Download Mental Retardation, Giftedness, and Emotional Behavioral Disorder

Mental Retardation,
Giftedness, and Emotional
Behavioral Disorder
Lizamarie CampoamorOlegario
Core Features of Abnormal
Behavior (Mental Illness)
• Maladaptive Behavior
– maladaptive to one’s self
• inability to reach goals and
• to adapt to life’s demands
– maladaptive to society
• interferes, disrupts social group functioning
• Loss of ability to control
– thoughts, behaviors, or feelings adequately
• Mental Disorder
– Significant impairment in psychological
functioning
Disability %
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Specific learning disabilities 51.1
Speech/Lang. impairments 20.8
Mental retardation 11.6
Serious emotional disturbance 8.7
Visual impairments .5
Autism .5
Deaf-blindness < 0.1
MENTAL RETARDATION
Mental Retardation
• Intellectual Disability
– Politically more correct
• Significantly sub-average Intelligence
– benchmark is below 70 IQ
• Onset before age 18
• Affects about 1% of general population
• Note: Cannot use IQ alone to diagnose
MR
Mental Retardation
• Significant impairment in at least 2 adaptive skills areas:
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Daily Living Skills
Personal Social Skills
Occupational Skills
Communication
Self-Care
Home Living
Social Skills
Community Use
Self-Direction
Health and Safety
Functional Academics
Leisure
Work
Categories of Mental
Retardation
• Mild (IQ 70-50)
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About 85% of persons with MR
Focus on basic academics
Good vocational prognosis
Can achieve success at about
the 6th grade
– MA is upto 12 yrs old only
Categories of MR
• Moderate (IQ 35-50)
– Focus on self-help skills,
low-level vocational
training, sheltered
workshops
– Some independence possible
– MA is upto 7 yrs old only
• Severe (IQ 20-35) & Profound (IQ < 20)
– Custodial care - basic living skills
– MA is upto 3 yrs old only
Causes/ Risk Factors
• Mild MR: socio-cultural and family
environment
• Socio-Cultural Conditions
– Poverty, homelessness, overcrowding,
stressful living conditions, nutritional
insufficiency
• Family Environment
– Parents who are immature, mentally ill,
abusive, or criminal; poor child discipline;
severe marital or relationship problems
Causes/ Risk Factors
• More severe MR: genetic and other
organic factors
• Heritability of intelligence - 50%
• Prenatal infections and toxic substances
– Fetal alcohol syndrome or
milder fetal alcohol symptoms
– Fetal addiction/ drug use
– Smoking
– Exposure to lead and mercury
– Untreated maternal high
blood pressure or diabetes
Causes/ Risk Factors
• Infections (TORCH)
– Toxoplasma infection (toxoplasmosis)
• mostly associated with cats, undercooked meats
– Other infections
• Hepatitis B, syphilis, and the virus that causes
chicken pox, herpes zoster.
– Rubella/ German measles
– Cytomegalovirus/ mononucleosis
– Herpes simplex, sexually transmitted disease
• Birth injuries: hypoxia, intracranial
hemorrhage
Causes/ Risk Factors
• Head traumas: shaken baby syndrome
• Chromosomal Abnormalities
– Phenylketonuria (PKU)
• inability to metabolize
phenylalanine
– Turner’s syndrome (XO)
• females having a single
x chromosome
– Down’s syndrome or
trisomy 21
Causes/ Risk Factors
– Klinefelter’s syndrome
• xxy appears in the
23rd chromosome in males
– XYY
• abnormally large aggressive males who may
become aggressive criminals
– trisomy 13 (Palau’s syndrome)
– trisomy 18 (Edward’s syndrome)
– Triple x, – 1:1000 to 2000 females
Causes/ Risk Factors
• Metabolic and Other Birth Defects
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Biotinidase deficiency
Galactosemia
Homocystinuria
Maple Syrup Urine Disease (MSUD)
PKU (phenylketonuria)
Tyrosinemia
Congenital Hypothyroidism
Sickle cell disease
Toxoplasmosis
Duchenne muscular dystrophy
“Behavioral” Difficulties
• Environmental
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inappropriate school setting
bullying
social outcast
domestic violence
physical/ sexual abuse
insecure family situation
loss of important caregivers/ supports
• Medical
– seizures
– other undiagnosed medical illnesses
“Behavioral” Difficulties
• Psychiatric Illness
– Much higher incidence
than for general child
population
– 27% to 71% of
children with MR have
one or more co-morbid
psychiatric diagnoses
– Prevalence is
underestimated
– Psychopathology is
more likely to cause
IEP Goals and Objectives
• Focus on habilitation
– i.e., skills for successful adult living
• “…daily life, citizenship, and future career”
• Emphasize Functional Academics
– remember: prompts, additional direct
instruction & extra guided practice
• Functional Practice Activities
– address skill areas for adult expected
outcomes
IEP Goals and Objectives
• Functional reading
– Signs, newspapers, magazines, menus,
schedules, phone book, advertisements,
directions, labels
• Functional writing
– Shopping list, notes, email, letters, job
application, forms, messages
• Functional math
– Purchasing, budgeting, comparison
shopping, banking, using a credit card, food
preparation, measurement, time
IEP Goals and Objectives
• Improving General Work Habits
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Attendance and punctuality
Work completion & quality
Working with others
Following directions
Working at a satisfactory rate
Accepting supervision
Demonstrating occupational safety skills
Inclusion of student with
Severe Disabilities
• Six Principles
– Parental involvement essential
– Students with MR can receive positive
academic and learning outcomes
– Students with MR realize acceptance,
interactions, and friendships
– Positive outcomes accrue to students without
disabilities (e.g., Educating Peter)
– Collaborative efforts between school
personnel is essential for success
– Curricular adaptations are vital
GIFTEDNESS
What is “Gifted?”
• Traditional Definition
– IQ > 130
– Top 2.2% of Population
– Superior mental ability requiring
differentiated instruction/curriculum
• Problems
– IQ testing culturally biased, difficult/costly
to administer
– More expansive definition needed to provide
services for children who may not fit into
traditional idea of giftedness
What is “Gifted?”
• Contemporary Definitions
– Gardner’s Multiple
Intelligences
– Sternberg’s Triarchic Theory
• Analytic Giftedness
– Intellectual Abilities/ Problem
Solving
• Synthetic Giftedness
– Creativity/ Insightfulness/
Intuition
• Practical Giftedness
– Applying above to everyday
situations
• Definitions vary
Giftedness Can Be Seen
Through Any of These
• Can operate on multiple brain channels
simultaneously and process more than
one task at a time
• Has a passionate interest in one or more
topics, and would spend all available
time learning more about that topic if he
or she could
• Is able to deal with concepts that are too
complex and abstract for age peers
Giftedness Can Be Seen
Through Any of These
• Learns new material faster, and at an
earlier age, than age peers
• Remembers what has been learned,
making review unnecessary.
Some early signs of giftedness
• Abstract reasoning &
problem-solving skills
• Advanced progression through
developmental milestones
• Curiosity
• Early & extensive language development
• Early recognition of caretakers
(for example, smiling)
• Enjoyment and speed of learning
• Excellent sense of humor
• Extraordinary memory
Some early signs of giftedness
• High activity level
• Intense reactions to noise, pain, or
frustration
• Less need for sleep in infancy
• Long attention span
• Sensitivity and compassion
• Perfectionism
• Unusual alertness in infancy
• Vivid imagination
(for example, imaginary companions)
Skills demonstrated by gifted
and average children
Gifted
Average
Recognized Letters by Age 2
56%
33%
Recognized First Word by Age 2
31%
15%
Sight Read Easy Reader by Age 4
50%
22%
Sounded Out New Words by Age 4
42%
13%
Solved a 20-Piece Puzzle by Age 3
81%
49%
Showed an Interest in Time by Age 2
24%
5%
Told Time in Hours by Age 5
61%
28%
Counted to Ten by Age 3
52%
24%
High Degree of Math Understanding
40%
8%
Comparison of Gifted Children
and Bright Children
A Bright Child:
A Gifted Learner:
Knows the answers
Asks the questions
Is interested
Is highly curious
Is attentive
Is mentally and physically
involved
Has good ideas
Has wild, silly ideas
Works hard
Plays around, yet tests well
Answers the questions
Discusses in detail,
elaborates
Comparison of Gifted Children
and Bright Children
A Bright Child:
A Gifted Learner:
Top group
Beyond the group
Listens with interest
Shows strong
feeling & opinions
Learns with ease
Already knows
6-8 repetitions for
mastery
Understands ideas
1-2 repetitions for
mastery
Constructs abstractions
Enjoys peers
Prefers adults
Comparison of Gifted Children
and Bright Children
A Bright Child:
A Gifted Learner:
Grasps the meaning
Draws inferences
Completes
assignments
Initiates projects
Is receptive
Is intense
Copies accurately
Creates a new design
Enjoys school
Enjoys learning
Absorbs information
Manipulates information
Comparison of Gifted Children
and Bright Children
A Bright Child:
A Gifted Learner:
Technician
Inventor
Good memorizer
Good memorizer
Enjoys sequential
presentation
Thrives on complexity
Is alert
Is keenly observant
Is pleased with own
learning
Is highly self-critical
Other Characteristics of the
Gifted
• First-borns and only children
more likely to be identified as gifted
• Children of gifted parents
• Visual-spatial learners
more prevalent
• Approx. 1/6 of gifted children have some
sort of co-morbid learning disability
– Dyslexia, ADHD, Central Auditory
Processing Disorder
– making identification difficult
Other Characteristics of the
Gifted
• More likely to be introverted than
general population
• Asynchronous development
– May be advanced in one or more areas and
behind in another
– Exacerbated by heightened emotional
intensity often found in gifted children
• Csikszentmihalyi’s “Flow” Theory
Other Characteristics of the
Gifted
• “Overexcitabilites”
• Too creative” for
IQ tests
Issues gifted children and
adolescents face
• Understanding and accepting
what it means to be gifted
• Evaluating one’s life relative to
different measures of success
• Recognizing the difference bet.
“better at” & “better than.”
• Coping with the frustration of
having too many options
Issues gifted children and
adolescents face
• Overcoming the barriers of others’
expectations (No matter how well they
do, there is always someone telling them
they could have done better)
• Understanding the concept of
asynchronous development
(Being a child with the intellectual ability
of an adult.)
• Becoming an advocate for one’s own
self-interests.
• Understanding the role of socialization.
Things Parents Can Do…
• Evaluate your parenting style
– focus on positive aspects of behavior
– allow for unstructured time
– balance permissiveness with authority.
• Discipline doesn't have to be negative
• Provide an enriched environment
• In order to avoid stress, children need to
– be physically fit and learn to relax
– learn to break tasks into manageable bites
– need to have positive role models
Things Parents Can Do…
• Creativity requires a nurturing,
expressive climate
• Help your child learn critical thinking,
problem solving, and study skills
• Make learning fun
Things that Hinder Creativity
in Gifted Children
• Insisting that children do things the
"right way"
• Pressuring children to be realistic, to
stop imagining
• Making comparisons with other children
• Discouraging children's curiosity
Problems Associated with
Characteristic Strengths
Strengths
Possible Problems
Acquires and retains
information quickly.
Impatient with slowness of
others; dislikes routine and
drill; may resist mastering
foundational skills; may make
concepts unduly complex.
Asks embarrassing questions;
Inquisitive attitude, intellectual
strong-willed; resists direction;
curiosity; intrinsic motivation;
seems excessive in interests;
searching for significance.
expects same of others.
Ability to conceptualize,
abstract, synthesize; enjoys
problem-solving and
intellectual activity.
Rejects or omits details;
resists practice or drill;
questions teaching
procedures.
Problems Associated with
Characteristic Strengths
Strengths
Possible Problems
Can see cause--effect
relations.
Difficulty accepting the
illogical-such as feelings,
traditions, or matters to be
taken on faith.
Love of truth, equity, and
fair play.
Difficulty in being practical;
worry about humanitarian
concerns.
Enjoys organizing things
and people into structure
and order; seeks to
systematize.
Constructs complicated
rules or systems; may be
seen as bossy, rude, or
domineering.
Problems Associated with
Characteristic Strengths
Strengths
Possible Problems
May use words to escape or
Large vocabulary and facile
avoid situations; becomes
verbal proficiency; broad
bored with school and ageinformation in advanced
peers; seen by others as a
areas.
"know it all."
Critical or intolerant toward
Thinks critically; has high
others; may become
expectancies; is self-critical
discouraged or depressed;
and evaluates others.
perfectionistic.
Keen observer; willing to
Overly intense focus;
consider the unusual; open
occasional gullibility.
to new experiences.
Problems Associated with
Characteristic Strengths
Strengths
Possible Problems
Creative and inventive; likes
new ways of doing things.
May disrupt plans or reject
what is already known; seen
by others as different and out
of step.
Intense concentration; long
attention span in areas of
interest; goal-directed
behavior; persistence.
Resists interruption; neglects
duties or people during period
of focused interests;
stubbornness.
Sensitivity, empathy for
others; desire to be accepted
by others.
Sensitivity to criticism or peer
rejection; expects others to
have similar values; need for
success and recognition; may
feel different and alienated.
Problems Associated with
Characteristic Strengths
Strengths
Possible Problems
High energy, alertness,
eagerness; periods of
intense efforts.
Frustration with inactivity;
eagerness may disrupt
others' schedules; needs
continual stimulation; may
be seen as hyperactive.
Independent; prefers
May reject parent or peer
individualized work; reliant input; non-conformity; may
on self.
be unconventional.
Diverse interests and
abilities; versatility.
May appear scattered and
disorganized; frustrations
over lack of time; others
may expect continual
competence.
Problems Associated with
Characteristic Strengths
Strengths
Possible Problems
Strong sense of humor.
Sees absurdities of
situations; humor may not
be understood by peers;
may become "class clown"
to gain attention.
Adapted from Clark (1992) and Seagoe (1974)
Famous gifted people
• Albert Einstein
– was always at the top of his class
– but hated school because of strict rules and
rote learning
– one of his greatest works, the theory of
relativity
• Thomas Alva Edison
– greatest inventor of all time
light bulb and the phonograph
– teachers complained his inattentiveness
Famous gifted people
• Leonardo Da Vinci
– the quintessential Renaissance Man
– an engineer and a painter, a mathematician
and a musician, a writer and an architect
– had more talent than his masters, but he
owed his learning to them
School Factors that Fail Gifted
Students (Hansen & Toso,
2007)
• Lessons that don't engage their interests
• Lack of meaningful relationships with
teachers
• Detachment from classmates
– A gifted child is still a child
– Acceptance from those around them
• Economic Status
• Interpersonal Relationships
– Giftedness does not always come with a high
social aptitude
School Factors that Fail Gifted
Students (Hansen & Toso,
2007)
• Experience of Loss
– death of one family member or the divorce
of parents Isolation
• Isolation
– Gifted students that fall behind don't
associate with the group of high achievers
Strategies for Teaching Gifted
and Talented Students
• Create alternative activities that go
beyond the regular curriculum.
• Work with students to design an
independent project that they would be
interested in completing for credit.
• If possible, involve students in academic
competitions in your area.
• Create tiered assignments, which have
different expectations for different levels
of learners.
Common Myths
• Gifted students do not need help.
• The social and emotional development of
the gifted student is at the same level as
his/her intellectual development.
• Gifted students need to serve as
examples to others, and they should
always assume extra responsibility.
• Gifted students are naturally creative
and do not need encouragement.
EMOTIONAL BEHAVIORAL
DISORDER
Emotional & Behavioral
Disorders (EBD)
• a condition in which
behavioral or emotional
responses of an individual
are so significantly different
in degree and/ or kind from
his/her generally accepted
age appropriate, ethnic, or
cultural norms
Emotional & Behavioral
Disorders (EBD)
• adversely affect
performance in one
or more areas
– self-care
– social relationships
personal
adjustment
– academic progress
– classroom
behaviors
– work adjustment
Emotional & Behavioral
Disorders (EBD)
• The child/ youth demonstrates four
(4) or more of the following:
– An inability to establish or maintain
satisfactory relationships with peers
or adults
– A general mood of unhappiness
– Inappropriate behavior or
feeling under ordinary
conditions
Emotional & Behavioral
Disorders (EBD)
– Continued difficulty in coping with
the learning remedial intervention
– Physical symptoms or fears associated
with personal or school problems
– Difficulties in accepting the realities of
personal responsibility accountability
– The behavior is a danger to himself,
other people, or property
Emotional & Behavioral
Disorders (EBD)
• All five of these qualifiers must
exist:
– Behavior significantly different in
degree and/ or kind from applicable
normative data
– Behavior is adversely affecting
educational performance in one or
more areas
Behavior is not a transient response
to stressors in the student’s
environment
Emotional & Behavioral
Disorders (EBD)
– Behavior persists after intervention
and support
– Behavior is displayed in multiple
environments, one of which must be in
school
A Note on Terminology
• No generally agreed-on definition
• Variety of terms:
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emotionally disturbed
socially maladjusted
psychologically disordered
emotionally handicapped
Psychotic
serious emotionally disturbed
• The term behavior disorder is currently
and more frequently being used by many
professional and parents
Prevalence of EBD
• 2% of the school-age population
(USDOE estimate)
• More males than females
• Older students identified more than
younger
• Poverty appears to double the risk of
EBD
• African American males are
overrepresented
Causes of Emotional Disorders
• Biological Factors
– genetic, neurological, or
biochemical
– prenatal drug exposure
• Environmental Factors
– (a) an adverse early rearing
environment
– (b) an aggressive pattern of
behavior displayed on
entering school
– (c) social rejection by peers.
Causes of Emotional Disorders
• Family
– child abuse
– disrupted
• Society
– impoverished
environment,
including poor
nutrition
– a sense of frustration
and hopelessness
Classification of EDB
(DSM-IV)
• Disruptive or
externalizing behavior
– attention-deficit
hyperactivity disorder
– conduct disorder
– oppositional defiant
disorder
• Emotional or
internalizing behavior
– anxiety
– Depression
Classification of EDB
(DSM-IV)
• Other disorders that do
not fit into this
classification system
– Autism
– Schizophrenia
– Eating disorders
Externalizing behavior
disorders
• Conduct disorder
(disruptive behavior)
– a repetitive and persistent
pattern of behavior in which
the basic rights of others or
major age-appropriate
societal norms or rules are
violated, as manifested by
the presence of three or
more of the following
criteria in the past 12
months, with at least one in
the past 6 months:
Externalizing behavior
disorders: Conduct Disorder
• Aggression to people or animals
– often bullies, threatens, or intimidates
– often initiates physical fights
– has used a weapon that can cause physical
harm to others (bat, brick, broken bottle,
knife, gun, etc.)
– has been physically cruel to people
– has been physically cruel to animals
– has stolen while confronting a victim (e.g.,
mugging, purse snatching, extortion, armed
robbery)
– has forced someone into sexual activity
Externalizing behavior
disorders: Conduct Disorder
• Destruction of property
– has deliberately engaged in fire setting w/ the
intention of causing serious damage
– has deliberately destroyed another's
property (other than setting fire)
• Deceitfulness or theft
– has broken into someone else's home,
building, or car
– often lies to obtain goods or favors or
to avoid obligations
– has stolen items of nontrivial value
without confronting a victim
(shoplifting, forgery, etc.)
Externalizing behavior
disorders: Conduct Disorder
• serious violation of rules
– often stays out at night despite parental
prohibitions, beginning before age 13
– has run away from home overnight at least twice
while living in parental or parental surrogate home
(or once without returning for a lengthy period)
– is often truant from school, beginning before age
13.
– The disturbance in behavior causes clinically
significant impairment in social, academic or
occupational functioning.
– If the individual is age 18 years or older,
criteria are not met for antisocial personality
disorder.
Externalizing behavior
disorders
• Oppositional defiant disorder (ODD)
– less severe form of Conduct disorder.
– a pattern of negativistic, hostile, and defiant
behavior lasting at least 6 months, during
which 4 or more of the following are
present:
• often loses temper
• often argues with adults
• often actively defies or refuses to comply with
adult's requests or rules
• often deliberately annoys people
• often blames others for his or her mistakes or
behavior.
• is often touchy or easily annoyed by others
Externalizing behavior
disorders
• is often angry and resentful
• is often spiteful or vindictive
– The disturbance in behavior causes clinically
significant impairment in social, academic,
or occupational functioning.
– The behaviors do not occur exclusively
during the course of a Psychotic or mood
disorder.
– Criteria are not met for Conduct Disorder,
and, if the individual is 18 years or older,
criteria are not met for Antisocial
Personality Disorder.
Internalizing behavior
disorders
• Anxiety disorders
– General Anxiety
• anxiety and excessive worry
most of the time, present six months or more
• lives in a state of constant nervousness
• usually overreact to any type of stress
• have trouble making decisions and when
they actually do, this usually causes
additional worries
– Panic Attack
Internalizing behavior
disorders: Anxiety Disorders
– Phobias
• fear of a specific stimulus or a situation
sufferer usually knows that the fear is irrational
but cannot do anything about it
– Obsessive-Compulsive Disorders (OCD)
• know that their behavior is irrational and
repugnant but are unable to resist
• Obsession: persistent intrusion of unwelcome
thoughts, images, or impulses that cause anxiety
(repeated doubts, requirements to have things in a
specific order, etc.)
• Compulsion: an irresistible urge to carry certain
acts or rituals that reduce anxiety (hand washing,
checking, praying, counting, repeating words
silently, etc.)
Examples of Obsessions
Internalizing behavior
disorders
– Post-Traumatic Stress Disorder (PTSD)
• can develop following exposure to an extremely
traumatic event or series of events in a child’s life,
or witnessing or learning about a death or injury
to someone close to the child
• symptoms must occur within one month after
exposure to the stressful event
• responses include flashbacks, guilt, intense fear,
helplessness, difficulty falling asleep, nightmares,
persistent re-experiencing of the event, numbing
of general responsiveness, or increased arousal.
• may repeat their experience in daily play
activities, or may lose recently acquired skills,
such as toilet training or expressive language
skills.
Internalizing behavior
disorders
• Mood/ Affective
Disorders
– disturbances of normal
mood
– Bipolar disorders
• formerly known as manicdepression
• patient experiences swings
from depression (extreme
sadness) to mania (extreme
happiness) with no
discernable external cause
Internalizing behavior
disorders
– Depressive disorders
• major depressive disorder - in a depressed mood
for most of the day, nearly everyday or has lost
interest or pleasure in all, or almost all activities
for a period of at least 2 weeks
• individual experiences major depressive episode
and depressive characteristics, such as lethargy
and hopelessness, for at least 2 weeks and of the
nine (9) at least two (2) must be present
Internalizing behavior
disorders
– i. depressed mood most of the day
– ii. reduced interest or pleasure in all or most
activities
– iii. significant weight loss or gain, or
significant decrease or interest in appetite
– iv. trouble sleeping or sleeping too much
– v. psychomotor agitation or retardation
– vi. Fatigue or loss of energy
– vii. Feeling worthless or guilty in an excessive
or inappropriate manner
– viii. Problems in thinking,
concentrating, or making decisions
– ix. Recurrent thoughts of suicide or
death
Internalizing behavior
disorders
– Dysthymic disorder
• generally more chronic (continuing in a long time
or recurring) and has fewer symptoms than major
depressive disorder
• symptoms:
– i. no major depression episode during the first 2
years
– ii. depressed mood for at least 2 years not broken
by normal mood more than two months
– iii. two or more of these six symptoms must be
present: poor appetite or overeating, sleep
problems, low energy or fatigue, low self-esteem,
and feeling of hopelessness
Low Incidence Disorders
• occur very infrequently but are quite
serious when they do occur
• Schizophrenia
– 1 percent of the general population
over the age of 18
– characterized by loss of contact with
environment and personality changes
– involves bizarre delusions (such as believing
one's thoughts are controlled by the police)
– hallucinations (such as voices telling one
what to think)
Low Incidence Disorders
– "loosening" of associations (disconnected
thoughts)
– Incoherence, disorganized speech
– Subtypes of schizophrenia
• a. disorganized schizophrenia: individual has
delusions and hallucinations that have little
or no recognizable meaning – hence, labeled
disorganized
• b. catatonic schizophrenia: characterized by
bizarre motor behavior, which sometimes take a
form of a completely immobile stupor
• c. paranoid schizophrenia: characterized by
delusions of reference, or grandeur, and
persecution
• d. undifferentiated schizophrenia: characterized
by disorganized behavior, hallucinations,
delusions, and incoherence
Low Incidence Disorders
• Eating Disorders
– Anorexia nervosa:
the relentless pursuit of thinness
• Person refuses to maintain normal
body weight for age and height
• Weighs 85% or less than what is
expected for age and height
• In women, menstrual periods stop.
In men levels of sex hormones fall.
• often includes depression, irritability, withdrawal,
and peculiar behaviors such as compulsive rituals,
strange eating habits, and division of foods into
"good/safe" and "bad/dangerous" categories
Low Incidence Disorders
– Bulimia nervosa:
the diet-binge-purge disorder
• Person binge eats
• Feels out of control while eating
• Vomits, misuses laxatives, exercises, or
fasts to get rid of the calories
• Diets when not bingeing.
Becomes hungry and binges again
• Believes self-worth requires
being thin
• May shoplift, be promiscuous, and
abuse alcohol, drugs, & credit cards
• put up a brave front, but often
depressed, lonely, ashamed, and
empty inside
Low Incidence Disorders
– Binge eating disorder
• The person binge eats frequently and
repeatedly
• Feels out of control and unable to stop
eating during binges
• May eat rapidly and secretly, or may
snack and nibble all day long.
• Feels guilty and ashamed of binge
eating
• Has a history of diet failures
• Tends to be depressed and obese.
• may eat for emotional reasons: to
comfort themselves, avoid threatening
situations, and numb emotional pain
Low Incidence Disorders
• Eating Disorders
– Pica
• the persistent eating of nonnutritive materials for
at least a month (cloth, string, hair, plastic, plaster
paint, etc.)
• nearly all girls
– Rumination disorder
• repeated regurgitation and rechewing of food
• Onset is typically around adolescence and may be
associated with a stressful event
Low Incidence Disorders
• Tic Disorders
– stereotyped movements or vocalizations that
are involuntary, rapid, and recurring over
time
– may take the form of eye blinking, facial
gestures, sniffing, snorting, repeating certain
words or phrases, or grunting.
– includes Tourette Syndrome
Low Incidence Disorders
• Tourette’s Disorder
– occurs in approximately 4-5 individuals per
10,000
– includes both multiple motor tics and one or
more vocal tics, which occur many times per
day, nearly every day, or intermittently
throughout a period of more than one year.
Low Incidence Disorders
• Selective Mutism
– formerly called Elective-Mutism
– persistent refusal to talk in typical school,
social, or work environments
– usually occurs before the age of five, but
may not be evaluated until a child enters
school for the first time
Low Incidence Disorders
• Adjustment Disorders
– emotional or behavioral symptoms that
children may exhibit when they are unable,
for a time, to appropriately adapt to
stressful events or changes in their lives
– must occur within three months of a
stressful event or change, and last no more
than six months after the stressor ends
– marked distress, in excess of what would be
expected from exposure to the event(s), or an
impairment in social or school functioning.
Some key components of
effective schools
• Consistency of rules, expectations, and
consequences across the school
• Cultural sensitivity
• High level of supervision in all school
settings
• High levels of parent and community
involvement
Some key components of
effective schools
• Positive school climate
• School-wide strategies for resolving
conflict
• Strong feelings of identification and
involvement on the part of students
• Well utilized space and lack of
overcrowding
What to Teach Students with
EBD
• The student may be enrolled in three or
more alternate courses:
–
–
–
–
–
–
self care
social relationships
personal adjustment
anger management
anxiety reduction
behavior control
Ten components to a
preventive discipline program
1. Inform pupils of what is expected of
them
2. Establish a positive learning climate
3. Provide a meaningful learning
experience
4. Avoid threats
5. Demonstrate fairness
6. Build and exhibit self-confidence
Ten components to a
preventive discipline program
7. Recognize positive student attributes
8. Time the recognition of student
attributes
9. Use positive modeling
10. Structure the curriculum & classroom
environment
• Students with emotional disorders do
well in educational programs that stress
positive behavior management, selfdirection, and the development of
interpersonal skills.
Famous People with Mood
Disorders
•
•
•
•
Britney Spears: bipolar unconfirmed
Harrison Ford: depression
Abraham Lincoln: depression
Brooke Shields: postpartum depression
Famous People with Mood
Disorders
• Jim Carrey: depression
• John Denver:
depression
• Diana Princess of
Wales: depression and
bulimia nervosa
• Ludwig Van Beethoven:
bipolar disorder
• Vincent van Gogh:
bipolar disorder