The document provides an overview of emotional disturbance in children, defining it as a condition that adversely affects educational performance due to various characteristics such as an inability to learn, build relationships, or manage emotions. It details several emotional and behavioral disorders including conduct disorders, oppositional defiant disorder, anxiety disorders, and eating disorders, along with management strategies like behavior contracts and token economies. Medications like SSRIs are mentioned as treatments for conditions like depression and anxiety.

1. Emotional Disturbance Overview

2. 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

3. 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

4. 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.

5. 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).

6. Characteristics Hyperactivity (short attention span, impulsiveness); Aggression/self-injurious behavior (acting out, fighting);

7. 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).

8. 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.

9. Characteristics Males are identified as having emotional disturbances more frequently than females, especially in elementary years

10. 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.

11. Characteristics Students with emotional disturbances may have low self-esteem and poor social skills.

12. Characteristics Students with emotional disturbances can benefit from classes that are highly structured and have clear rules that are consistently enforced.

13. Academic Symptoms Disruptive to classroom activity. Impulsive. Inattentive, distractible. Appears pre-occupied.

14. Academic Symptoms Disregards all classroom rules. Poor concentration. Extreme resistance to change and transitions. Speaks out, repeatedly.

15. Academic Symptoms Is aggressive. Bullies and intimidates others. Regular truancy from school.

16. Academic Symptoms Dishonest, consistently blames others. Low self esteem. Unable to work in groups.

17. Academic Symptoms Engages in self injurious behavior. Has no regard for personal space and belongings. Persistently tries to manipulate situations.

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

19. Management The behavior contract is a written agreement about how the individual will behave.

20. Management It will indicate the appropriate consequence should the student neglect to behave according to the contract and

21. Management it also states the reinforcer to be used for successful compliance. The behavior contract provides the student with structure and self-management.

22. 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:

23. 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.

24. Token Economy A token economy is an intensive, in-class positive reinforcement program for building up and maintaining appropriate classroom performance and behavior.

25. 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.

26. Token Economy Token programs involve the distribution of tokens (for example, stickers, stars, smiley faces, etc) or points following appropriate behavior.

27. Token Economy The tokens or points can be accumulated throughout the day and exchanged for designated rewards at a specified time.

28. 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.

29. 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.

30. Conduct Disorders This pattern is not selective and is exhibited in the home, at school, with peers and in the child's community.

31. Conduct Disorders Other behaviors present with this condition may include vandalism, stealing, physical aggression, cruelty to animals and fire setting.

32. Oppositional Defiant Disorder This disorder is usually characterized by patterns of negativistic, hostile and defiant behaviors with peers as well as adults.

33. 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.

34. 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.

35. Separation Anxiety Disorder This disorder is characterized by extreme anxiety associated with separation from someone with whom the child views as a significant other

36. Separation Anxiety Disorder This separation anxiety is frequently exhibited at school and at home.

37. Anorexia Nervosa Children with this condition show a marked disturbance and unwillingness to maintain a minimal body weight for their age and height.

38. Anorexia Nervosa An extreme distorted sense of body image exists and intense fears and worries about gaining weight become obsessive

39. 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.

40. 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.

41. 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.

42. Tourette’s 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.

43. Tourette’s Syndrome The above symptoms may change as the child develops but the course of the disorder is usually lifelong

44. Tourette’s 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.

45. 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.

46. 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.

47. 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.

48. 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.

49. Obsessive Compulsive Disorder The major characteristics associated with this disorder are persistent obsessions (persistent thoughts) or compulsions (repetitive acts) that significantly interfere with the individual’s normal daily social, educational, occupational or environmental routines.

50. 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 .

51. Schizoid Personality Disorder The child with this disorder exhibits a restrictive range of emotional experiences and expression and indifference to social situations.

52. 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.

53. 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.

54. 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.

55. 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.

56. 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.

57. Post Traumatic Stress Disorder When the aftermath of a traumatic experience interferes with normal functioning, the person may be suffering from PTSD.

58. 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

59. Antidepressant Medication Some of the newest antidepressants are called selective serotonin reuptake inhibitors (SSRIs) .

60. 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.

61. Examples of Antidepressants Celexa Effexor Lexapro Wellbutrin Zoloft Prozac Paxil

62. Antianxiety Medications Klonopin Xanax ) Valium ) Ativan ).