Common Childhood Emotional and Behavioral Disorders

Common Childhood Emotional and Behavioral

DisordersBy Christina Saad, Ed.S.

School PsychologistDry Creek Joint Unified School District

January 2014

I. Important definitionsII. New stats III. DSM-5: Notable changesIV. How mental (emotional and behavioral)

disorders effect learningV. Quick and dirty short-term interventionsVI. Questions? Comments?

The purpose of this presentation: I. To inform educators of dominant mental disorders among

childrenII. To educate about the affects of mental disorders on

learning and education

Today’s Agenda

Common mental disorders explained through Sesame Street characters…

Definitions of childhood mental disorders

What is a childhood mental disorder?

The CDC defines it as “…..as serious changes in the ways children typically learn, behave, or handle their emotions.”

Symptoms of a mental disorder usually start in early childhood

Some symptoms may start to develop in teenage years

Diagnosis is made during school age years

Suicide, which is the result of mental disorders and other factors, was the second leading cause of death among children ages 12-17 years old in 2010.

Specific symptoms for common childhood mental disordersADHD (Attention-Deficit/ Hyperactivity Disorder)Trouble concentrating; difficulty sitting still, interrupting others during a conversation or acting impulsively without thinking things through Often accompanied with: Anxiety Learning disabilities Speech or hearing problems Obsessive-compulsive disorder Tics Behavioral problems such as oppositional defiant disorder (ODD) or conduct disorder (CD)

Conduct Disorder Aggression to people and animals Destruction of property Deceitfulness or theft Serious violations of rules

Oppositional Defiant DisorderA pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present: Often loses temper Often argues with adults Often actively defies or refuses to comply with adults’ requests or rules Often deliberately annoys people Often blames others for his or her mistakes or misbehavior Is often touchy or easily annoyed by others Is often angry and resentful Is often spiteful or vindictive

Specific symptoms of common childhood mental disorders cont.Generalized Anxiety DisorderPeople with generalized anxiety disorder (GAD) experience constant, chronic, and unsubstantiated worry, often about health, family, money, or work. This worrying goes on every day, possibly all day. It disrupts social activities and interferes with work, school, or family.  Physical symptoms of GAD include the following: Muscle tension Fatigue Restlessness Difficulty sleeping Irritability Edginess Gastrointestinal discomfort or diarrhea

Depression Frequent sadness, tearfulness, and/or crying Hopelessness Decreased interest in activities or inability to enjoy previously favorite activities. Persistent boredom; low energy. Social isolation, poor communication. Low self-esteem and guilt. Extreme sensitivity to rejection or failure Increased irritability, anger, or hostility Frequent absences from school or poor performance in school. A major change in eating and/or sleeping patterns Thoughts or expressions of suicide or self-destructive behavior

Autistic Spectrum Disorder Deficits in functional verbal communication Deficits in social skills Repetitive or stereotypical behaviors Insistence on sameness Highly restricted or fixated interests Hypo/hyper-reactivity to environmental changes (sensory) 

Statistics from the Centers for Disease Control (CDC)

Most prevalent mental disorder among children ages 3-17 is ADHD

Data collected from a variety of data sources between the years 2005-2011 show children aged 3-17 years currently had:

◦ ADHD (6.8%)◦ Behavioral or Conduct Problems (3.5%)◦ Anxiety (3.0%)◦ Depression (2.1%)◦ Autism Spectrum Disorders (1.1%)◦ Tourette’s Syndrome (0.2%) (among children aged 6–17 years)

Is this surprising to anyone? Which ones did you not expect to make the list?

DSM 5: Diagnostic Statistical Manual of Mental Disorders, 5th

Edition (2013)

DSM 5: Notable changes

Autistic Spectrum Disorder (No longer Asperger’s, PDD-NOS, Childhood Disintegrative Disorder, and Retts Disorder)◦ Thought to decrease dx by 10%

ADHD (evidence prior to age 13 instead of age 7)◦ Likely to increase prescriptions and dx among teens/adults

Disruptive Mood Dysregulation Disorder◦ Most controversial addition◦ Severe, recurrent temper outbursts, verbal or behavioral that

are grossly out of proportion; temper outbursts inconsistent with developmental level; present in at least 2/3 settings; cannot coexist with ODD, Intermittent Explosive Disorder or Bipolar disorder; Age of onset—before age 10 but cannot be applied to children 6 and under.

What do mental disorders look like in the classroom

setting?

Some things to keep in mind…. IF a student is already diagnosed, the parent should have

already notified the school. That information should be in the cum folder or health folder.

IF a student is exhibiting symptoms in the classroom enough to impede education, hold a meeting. These things shouldn’t be discussed over the phone if you can help it!

We as school staff (even school psychologists) should NEVER recommend medication– the district can be held liable for paying for it! Instead, recommend a visit to the doctor/physician

UNLESS you feel comfortable discussing their child’s emotional/behavioral issues, consult with school psychologist before approaching parents

ADHD: daydreaming, up out of seat frequently, not paying attention, vocally interrupting teacher/students, difficulty remembering oral directions, fidgeting in seat, trouble keeping friends (constant in-fighting)

Conduct/ODD: Fighting with peers, bullying, physical aggression, damage to desk or other students possessions, frequent lying or deception, stealing toys from other students, willful breaking of rules

Anxiety: School refusal, chewing pencils/markers, stuttering, frequent crying, refusal to talk in class or to teacher, frequently sent to see school nurse

Depression: Laying head on desk, frequent crying in class and during recess, refusing to interact with peers, sensitivity to criticism, lack of appetite at lunch, lack of interests in fun activities, lack of motivation to complete tasks, sleepiness

Autism Spectrum Disorders: Fixation on one task, repetitive vocalizations or movements with fingers or hands (hand flapping), difficulty making/keeping friends, blank stares (flat affect), imitating others, hyperlexia, graphic memory, inability to follow oral directions, seemingly off task or inattentive, acting out if routine changes abruptly, speech/language and articulation difficulties.

How childhood mental disorders effect learning

AbsencesSuspensions due to behaviorMedication adjustmentMemory/retention; Comprehension (oral

directions, reading, etc.) Motivation (difficult to pinpoint)Family dynamic and homework completion

Any other ways these disorders can potentially impede learning?

Quick and dirty interventions for teachers

to use

Communication with parents is KEY

Allow some time! Daily check-in’s Shorten assignments Nonverbal signal to get on task Behavior student contract Task completion student contract Teach mnemonic devices (e.g.

PEMDAS)

Move assigned seat frequently Point out the positives—ignore

the negatives! Create situations where students

can make friends More concrete—less abstract Hold classroom meetings Consult with colleagues

(teachers, admin and psych)

Some ideas…

The not so quick and dirty….

•Home visits (if needed)•SST meeting (if needed)•504 Plan meeting (if needed)

Any other ideas?

Questions? Comments?

…Thanks!