REPORT:

Teachers have the opportunity to observe many different students that come in and out of their classes
each year. These students are all unique in their abilities, interests, and challenges. Some students fit in
well in a mainstream setting, making progress on the core curriculum and forming healthy relationships
with peers.

However, once in a while, teachers will work with students who have severe emotional and behavioral
challenges. These students may seem like loners, avoiding interaction with classmates and adults. They
may get into fights with other students, or engage in self-injurious behaviors. Their academic
performance will be significantly lower than the rest of their peers.

When these symptoms persist, teachers should begin looking into emotional and behavioral disorders
and how these students might qualify for and benefit from special education services.

PPT: "Emotional and Behavioral Disorder" is an umbrella term under which several distinct diagnoses
(such as Anxiety Disorder, Manic-Depressive Disorder, Oppositional-Defiant Disorder, and more) fall.
These disorders are also termed "emotional disturbance" and "emotionally challenged."

Definition & Characteristics

The Individual with Disabilities Education Act of 2004 (IDEA) classifies emotional and behavioral
disorders under a category called emotional disturbance. In order to qualify under emotional
disturbance, a child must exhibit at least one of the following characteristics:

1. The development of physical symptoms related to personal problems

2. Persistent unhappy or depressed moods

3. A lack of personal relationships with peers and adults

4. An inability to learn that isn't caused by another disability

5. Inappropriate behavior or feelings in normal situations

REPORT:

IDEA also clarifies that these characteristics must be observed over a long period of time and adversely
affect a student's performance in school. This means that teachers will see a student's grades and test
scores drop and not recover without special help.

PPT: When a student is classified under emotional disturbance, teachers can expect to see a variety of
challenging behaviors. Some of these characteristics are listed here:

1. A lack of peer relationships due to fear or anxiety

2. Poor attention span

3. Low academic performance

4. Impulsive behaviors

5. Aggression toward self or others

6. Poor coping skills and immaturity

REPORT:

Not every student with an emotional disturbance will exhibit all of these behaviors. Sometimes, these
behaviors change due to different phases of a child's development. The underlying similarity found
among students with emotional disturbances is that these challenging behaviors persist and cannot be
overcome or changed without individualized intervention.

PPT: Before any studies were done on the subject, mental illnesses were often thought to be a form of
demonic possession or witchcraft.

REPORT:

Since much was unknown, there was little to no distinction between the different types of mental illness
and developmental disorders that we refer to today. Most often, they were dealt with by performing an
exorcism on the person exhibiting signs of any mental illness.

PPT: In the early to mid-1800s, asylums were introduced to America and Europe. There, patients were
treated cruelly and often referred to as lunatics by the doctors in the professional fields.

REPORT:

The main focus of asylums was to shun people with mental illnesses from the public.

PPT: In 1963, the Community Mental Health Centers Construction Act (Public Law 88-164), was passed
by Congress and signed by John F. Kennedy, which provided federal funding to community mental
health centers.

REPORT:

This legislation changed the way that mental health services were handled and also led to the closure of
many large asylums. Many laws soon followed assisting more and more people with EBDs.

PPT: 1978 came with the passing of Public Law 94- 142 which required free and public education to all
handicapped children including those with EBDs. An extension of PL 94-142, PL 99-457, was put into act
which would provide services to all handicapped children from the ages of 3-5 by the 1990-91 school
year. PL 94-142 has since been renamed to the Individuals with Disabilities Education Act (IDEA).

What Causes Emotional and Behavioral Disorders?

REPORT:

Emotional and behavioral disorders are so disruptive that parents and others frequently want to know
what causes them. When a child or adolescent consistently has intense emotional or physical outbursts,
their relationships and learning suffer. Adults and other children and teens are also negatively affected
by the eruptions of feelings and problem behaviors.

Biological causes originate within the child or teen. The brain is often the root source of the
development of E/BD. Sometimes there’s a chemical imbalance. Other times, brain development is
affected. Sometimes, too, brain injury leads to problems in the emotional center of the brain.
Experiencing trauma, with or without a diagnosis of posttraumatic stress disorder (PTSD), negatively
affects brain processing and can lead to emotional and behavior problems.

Sometimes, problems with a mother’s pregnancy and delivery can cause damage to an unborn or
newborn baby. These difficulties can contribute to future emotional and behavioral disorders.
Additionally, if a child’s mother used drugs or alcohol during pregnancy, the child is at increased risk of
many physical- and mental health problems, including emotional and behavioral disorders.

Illness is a suspected cause of E/BD. Illnesses or physical disability have been shown to cause or
contribute to disturbances in behavior and emotion. While not an illness, malnourishment has been
implicated in these disorders, too.

Genetics, it seems, also plays a part in the development of E/BD, although the exact link remains
unclear. Perhaps relating to genetics is personality. A child’s ingrained temperament can predispose
them to emotional and behavioral problems and disorders if other circumstances are present.

Developmental Causes of Emotional and Behavioral Disorders

Development refers to the lifelong process of changing and maturing. Every stage of life has tasks that
must be completed successfully for mental health and life satisfaction. When a child’s development is
disrupted and problematic, there can be negative consequences for mental health and cognitive growth.

PPT: Emotional and developmental disorders can spring from these developmental causes:

Attachment problems, REPORT: either lack of positive attachment to the primary caregiver or
overattachment leading to clinginess and difficulties separating from the caregiver

A failure to develop trust during infancy and early toddlerhood, resulting in fear and mistrust

Inability to experience some autonomy and instead internalize a sense of shame for exploring

Thwarted attempts to show initiative and instead made to feel guilty for wanting to try new things

Failure to experience a sense of competence, which leads to feelings of inferiority, during the
elementary years

REPORT: When kids don’t experience success at any one of these developmental tasks, their risk of
developing E/BD increases, and the more developmental problems a child has, the greater the risk for
E/BD.

Causes of Emotional and Behavioral Disorders: Home Life

REPORT: Parents are vital in the healthy development of their children. Some aspects of parenting or
the home environment can contribute to emotional and behavioral disorders. These include:

PPT:

1. Significant, chronic stress in the home

2. Lack of structure
3. Authoritarian parenting style with rigid, excessive rules and punishments
 4. Permissive parenting with few if any expectations, limits, or establishment of acceptable
behaviors
5. Inconsistent expectations and discipline
6. Disinterested, distant parents
7. Abuse
8. Violence and general dysfunction in the home
9. More negative than positive interactions in the home

Learned Behavior: A Cause of Emotional and Behavior Disorders

REPORT: Sometimes, there are no underlying biological or developmental causes of emotional and
behavioral disorders. Instead, children learn that outbursts get them what they want and need—
attention from the adults in their lives. Ways they learn this include:

PPT:

1. High levels of negativity and pessimism modeled in the home

2. Associating punishment for behavior problems with receiving more attention
3. Realizing that acting out is the only way to receive a response from parents or teachers

REPORT: Multiple factors are potential causes of emotional and behavioral disorders. Knowing how
biology, development, and parenting and the home environment contribute to E/BD will help you take
measures to give your kids positive experiences from birth (or prenatally) through the child and teen
years.

WHAT ARE THE TYPES OF BEHAVIORAL DISORDERS?

PPT: An anxiety disorder is a common mental illness defined by feelings of uneasiness, worry and fear.
REPORT: While anxiety occurs for everyone sometimes, a person with an anxiety disorder feels an
inappropriate amount of anxiety more often than is reasonable. For example, an average individual may
feel some anxiety before going to a dentist appointment but a person with anxiety disorder may feel
anxiety every time, they leave their home.

What are Anxiety Disorders Symptoms?

PPT: Specific symptoms vary by type of anxiety disorder, but typically, anxiety disorders are defined by:

1. Feelings of being on edge or restlessness

2. Feelings of being fearful or powerless
3. Physical symptoms such as muscle tension, sweating or heart palpitations
4. A sense of doom or impending danger
5. Difficulty concentrating or mind going blank
6. Irritability
7. Sleep disturbances

REPORT: The definition of an anxiety disorder also includes an impairment of day-to-day functioning. A
person with an anxiety disorder often experiences a significantly reduced quality of life and anxiety
disorders are associated with possibly fatal heart conditions.

PPT: Types of Anxiety Disorders

Several types of anxiety disorders are identified in the latest version of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV-TR).

1. Obsessive-compulsive disorder (OCD)

2. Generalized anxiety disorder (GAD)
3. Panic disorder
4. Posttraumatic stress disorder (PTSD)
5. Agoraphobia
6. Social phobia, also referred to as social anxiety disorder
7. Specific phobia (also known as a simple phobia)
8. Adjustment disorder with anxious features
9. Acute stress disorder
10. Substance-induced anxiety disorder
11. Anxiety due to a general medical condition

REPORT: Social phobia is the most common anxiety disorder and typically manifests before the age of
20. Specific, or simple phobias – such as a fear of snakes – are also very common with more than one-in-
ten people experiencing a specific phobia in their lifetime.

PPT: Anxiety Disorder Treatment

Anxiety disorder treatment is typically in the form of psychotherapy and is sometimes combined with
medication.

REPORT: Anxiety disorders often occur with other disorders such a substance use disorder, so anxiety
disorder treatment often includes the treatment for those disorders as well. Education about mental
illness, anxiety disorders in particular, and lifestyle changes are often crucial to the success of anxiety
disorder treatment.

PPT: Bipolar Disorder Definition – Moods

Bipolar disorder is characterized by periods of highly elevated or irritated mood and energy, known as
manic or hypomanic moods depending on their severity.

REPORT: These alternate with periods of very deep, profound, low mood and energy, known as
depressed moods. Symptoms of depression can cooccur alongside the symptoms of mania or
hypomania and these are known as mixed moods. It is also possible to have periods of time where few,
if any, symptoms are present and these are known as euthymic moods.

PPT: A mood that meets the following criteria is known as an “episode.”

PPT: Bipolar Disorder Criteria

Of course, just experiencing one instance of depression doesn’t qualify as bipolar disorder. The following
are the bipolar disorder criteria:

1. If a person experiences both depressions and manias, this is known as bipolar type I.
2. If a person experiences both depressions and hypo manias (less severe than manias), then this is
known as bipolar type II.
 3. Individuals who experience symptoms of depression and hypomanic episodes but do not meet
the full criteria for their diagnosis are given a diagnosis of cyclothymia (considered less severe
than bipolar disorder types I and II).
4. It is also possible to have a form of bipolar disorder that doesn’t neatly fit into the above
categories but, at the doctor’s discretion, still warrants a bipolar disorder diagnosis, and this is
known as an “other bipolar and related disorder.”

Treatment of Bipolar Disorder

Bipolar depression treatment is usually a long-term approach. Mood stabilization, symptom reduction,
and the development of coping strategies is best done with a combination of medication and
psychotherapy.

REPORT: Medication and psychotherapy are the primary approaches to treat bipolar depression;
however, other treatments exist that can augment medication and therapy. These include
complementary treatments like light therapy, brain stimulation procedures, peer support, and lifestyle
changes.

PPT: Obsessive-Compulsive Disorder

Often referred to as OCD, obsessive-compulsive disorder is actually considered an anxiety disorder

(which was discussed earlier in this fact sheet). OCD is characterized by recurrent, unwanted thoughts
(obsessions) and/or repetitive behaviors (compulsions).

REPORT: Repetitive behaviors (handwashing, counting, checking, or cleaning) are often performed with
the hope of preventing obsessive thoughts or making them go away. Performing these so-called
“rituals,” however, provides only temporary relief, and not performing them markedly increases anxiety.

Thoughts and Rituals of Obsessive-Compulsive Disorder

REPORT: The rituals of those with obsessive-compulsive disorder result out of an attempt to stop the
obsessive thoughts associated with OCD. Everyone goes back, on occasion, to verify that they've turned
off the oven, locked the car or front door. But for those with OCD, these compulsions become extremely
excessive, interfering with normal life. The person may or may not realize that his or her thoughts and
behaviors are excessive, but even those who realize that their behavior doesn't make sense cave into
the compulsive ritual.

PPT: Common-obsessive thoughts include:

1. Fear of contamination by germs or harmful substances

2. Fear of harming others or self (REPORT: i.e. accidentally starting a fire)
3. Unwanted sexual thoughts
4. Unwanted religious thoughts (REPORT: i.e. sacrilegious images of Christ or blasphemous
thoughts)
5. Need for symmetry or exactness (REPORT: i.e. need to line up objects, such as toys or
magazines on a table)
6. Unwanted urge to harm another
Common compulsions include:

1. Ritual hand washing

2. Excessive cleaning (REPORT: i.e. house or office)
3. Ordering and arranging objects
4. Repetitive activities (REPORT: i.e. walking in and out a door, opening and shutting a cabinet or
drawer)
5. Counting
6. Hoarding
7. Mental rituals (REPORT: i.e. silently repeating meaningless words to remove a disturbing
image)

REPORT: People with OCD can get help by visiting a mental health professional. The therapist or doctor
can prescribe medical treatments and share self-help strategies to help break the cycle of unwanted
thoughts and urges. We have more information on OCD help and self-help here.

Attention Deficit Hyperactivity Disorder (ADHD)

PPT: According to Centers for Disease Control and Prevention, ADHD is a condition that impairs an
individual’s ability to properly focus and to control impulsive behaviors, or it may make the person
overactive.

REPORT: ADHD is more common in boys than it is in girls. According to the Wexner Medical Center at
Ohio State University, males are two to three times more likely than females to get ADHD.

PPT: Oppositional defiant disorder (ODD) is a pattern of disobedient, hostile, and defiant behavior
toward authority figures.

To fit this diagnosis, the pattern must persist for at least 6 months and must go beyond the bounds of
normal childhood misbehavior.

This disorder is more prevalent in boys than girls. Some studies have shown that 20% of the school-age
population is affected. However, most experts believe this figure is inflated due to changing cultural
definitions of normal childhood behavior, and other possible biases including racial, cultural, and gender
biases.

Wag na sabihin: This behavior typically starts by age 8. Emotionally draining for the parents and
distressing for the child, oppositional defiant disorder can add fuel to what may already be a turbulent
and stressful family life.

REPORT: While this is one of the most difficult of behavioral disorders, setting firm boundaries with
consistent consequences plus a commitment to improving your relationship with your child can help
your family overcome the dominating grip that oppositional defiant disorder may have on your
household.

What are the signs and symptoms of Oppositional Defiant Disorder?

REPORT: Three characteristics of the child who has ODD are: aggression, defiance and the constant
need to irritate others. When documenting the child's behavior; characteristics or behavior patterns
should be in place for at least 6 months. The behaviors will have a negative impact on social and
academic functioning. It is important to look for the following characteristics:

PPT:

1. The child often loses his/her temper

2. The child is defiant and doesn't obey rules/routines
3. The child argues often with adults and peers
4. The child seems to go out of his/her way to annoy others in very bothersome ways
5. The child is often lacking accountability and blames others for inappropriate behaviors
6. The child often seems angry, resentful, spiteful and vindictive
7. The child is often prone to tantrums and will be non-compliant
8. The child is constantly in trouble at school

How is Oppositional Defiant Disorder diagnosed?

REPORT: Psychiatric disorders are diagnosed by a review of medical history, ruling out other disorders,
medical tests and ongoing observation. Parents may ask their pediatrician or family physician to refer
them to a child and adolescent psychiatrist, who can diagnose and treat ODD and any coexisting
psychiatric condition.

How is Oppositional Defiant Disorder treated?

REPORT: There are relatively few studies done on the effective treatment for ODD. There is no one way
to treat cases of ODD. Sometimes, medication is used to treat some of the symptoms, sometimes
psychotherapy and or family therapy is used but more often than anything else, behavior modification is
used. The earlier a form of consistent treatment is in place, the greater chance of success.

PPT: CHALLENGES FACED BY LEARNERS WITH EMOTIONAL AND BEHAVIOURAL DISORDERS

Some students with emotional disturbance and/or behavioral problems have negative self-concepts and
low self-esteem. In the classroom, students may be frequently off-task and may adversely affect the
learning of some others. Students may have problems working in groups and in forming relationships.

How does the family be affected by having a child person with emotional and behavioral disorder?

This upheaval and state of crisis for parents with children who are diagnosed as having a serious
emotional disorder disrupts communication patterns, family roles, and living patterns for the family. The
marital unit, sibling and parental relationships are all affected by the needs and behaviors of the child.

CHALLENGES OF TEACHING STUDENTS WITH EBD

Teachers will often experience stressor when working with students who have emotional behavioral
disorder. These stressors may present themselves as naive expectations, of themselves, in
administration, parental support or in community. Many regular education teachers lack the skills
needed to deal with these unexpected outbursts and behavioral from these students.

Support for Students with Behavioral Disorders

Get evaluated. REPORT: Parents should ask a medical doctor, licensed counselor, or psychiatrist to
evaluate their child and ascertain whether they have a behavioral disorder.
Review the evaluation. REPORT: After receiving results, schedule a meeting to sit down with the
individual who did the evaluation to learn more. Ask if they can convey this information to school
administrators, teachers, counselors, and others at school who interact with your child.

Sit down with school staff. REPORT: After the school receives the evaluation, meet with the school
psychologist, your child’s teachers, the principal, and other relevant parties to create a plan.

Figure out what your child needs. WAG NA TO: Most students with behavioral disorders receive
support through the Americans with Disabilities Act or Section 504 for the Rehabilitation Act. The ADA
allows for children to receive an Individualized Education Program (IEP) and access to special education
services. 504 plans are formal agreements that ensure students with disabilities receive the support they
need.

Make a plan. WAG NA TO While both IEPs and 504 plans work to ensure children receive support, only
the IEP is enforceable by law. The IEP provides individualized and special services to help the child
succeed, while the 504 ensures access to services and provides accommodations to help their needs be
met as adequately as other learners. Whether opting for an IEP or 504 Plan, REPORT: ensure the school
creates a new, unique, and individualized plan rather than relying on a generic one. Do not sign off on
the form until you feel it adequately addresses all your child’s needs.

Document all communications. REPORT: Whenever you communicate with medical professionals or
school staff, keep detailed records of those interactions. WAG NA TO: Note the date and time when you
make requests or ask the school for updates, write emails whenever you voice concerns, and circulate
memos outlining all the points discussed to anyone with direct involvement in your child’s education.
Parents carry the burden of proof when it comes to demonstrating whether or not a school provides
adequate support to a student with behavioral disorders.

For Parents: Behavioral Disorders & Supporting Your Student

7 Tips Help Your Child Succeed in School

Tell teachers.

REPORT: “Make sure the teacher knows about your child’s issues, as hiding it does not help,” says
MacLean. “Consider involving the teacher in the diagnosis.”

Keep the school updated.

REPORT: “Allow teachers to read the notes or referral from a doctor and keep him/her updated on any
new issues at home,” says MacLean. “You should also update them on any medications your child is
taking.”

Listen and believe teachers.

REPORT: “Parents should be open to hearing about their child’s behavior in class, as it is rare in my
experience that teachers make up behaviors to tell parents,” says Ferone. “The most unproductive thing
I’ve heard is when parents say ‘my child doesn’t do that at home, so I know she/he wouldn’t do it at
school.’”

Stay in regular communication.

REPORT: “Having a system of regular communication with your child’s teachers is essential,” says
Ferone. “Consider using email, text messages, phone calls, or a shared notebook.”

Create a contract.

REPORT: “A shared behavior contract which determines rewards at home based on school behavior can
be an effective motivator,” suggests Ferone.

Create down time.

REPORT: “Allow the child time off, time to play, and time to relax,” encourages MacLean. “All of these
things will be important in successful learning.”

Be calm around your child.

REPORT: “All children learn differently,” reminds MacLean. “Don’t worry or get upset—especially
around your child—about issues that can be solved down the road.”

Educator Tips: 10 Teaching Methods for Students with Behavioral Disorders

REPORT: Helping students with behavioral disorders presents teachers with the opportunity to make a
real difference in the lives of those learners, but it is not without challenges. When faced with endless
grading, large classroom sizes, and never-ending lesson planning, teachers need a game plan for serving
the needs of these students without neglecting other learners. The following tips exist to help teachers
find balance and identify the best support mechanisms in the classroom.

Collaborate with parents. WAG NA TO: Keeping the lines of communication open with parents can help
teachers gain a better sense of how to best support the child, notes MacLean. “Parents and teachers
need to work together to create a smooth transition between home and daycare/school,” she says.

Take time to understand the diagnosis. WAG NA TO: “In order to address issues most effectively,
determining the cause of the behavior is important, as strategies differ for a student with ADHD vs. a
student with clinical disability or one acting out due to learning disabilities,” says Ferone. “For students
with diagnoses, medication and therapy might be recommended or academic support.”

Create a routine. REPORT: “Having a structured classroom with predictable routines while developing
positive relationships with students goes a long way to addressing the needs of many,” encourages
Ferone. WAG NA TO: “If your school has adopted PBIS or other behavioral systems, use this for
consistency.”

Introduce Social Emotional Learning. REPORT: “This method helps teachers educate students on how to
identify emotions and self-regulate, rather than the teacher doling out consequences for misbehavior,”
says Ferone. WAG NA TO: If you want to learn more about SEL, check out our guide: Why is Social-
Emotional Learning Important?

Introduce Restorative Justice principles. REPORT: “Restorative justice practices include ‘restoring the
relationship’ goals which are more productive than punishment,” notes Ferone. “Particularly with
younger students, explicit teaching of expected behaviors is recommended, as teachers often take for
granted that students know what they mean when they tell them to ‘behave’.”
Use visuals. WAG NA TO: “Visuals are great for all students – including those that spell out rules,
provide graphics of good classroom behavior, provide charts for work completion, and offer stars for
productive behavior,” says Ferone. “I do not recommend the new trend of using red, yellow, and green
clips to call out student behavior, as it seems like ‘shaming’ learners and encourages other students to
‘tell on’ fellow students and chips away at the relationships.”

Go beyond RTIs. WAG NA TO: “These general strategies can reach 80% of the student population,” says
Ferone. “For those who need more support with behavior, using student contracts and checklists to
monitor behavior and earn rewards can be effective.”

Complete assessments and plans. WAG NA TO: “Functional Behavior Assessments and Behavior
Intervention Plans can be used to identify the triggers and causes of behaviors,” notes Ferone. “It is
important to understand the underlying root of the behavior, e.g., is it depression, ADHD, difficult
family/home circumstances, undiagnosed learning issues, developmental delay, etc.”

Rely on other school staff. WAG NA TO: “Teachers should be encouraged to use supports of the school,
including the school counselor,” encourages Ferone. “A referral to the student support team may be in
order and could lead to a special education referral if interventions do not help.”

Create a good classroom culture. REPORT: “Keeping the class as calm and nurturing as possible by
using soft voices and having quiet areas can really help set the tone,” says MacLean. “Try to invite
students with smiles and feel prepared for the children each day.”

FINAL REPORT: Students with emotional and behavioral disorders (EBD) are at greater risk for academic
failure and negative postschool outcomes when compared to other disability categories. It is important
to learn how to promote protective factors for students with EBD to foster resilience.