Emotional Disturbance

Definition

Many terms are used to describe emotional, behavioral or mental disorders. Currently, students with such disorders are categorized as having a serious emotional disturbance, which is defined under the Individuals with Disabilities Education Act as follows:

“…a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance –

1. An inability to learn that cannot be explained by intellectual, sensory, or health factors;
2. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers;
3. Inappropriate types of behavior or feelings under normal circumstances;
4. A general pervasive mood of unhappiness or depression; or
5. A tendency to develop physical symptoms or fears associated with personal or school problems.” [Code of Federal Regulations, Title 34, Section 300.7(b)(9)]

As defined by the IDEA, serious emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have a serious emotional disturbance. [Code of Federal Regulation, Title 34, Section 300.7(b)(9)]

It is important to know that the Federal government is currently reviewing the way in which serious emotional disturbance is defined and that the definition may be revised.

Incidence

For the 1998-99 school year, 463,172 children and youth with a serious emotional disturbance were provided services in the public schools (Twenty-Second Annual Report to Congress, U.S. Department of Education, 2000).

Characteristics

The causes of emotional disturbance have not been adequately determined. Although various factors such as heredity, brain disorder, diet, stress, and family functioning have been suggested as possible causes, research has not shown any of these factors to be the direct cause of behavior problems. Some of the characteristics and behaviors seen in children who have emotional disturbances include:

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

Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings and are sometimes identified as children who have a severe psychosis or schizophrenia.

Many children who do not have emotional disturbances may display some of these same behaviors at various times during their development. However, when children have serious emotional disturbances, these behaviors continue over long periods of time. Their behavior thus signals that they are not coping with their environment or peers.

Educational Implications

The educational programs for students with a serious emotional disturbance need to include attention to mastering academics, developing social skills, and increasing self-awareness, self-esteem, and self-control. Career education (both academic and vocational programs) is also a major part of secondary education and should be a part of every adolescent’s transition plan in his or her Individualized Education Program (IEP).

Behavior modification is one of the most widely used approaches to helping children with a serious emotional disturbance. However, there are many other techniques that are also successful and may be used in combination with behavior modification. Life Space Intervention and Conflict Resolution are two such techniques.

Students eligible for special education services under the category of serious emotional disturbance may have IEPs that include psychological or counseling services as a related service. This is an important related service which is available under the law and is to be provided by a qualified social worker, psychologist, guidance counselor, or other qualified personnel.

There is growing recognition that families, as well as their children, need support, respite care, intensive case management services, and multi-agency treatment plan. Many communities are working toward providing these wrap-around services, and there are a growing number of agencies and organizations actively involved in establishing support services in the community. Parent support groups are also important, and organizations such as the Federation of Families for Children’s Mental Health and the National Alliance for the Mentally Ill (NAMI) have parent representatives and groups in every state. Both of these organizations are listed under the resource section of this fact sheet.

Other Considerations

Families of children with emotional disturbances may need help in understanding their children’s condition and in learning how to work effectively with them. Help is available from psychiatrists, psychologists or other mental health professionals in public or private mental health settings. Children should be provided services based on their individual needs, and all persons who are involved with these children should be aware of the care they are receiving. It is important to coordinate all services between home, school, and therapeutic community with open communication.

Resources

Adamec, C. (1996). How to live with a mentally ill person: A handbook of day-to-day strategies. New York, NY: John Wiley & Sons. (Telephone: 1-800-225-5945. Web: www.wiley.com)

Jordan, D. (2000). A guidebook for parents of children with emotional or behavior disorders (2nd ed.). Minneapolis, MN: PACER Center. [Telephone: (952) 838-9000; (952) 838-0190 (TTY). Web: www.pacer.org.]

Jordan, D. (2000). Honorable intentions: A parent’s guide to educational planning for children with emotional or behavioral disorders (2nd ed.). Minneapolis, MN: PACER Center. [Telephone: (952) 838-9000; (952) 838-0190 (TTY). Web: www.pacer.org.]

Koplewicz, H.S. (1996). It’s nobody’s fault: New hope and help for difficult children. New York: Random House/Times Books. (Telephone: 1-800-733-3000. Web: www.randomhouse.com.)

Wilen, T.E. (1998). Straight talk about psychiatric medications for kids. New York: Guilford. (Telephone: 1-800-365-7006. Web: www.guilford.com)

Organizations

American Academy of Child and Adolescent Psychiatry Public Information Office 3615 Wisconsin Ave., NW Washington, DC 20016 (202) 966-7300 Web: www.aacap.org

ERIC Clearinghouse on Disabilities and Gifted Education Council for Exceptional Children 1110 N. Glebe Road, Suite 300 Arlington, VA 22201-5704 1-800-328-0272 (703) 264-9449 (TTY) E-mail: [email protected] Web: http://ericec.org

Federation of Families for Children’s Mental Health 1101 King Street, Suite 420 Alexandria, VA 22314 (703) 684-7710 E-mail: [email protected] Web: www.ffcmh.org

National Alliance for the Mentally Ill (NAMI) Colonial Place Three 2107 Wilson Boulevard, Suite 300 Arlington, VA 22203-3754 (703) 524-7600; (703) 516-7227 (TTY) (800) 950-6264 E-mail: [email protected] Web: www.nami.org

National Clearinghouse on Family Support and Children’s Mental Health Portland State University P.O. Box 751 Portland, OR 97207-0751 (800) 628-1696 (503) 725-4040 Web: www.rtc.pdx.edu/

National Mental Health Association 1021 Prince Street Alexandria, VA 22314-2971 (703) 684-7722 (800) 969-6642 (800) 433-5959 (TTY) E-mail: [email protected] Web: www.nmha.org

For your state CASSP (Children and Adolescent Service System Program) office and State Mental Health Representative for Children call NICHCY (1-800-695-0285) and ask for a State Resource Sheet for your state or download it from our Web site.

Publication of this document is made possible through Cooperative Agreement #H326N980002 between the Academy for Educational Development and the Office of Special Education Programs of the U.S. Department of Education. The contents of this document do not necessarily reflect the views or policies of the Department of Education, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

NICHCY P.O. Box 1492 Washington, DC 20013 (800) 695-0285 · v/tty (202) 884-8441 · fax

Posted August 26, 2002