Archive for the 'Acting out' Category

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More than police preparation needed

Sometimes when police officers interact with children and youths with Emotional and Behavioral Disorders, the results concern me, as noted previously in my posts Letter to editors, Law enforcement protection, and Police training recommended (also see mollyg’s comment on the last of these posts). I came across another instance recently and want to report it here with links for further study.

According to a report from the Oregon Advocacy Center (OAC), an independent and not-for-profit organization that provides advocates for people with disabilities in Oregon (US), the story is about an 11-year-old boy (4’4″ or 1.3 meters tall and 65 lbs or 30 kilograms in weight) who had a long history of Emotional and Behavioral Disorders. The boy, referred to as “J” in the report, lived in a residential facility that had a school on the premises. One day, in an apparent rage, he destroyed items in his special education classroom and a teacher aide suffered scrapes and bruises when unsuccessfully restraining him. The teacher and aide took the other children out of the room and sought assistance. Someone called the police, who apparently arrived promptly. Meanwhile, the boy barricaded himself in the room.

On October 4, 2004, four armed police officers wearing riot gear and pre-authorized by a police captain to use a taser gathered in an Oregon elementary school hallway outside of a special education classroom. From behind the barricaded doorway, they could hear the screaming and swearing of a single fifth-grader. He had been trashing the room’s contents for thirty minutes or more and throwing them through the hole where the door’s window had been. Eventually, the police got behind a table and entered the room by pushing aside the furniture piled against the door.

As the four officers entered, one with a drawn taser and the other three “capable of providing lethal cover if the need arose,” the boy held a five-inch long metal drawing compass with a pointed end over his head as if to throw it. The officer who carried the taser fired his darts. The boy dropped on his back, twitching as a 5-second cycle of 50,000 volts went through his body. When he stopped moving, he was lifted to his feet and handcuffed.

In my view, this situation represents several failings, many of which the OAC reported noted. It’s easy to express concern about use of a taser on a small child; the police officers needed to know and employ other ways of handling the situation, to be sure. However, the situation should never have been allowed to escalate to the point that someone at the school called police; there are both preventative measures and means of responding to violent outbursts that can be employed. Here’s more from the OAC report:

The injection of police into situations where special education students have emotional outbursts is a short-sighted remedy that has not been shown to be effective in our state or elsewhere. More importantly, calling police as a method to control children like J is, in our view, almost never necessary and almost always traumatic. In all but the truly dangerous circumstance where a student poses an imminent threat to another person, we believe that the introduction of police into the mix should be viewed as an indication of poor educational practice and planning.

To their credit, it appears that many people involved did good things. Teachers had received (apprently ineffective) training in restraint. Teachers took other students out of harm’s way. School personnel were apparently concerned about risks to the boy himself.

I am in no position to second guess the people involved in this situation. The realists among we special educators know that sometimes these students have outbursts. However, I see it as a good example of how people in my position and other similar positions—those charged with preparing teachers and other public servants to do their jobs—need to anticipate the possibility that our students will have to address such volitile situations. We need to make sure that special educators, not just the police, know how to handle problems such as those that this boy apparently presented.

Please add to the list by commenting: Schools need policies and procedures for handling emergencies. Teachers need to provide environments that reduce the probability of outbursts. Teachers need real practice (not just idle theorizing) about calm restraint. Administrators need the same. Etc.

Link to the OAC report. Link to an advertisement for a book by Dennis Debbaudt entitled Autism, Advocates, and Law Enforcement Professionals. A friend told me that developmental disabilities councils in US states have created or are creating guidelines on interactions; if you know of such documents in your area (US or not), please pass them along to me.

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Maternal monitoring

Professor David Schwebel and colleagues of the Department of Psychology and the Youth Safety Lab at the University of Alabama Birmingham (AL, US) reported that mothers’ ignoring of dangerous behavior correlates with children with externalizing behavior. These results are consistent with other research showing that parental monitoring of behavior is a component in Emotional and Behavioral Disorders.

How mothers parent their children with behavior disorders: implications for unintentional injury risk.

How mothers parent their children with behavior disorders: implications for unintentional injury risk.
J Safety Res. 2006;37(2):167-73
Authors: Schwebel DC, Hodgens JB, Sterling S
INTRODUCTION: This study was designed to test the role of parental supervision in explaining why children with behavior disorders have increased risk of unintentional injury. METHOD: Children referred to a pediatric behavior disorders clinic and their mothers were unknowingly observed in a “hazard room” environment that housed several items that appeared dangerous but actually were altered to be safe. RESULTS: Mother and child behavior in the hazard room was correlated to parent-, teacher-, and observational-reports of children’s externalizing behavior patterns, children’s injury history, and mother’s parenting styles. Maternal ignoring of children’s dangerous behavior in the hazard room was the strongest correlate to children’s injury history. CONCLUSIONS: Poor parental supervision might serve as a mechanism to explain why children with behavior disorders, and those with oppositional behavior patterns in particular, have increased risk of unintentional injury.

Link to PUBMED abstract.

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Police training recommended

After a police officer killed a young man who apparently had Emotional and Behavioral Disorders, the Boise (ID, US) Community Ombudsman has recommended the officers receive additional training in handling unusual situations, according to a report by Aileen Simborio KTRV-TV. Ombudsman Pierce Murphy reviewed the incident in which officer Andrew S. Johnson shot Matthew Jones in December of 2004.

The 16-year-old was shot by Johnson on Dec. 18, 2004, after responding to the Jones family home at the request of Matthew’s father. Johnson shot Jones four times, killing him, after Johnson says he was attacked by Jones, who was carrying a World War Two Japanese rifle with a bayonet attached.

Murphy believes Johnson did not follow proper procedure when he responded. That’s why Murphy is recommending officers go through more training, specifically implementing what’s called a Crisis Intervention Team model which would help officers better respond to situations involving people suffering from mental illness or significant emotional disturbance.

Surely, responding to a situation such as this one is difficult for officers. They are accustomed to demanding (and obtaining) immediate compliance with orders, but most anyone who’s worked with kids with EBD knows that compliance is a common problem. Furthermore, confrontation rarely brings compliance; rather it often causes kids to escalate.

There are curricula available and in use for helping officers of the law to handle individuals with disabilities. Examples are here, here, and here; there are many others. Do you think your community should promote use of these curricula? Would using them reduce the chances of another child being killed? I hope so.

Link to Ms. Simborio’s story. She provided a link to Ombudsman Murphey’s full report, too.

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Bullying study

Just in case someone forgot or didn’t understand in the first place, bullying has nasty consequences.

PEDIATRICS Vol. 118 No. 1 July 2006, pp. 130-138 (doi:10.1542/peds.2005-2388)

Bullying Victimization Uniquely Contributes to Adjustment Problems in Young Children: A Nationally Representative Cohort Study

Louise Arseneault, PhDa, Elizabeth Walsh, MDb, Kali Trzesniewski, PhDa, Rhiannon Newcombe, PhDa, Avshalom Caspi, PhDa,c and Terrie E. Moffitt, PhDa,c

a Social, Genetic and Developmental Psychiatry Centre
b Division of Psychological Medicine, Institute of Psychiatry, King’s College, London, United Kingdom
c Department of Psychology, University of Wisconsin, Madison, Wisconsin

OBJECTIVE. It has been shown that bullying victimization is associated with behavior and school adjustment problems, but it remains unclear whether the experience of bullying uniquely contributes to those problems after taking into account preexisting adjustment problems.

METHODS. We examined bullying in the Environmental Risk Study, a nationally representative 1994–1995 birth cohort of 2232 children. We identified children who experienced bullying between the ages of 5 and 7 years either as pure victims or bully/victims. We collected reports from mothers and teachers about children’s behavior problems and school adjustment when they were 5 years old and again when they were age 7.

RESULTS. Compared with control children, pure victims showed more internalizing problems and unhappiness at school when they were 5 and 7 years. Girls who were pure victims also showed more externalizing problems than controls. Compared with controls and pure victims, bully/victims showed more internalizing problems, more externalizing problems, and fewer prosocial behaviors when they were 5 and 7 years. They also were less happy at school compared with control children at 7 years of age. Pure victims and bully/victims showed more behavior and school adjustment problems at 7 years of age, even after controlling for preexisting adjustment problems at 5 years of age.

CONCLUSIONS. Being the victim of a bully during the first years of schooling contributes to maladjustment in young children. Prevention and intervention programs aimed at reducing mental health problems during childhood should target bullying as an important risk factor.

Link to the Pediatrics abstract.

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Predicting conduct problems

A group of sociologists from the University of Montreal (Quebec, Canada) showed that “kindergarten boys who from low socioeconomic areas are hyperactive, fearless, infrequently prosocial, and raised in adverse family environments” are more likely to report affiliating with deviant peer groups as adolescents than other kindergarten boys who have only one or two of those four risk factors. I wonder whether use of Shep Kellams’ preventative intereventions (see my note on Teach Effectively! yesterday) would divert these boys from the path.

Prediction of early-onset deviant peer group affiliation: a 12-year longitudinal study.

Arch Gen Psychiatry. 2006 May;63(5):562-8

Authors: Lacourse E, Nagin DS, Vitaro F, Côté S, Arseneault L, Tremblay RE

CONTEXT: Deviant peer group involvement is strongly related to onset, aggravation, and persistence of conduct problems during adolescence. OBJECTIVE: To identify early childhood behavioral profiles that predict early-onset deviant peer group involvement. DESIGN: A 12-year longitudinal study of behavioral development. SETTING: Fifty-three inner-city elementary schools in a large Canadian city. PARTICIPANTS: A total of 1037 boys in kindergarten from low socioeconomic neighborhoods. MAIN OUTCOME MEASURES: Annual self-reported deviant peer group involvement from 11 to 17 years of age. RESULTS: Kindergarten boys were at highest risk of following an early adolescence trajectory of deviant peer group affiliation if they were hyperactive, fearless, and low on prosocial behaviors but much less at risk if they scored high on only 2 of these dimensions. Family adversity had no main effect but substantially increased the risk of following an early adolescence trajectory of deviant peer group affiliation for boys with a profile of hyperactivity, fearlessness, and low prosocial behaviors. CONCLUSIONS: Kindergarten boys from low socioeconomic areas who are hyperactive, fearless, infrequently prosocial, and raised in adverse family environments are at much heightened risk of engaging in deviant peer groups early in their development. Boys at high risk can be identified as early as kindergarten and should be targeted for preventive intervention.

PMID: 16651513 [PubMed - indexed for MEDLINE]

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Literacy and behavior problems

Here’s an abstract from PubMed discussing links between behavior disorders and literacy problems.

Literacy and mental disorders.

Curr Opin Psychiatry. 2006 Jul;19(4):350-354

Authors: Maughan B, Carroll J

PURPOSE OF REVIEW: This review examines recent evidence on the comorbidity between literacy problems and psychiatric disorder in childhood and discusses possible contributory factors. RECENT FINDINGS: Recent studies confirm the substantial overlap of literacy problems with a range of emotional/behavioural difficulties in childhood. Literacy problems and inattention may share genetic influences, contributing to associations with attention deficit hyperactivity disorder. To an extent, links with conduct problems may be also mediated by attentional difficulties. In addition, findings suggest bidirectional influences whereby disruptive behaviours impede reading progress and reading failure exacerbates risk for behaviour problems. Associations between literacy problems and anxiety disorders are not entirely mediated by inattentiveness. Rather, comorbid anxiety disorders seem likely to arise from the stressors associated with reading failure. Findings in relation to depression are less consistent, but suggest that poor readers may be vulnerable to low mood. Children with autism seem more likely to face problems in reading comprehension than the decoding difficulties more prominent in other disorders. SUMMARY: Literacy problems are associated with increased risks of both externalizing and internalizing disorders in childhood, with different mechanisms likely to be implicated in each case. When comorbid problems occur, each is likely to require separate treatment.

PMID: 16721162 [PubMed - as supplied by publisher]

Link to the PubMed source.

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Expulsion

While I was away I missed a humane and thoughtful reflection on expulsion by Mrs. Ris.

Teaching-Family model

If you’re interested in a model for how to change children’s behavior in a home-like setting, there are several that have strong evidentiary bases. One of these is the the Teaching Family Project, affiliated with folks at the University of Kansas. Under the title “Family-Like Environment Better for Troubled Children and Teens,” the American Psychological Association has an appropriately lauditory review of it.

The Teaching-Family Model is one of the few evidence-based residential treatment programs for troubled children. In the past, many treatment programs viewed delinquency as an illness, and therefore placed children in institutions for medical treatment. The Teaching-Family Model, in contrast, views children’s behavior problems as stemming from their lack of essential interpersonal relationships and skills. Accordingly, the Teaching-Family Model provides children with these relationships and teaches them these skills, using empirically validated methods.

In 1970 Pat and I served as house parents for four children who had, until then, been residents of a state hospital for children with emotional, behavioral, and intellectual disabilities. I read about and admired the work of the Teaching Family folks and then later, while in graduate school, watched over his shoulder as Dick Jones helped conduct an external evaluation of the T-F model. Now, I’m glad to see that the model’s still going strongly.

Link to the APA article.

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Whom to believe

A blogger identifying herself as Kayla and who says she has EBD posted an entry about her woes. It’s the only entry in the blog and it seems almost patently predictable.

Blockquote>My mom is going to put me in a shelter for her not being able to deal with me and my anger. I cant help if i express my anger differently than others and i cant help that i have ebd (emotional behavior disorder).

Reading this post, I am reminded of the fictitious letters that were rumored to be sent to Dear Abby or Ann Landers. Is someone making this up? Is this actually a youth’s opinion? I guess I’ll check back now and again to see what’s new on the blog.

Link to Kayla’s entry.

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Special schools help some students

Sometimes special schools are very helpful for students with Emotional and Behavioral Disorders, according to a story by Molly Walsh iin the Burlington (VT; US) Free Press. Ms. Walsh leads with a story about Julie Benay, an associate principal in a public school, enrolling a boy in Project Soar, a private school for children whose behavior makes it impossible to teach them in public school settings.

It was a sad moment for Benay, who believes that Vermont public schools should serve all children.

“I felt defeated,” she recalled. “I felt like I hadn’t done enough for him.”

The tears Benay shed over that child have dried. His behavior improved dramatically after a publicly funded stint at Project Soar, and he was able to return to Swanton Elementary School, where Benay is associate principal. Although she remains deeply concerned about what she views as an increase in students with serious emotional and behavioral problems, the chapter in the kindergartner’s life ended well partly because of Soar, she said.

Ms. Walsh draws heavily on people’s opinions about and explanations of various schooling alternatives and the causes of EBD. She goes on to explain how expensive Project Soar placements are—the kind of costs that allow school board members to grab headlines by decrying the cost of educating students with disabilities— but also how they provide needed services. The story also includes statistics for Vermont as well other topics of local interest.

Link to Ms. Walsh’s article.

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Gender and EBD

Barbara Maughan and colleagues at King’s College’s (London; UK) Institute of Psychiatry have been conducting longitudinal research on the development of behavior disorders. They have just published a report of a study (Title: Preadolescent Conduct Problems in Girls and Boys) that examines gender differences in the factors that predict disruptive behavior disorders. Here’s the abstract:

OBJECTIVE:: To examine sex differences in correlates of disruptive behavior disorders (DBDs) in preadolescent children using indicators of a wide range of well-established risk factors for DBDs and outcomes 3 years after initial assessment. METHOD:: Analyses were based on data for 5- to 10-year-olds (n = 5,913) from the British Child and Adolescent Mental Health Survey 1999, and a 3-year follow-up of selected subsamples (n = 1,440) at ages 8 through 13 years. DSM-IV diagnoses were assigned using the Developmental and Well-Being Assessment at both contacts. RESULTS:: Boys and girls were equally exposed to most social and family risks for DBDs, with little evidence of differential sensitivity to these risks. Boys were exposed more to neurodevelopmental difficulties, attention-deficit/hyperactivity disorder, and peer problems and had lower rates of prosocial behaviors; together, these factors and physical punishment could account for 54% of the observed sex differences in DBDs. At follow-up, outcomes for girls and boys with DBDs were very similar. For children with subthreshold conduct problems at initial assessment, boys were more likely to go on to exhibit DBDs than were girls (25% versus 7%). CONCLUSIONS:: Sex differences in the levels of a variety of child characteristics and interpersonal factors are likely to be important in understanding sex differences in risk for DBDs in preadolescent samples.

The study is published in a very prestigious source. Here’s the reference:

Messer J., Goodman R., Rowe R., Meltzer H., & Maughan B. (2006). Preadolescent conduct problems in girls and boys. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 184-191.

Link to the Pub Med abstract for the study. Reviewing the full study requires a subscription the AACAP journal.

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Antisocial behavior

The most recent of a series of books examining the characteristics, causes, treatment, and consequences of antisocial behavior in children and youths, this volume by the Oregon Social Learning Center (OSLC) team examines the behavioral processes that build and sustain deviant interactions between children and their families (as well as teachers and others). Professors Patterson and Reid have been working on this topic for more than 40 years and they have examined these processes using many different scientific methods. They have assembled chapters from an all-star cast of people with whom they have worked during that time and the contributed chapters cover both the development of and intervention in antisocial behavior.

Reid, J. B., Patterson, G. R., & Snyder, J. J. (Eds.). (2002). Antisocial behavior in children and adolescents: A developmental analysis and model for intervention. Washington, D.C., American Psychological Association.

Learn more about the book from a page on the Web site of the American Psychological Association. To learn more about the OSLC, check the link in the sidebar. During my graduate studies, I worked with this research group for a bit more than a year; I learned a tremendous amount from the interactions and readings I had during that period.

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