EBD Blog

If you teach, administer, or are simply concerned about special education and you haven’t been following Miss Dennis’ accounts of teaching in the Bronx, you owe it to yourself to scurry on over to Your Mama’s Mad Tedious and catch up. That’s a link to her blog over there in the list on the sidebar under “blogroll.”

Earlier this year, Miss Dennis reported that she wouldn’t prepare IEPs for students whom she didn’t teach. It made sense to me (and I thought I’d put an entry here or over on Teach Effectively, but I can’t find it).

Now, Miss Dennis reports that her supervisor charged her with insubordination because of her action. The story provides a fascinating commentary on teaching special education. Just what is insubordination? When should someone agree to do something inappropriate?

(1) There is another report in the case of the Conroe (TX, US) suit to which I referred in the entry “school safety” a few days ago. Attorney Michael Josephson, the lawyer for a girl with Emotional and Behavioral Disorders who is one of several girls sexually assaulted on school grounds, “says she now suffers severe and disabling emotional disturbance and needs special educational supervision,” according to a story reported by KGBT. I suspect that the KGBT coverage is based on the earlier story and is just slightly mis-representing it. It would be odd for Mr. Johnson to argue that the school owed the girl protection as a result of her disability and then to argue that the assault caused the disability. I’m enquiring….

(2) I’ve seen nothing added to the new EBD blog. Here’s hoping they return to posting entries.

For those who wonder about such things, especially in light of the flaps over (a) facilitated communication (see statement on SpedPro) and (b) the Judge Rotenberg Center (see earlier post on EBD Blog), there are some well-documented procedures for treating Autism. The US National Academy of Sciences has published a monograph detailing these procedures and the evidence supporting them. One can get a copy of the monograph from the National Academy Press site.

The Judge Rotenberg Educational Center in Canton (MA, US) has come into the news recently, apparently regarding its use of Faradic aversive conditioning in the treatment of autism. Faradic aversive conditioning is the administration of an electric shock contingent on the performance of a specific behavior and the center uses it to eliminate dangerous behaviors such as self-injury (biting, hitting, banging one’s head, etc.). Faradic aversive conditioning is a procedure that reduces the frequency of the behavior. Thus, it is a punishment in the psychological sense, not the everyday sense of the word.

The Judge Rotenberg Center, led by Matthew Israel, uses what it calls a “graduated electronic decelerator” that delivers a shock of about 3-11 milliamps for about 2 seconds, similar to what one would get from a few flashlight batteries. The center uses these aversives with approximately 50% of its residents when less-punitive measures have failed to reduce their problem behavior, and it uses them in accord with precisely defined policies that have been approved by parents and courts.

Still, the very term “shock” is enough to frighten some people and when it is combined with “therapy” and “autism,” the concept evokes strong reactions. Glance over the headlines I’ve provided in the links at the end of this entry to get a sense of how the press uses sensational language in its coverage of the story. However, here’s the way Ken Maguire, Associated Press writer who published a carefully researched and worded background piece, characterized reactions to the terms:

Hear about shock therapy and what pops to mind are scenes out of the movie “One Flew Over the Cuckoo’s Nest.” But the skin shocks are not electroconvulsive therapy, which began in the 1930s as a way to treat schizophrenia.

Mr. Israel’s program and the Judge Rotenberg Center have been the focus of attacks in the past—Mr. Maguire’s story was published under the headline, “Canton school’s shock therapy comes under fire — yet again.” In fact, the center is funded in part by money Mr. Israel obtained from lawsuits against people and agencies that used false information in efforts to close the school in the 1970s and 80s.

Questions about using aversive procedures have been debated extensively in the special education and psychology literature. I’ve appended a reference to a very thorough discussion of both sides of the issue for those who are willing to examine it calmly; even if one has a predisposition to argue for or against the use of Faradic aversive conditioning and other aversive, there are worthwhile chapters in the book edited by A. Repp and N. Singh.

Also, for the rational, the Boston (MA, US) Globe published a sensible editorial 23 June about the controversy. It takes a reasoned approach to the aversives issue but raises legitimate questions about another matter (staff licenses). The editorial predates more recent allegations that some residents at the Judge Rotenburg Center have burns; these allegations are not yet substantiated and it will be important to get the facts about them before condeming or defending the center on that count.

Repp, A. C., & Singh, N. N. (Eds.). (1990). Perspectives on the use of nonaversive and aversive interventions for persons with developmental disabilities. Sycamore, IL: Sycamore.

Link to Mr. Maguire’s article, as printed in the Boston Globe. Links to other news coverage on this story:

• Boston Globe: State checking burn claims at school
• Associated Press story, carried in Boston Globe: State investigates burn claims from therapy at Canton School; variations carried by Providence (RI, US) WPRI, Worcester (MA, US) Telegram (subscription), New York (NY, US) WNBC, Danbury (CT, US) News Times, New York Newsday, Portsmouth (NH, US) Herald News, Boston WCVB, and Hartford (CT, US) WFSB
• WBUR (Boston, MA, US): Electric Shock Treatments: Tough love or Torture?
• Boston Globe: A shocking form of therapy
• Boston Globe: New York asks curb to shocks at school
• New York (NY, US) Sun: Regents Votes To Put Limits on Schools’ Behavioral Therapy Like
• Boston Globe: NY report denounces shock use at school
• Elmira (NY, US) Star-Gazette: Regents expected to limit extreme therapy
• Boston Globe: State investigates 7 at Canton school
• Middletown (NY, US) Times Herald-Record: Treatment or torture?

A former police officer named Donald P. Mauro was convicted on 18 counts of sexual assault in June 2005 after four students said he had sexual contact with them on the campus of a Conroe (TX, US) school. According to a story by Renée C. Lee in the Houston Chronicle, attorney Michael Josephson has amended a law suit brought on behalf of one of the students and her parents against Mr. Mauro to name the local education agency as a defendant, too. The suit alleges that the LEA failed in its duty to follow a feature of the girl’s Individualized Education Plan.

Josephson said his client required a special education plan because she suffers from a severe and disabling emotional disturbance. The plan called for her to be monitored at all times and escorted to her classes by educational staff, he said.

Link to Ms. Lee’s story.

The British Medical Association (BMA) issued a report 20 June 2006 about the mental health of children and youths in Great Britan. News coverage of the report by Sarah Hall of the Guardian emphasized findings that the prevalence of emotional and Behavioral Disorders has doubled to ~10%.

The report, Child and Adolescent Mental Health, reveals that 9.6% of children aged between five and 16 experience some kind of mental health disorder such as eating, emotional or behavioural problems. The study finds that in the 11-16 age group, 12.6% of boys and 10% of girls suffer from a mental disorder.

The report itself provides no new data about mental health, but summarizes data from other studies and integrates them to develop policy recommendations. In addition to examining earlier studies and reports on prevalence and risk factors, health inequalities, barriers to receiving treatment, strategies for improving care (in England, Scotland, Wales, and Northern Ireland), multi-agency collaboration (what US readers would call “wraparound services”), and methods for promoting good mental health. The report’s conclusion and recommendations are worth noting.

• Recommendations
  • Government policies and strategies that are currently being implemented, such as ‘Every child matters’, ‘Choosing health’ and the national service frameworks, must be fully monitored, and data collected and analysed to ensure that they are effective and addressing need. This information should be made publicly available and accessible.
• Child and adolescent mental health services
  • The government must address the current shortage of mental healthcare professionals.
  • There must be adequate funding for CAMHS to ensure that they are properly resourced and staffed.
  • Innovative services are needed to meet the needs of young people, and access to such services must be improved. Examples include a range of venues that differ from the traditional clinical setting, and easy access to a mixture of services.
• Multi-agency working
  • It is essential that all professionals providing CAMHS receive adequate training and support enabling them to work effectively together. Measures that have already been taken to implement multi-agency working must be continued and extended. Governments need to ensure that the resources, including training in the healthcare information technology system, are available to allow this to happen.
• Mental health inequalities
  • The provision of appropriate mental health services to 16 and 17 year olds must be improved. Young people should not be receiving adult care when they are not mature enough to do so. CAMHS should be extended to encompass this age group in all areas.
  • Collaboration between CAMHS and AMHS must continue and improve to ensure a smooth transition to adult services.
  • The provision of mental health services to looked after children and young people must be improved. CAMHS professionals and registered carers need training in order to support these groups in their particular needs.
  • The current inadequacy of mental health services for children and young people with learning disabilities must be addressed.
  • The reforms outlined in the Child Poverty Review must be implemented to end child deprivation and therefore reduce risk factors for mental health problems.
  • Current inequalities in mental healthcare experienced by BME groups must be tackled:
    • initiatives set out by NIMHE and DH must be properly implemented
    • healthcare professionals and providers of CAMHS should receive training in cultural values and beliefs, to enable them to care for children and young people from BME backgrounds more effectively. Language translation services must be available
    • racism within mental health services must be tackled and eliminated.
  • Barriers to receiving healthcare faced by asylum seeker and refugee children must be addressed.
  • Actions must be taken to improve access to mental health services in young offender institutions, and to tackle the high rate of suicide among young offenders.
  • In addition to the above, CAMHS in Northern Ireland must be reformed and modernised, in line with current policy recommendations, to address gaps in provision.
• Mental health promotion
  • There is a need to improve public knowledge and understanding of mental health.
  • There should be better provision and dissemination of information about mental health aimed at children and young people, appropriate to different age ranges. This should include information about what different mental health problems are, how and where to access help and support, what different mental health professionals do, and what treatments entail. Information should be presented in a variety of media that appeal to children and young people, and in different languages.
  • The media should be encouraged to show those with mental health problems in a positive light, including children and young people.
  • There is a need for more and better mental health promotion to BME groups in order to address health inequalities.
  • Current strategies to address stigma and discrimination against those with mental health problems must be fully implemented. They should be monitored to ensure that they are adequate and effective.

Link to the BMA report and to Ms. Hall’s story.

A large-scale study in Finland revealed differences by gender and by family situation in some self-reported and parent-reported behavior problems. Here’s the abstract.

Attention and behavioural problems of Finnish adolescents may be related to the family environment.

Eur Child Adolesc Psychiatry. 2005 Dec;14(8):471-8

Authors: Hurtig T, Taanila A, Ebeling H, Miettunen J, Moilanen I

BACKGROUND: Adolescents’ attention and behavioural problems in relation to the family environment were studied in the Northern Finland 1986 Birth Cohort. METHOD: Fifteen-year-old adolescents (N=6888) completed the Youth Self-Report (YSR) questionnaire and their parents (N=6643) completed the Strengths and Weaknesses in ADHD and Normal Behaviours (SWAN) questionnaire. The ratings were compared in relation to gender and family characteristics. RESULTS: Girls scored higher than boys on the YSR attention problems subscale (means 4.61 vs. 3.41), the rule-breaking behaviour subscale (means 4.25 vs. 3.69) and the aggressive behaviour subscale (means 7.18 vs. 5.63). Parents reported more SWAN attention problems in their sons than in their daughters. Living in an other than intact family increased YSR and SWAN attention problems and YSR behavioural problems in both genders. Adolescents living in very large families (11-19 children) had least attention and behavioural problems. CONCLUSIONS: Attention and behavioural problems seem to be common among adolescents in Finland. For both genders, living in other than intact families increases especially behavioural problems. Additionally, a very large family seems to be a protective factor against those problems.

PMID: 16341505 [PubMed - indexed for MEDLINE]

Link to PUBMED abstract shown here.

There’s a new blog focused on Emotional and Behavioral Disorders. It’s hosted by Blogspot, is called “Behavioral Disorders,” and the url is http://teachersrus-ccs.blogspot.com. Folks identifying themselves as Courtney Tucker and Chaz have posted entries about types of behavior disorders and general recommendations for teaching.

I wonder what brought these folks together to create the blog. Is it a group of teachers banding together? Perhaps the class project of a college class on EBD? Whoever they are (the “about” entry provides no backgrounds), in the first entry they provide this (unsigned) purpose:

In this blog we will be discussing various behavioral disorders that affect children throughout their school years. We hope that this will be educational for you and help you in your teaching careers.

I look forward to these folks contributing to advancing understanding of Emotional and Behavioral Disorders. Link to the new blog.

Over on SpedPro.org, a couple of my colleage and I have posted a statement expressing dismay about the support offered by Time magazine in two May 2006 issues for Facilitated Communication.

We the undersigned register our dismay about Time magazine’s support of Facilitated Communication in the 10 May 2006 article entitled “‘Helping’ Autistic People to Speak” and 15 May issue entitled “Inside the Autistic Mind” by Claudia Wallis. Time might as well have endorsed cold fusion or phlogiston as give Facilitated Communication a favorable review.

Link to the statement.

Sheila Crowell, a doctoral student at the University of Washington (Seattle, WA; US), and several colleagues have found that “cutting,” a parasuicidal behavior that has been much in the news lately, may have biological markers, according to a press release written by Joel Schwarz.

University of Washington psychologists have discovered that adolescent girls who engage in behaviors such as cutting themselves have lower levels of serotonin, a hormone and brain chemical, in their blood. They also have reduced levels in the parasympathetic nervous system of what is called respiratory sinus arrhythmia, a measure of the ebb and flow of heart rate along with breathing.

Link to Mr. Schwarz’s story.

Over on LeftBrain/RightBrain Kevin Leitch posted a thoughtful analysis of Dan Olmstead’s most recent article about the hypothesis that autism is caused—or at least triggered—by mercury in the form of thimerisol that was once used as preservative in vacines for measles, mumps, and rubella.

Does MMR cause autism – its a matter of science, not propaganda. If Olmsted wishes to convince people capable of rational thought then he needs to provide the science.

Link to Mr. Leitch’s entry. Link (via Washington Times) to Mr. Olmstead’s United Press International article.

Six months ago District Court Judge Michael A. Ponsor (MA, US) ruled that Massachusetts failed to provide appropriate health services to 1000s of children with Emotional and Behavioral Disorders, according to Buffy Spencer of the The Republican, and now lawyers for the parents are claiming that the state has not complied with the ruling. Lawyers for Massachusetts, however, say negotiations are going well.

In their report, lawyers for the plaintiffs ask the court to establish a briefing and hearing schedule to establish a remedial plan “so that children can finally begin to receive the in-home support services to which they are entitled.”

They wrote, “Almost five years after the filing of this lawsuit, children with serious emotional disturbance still have not received any new programs, services or treatments that would allow them to remain in their homes and home communities.”

The lawyers wrote that after three months of intensive negotiations, including nine all-day sessions, the parties still do not agree on almost any important issue. They say that the court now must determine at least key elements of the remedy.

State Attorney General Thomas F. Reilly, representing the defendants, wrote that a court hearing is not necessary and it is the most efficient use of time to continue negotiations.

He wrote, “The parties are working well together and the remedy negotiation meetings have been productive.” He said that more negotiations are scheduled with the goal of submitting a joint proposal to the court.

Link to Ms. Spencer’s story. See earlier articles on this story, including “Judge rips state on care for mentally ill children” (by Scott Allen of the Boston Glob) and ArcMass