Archive for the 'Policy' Category

US ED resource on restraint and seclusion

Published on 15 May 2012 in Administration, Advocacy, Behavior management, Families, News, Policy, The press and Treatment. 0 Comments Tags: , , , , , , , , , , , , , , .

The US Department of Education (ED) published Restraint and Seclusion: Resource Document today. After the extensive discussions the last few years about abuses of management procedures (see , especially those used with children and youths with Emotional and Behavioral Disorders, ED contracted with an agency to create this document that provides guidelines for the appropriate use of restraints and seclusion.

The foundation of any discussion about the use of restraint and seclusion is that every effort should be made to structure environments and provide supports so that restraint and seclusion are unnecessary. As many reports have documented, the use of restraint and seclusion can, in some cases, have very serious consequences, including, most tragically, death. There is no evidence that using restraint or seclusion is effective in reducing the occurrence of the problem behaviors that frequently precipitate the use of such techniques.

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First Step supported by WWC

Published on 14 March 2012 in Acting in, Acting out, Administration, News, Policy, Prevention, Research, The press and Treatment. 1 Comment Tags: , , , , , , , , .

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.

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CCBD Webinar on seclusion and restraint coming soon

Published on 6 March 2012 in Advocacy, News, Policy, Professsional development, The press and Treatment. 0 Comments

The Council for Children with Behavior Disorders of the Council for Exceptional Children will present a Webinar 8 March 2012 entitled “Physical Restraint and Seclusion in Schools: Issues, Policies and Practices.” This is a terrifically important issue for practitioners and administrators.

Federal legislation is pending that, if passed, would regulate the use of physical restraint and seclusion procedures for students in school settings. This webinar will discuss the legislative, policy, and practice issues that have arisen because of the deaths and injuries of students due to these procedures. The webinar will provide an overview of the content that will be covered in more detail during the strand on restraint and seclusion at the CEC Convention & Expo in April 2012.

The session, which runs from 4:00PM – 5:00PM ET, requires registration for a fee ($114; save lots if you’re a CEC member!). Visit the CEC page devoted to the CCBD Webinar on seclusion and restraint to learn more. Entire teams can register for the price of one and later download the slides for review.

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Virginia mental health needs

Published on 22 January 2012 in Advocacy, Families, Mental health, Musings, News, Policy and The press. 0 Comments Tags: , , , , , , , , .

In a statement entitled “A proposal that would assist troubled youths in Virginia” the Washington Post editorial board lent its support to efforts to fund mental health services for children and youth. The editorial, published 11 January 2012, recounted a history of rueful cost cutting and encouraging advocacy in my commonwealth.

A YEAR AGO, Virginia Gov. Robert F. McDonnell (R) proposed slashing millions of dollars from the state’s already badly fragmented and underfunded programs for at-risk children and teenagers. The cuts targeted funding for specially trained foster families and other services for children, including some who posed a danger of violence to themselves and others. The cuts were rejected, and funding restored, thanks to a bipartisan group of lawmakers responding to an outcry from advocacy groups and local governments, which would have borne the brunt of the governor’s proposal. In the end, the debate turned a useful spotlight on a critical hole in the state’s social services safety net.

The Post editorial team explained that the current budget does not contain such cost-cutting measures, but that difficulties for mental health services persist because of other problems (e.g., local government fiscal shortages). In the end, the need for services is great and, as the editorial shows, the need for serious discussion about funding of them is clear. Read the full editorial on the Post’s Web site.

If you’re in Virginia and you can make it to Richmond, join Voices for Virginia’s Campaign for Children’s Mental Health for “Advocacy Day at the General Assembly” Thursday 26 January 2012. If you live somewhere else, scout about for ways you can help support mental health services in your local or regional government.

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Altering Autism insurance coverage legislation in VA

Published on 30 March 2011 in Autism, Families, News, Policy, The press and Treatment. 0 Comments Tags: , , , , , , , , , , , .

Writing in the Richmond Times Dispatch, Olympia Meola reported on potential changes in support for insurance coverage for therapy for children with Autism in the Commonwealth of Virginia in the US. Under the headline “McDonnell will try to amend autism bill,” Ms. Meola described developments in Governor Robert “Bob” McDonnell’s plans for altering recent legislation requiring insurance payments for treatment.

Gov. Bob McDonnell is expected today to reveal proposed changes to a bill requiring insurance coverage of autism treatments, and some could be substantial alterations to what the General Assembly passed.

Conversations were continuing as of Tuesday between the governor’s office, lawmakers and interested parties about possible changes to a measure that would require coverage of autistic children ages 2 to 6.

Advocates of the bill said some significant tweaks could be “deal breakers.”

The amendments floated in the past week range in scope, from technical to more substantial, including changes in who could supervise treatment and when the law would take effect, according to those familiar with the proposals.

Link to Ms. Meola’s story.

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Autism legislation in Virginia

Published on 6 February 2011 in Autism, Families, News, Policy and The press. 0 Comments Tags: , , , , , , .

Under the headline “Autism legislation advances in Virginia” in the Washington Post Fredrick Kunkle and Anita Kumar reported about the slow-but-significant progress that parents in the US state of Virginia have made in advancing toward mandating coverage of treatment for Autism by insurance companies. That the advances run counter to many conservative US legislators’ opposition to health policies that mandate coverage for those in need of services and that it is occuring in an election year in Virginia, a state that usually tilts toward the conservative, makes the analysis especially intriguing.

In the beginning, several Northern Virginia families whose children have autism thought that their wrenching stories would be enough to get some help from their representatives in the General Assembly.
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NAS presses MH pubs

Published on 25 January 2011 in Bookshelf, Mental health, News, Policy and The press. 0 Comments Tags: , , , , , .

Noting recent news in the US, the National Academy of Sciences has taken the opportunity to promote some of its publications related to mental health. Among these is one that is relevant to those concerned about EBD among children and youths, a 2009 report by the Institute of Medicine and National Research Council that I’ve mentioned previously, Preventing Mental, Emotional, and Behavioral Disorders Among Young People. Here’s the full release:

Mental Health Care Gains Attention in Wake of Tucson Shooting

By Christine Stencel

January 21, 2011 – The attack on U.S. Rep. Gabrielle Giffords and her audience in Tucson, Ariz., has touched off a national discussion about the capabilities of the country’s mental health system. The majority of respondents to a USA Today-Gallup Poll survey said failure of the mental health system bears “a great deal” of the blame for the Tucson shooting. Two reports from the Institute of Medicine and National Research Council provide guidance on improving mental health care in the United States.

Preventing Mental, Emotional, and Behavioral Disorders Among Young People, a 2009 report by the Institute of Medicine and National Research Council, calls for national leadership in the prevention of these disorders and promotion of young people’s mental health. Many preventive programs and strategies have been shown to be effective, the report notes, but the country lacks priorities and public goals for these efforts. The report outlines steps that federal and state agencies, community groups, and parents can take to intervene when symptoms arise and to promote mental health.

Improving the Quality of Health Care for Mental and Substance-Use Conditions, an earlier report from the Institute of Medicine, underscored the need for greater parity for care of mental conditions and substance abuse in the nation’s health care system. The separation of mental health from other forms of medical care undermines the overall quality of Americans’ well-being, it says. The report outlines an agenda to capitalize on recent advances in diagnosing and treating these conditions and better integrate them into the health care delivery system.

Link to the NAS Web site for appropriate links to the documents.

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The Congressional Mental Health Caucus

Published on 17 January 2011 in Mental health, News, Policy and The press. 0 Comments Tags: , , , , , , , , .

Sadly, mental health has been in the US news of late. I’m reminded that in the US legislature there is the Congressional Mental Health Caucus, which takes as its goals reducing negativism and stigma, aiding efforts to access mental health services, improving work-related productivity, and protecting veterans who have mental health problems. Although the caucus does not explicitly state child mental health as a focus of concern, it has supported awareness efforts such as National Children’s Mental Health Day.
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Mental Health Initiative

Published on 9 November 2010 in Autism, Depression, Families, Musings, News, Policy, Schizophrenia and Treatment. 0 Comments Tags: , , .

Sometimes folks lose sight of the fact that disability and mental health issues are international in scope. They’re not confined just to one’s own neighborhood, locality, geopolitical area, etc. Fortunately, there are groups that transcend borders (you can probably think of the names of some well-know organizations that function internationally), and there are some in EBD, too. The Open Society Mental Health Initiative is an example:

The OSI Public Health Program’s Mental Health Initiative aims to ensure that people with mental disabilities (mental health problems and/or intellectual disabilities) are able to live as equal citizens in the community and to participate in society with full respect for their human rights. The Mental Health Initiative focuses on ending the unjustified and inappropriate institutionalization of people with mental disabilities by advocating for the closure of institutions and the development of community-based alternatives. The initiative works in Central and Eastern Europe and the former Soviet Union (read more about the history of mental health policies in this region).

The OSI initiative is more than a one-trick pony. It’s about a lot of things, and its foci include children with Autism, mental health issues, and more. I encourage readers to check the site. Here is a link to the OSI MHI home page.

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Props for Ron Artest

Published on 8 November 2010 in Bullying, News, Policy and The press. 0 Comments Tags: , , , , .

Some readers of EBD Blog might know that I follow basketball. That gives me a unique opportunity to mix my interest in hoops with my concern about EBD in this post. I have the chance to acknowledge efforts by Ron Artest, a professional basketball player, to support mental health initiatives. My hat’s off to Mr. Artest for using his celebrity in this helpful manner.

Let me provide a little detail. In one of these efforts, Mr. Artest announced plans to use the ring he received as a member of Los Angeles Lakers when they won the 2010 National Basketball Association championship in a fund-raising raffle for mental health work. Interested readers can learn how to buy raffle tickets here. But that’s only one activity. To read about them all, follow this link. In fact, if one really wants to learn how substantial Mr. Artest’s impact has been, wade through the results of this Google search showing the press coverage of his efforts.

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If we ignore problems, they don’t go away

Published on 20 September 2010 in Administration, Families, Musings, News, Policy, The press and Treatment. 3 Comments

Ignoring children’s mental health problems will just make things worse. Left to their own devices, very few kids are likely to work things out independently. And a lot more problems exist than we might like to admit exist.

The schools in Virginia identify about 1 student in every 100 students as needing special education services because she or he has emotional or behavioral disorders. Yet, the Virginia Department of Behavioral Health and Developmental Services estimates that 1 in every 5 children will need mental health services. To be sure, not every child who needs mental health services will need special education services, and vice versa. Still, the discrepancy between these numbers illustrates the enormous gaps in recognition of needs and provision of help for children that different agencies offer. Greater coordination and collaboration are important. It should start with understanding and communication. Case management, wrap-around services, and similar practices would be fine results of such communication.

Not all mental health problems are manifested in destructive, overt, disobedient actions. Nor are all mental health problems hidden, repressed, anxiety disorders. They come in lots of shapes and sizes, affect children across the intellectual spectrum, are not confined to any particular ethnic group (nor is any ethnic group immune to them). Mental health problems can strike anywhere, rarely briefly and too often for a lifetime.

Don’t ignore. Deal.

In Virginia (US) we are fortunate to have the Campaign for Children’s Mental Health. Visit this effort to promote awareness and encourage policy makers to recognize the need for action on behalf of children. Learn about the many marvelous organizations that have supported the work of the Campaign for Children’s Mental Health. If you have an organization in your geographical region (whether it is a locality in the US or elsewhere on Earth [or even in the cosmos!]), drop a note in a comment recognizing it, please. Meanwhile, over in the left rail, please check out NAMI, FFCMH, and other Web resources related to children’s mental health.

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Another photo for fun

Published on 14 September 2010 in Acting in, Acting out, ADHD, Administration, Assessment, Autism, Behavior management, Bi-polar, Bullying, Conduct disorder, Delinquency, Depression, Families, Photos, Policy, Prevention, Professsional development, Research, Schizophrenia and Treatment. 0 Comments Tags: , , , .

I was moving some materials from one office to another when I came across this photo of some friends. Believe it or not, I took this with a film camera. Yes, it is from the 1990s, even before 1997 or so, I think.

I suspect it was at one of the annual meetings in Tempe (AZ, US) of the Teacher Educators of Children with Behavior Disorders, as these are some of the usual suspects who attended those meetings. A casual search on any of these folks’ names will reveal that they are prominent contributors to the literature about improving the lives of children and youths with Emotional and Behavioral Disorders, the families of those children and youths, other students who do and do not have disabilities, their teachers and administrators, and on and on. Students who studied just these people’s writing in detail would get quite a valuable education.

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