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Emotional and behavioral disturbances represent significant behavioral excesses or deficits. Many labels are used to denote deviant behavior; these labels include: emotionally handicapped or disturbed, behaviorally disordered, socially maladjusted, delinquent, mentally ill, psychotic, and schizophrenic. Each of these terms refers to patterns of behavior that depart significantly from the expectations of others. In recent years, "behavioral disorders" has gained favor over "emotional disturbance" as a more accurate label leading to more objective decision-making and fewer negative connotations. Public Law 94-142 defines serious emotional disturbance (SED) as "a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which adversely affects educational performance: --An inability to learn which cannot be explained by intellectual, sensory, or health factors. --An inability to build or maintain satisfactory interpersonal relationships with peers and teachers. --Inappropriate types of behavior or feelings under normal circumstances. --A general pervasive mood of unhappiness or depression. --A tendency to develop physical symptoms or fears associated with personal or school problems." The federal definition includes children who are diagnosed as schizophrenic, but excludes socially maladjusted children "unless it is determined that they are seriously emotionally disturbed." Although autism was formerly included under the SED designation, in 1981 it was transferred to the category of "other health impaired." In A STUDY OF CHILD VARIANCE, Rhodes and Tracy (1974) identified several conceptual models for understanding emotional and behavioral disorders. Biophysical, psychoanalytical, behavioral, sociological, and ecological models offer different theoretical perspectives on the nature and causes of behavioral deviance. How Many Children are Emotionally Disturbed? Estimates of the number of school-age children and adolescents with emotional or behavioral disorders depend on the definitions and criteria that are used. At some point in their lives, most individuals exhibit behavior that others consider excessive or inappropriate for the circumstances. Thus, frequency, intensity, duration, and context must be considered in making judgments of disturbance. Unlike some other educational disabilities, emotional and behavioral disorders are not necessarily lifelong conditions. Although teachers typically consider 10%-20% of their students as having emotional or behavioral problems, a conservative estimate of the number whose problems are both severe and chronic is 2%-3% of the school-age population. Currently, less than one-half that number are formally identified and receive special education services. What are Typical Patterns of Disordered Behavior? There is considerable agreement about general patterns or types of disordered behavior. Achenbach (1982) suggests two discrete patterns which he calls "externalizers" (aggressive, disruptive, acting out) and "internalizers" (withdrawn, anxious, depressed). Quay (1972) identifies the following four dimensions: - CONDUCT DISORDERS (aggression, disobedience, irritability);
- PERSONALITY DISORDERS (withdrawal, anxiety, physical complaints;
- IMMATURITY (passivity, poor coping, preference for younger playmates); and
- SOCIALIZED DELINQUENCY (involvement in gang subcultures).
In addition to CONDUCT DISORDERS and PERSONALITY PROBLEMS, Rizzo and Zabel (1988) discuss PERVASIVE DEVELOPMENTAL DISORDERS (including autism and childhood schizophrenia) and LEARNING DISORDERS (including attention deficit disorders with hyperactivity). Not all behaviorally disordered students experience academic difficulties, but the two factors are often associated. What Are the Educational Implications? Educational interventions should match the established needs of students with behavioral disorders. Multidisciplinary educational teams, including parents, must design programs to meet the individual behavioral and academic needs of identified SED students. Most students can benefit from supportive treatments provided in regular programs. For others, at least temporary placements in special classrooms, schools, or institutional programs may be appropriate. Special programs usually attempt to provide a "therapeutic milieu," a structured environment where students experience a high degree of success; rules and routines are predictable; and students are consistently rewarded for appropriate behavior. Behavior management techniques, such as positive reinforcement, token economies, contracting, and time-out, which rely on direct measurement and monitoring of behavioral change, are commonly used in SED programs. The assessment and systematic teaching of social skills through modeling, discussion, and rehearsal are frequently used to help students increase control over their behavior and improve their relations with others. In addition, supportive therapies involving music, art, exercise, and relaxation techniques, as well as affective education, individual, and group counseling are sometimes employed to improve self-understanding, self-esteem, and self-control.
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