Archive for the 'Acting out' Category

Students with EBD Hit Hardest by Texas Cap in Special Ed Enrollment

According to reports Brian M. Rosenthal published in the Houston (TX, US) Chronicle, since the early 2000s when the Texas Education Agency (TEA) essentially limited enrollment in special education to 8.5% of the school population, the category of students with disabilities that saw the largest decline in enrollment was emotional disturbance.

Mr. Rosenthal published a series of articles reporting his investigation of systematic denial of services to students with disabilities in Texas beginning in September 2016. The TEA created a system for rating local education agencies’ special education programs that included a benchmark for how many students should be be enrolled. In an installment published 19 November 2016 and entitled “Mentally ill lose out as special ed declines,” he begins the report with the story of Alston Jeffus, an adolescent who is on his way home after spending months in a state hospital. Here are a few paragraphs from Mr. Rosenthal’s article:

The Texas Education Agency’s decision to set an 8.5 percent target for special education enrollment has led schools to cut services for children with all types of disabilities, but mentally ill students like Alston have been disproportionately affected, the Houston Chronicle has found.

Federal law requires schools to provide counseling, therapy, protection from discipline and other support to children with “emotional disturbances,” including severe anxiety, depression, bipolar disorder and post-traumatic stress disorder. Today, however, Texas schools serve 42 percent fewer of those students, relative to overall enrollment, than when the TEA set the benchmark in 2004.

It is a bigger drop than has occurred in almost any other disability category.

In all, an estimated 500,000 school-age children in Texas have a serious mental illness that interferes with their functioning in family, school or community activities, according to the state Health and Human Services Commission.

Only 30,034 receive special education services.

There is a lot more to this story (subscription may be required). I recommend it to readers. Also, I encourage readers haven’t been following Mr. Rosenthal’s excellent reporting on this matter to catch up; the Chronicle published a guide to the series.

Criminalizing mental health problems

Police officers sometimes must use extreme force to protect the population (us!) and themselves from harm. I get that. I am fretful, however, about their use of force in situations with people who have EBD.

As loyal readers know, I have remarked repeatedly about the potential dangers that emerge when individuals schooled in demanding immediate compliance (e.g., “Put that down right now”) issue such commands in very very domineering language to people who have learned to resist or flee in the presence of forceful commands— i.e., many individuals such as kids with Autism, oppositional disorders, and other EBDs.

So, what does an ill-trained officer do in such a situation (which she or he shouldn’t have initiated in the first place)? Well, escalate it: “I told you to put that f’ing thing down. NOW DO IT OR I’LL LIGHT YOU UP!” Then the officer might move toward the individual with EBD in a take-control sort of way. The individual with EBD, predictably, either makes a threatening movement, dives, or gets the hell out of Dodge City. The officer responds accordingly, still in domination mode.

Next? Taser…gun…? In “This is Crazy,” Brave New Media asks important questions about encounters between people with mental illness and the police. Warning some scenes may be wrenching. Please watch this film. Please share it with others.

Little Keswick to feature talk by Ross Greene

The Little Keswick Foundation for Special Education, a philanthropic group associated with the Little Keswick School in central Virginia, announced that Ross Greene, author of The Explosive Child and Lost at School, will speak at its 16th Annual Education Symposium scheduled for 10 October 2013 from 7:00 to 9:00 PM at Piedmont Virginia Community College’s V. Earl Dickinson Center. The session, entitled “Collaborative & Proactive Solutions: Understanding and Helping Behaviorally Challenging Kids (and their Caregivers),” is open to the public and there is no admission fee.

A child psychologist, Ross Greene has taught courses for the Department of Psychiatry at Harvard Medical School and the Department of Psychology at Virginia Tech. He is founder of Lives in the Balance, a non-profit devoted to explaining and supporting his theraputic approach, called “Collaborative Problem Solving.” In addition to his books, Professor Greene has published research articles in well-respected journals such as Journal of Consulting and Clinical Psychology, American Journal of Psychiatry, and Journal of Emotional and Behavioral Disorders.
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First Step supported by WWC

The US What Works Clearinghouse (WWC) reviewed research about First Step to Success, an early intervention program for K-3 children who are at risk of developing antisocial behavior, and identified it as having positive effects on ratings of student behavior and potentially positive effects on ratings of emotions, social skills, and academic outcomes. The WWC based its review on two studies by the developers of First Step, Hill Walker and colleagues—alert readers of EBD Blog will recognize one of them (see “First Step Takes Off“).

What Works—which some folks have taken to calling “what doesn’t work,” because they say it rarely identifies practices that are effective—gave the research undergirding First Step a strong review:

The WWC review of interventions for Children Classified as Having an Emotional Disturbance addresses student outcomes in seven domains: external behavior, emotional/internal behavior, social outcomes, reading achievement/ literacy, math achievement, school attendance, and other academic performance. The two studies that contribute to the effectiveness rating in this report cover five domains: external behavior, emotional/internal behavior, social outcomes, reading achievement/literacy, and other academic performance. The findings below present the authors’ estimates and WWC-calculated estimates of the size and statistical significance of the effects of First Step to Success on children classified as having an emotional disturbance….

Two studies reported findings in the external behavior domain.

Walker et al. (1998) found, and the WWC confirmed, four positive and statistically significant differences between treatment and comparison groups on academic engaged time, the Child Behavior Checklist–Teacher Report Forms (CBCL-TRF) Aggression Subscale, the Early Screening Project (ESP) Adaptive Behavior Subscale, and the ESP Maladaptive Behavior Subscale.

Walker et al. (2009) found, and the WWC confirmed, four positive and statistically significant differences between treatment and comparison groups on academic engaged time, the Social Skills Rating System (SSRS) Problem Behavior Subscale for Parents, the SSRS Problem Behavior Subscale for Teachers, and the SSBD Maladaptive Behavior Index. Although the overall design of the Walker et al. (2009) study meets evidence standards, there was high attrition on one outcome: the SSRS Problem Behavior Subscale for Parents outcome. The authors established equivalence for the analytic sample for this outcome; thus, this finding meets evidence standards with reservations.

The mean effect size from the four outcomes in Walker et al. (1998) and the mean effect size from the four out- comes in Walker et al. (2009) were both statistically significant. Thus, for the external behavior domain, two studies with strong designs showed statistically significant positive effects. This results in an intervention rating of positive effects for the domain, with a small extent of evidence.

Walker, H. M., Kavanagh, K., Stiller, B., Golly, A., Severson, H., & Feil, E. (1998). First Step to Success. An early intervention approach for preventing school antisocial behavior. Journal of Emotional and Behavioral Disorders, 6, 66–80.

Walker, H. M., Seeley, J. R., Small, J., Severson, H. H, Graham, B. A., Feil, E. G., . . . Forness, S. R. (2009). A randomized controlled trial of the First Step to Success early intervention: Demonstration of program efficacy outcomes in a diverse, urban school district. Journal of Emotional and Behavioral Disorders, 17, 197–212.

Webinar on FBA and positive behavior support plans


Tim Lewis

If you and your colleagues need to obtain a good foundation on the use of functional behavioral assessment and positive behavior support plans, there is an opportunity coming to satisfy that need.Tim Lewis will present another Webinar under the auspices of the Council for Exceptional Children (CEC), and this one is entitled “Designing Individual Student Positive Behavior Support Plans Through Functional Behavioral Assessment.” It is scheduled for Tuesday 25 October 2011 from 4:00 to 5:00 PM (Eastern Time, US).

Professor Lewis is among the leaders in the area of Emotional and Behavioral Disorders and positive behavior interventions and supports (PBIS). He co-edits the journal Behavioral Disorders and co-directs major projects on PBIS. Follow this link to learn more about the event and how to register for it; it is the third in a series of Webinars on the topic of PBIS that Professor Lewis is providing via CEC. (I don’t have a financial interest in them; I’m just shilling for them for free here.)

Addressing bullying via PBIS


Tim Lewis

Do you want to learn how to do something about bullying in schools? Here’s a way to get started.

Under the auspices of the Council for Exceptional Children (CEC), Tim Lewis will present an online seminar (“Webinar”) entitled “Addressing Bullying Behavior Through Schoolwide Positive Behavior Supports” on Thursday 20 October 2011 from 4:00 to 5:00 PM (Eastern Time, US). Professor Lewis, who teaches and conducts research at the University of Missouri, has a wealth of experience and expertise in the area of Emotional and Behavioral Disorders and positive behavior interventions and supports (PBIS), so this an excellent opportunity to get a good grounding in how to use the features of PBIS to help a school manage bullying problems. Follow this link to learn more about the event and how to register for it; it is one in a series of Webinars on the topic of PBIS that Professor Lewis is providing via CEC. (I don’t have a financial interest in them.)

Cog mod for PTSD

In the Journal of Behavior Therapy and Experimental Psychiatry, Joanna Kowalik and colleagues reported that their review of studies on the use of cognitivie behavioral therapy for treating posttraumatic stress disorder (PTSD) revealed that cog-mod appears effective in changing raters’ responses on some of the widely used scales of the Child Behavior Checklist. However, the results of their literature review are not as powerful as one might hope, given the small number of studies and substantial variability in the studies themselves.

Abstract

Background and objectives There is no clear gold standard treatment for childhood posttraumatic stress disorder (PTSD). An annotated bibliography and meta-analysis were used to examine the efficacy of cognitive behavioral therapy (CBT) in the treatment of pediatric PTSD as measured by outcome data from the Child Behavior Checklist (CBCL).

Method A literature search produced 21 studies; of these, 10 utilized the CBCL but only eight were both 1) randomized; and 2) reported pre- and post-intervention scores.

Results The annotated bibliography revealed efficacy in general of CBT for pediatric PTSD. Using four indices of the CBCL, the meta-analysis identified statistically significant effect sizes for three of the four scales: Total Problems (TP; ?.327; p = .003), Internalizing (INT; ?.314; p = .001), and Externalizing (EXT; ?.192; p = .040). The results for TP and INT were reliable as indicated by the fail-safe N and rank correlation tests. The effect size for the Total Competence (TCOMP; ?.054; p = .620) index did not reach statistical significance.

Limitations Limitations included methodological inconsistencies across studies and lack of a randomized control group design, yielding few studies for meta-analysis.

Conclusions The efficacy of CBT in the treatment of pediatric PTSD was supported by the annotated bibliography and meta-analysis, contributing to best practices data. CBT addressed internalizing signs and symptoms (as measured by the CBCL) such as anxiety and depression more robustly than it did externalizing symptoms such as aggression and rule-breaking behavior, consistent with its purpose as a therapeutic intervention.

Because they are integrating so few studies it is very difficult to have a sensitive meta-analysis in this case. However, that Professor Kowalik and her collaborators found differences at all is encouraging. I hope they’ll continue to follow this literature. Also, I hope researchers will be using other measures of outcomes and that those other measures will be examined in future integrative literature reviews, too.

Kowalik, J., Weller, J., Venter, J., & Drachman, D. (2011). Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: A review and meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 42, 405-413. doi:10.1016/j.jbtep.2011.02.002

Counselling explained. You can find counselling services in your local private hospital in Nottingham, UK.

Follow up of Fast Track

These are the lead researchers in the Conduct Problems Prevention Research Group with their current universities (over the years, some have changed affiliations):

The Conduct Problems Prevention Research Group, a team of composed of seven of the most eminent US scholars studying the development of childhood behavior disorders, published another in its series of papers tracking the outcomes of the children it has been following in a long-term study about preventing acting out disorders. In this longer-term follow-up analysis, the team found that the effects were still present for the children who showed the most risk of having behavior disorders in the first place.

This project and these folks are the big time. The work has been conducted very carefully and cannot be represented as an example of over-hyped findings.
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