquiring and using information through language, both written and spoken, and may show up as an inability to think, read, write, spell or listen.&quot; </li></ul><ul><li>The child's academic ability falls substantially below their age and education level and significantly interferes with academic achievement </li></ul>Source: http://www.kidica.com/education/learning/learning-disabilities.aspx
  10. 11. What Learning Disabilities look like <ul><li>Learning Disorders </li></ul>Linguistic skills : understanding or naming math terms Perceptual skills : recognizing or reading numerical symbols and clustering objects into groups Attention skills : correctly copying numbers, adding carried numbers, and observing operational signs Math skills : following sequences of math steps, counting objects, and learning multiplication tables Mathematics Disorder (Affects 1% of school children) Problems with reading accuracy, speed or comprehension Reading Disorder (Dyslexia) 60-80% of individuals with this disorder are male
  11. 12. What Learning Disabilities look like <ul><li>MOTOR SKILLS DISORDER </li></ul>Younger children may display clumsiness and delays in achieving developmental motor milestones such as walking, crawling, and sitting Older children may display difficulties with the motor aspects of assembling puzzles, playing ball and printing Developmental Coordination Disorder (Prevalence as high as 6% for children ages 5-11) Marked impairment in the development of motor coordination which is not due to a general medical condition such as cerebral palsy or muscular dystrophy
  12. 13. What Learning Disabilities look like <ul><li>COMMUNICATION DISORDERS </li></ul>Disturbance in the normal fluency and time patterning of speech that is inappropriate for the individual's age Stuttering (Affects 1% of pre-pubescent children. Boys outnumber girls 3:1. Onset is typically between 2-7 years-old) Failure to use developmentally expected speech sounds that are appropriate for age and dialect. Errors in sound production and use, substituting one sound for another (e.g., using &quot;t&quot; for a &quot;k&quot; sound. Phonological Disorder (2-3% of 6-7 year-olds present with moderate to severe cases) Receptive : difficulty understanding words or sentences Expressive : limited vocabulary, errors in tense, difficulty expressing ideas Mild : difficulty understanding types of words (i.e., spatial terms) or statements (i.e., complex if-then sentences) Severe : inability to understand basic vocabulary or simple sentences Mixed Receptive-Expressive Language Disorder (Detectable before age 4. May occur in up to 3% of school-age children. Two types: Developmental in which speech may begin late and Acquired due to encephalitis or head trauma) Limited amount of speech and range of vocabulary, difficulty acquiring new words, omissions of critical parts of sentences, use of unusual word order, and slow rate of language development Younger children may speak rapidly with erratic rhythm of speech Older children may have problems with taking down dictation, copying sentences and spelling Expressive Language Disorder (Developmental type is usually recognized by age 3 and approximately half of the children outgrow it. Acquired type is due to brain lesions, head trauma or stroke)
  13. 14. Common Types of Learning Disabilities Problems with reading, math, maps, charts, symbols, pictures Difficulty interpreting visual information Visual Processing Disorder Problems with reading, comprehension, language Difficulty hearing differences between sounds Auditory Processing Disorder Problems with hand–eye coordination, balance, manual dexterity Difficulty with fine motor skills Dyspraria (Sensory Integration Disorder) Problems with handwriting, spelling, organizing ideas Difficulty with writing Dysgraphia Problems doing math problems, understanding time, using money Difficulty with Math Dyscalculia Problems reading, writing, spelling, speaking Difficulty processing language Dyslexia
  14. 15. Potential symptoms of learning disabilities <ul><li>Poor performance on tests </li></ul><ul><li>Difficulty discriminating size, shape, color </li></ul><ul><li>Difficulty with concepts of time </li></ul><ul><li>General awkwardness </li></ul><ul><li>Confusion when faced with instructions </li></ul><ul><li>Difficulty with problem solving </li></ul><ul><li>Poor short- and long-term memory </li></ul><ul><li>Impulsive behavior </li></ul><ul><li>Low tolerance for frustration </li></ul><ul><li>Excessive movement during sleep </li></ul><ul><li>Over-excitability during group play </li></ul><ul><li>Poor social judgment </li></ul><ul><li>Inappropriate, unselective and often excessive displays of affection </li></ul><ul><li>Inappropriate behavior for situation </li></ul><ul><li>Gullibility </li></ul><ul><li>Distractibility </li></ul>Source: http://www.kidica.com/education/learning/learning-disabilities.aspx
  15. 16. The difficulties faced by a child with a learning disability <ul><li>A child with a learning disability may face difficulties beyond basic and life skills. The child may experience feelings of frustration, anger, anxiety, shame and low self-esteem brought on by the inability to achieve at school at the same rate as peers. Research has shown that: </li></ul><ul><li>Those with learning disabilities may experience an increased level of anxiety </li></ul><ul><li>Individuals with learning disabilities may be at greater danger for depression </li></ul><ul><li>People with learning disabilities experience higher levels of loneliness </li></ul><ul><li>Those with learning disabilities may have a lower level of self-esteem </li></ul><ul><li>Individuals with learning disabilities are at greater threat for substance abuse </li></ul><ul><li>People with learning disabilities may be at greater risk for juvenile delinquency (though there is some debate here as to how much of this may be led by more able peers) </li></ul>Source: http://www.kidica.com/education/learning/learning-disabilities.aspx
  16. 17. More about LD <ul><li>http://www.kidica.com/education/learning/learning-disabilities.aspx </li></ul><ul><li>http://www.helpguide.org/mental/learning_disabilities.htm </li></ul>
  17. 18. Case Study 1: T <ul><li>Background: </li></ul><ul><ul><li>T is 18 and hope to graduate this year (she does have enough credit to be a senior) </li></ul></ul><ul><ul><li>She is a smart friendly girl but looks awkward. </li></ul></ul><ul><ul><li>She is highly anxious (can get panic attacks followed by physical symptoms such as stomach pains or vomiting), has difficulties ready social clues, process information very slowly, she has trouble with transitions (especially downtime) </li></ul></ul><ul><ul><li>She has high sensibility to smells </li></ul></ul><ul><ul><li>She has no serious learning disabilities but her anxiety is severe enough to prevent her from performing at her best sometimes. </li></ul></ul><ul><ul><li>She has a good understanding of abstract concepts but can get side tracked and think deeper and deeper about thins until she cannot make sense of them anymore </li></ul></ul><ul><ul><li>She asks questions easily, she likes math and science (my classes, yeah!) and she wants to do well and get credit to go to college. </li></ul></ul>
  18. 19. Case Study 1: T <ul><li>What teaching strategies could you use to help T do well in your class? </li></ul><ul><li>What should you avoid? </li></ul><ul><li>How should you setup your classroom to help T fill at ease doing work? </li></ul><ul><li>What else could you do? </li></ul><ul><li>When defining a solution think about how T might feel if you do this. </li></ul>
  19. 20. Case Study 1: T … and R <ul><li>R is another student in the classroom. He is very bright but does not read social clues easily. He is very quick doing work and understanding concepts and likes to be intellectually challenged constantly. He wants to go to college and is motivated to do well ( a “good” student overall). </li></ul><ul><li>How do you accommodate R and T in the same classroom? </li></ul>
  20. 21. Case Study 2: G <ul><li>Background: </li></ul><ul><li>G is 17. He has ADD. He has some characteristics of autism but not diagnosed for it. He is highly anxious. He can be oppositional. He wants to do the minimum amount of work possible. He has trouble expressing himself clearly verbally and in writing. He process things very slowly. He uses his guitar to help him focus but this can be distracting. He has low writing skills overall. </li></ul>
  21. 22. Case Study 2: G <ul><li>What teaching strategies could you use to help G do well in your class? </li></ul><ul><li>What should you avoid? </li></ul><ul><li>How should you setup your classroom to help G fill at ease doing work? </li></ul><ul><li>What else could you do? </li></ul><ul><li>When defining a solution think about how G might feel if you do this. </li></ul>
  22. 23. Final Case Study <ul><li>Now R, T and G are in the same class and you have also D who has ADD (does not stop talking), cannot read social clues, has trouble with executive functioning and processes information extremely slowly and has not been in most school most of his sophomore year so does not have many good student skills. </li></ul><ul><li>What do you change or how do you accommodate all these students in your classroom to make sure they are all getting what they need to reach their goals? </li></ul>
  23. 24. My Typical Class Routine <ul><li>Have an agenda on the board of what we will be doing during class with approximate times </li></ul><ul><li>Discuss HW first (not at the end of class) </li></ul><ul><li>Have activities that all can do and teach to different intelligence: say it, show it, have the students do it … For example, do a lab introducing (or reviewing) concepts, review concepts (lecture), apply concepts using various level worksheets or problems  Find the right curriculum and adapt it as needed day to day </li></ul><ul><li>No more than 20 minutes lecturing (if possible) </li></ul><ul><li>Have challenges for students who can do more than expected that day </li></ul><ul><li>Adapt instructions to students needs: change the design of your worksheets </li></ul><ul><li>Make things interesting: relate to students interests and real life applications </li></ul><ul><li>If possible, have students start their HW in class (the last 5-10 minutes) to make sure they know what to do </li></ul><ul><li>Plan for the unexpected  Mythbusters to the rescue! </li></ul>
  24. 25. What are the best strategies? <ul><li>Be patient! </li></ul><ul><li>Don’t label or be judgmental! </li></ul><ul><li>Get support </li></ul><ul><li>Have a clear routine, be creative and structured </li></ul><ul><li>Work with the child and parents </li></ul><ul><li>Every day is a different day and provides new opportunities for success </li></ul>
  25. 26. Q/A + What do you see in your classroom? <ul><li>Let’s discuss … </li></ul>
  26. 27. CONCLUSIONS <ul><li>There are many different types of disabilities, usually categorized as Learning Disabilities (LD or LLD) or Emotional Disabilities (ED or SED). </li></ul><ul><li>Unfortunately, even though one would like to be able to categorize each disability separately and find solutions to help children with each type, it is not as simple. Very often, the disabled children we deal with in the classroom combined more than one of the disabilities we can categorize, thus, making our job as educators more challenging as we have to figure out how all the combined disabilities of one child influence his/her behavior as well as his/her learning abilities. </li></ul><ul><li>Our challenge is to solve the maze of mental, medical, physical, genetic, and environmentally caused disabilities to teach academic knowledge to our students.&quot; </li></ul>
  27. 29. EXTRA
  28. 30. Test your Understanding <ul><li>Which one of these children may have ADD/ADHD? </li></ul><ul><ul><li>The hyperactive boy who talks nonstop and can’t sit still. </li></ul></ul><ul><ul><li>The quiet dreamer who sits at her desk and stares off into space. </li></ul></ul><ul><ul><li>Both A and B </li></ul></ul>Source: http://www.helpguide.org/mental/adhd_add_signs_symptoms.htm
  29. 31. ADD/ADHD Myths <ul><li>Myth #1: All kids with ADD/ADHD are hyperactive. </li></ul><ul><li>Some children with ADD/ADHD are hyperactive, but many others with attention problems are not. Children with ADD/ADHD who are inattentive, but not overly active, may appear to be spacey and unmotivated. </li></ul><ul><li>Myth #2: Kids with ADD/ADHD can never pay attention. </li></ul><ul><li>Children with ADD/ADHD are often able to concentrate on activities they enjoy. But no matter how hard they try, they have trouble maintaining focus when the task at hand is boring or repetitive. </li></ul><ul><li>Myth #3: Kids with ADD/ADHD choose to be difficult and could behave better if they wanted to. </li></ul><ul><li>Children with ADD/ADHD may do their best to be good, but still be unable to sit still, stay quiet, or pay attention. They may appear disobedient, but that doesn’t mean they’re acting out on purpose. </li></ul><ul><li>Myth #4: Kids will eventually grow out of ADD/ADHD. </li></ul><ul><li>ADD/ADHD often continues into adulthood, so don’t wait for your child to outgrow the problem. Treatment can help your child learn to manage and minimize the symptoms. </li></ul><ul><li>Myth #5: Medication is the best treatment option for ADD/ADHD. </li></ul><ul><li>Medication is often prescribed for Attention Deficit Disorder, but it might not be the best option for all children. Effective treatment for ADD/ADHD also includes education, behavior therapy, support at home and school, exercise, and proper nutrition. </li></ul>
  30. 32. ADD/ADHD <ul><li>Attention Deficit (Hyperactivity) Disorder —responses that can involve everything from movement to speech and attentiveness. </li></ul><ul><li>The three primary characteristics of ADD/ADHD are inattention, hyperactivity, and impulsivity. </li></ul>
  31. 33. Symptoms of inattention in children <ul><li>Doesn’t pay attention to details or makes careless mistakes </li></ul><ul><li>Has trouble staying focused; is easily distracted </li></ul><ul><li>Appears not to listen when spoken to </li></ul><ul><li>Has difficulty remembering things and following instructions </li></ul><ul><li>Has trouble staying organized, planning ahead, and finishing projects </li></ul><ul><li>Frequently loses or misplaces homework, books, toys, or other items </li></ul>
  32. 34. Symptoms of hyperactivity in children <ul><li>Constantly fidgets and squirms </li></ul><ul><li>Often leaves his or her seat in situations where sitting quietly is expected  </li></ul><ul><li>Moves around constantly, often running or climbing inappropriately </li></ul><ul><li>Talks excessively, has difficulty playing quietly </li></ul><ul><li>Is always “on the go,” as if driven by a motor </li></ul>
  33. 35. Symptoms of impulsivity in children <ul><li>Blurts out answers without waiting to be called on hear the whole question </li></ul><ul><li>Has difficulty waiting for his or her turn </li></ul><ul><li>Often interrupts others </li></ul><ul><li>Intrudes on other people’s conversations or games </li></ul><ul><li>Inability to keep powerful emotions in check, resulting in angry outbursts or temper tantrums </li></ul>
  34. 36. Positive Effects of ADD/ADHD <ul><li>Creativity – Children who have ADD/ADHD can be marvelously creative and imaginative. The child who daydreams and has ten different thoughts at once can become a master problem-solver, a fountain of ideas, or an inventive artist. Children with ADD may be easily distracted, but sometimes they notice what others don’t see. </li></ul><ul><li>Flexibility – Because children with ADD/ADHD consider a lot of options at once, they don’t become set on one alternative early on and are more open to different ideas. </li></ul><ul><li>Enthusiasm and spontaneity – Children with ADD/ADHD are rarely boring! They’re interested in a lot of different things and have lively personalities. In short, if they’re not exasperating you (and sometimes even when they are), they’re a lot of fun to be with. </li></ul><ul><li>Energy and drive – When kids with ADD/ADHD are motivated, they work or play hard and strive to succeed. It actually may be difficult to distract them from a task that interests them, especially if the activity is interactive or hands-on. </li></ul>
  35. 37. Helping ADD/ADHD Children in School <ul><li>Distractibility: </li></ul><ul><li>Helping kids who distract easily involves physical placement, increased movement, and breaking long work into shorter chunks. </li></ul><ul><li>Seat the child with ADD/ADHD away from doors and windows. Put pets in another room or a corner while the student is working. </li></ul><ul><li>Alternate seated activities with those that allow the child to move his or her body around the room. Whenever possible, incorporate physical movement into lessons. </li></ul><ul><li>Write important information down where the child can easily read and reference it. Remind the student where the information can be found. </li></ul><ul><li>Divide big assignments into smaller ones, and allow children frequent breaks. </li></ul>
  36. 38. Helping ADD/ADHD Children in School <ul><li>Interrupting: </li></ul><ul><li>Reducing the interruptions of children with ADD/ADHD should be done carefully so that the child’s self-esteem is maintained, especially in front of others. </li></ul><ul><li>You can use discreet gestures or words you have previously agreed upon to let the child know they are interrupting. Praise the child for interruption-free conversations. </li></ul>
  37. 39. Helping ADD/ADHD Children in School <ul><li>Impulsivity: </li></ul><ul><li>Methods for managing impulsivity include behavior plans, immediate discipline for infractions, and ways to give children with ADD/ADHD a sense of control over their day. </li></ul><ul><li>Make sure a written behavior plan is near the student. You can even tape it to the wall or the child’s desk. </li></ul><ul><li>Give consequences immediately following misbehavior. Be specific in your explanation, making sure the child knows how they misbehaved. </li></ul><ul><li>Recognize good behavior out loud. Be specific in your praise, making sure the child knows what they did right. </li></ul><ul><li>Write the schedule for the day on the board or on a piece of paper and cross off each item as it is completed. Children with impulse problems may gain a sense of control and feel calmer when they know what to expect. </li></ul>
  38. 40. Helping ADD/ADHD Children in School <ul><li>Fidgeting and hyperactivity: </li></ul><ul><li>Strategies for combating hyperactivity consist of creative ways to allow the child with ADD/ADHD to move in appropriate ways at appropriate times. </li></ul><ul><li>Ask children with ADD/ADHD to run an errand or do a task for you, even if it just means walking across the room to sharpen pencils or put dishes away. </li></ul><ul><li>Encourage the child to play a sport—or at least run around before and after school. </li></ul><ul><li>Provide a stress ball, small toy, or other object for the child to squeeze or play with discreetly at his or her seat. </li></ul><ul><li>Limit screen time in favor of time for movement. </li></ul><ul><li>Make sure a child with ADD/ADHD never misses recess or P.E. </li></ul>
  39. 41. Helping ADD/ADHD Children in School <ul><li>Trouble following directions: </li></ul><ul><li>Helping children with ADD/ADHD follow directions means taking measures to break down and reinforce the steps involved in your instructions, and redirecting when necessary. </li></ul><ul><li>Try being extremely brief when giving directions, allowing the child to do one step and then come back to find out what they should do next. </li></ul><ul><li>If the child gets off track, give a calm reminder, redirecting in a calm but firm voice. </li></ul><ul><li>Whenever possible, write directions down in a bold marker or in colored chalk on a blackboard. </li></ul>
  40. 42. Addiction is common in people with mental health problems <ul><li>According to reports published in the Journal of the American Medical Association : </li></ul><ul><ul><li>Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse. </li></ul></ul><ul><ul><li>Thirty-seven percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness. </li></ul></ul><ul><ul><li>Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs. </li></ul></ul><ul><li>Source: National Alliance on Mental Illness </li></ul>
  41. 43. Adictions <ul><li>Substance Abuse: </li></ul><ul><ul><li>Addiction is common in people with mental health problems </li></ul></ul><ul><ul><li>What comes first: Substance abuse or the mental health problem? </li></ul></ul><ul><ul><ul><li>Alcohol or drugs are often used to self-medicate the symptoms of depression or anxiety. </li></ul></ul></ul><ul><ul><ul><li>Alcohol and drug abuse can increase underlying risk for mental disorders. </li></ul></ul></ul><ul><ul><ul><li>Alcohol and drug abuse can make symptoms of a mental health problem worse . </li></ul></ul></ul><ul><ul><li>Overcoming Alcohol and Drug Addiction While Coping with a Bipolar Disorder, Depression or Anxiety. </li></ul></ul><ul><ul><li>Recovery depends on treating both the addiction and the mental health problem. </li></ul></ul><ul><ul><li>What do you see in the classroom? How do you deal with it? </li></ul></ul>
  42. 44. Other Addictions <ul><li>Smoking </li></ul><ul><li>Gambling </li></ul><ul><li>Internet </li></ul><ul><li>Gaming </li></ul><ul><li>Cutting & Self-Injury </li></ul>
  43. 45. Depression <ul><li>Common signs and symptoms of depression </li></ul><ul><ul><li>Feelings of helplessness and hopelessness </li></ul></ul><ul><ul><li>Loss of interest in daily activities </li></ul></ul><ul><ul><li>Inability to experience pleasure </li></ul></ul><ul><ul><li>Appetite or weight changes </li></ul></ul><ul><ul><li>Sleep changes </li></ul></ul><ul><ul><li>Loss of energy </li></ul></ul><ul><ul><li>Strong feelings of worthlessness or guilt </li></ul></ul><ul><ul><li>Concentration problems </li></ul></ul>
  44. 46. Teen Depression <ul><li>SIGNS AND SYMPTOMS OF DEPRESSION IN TEENS </li></ul><ul><li>Sadness or hopelessness </li></ul><ul><li>Irritability, anger, or hostility </li></ul><ul><li>Tearfulness or frequent crying </li></ul><ul><li>Withdrawal from friends and family </li></ul><ul><li>Loss of interest in activities </li></ul><ul><li>Changes in eating and sleeping habits </li></ul><ul><li>Restlessness and agitation </li></ul><ul><li>Feelings of worthlessness and guilt </li></ul><ul><li>Lack of enthusiasm and motivation </li></ul><ul><li>Fatigue or lack of energy </li></ul><ul><li>Difficulty concentrating </li></ul><ul><li>Thoughts of death or suicide </li></ul>
  45. 47. Teen vs. Adult Depression <ul><li>The difference between teenage and adult depression </li></ul><ul><li>Irritable or angry mood – As noted above, irritability, rather than sadness, is often the predominant mood in depressed teens. A depressed teenager may be grumpy, hostile, easily frustrated, or prone to angry outbursts. </li></ul><ul><li>Unexplained aches and pains - Depressed teens frequently complain about physical ailments such as headaches or stomachaches. If a thorough physical exam does not reveal a medical cause, these aches and pains may indicate depression. </li></ul><ul><li>Extreme sensitivity to criticism - Depressed teens are plagued by feelings of worthlessness, making them extremely vulnerable to criticism, rejection, and failure. This is a particular problem for “over-achievers.” </li></ul><ul><li>Withdrawing from some, but not all people - While adults tend to isolate themselves when depressed, teenagers usually keep up at least some friendships. However, teens with depression may socialize less than before, pull away from their parents, or start hanging out with a different crowd. </li></ul>
  46. 48. Effects of teen depression <ul><li>Problems at school </li></ul><ul><li>Depression can cause low energy and concentration difficulties. At school, this may lead to poor attendance, a drop in grades, or frustration with schoolwork in a formerly good student. </li></ul><ul><li>Other problems too but outside the scope of discussion here. </li></ul>
  47. 49. Mania <ul><li>Common signs and symptoms of mania </li></ul><ul><ul><li>Feelings of euphoria or extreme irritability </li></ul></ul><ul><ul><li>Unrealistic, grandiose beliefs </li></ul></ul><ul><ul><li>Decreased need for sleep </li></ul></ul><ul><ul><li>Increased energy </li></ul></ul><ul><ul><li>Rapid speech and racing thoughts </li></ul></ul><ul><ul><li>Impaired judgment and impulsivity </li></ul></ul><ul><ul><li>Hyperactivity </li></ul></ul><ul><ul><li>Anger or rage </li></ul></ul>
  48. 50. Anxiety <ul><li>Common signs and symptoms of anxiety </li></ul><ul><ul><li>Excessive tension and worry </li></ul></ul><ul><ul><li>Feeling restless or jumpy </li></ul></ul><ul><ul><li>Irritability or feeling “on edge” </li></ul></ul><ul><ul><li>Racing heart or shortness of breath </li></ul></ul><ul><ul><li>Nausea, trembling, or dizziness </li></ul></ul><ul><ul><li>Muscle tension, headaches </li></ul></ul><ul><ul><li>Trouble concentrating </li></ul></ul><ul><ul><li>Insomnia </li></ul></ul>
  49. 51. Emotional symptoms of anxiety <ul><li>In addition to the primary symptoms of irrational and excessive fear and worry, other common emotional symptoms of anxiety include: </li></ul><ul><li>Feelings of apprehension or dread </li></ul><ul><li>Trouble concentrating </li></ul><ul><li>Feeling tense and jumpy </li></ul><ul><li>Anticipating the worst </li></ul><ul><li>Irritability </li></ul><ul><li>Restlessness </li></ul><ul><li>Watching for signs of danger </li></ul><ul><li>Feeling like your mind’s gone blank </li></ul>
  50. 52. Physical symptoms of anxiety <ul><li>Common physical symptoms of anxiety include: </li></ul><ul><li>Pounding heart </li></ul><ul><li>Sweating </li></ul><ul><li>Stomach upset or dizziness </li></ul><ul><li>Frequent urination or diarrhea </li></ul><ul><li>Shortness of breath </li></ul><ul><li>Tremors and twitches </li></ul><ul><li>Muscle tension </li></ul><ul><li>Headaches </li></ul><ul><li>Fatigue </li></ul><ul><li>Insomnia </li></ul>
  51. 53. Symptoms of an anxiety attack include <ul><li>Surge of overwhelming panic </li></ul><ul><li>Feeling of losing control or going crazy </li></ul><ul><li>Heart palpitations or chest pain </li></ul><ul><li>Feeling like you’re going to pass out </li></ul><ul><li>Trouble breathing or choking sensation </li></ul><ul><li>Hyperventilation </li></ul><ul><li>Hot flashes or chills </li></ul><ul><li>Trembling or shaking </li></ul><ul><li>Nausea or stomach cramps </li></ul><ul><li>Feeling detached or unreal </li></ul>
  52. 54. Types of Anxiety Disorder <ul><li>Generalized Anxiety Disorder </li></ul><ul><li>Obsessive-compulsive disorder </li></ul><ul><li>Panic disorder </li></ul><ul><li>Phobia </li></ul><ul><li>PTSD </li></ul>
  53. 55. Post-traumatic stress disorder (PTSD) <ul><li>PTSD is the most severe form of emotional and psychological trauma. Its primary symptoms include intrusive memories or flashbacks, avoiding things that remind you of the traumatic event, and living in a constant state of “red alert.” If you have PTSD, it’s important to see a trauma specialist. </li></ul>
  54. 56. Bipolar Disorder <ul><li>There are several types of bipolar disorder. Each type is identified by the pattern of episodes of mania and depression. </li></ul><ul><li>Bipolar I Disorder ( mania and depression) – Bipolar I disorder is the classic form of the illness, as well as the most severe type of bipolar disorder. It is characterized by at least one manic episode or mixed episode. The vast majority of people with bipolar I disorder have also experienced at least one episode of major depression, although this isn’t required for diagnosis. </li></ul><ul><li>Bipolar II Disorder ( hypomania and depression) – Mania is not involved in bipolar II disorder. Instead, the illness involves recurring episodes of major depression and hypomania, a milder form of mania. In order to be diagnosed with bipolar II disorder, you must have experienced at least one hypomanic episode and one major depressive episode in your lifetime. If you ever have a manic episode, your diagnosis would be changed to bipolar I disorder. </li></ul><ul><li>Cyclothymia (hypomania and mild depression) – Cyclothymia is a milder form of bipolar disorder. Like bipolar disorder, cyclothymia consists of cyclical mood swings. However, the highs and lows are not severe enough to qualify as either mania or major depression. To be diagnosed with cyclothymia, you must experience numerous periods of hypomania and mild depression over at least a two-year time span. Because people with cyclothymia are at an increased risk of developing full-blown bipolar disorder, it is a condition that should be monitored and treated. </li></ul>
  55. 57. More about Bipolar Disorder <ul><li>Medical conditions and medications that can mimic the symptoms of bipolar disorder: </li></ul><ul><ul><li>Thyroid disorders </li></ul></ul><ul><ul><li>Corticosteroids </li></ul></ul><ul><ul><li>Antidepressants </li></ul></ul><ul><ul><li>Adrenal disorders (e.g. Addison’s disease, Cushing’s syndrome) </li></ul></ul><ul><ul><li>Antianxiety drugs </li></ul></ul><ul><ul><li>Drugs for Parkinson’s disease </li></ul></ul><ul><ul><li>Vitamin B12 deficiency </li></ul></ul><ul><ul><li>Neurological disorders (e.g. epilepsy, multiple sclerosis) </li></ul></ul>
  56. 58. Eating Disorders <ul><li>Anorexia </li></ul><ul><li>Bulimia </li></ul><ul><li>Binge Eating </li></ul>
  57. 59. Schizophrenia <ul><li>Schizophrenia is a brain disorder that affects the way a person acts, thinks, and sees the world. People with schizophrenia have an altered perception of reality, often a significant loss of contact with reality. They may see or hear things that don’t exist, speak in strange or confusing ways, believe that others are trying to harm them, or feel like they’re being constantly watched. With such a blurred line between the real and the imaginary, schizophrenia makes it difficult—even frightening—to negotiate the activities of daily life. In response, people with schizophrenia may withdraw from the outside world or act out in confusion and fear. </li></ul><ul><li>Most cases of schizophrenia appear in the late teens or early adulthood. For men, the average age of onset is 25. For women, typical onset is around the age of 30. </li></ul>
  58. 60. The most common early warning signs of schizophrenia include <ul><li>Social withdrawal </li></ul><ul><li>Hostility or suspiciousness </li></ul><ul><li>Deterioration of personal hygiene </li></ul><ul><li>Flat, expressionless gaze </li></ul><ul><li>Inability to cry or express joy </li></ul><ul><li>Inappropriate laughter or crying </li></ul><ul><li>Depression </li></ul><ul><li>Oversleeping or insomnia </li></ul><ul><li>Odd or irrational statements </li></ul><ul><li>Forgetful; unable to concentrate </li></ul><ul><li>Extreme reaction to criticism </li></ul><ul><li>Strange use of words or way of speaking </li></ul>
  59. 61. Autism Spectrum Disorders (ASD) <ul><li>Also called pervasive developmental disorder (PDD) </li></ul><ul><li>Three most common PDDs: </li></ul><ul><ul><li>Autism </li></ul></ul><ul><ul><li>Asperger's Syndrome </li></ul></ul><ul><ul><li>Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS) </li></ul></ul><ul><li>Childhood disintegrative disorder and Rett Syndrome are the other pervasive developmental disorders. Both are extremely rare genetic diseases </li></ul>
  60. 62. Autism <ul><li>Difficulty mastering certain academic skills can stem from Pervasive Developmental Disorders such as autism and Asperger’s syndrome. Children with an autism spectrum disorder may have trouble making friends, reading body language, communicating, and making eye contact. </li></ul>
  61. 63. Social interaction in autism spectrum disorders <ul><li>Basic social interaction can be difficult for children with autism spectrum disorders (ASDs). </li></ul><ul><li>Common social interaction impairments seen in autism spectrum disorders include: </li></ul><ul><li>Poor eye contact. </li></ul><ul><li>Unusual or inappropriate body language and facial expressions. </li></ul><ul><li>Lack of interest in other people. </li></ul><ul><li>Prefers to be alone. </li></ul><ul><li>Lack of empathy. </li></ul><ul><li>Doesn't share interests or achievements with others (drawings, toys). </li></ul><ul><li>Resistance to being touched. </li></ul><ul><li>Difficulty or failure to make friends. </li></ul>
  62. 64. Communication in autism spectrum disorders <ul><li>Speech problems </li></ul><ul><ul><li>Speak in an abnormal tone of voice, or with an odd rhythm or pitch. </li></ul></ul><ul><ul><li>End every sentence as if asking a question. </li></ul></ul><ul><ul><li>Use echolalia (the parrot-like repetition of the same words or phrases). </li></ul></ul><ul><ul><li>Respond to a question by repeating it, rather than answering it. </li></ul></ul><ul><ul><li>Refer to themselves in the third person. </li></ul></ul>
  63. 65. Communication in autism spectrum disorders <ul><li>Language comprehension </li></ul><ul><ul><li>Kids with autism may not understand simple directions or questions. Those who do have a firm grasp of spoken language often take what is said too literally. Metaphors and other figures of speech (such as &quot;it's raining cats and dogs&quot;) can be confusing, and they are typically oblivious to attempts at humor, irony, and sarcasm. Kids with autism spectrum disorders often: </li></ul></ul><ul><ul><li>Have trouble starting a conversation or keeping it going. </li></ul></ul><ul><ul><li>Use language incorrectly (grammatical errors, wrong words). </li></ul></ul><ul><ul><li>Have difficulty communicating needs or desires. </li></ul></ul><ul><ul><li>Don’t understand simple statements or questions. </li></ul></ul><ul><ul><li>Confuse pronouns. </li></ul></ul>
  64. 66. Communication in autism spectrum disorders <ul><li>Nonverbal Communication (NLVD) </li></ul><ul><ul><li>When kids with autism spectrum disorders do choose to interact with others, they sometimes come across as cold or &quot;robot-like.&quot; But while they may appear emotionally flat, the reality is that autistic individuals are far from unfeeling. What can look like indifference or insensitivity is actually due to &quot;mind blindness,&quot; or an inability to see things as other people do. </li></ul></ul><ul><ul><li>This makes the &quot;give-and-take&quot; of social interaction very difficult for children with autism spectrum disorders. Subtle social cues such as facial expressions, tone of voice, and gestures are often lost on them. They may also have trouble communicating through their own nonverbal behaviors. For example, your child may avoid eye contact, make very few gestures, or use facial expressions that don't match what he or she is saying. </li></ul></ul>
  65. 67. Asperger <ul><li>Symptoms of Asperger’s syndrome </li></ul><ul><li>As perger’s syndrome is the mildest of the autism spectrum disorders. Unlike autism, speech is not delayed or impaired in Asperger’s. Children with this disorder have good language and verbal skills. They have normal to high intelligence. However, they have problems socializing and communicating effectively with others.  Children with Asperger’s syndrome often come across to others as socially “clueless” or eccentric. </li></ul><ul><li>The signs and symptoms of Asperger’s syndrome include: </li></ul><ul><li>Obsession with a specific topic. </li></ul><ul><li>Long, one-sided conversations. </li></ul><ul><li>Inability to read other people’s reactions or nonverbal cues. </li></ul><ul><li>Unusual or inappropriate eye contact, gestures, and facial expressions. </li></ul><ul><li>Insensitivity to the feelings of others. </li></ul><ul><li>An overly-formal, high-pitched, or robotic speaking voice. </li></ul><ul><li>Failure to grasp humor, irony, and figures of speech. </li></ul><ul><li>Repetitive routines and rituals. </li></ul><ul><li>Clumsy or odd movements. </li></ul><ul><li>Sensitivity to light, sound, and pain. </li></ul>
  66. 68. Symptoms of PDD-NOS <ul><li>For children who meet some, but not all, of the criteria for autism or Asperger’s syndrome, a diagnosis of PDD-NOS (Pervasive Developmental Disorder - Not Otherwise Specified)is given. PDD-NOS is also sometimes called atypical autism ). </li></ul><ul><li>The PDD-NOS diagnosis is reserved for kids who have many autistic-like symptoms, but don’t quite fit into the “box” for the other autism spectrum disorders. For example, their symptoms might have started after the age of three, or they may demonstrate repetitive behaviors and abnormal speech, but have better social skills than other autistic kids. In some cases, a diagnosis of PDD-NOS is eventually changed to something else as the child gets older and the symptoms become clearer. </li></ul>
  67. 69. Executive Functioning <ul><li>The Basics </li></ul><ul><li>The executive functions all serve a &quot;command and control&quot; function; they can be viewed as the &quot;conductor&quot; of all cognitive skills. </li></ul><ul><li>Executive functions help you manage life tasks of all types. For example, executive functions let you organize a trip, a research project, or a paper for school. </li></ul><ul><li>Often, when we think of problems with executive functioning, we think of disorganization. However, organization is only one of these important skills. </li></ul>Source: http://www.ldonline.org/article/What_Is_Executive_Functioning%3F
  68. 70. A formal definition of Executive functioning <ul><li>The executive functions are a set of processes that all have to do with managing oneself and one's resources in order to achieve a goal. It is an umbrella term for the neurologically-based skills involving mental control and self-regulation. </li></ul>
  69. 71. A list of Executive Functions <ul><li>Inhibition - The ability to stop one's own behavior at the appropriate time, including stopping actions and thoughts. The flip side of inhibition is impulsivity; if you have weak ability to stop yourself from acting on your impulses, then you are &quot;impulsive.&quot; (When Aunt Sue called, it would have made sense to tell her, &quot;Let me check the calendar first. It sounds great, but I just need to look at everybody's schedules before I commit the whole family.&quot;) </li></ul><ul><li>Shift - The ability to move freely from one situation to another and to think flexibly in order to respond appropriately to the situation. (When the question emerged regarding who would watch the cats, Robin was stymied. Her husband, on the other hand, began generating possible solutions and was able to solve the problem relatively easily.) </li></ul><ul><li>Emotional Control - The ability to modulate emotional responses by bringing rational thought to bear on feelings. (The example here is Robin's anger when confronted with her own impulsive behavior in committing the family before checking out the dates: &quot;Why are you all being so negative?&quot;) </li></ul><ul><li>Initiation - The ability to begin a task or activity and to independently generate ideas, responses, or problem-solving strategies. (Robin thought about calling to check on the date of the reunion, but she just didn't get around to it until her husband initiated the process.) </li></ul><ul><li>Working memory - The capacity to hold information in mind for the purpose of completing a task. (Robin could not keep the dates of the reunion in her head long enough to put them on the calendar after her initial phone call from Aunt Sue.) </li></ul><ul><li>Planning/Organization - The ability to manage current and future- oriented task demands. (In this case, Robin lacked the ability to systematically think about what the family would need to be ready for the trip and to get to the intended place at the intended time with their needs cared for along the way.) </li></ul><ul><li>Organization of Materials - The ability to impose order on work, play, and storage spaces. (It was Robin's job to organize the things needed for the trip. However, she just piled things into the car rather than systematically making checklists and organizing things so important items would be easily accessible, so the space would be used efficiently, and so that people and &quot;stuff&quot; would be orderly and comfortable in the car.) </li></ul><ul><li>Self-Monitoring - The ability to monitor one's own performance and to measure it against some standard of what is needed or expected. (Despite the fact that they're off to Missouri without knowing how to get there, with almost no planning for what will happen along the way, and without a map, Robin does not understand why her husband is so upset.) </li></ul>
  70. 72. Helping Children with Executive Functioning <ul><li>Helping Children with Executive Functioning Problems Turn In Their Homework: </li></ul><ul><li>Walk through the process with the child </li></ul><ul><li>Develop templates of repetitive procedures </li></ul><ul><li>Provide accommodations </li></ul><ul><li>Teach the use of tricks and technology that help compensate for organizational weaknesses </li></ul><ul><li>Try this! </li></ul>
  71. 73. Walk through the process with the child <ul><li>For example: </li></ul><ul><li>There are many different ways that someone can get off-track in the process of getting homework from home to the teacher. Talk through the process with the student. Is the homework getting lost at home? Is the homework getting lost in the bottom of the backpack or the bottom of the locker? Is it in the proper notebook, but forgotten in the process of settling into the classroom? </li></ul><ul><li>Once you have identified the sticking point, consider what needs to be added to the routine to get past it. </li></ul><ul><li>For those who lose track of homework at home, consider instituting the following routine (from Enabling Disorganized Students to Succeed , by Suzanne Stevens): &quot;Homework is not done until your homework is in its proper folder or notebook, the folders and notebooks are packed into your backpack, and your backpack is on its launching pad.&quot; Try different ways of organizing homework to find the one that best suits your child. Some students do best with a separate homework folder so that everything that needs to be turned in is organized into one place. Others do better when they organize the homework by subject. </li></ul>
  72. 74. Develop templates of repetitive procedures <ul><li>For example: </li></ul><ul><li>Teachers can create a checklist of things to be done upon entering or leaving the classroom. </li></ul><ul><li>Parents can create written checklists or photo charts for completing chores, preparing to catch the bus in the morning, gathering necessary stuff for sports practice, etc. </li></ul>
  73. 75. Provide accommodations <ul><li>For example: </li></ul><ul><li>Build reminders until the desired pattern of behavior (e.g., turning in homework as soon as the student walks into the classroom) becomes a habit. R epeated performance of a behavior is what makes it a habit; once the behavior is automatic, then the burden is lifted from the executive system. </li></ul><ul><li>This as a step in the process of building independent skills, with the prospect of fading out the teacher's prompting. </li></ul>
  74. 76. Tricks and Technology <ul><li>Teach the use of tricks and technology that help compensate for organizational weaknesses. For example: </li></ul><ul><li>If the agenda book is the primary organizing tool for tracking assignments, it could also serve as a way to remind the student to turn in assignments. For example, after completing an assignment, the student could be taught to enter a note into the next day's assignments block for that subject. Then, at the end of class, when the student enters that night's homework assignment, he will see the reminder to turn in what is due that day. </li></ul><ul><li>Several versions of watches are available that can be set to vibrate and show a reminder phrase at the programmed time. &quot;Turn in homework&quot; can be a programmed reminder set to go off at the beginning or end of the class period. Cell phones often have an alarm function, as well, that can be set for reminder alarms. </li></ul><ul><li>When the student prints out an assignment at home, prompt the child to also email it to the teacher and the child's own web-based email account. Then, if the hard copy is misplaced, the child can print it out during class (with the teacher's permission) or during free time. </li></ul>
  75. 77. Try this! <ul><li>Few problems are as frustrating for kids as not receiving credit for homework that was actually completed on time but never turned in! </li></ul><ul><li>One tried and true behavioral strategy to remedy this is to link an already established habit to one that the student needs help acquiring. </li></ul><ul><li>To illustrate, Ivan is a seventh grader who forgets almost everything - except his peanut butter and jelly sandwich! - when he leaves home in the morning to catch the school bus. With daily reminders from his parents, he puts his homework folder on top of his lunch in the refrigerator before going to bed each school night. Then, putting the folder in his backpack, along with his PB&J, is a &quot;no-brainer.&quot; Ivan not only gets credit for his completed work but also learns how to creatively generate ways to manage his weaknesses. </li></ul>