Emotional Disturbances
Section 300.7c(4) of the Individuals with Disabilities Act (1997) defines Emotional Disturbance as a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:
An inability to learn that 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 term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.
The term emotional disturbance is often used interchangeably with the terms emotional disorder/problem, behavior disorder/disturbance, psychiatric illness, and mental illness/disorder. For more information, visit the Project Inspire information sheet for Mental Disorders, or any of the various links throughout this information sheet.
The symptoms of Emotional Disturbance can include everything from severe anxiety to having strange thoughts and hearing voices that nobody can hear. Following are some of the most common emotional disturbances.
Anxiety disorders: According to the
Anxiety Disorder Association of America "anxiety disorders are the
most common psychiatric illnesses affecting both children and adults". The
association identifies the following categories of anxiety disorders:
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Generalized Anxiety Disorder (GAD). Children with GAD worry excessively and unrealistically for six months or more about a variety things including, but not limited to, grades, performance in sport, and family issues. Adults with GAD chronically worry about health, money, or career. Symptoms for both may include restlessness, muscular tension, insomnia, fatigue, irritability, difficulty concentrating, abdominal upsets, and dizziness. |
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Obsessive-Compulsive Disorder (OCD). Individuals with OCD are troubled by persistent, repeating thoughts (obsessions) of exaggerated fears or worries that lead to the individual performing a ritual or routine (compulsion). An example would be a person who is obsessed with the thought of contamination who compulsively washes his/her hands. |
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Panic Disorder. Panic Disorder sufferers experience severe attacks of panic for no apparent reason, which can simulate a heart attack or mental breakdown. Symptoms may include chest pain, heart palpitations, choking, sweating, trembling, tingling sensations, fear of dying or losing control, and feelings of unreality. |
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Post-Traumatic Stress Disorder (PTSD). Following a traumatic event such as the unexpected death of a loved one, a sexual or physical assault or a catastrophic event such as occurred with the events of 9/11, individuals with PTSD will find themselves reliving the experience through nightmares or flashbacks, avoiding places related to the trauma, and/or detaching themselves from others through emotional numbing, and/or experiencing problems with sleeping, irritability, and poor concentration. Symptoms usually begin within 3 months of the trauma, although sometimes 6 months and even years can pass before the appearance of symptoms. |
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Societal Anxiety Disorder (Social Phobia). SAD is extreme anxiety about being judged by others or behaving in such a way that might cause embarrassment or ridicule. The symptoms include extreme perspiring, blushing, heart palpitations, and faintness. |
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Specific Phobias (fears). Phobics experience excessive fear of a specific object (ie. spiders, snakes) or situation (ie. heights, shots) that is usually inappropriate to the situation and that is recognized by the sufferer as being irrational. A phobia can lead to avoidance of typical everyday situations and is diagnosed if the fear persists for 6 months and interferes with the individual's daily routine. |
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Depression: Depression is an illness that affects many people
of all ages. The Depression
Alliance estimates that one in five people will suffer from depression at
some point in their lives. Depression includes a wide spectrum of physical and
psychological symptoms. Typically individuals will experience 2-3 of the
following symptoms, but not all, for more than 2 weeks:
Feelings of helplessness and hopelessness
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SEVERE DEPRESSION may also include suicidal ideas, failure to eat or drink, and delusions and/or hallucinations. |
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BIPOLAR DISORDER OR MANIC DEPRESSION involves radical mood swings, from "highs" of increased energy and euphoria, but sometimes, irritability and anger (National Schizophrenia Association), to "lows" of hopelessness and lack of energy. |
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POST-PARTUM DEPRESSION is extreme "baby blues" that can last from about 2 weeks to up to 2 years after the birth of a child. |
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SEASONAL AFFECTIVE DISORDER (SAD) is a form of depression that is associated with a lack of sunshine that occurs in higher latitudes where there are long winters and short time spans of sunlight. This type of depression can be treated with exposure to ultraviolet light from light boxes. |
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SCHIZOPHRENIA: Often mistakenly identified as "split personality", or the correct term, "multiple personality", schizophrenia actually means split-mind. The name "was intended to represent the fact that processes of thought, feeling and intention, guiding the person's actions no longer interact to form a coherent whole" (www.rethink.org). Schizophrenia is characterized by unusual activity of the chemical messengers at specific nerve endings in the brain. During an acute episode, what one senses and thinks becomes contorted so that the affected person experiences "positive" symptoms of hallucinations and delusions and/or "negative" symptoms of lethargy and/or indifference. According to the National Schizophrenia Fellowship one in a hundred people experience schizophrenia during their lifetime, but the majority of them will lead ordinary lives with help. |
CAUSES OF EMOTIONAL DISTURBANCES
The causes of emotional disturbances are varied and difficult to determine. They
may develop from a complicated set of risk factors that include genetics,
personality, brain chemistry and life experiences.
TREATMENTS FOR EMOTIONAL DISTURBANCES
If an individual is suffering from the symptoms of one of the above disorders or depression, it is imperative that they seek professional help immediately so that their particular type of emotional disturbance can be diagnosed and appropriate treatment can be recommended. Both professional help and self-help techniques can be effective in preventing or lessening the impact of the specific disturbance.
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PROFESSIONAL ASSISTANCE: Appropriate
treatment of an emotional disturbance begins with a complete psychological
evaluation that includes a review of one's physical health history. A
person's psychologist will ask the physician of record to rule out the
possibility that specific medications and/or medical conditions are
causing the symptoms of emotional disturbance. In addition, the
psychologist will consult with the patient about the nature and history of
the symptoms and follow up that with a mental status evaluation. The
outcome of the psychological diagnostic evaluation will determine the
choice of treatment (Psychology
Information On-line). Following are some different types of
professional treatment for emotional problems:
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SELF-HELP TECHNIQUES: As an individual
with a diagnosed emotional disturbance begins to understand her or his
particular type, she or he can learn some copying skills that may help to
control the symptoms. Some self-help techniques are:
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TEACHING TIPS
Following are some effective teaching strategies for teachers of children with emotional disturbances:
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Structure the class for success |
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Establish class rules that are stated positively (in terms of the appropriate behavior) |
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Have a set routine |
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Organize and plan class for active participation by all; little waiting time |
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De-emphasize competition |
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Reward appropriate behavior |
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Enforce fair and humane consequences for inappropriate behavior (follow the Behavioral Intervention Plan, if available) |
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Provide students with a safe space to be alone so that they can develop skills to control their behavior |
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Exercise caution regarding the use of peer tutors with children with emotional disturbances. |
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Assist all children with the development of the self-help skills listed above |
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In addition, educators of children with emotional disturbances should familiarize themselves with the National SED (Serious Emotional Disturbances) Agenda (U.S. Department of Education, 1994). The seven target areas of the Agenda are: |
Expand Positive Learning Opportunities and Results
Strengthen School and Community Capacity
Value and Address Diversity
Collaborate with Families
Promote Appropriate Assessment
Provide Ongoing Skill Development and Support
Create Comprehensive and Collaborative Systems
Osher, D., Osher, T., and Smith (1994, 10/1) provide an in-depth discussion of the National SED Agenda in "Toward a national perspective in emotional and behavioral disorders: A developmental agenda." www.ccbd.net/pdfs/BeyondBehavior/ACF6F.pdf
REFERENCES
All references used in developing this disability fact sheet have been cited above.
Links
Council for Children with Behavioral Disorders
Information on this sheet contains only suggested guidelines. Each person must be considered individually, and in many cases, a physician's written consent should be obtained.
This disability fact sheet was authored by Cathy Simbeck, a doctoral student at Texas Woman's University and assistant professor at Fort Lewis State College, Durango, CO.