Behavioral and emotional disabilities (known as BED, EBD, or SED) are complex in terms of identification and support. Often, children identified BED/EBD/SED exhibit significant behavioral challenges and may have a mental health diagnosis. Definition and Characteristics. According to the North Carolina definition of serious emotional disability (SED), a student must exhibit at least one of the characteristics of the disability over a long period of time and to a marked degree that adversely affects a child’s educational performance (NC DPI, 2010). The characteristics are: (a) An inability to make educational progress that cannot be explained by intellectual, sensory, or health factors. (b) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers; (c) Inappropriate types of behavior or feelings under normal circumstances; (d) A general pervasive mood of unhappiness or depression; (e) A tendency to develop physical symptoms or fears associated with personal or school problems. Students identified with SED can exhibit internalizing or externalizing behaviors (Gage, 2013). Most research has been conducted on externalizing behaviors because they are more prevalent in students with SED. Externalizing behaviors are outward expressions and may include aggression, disruption, and hyperactivity while internalizing behaviors are inward expressions and may include depression, withdrawal, or obsessive-compulsive behaviors (Gage, 2013) Causes and Risk Factors. While there are many unknown factors that could impact emotional development, research into causes of emotional disorders has yielded possible factors such as school related problems, abuse, poverty, and genetic/biological components (Smith, 2010). Prenatal drug abuse and maternal emotional disorders are among biological factors which increase the likelihood of emotional disabilities with mood disorders, depression, and schizophrenia having genetic ties (Smith, 2010). Research also indicates that maternal stress and anxiety has effects on the fetus that last until middle childhood or later (Rutter, 2003). Cognitive Behavioral Model There are five conceptual models for emotional disorders: psychoeducational, cognitive, behavioral, ecological, and medical. In the school setting, the cognitive-behavioral model is generally most realistic to implement and produces effective results. The cognitive-behavioral model is formed from B.F. Skinner’s theory on behavior modification. It is based on teaching strategies to individuals to assist them in understanding and modifying their thoughts and behavior. Mayer, Lochman, and Acker (2005) discussed that an individual is more likely to self-regulate when procedures and choices are in place for the individual to influence his or her own behavior rather than another individual forcing a plan. The cognitive-behavioral model also relies on manipulation of antecedents and consequences in regards to student behavior. Interventions. A number of evidence based interventions can be implemented to increase positive behaviors and decrease negative in children with behavior and emotional disabilities. Under the conceptual model, a positive reinforcement system can encourage students to perform specific tasks while obtaining a preferred consequence. Farmer, Reinke, and Brooks (2014) provided an overview of School Wide Positive Behavior Intervention Support (SWPBIS) which outlines the 3 components of SWPBIS: explicit schoolwide rules and expectations, consistency and collaboration, and reinforcement of positive behaviors. SWPBIS has been effective in decreasing discipline referrals and increasing teachers’ ability to address behaviors in the classroom. While SWPBIS provides a framework for organizing school and classroom management, the authors discuss the critical issues in addressing challenging behaviors in individual students, especially those with EBD. An additional intervention that uses the cognitive-behavioral model is the use of a check-in/check-out (CICO) system that incorporates positive reinforcement through positive adult attention and rewards (Maggin, Zurheide, Pickett, & Baillie, 2015). CICO is used as a secondary level of intervention in which students check in with a staff member in the morning, receive a monitoring card such as a daily behavior log, are provided with constant feedback throughout the day, check out in the afternoon to review progress and determine possible rewards, and requires a home connection with parent acknowledgement. Studies indicate that CICO provides more positive results when the function of the behavior is attention seeking rather than escape, however, it can be adapted to yield results for escape behavior (Maggin et al. 2015).
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