Emotional and Behavior Disorders:

History, Issues and Legal Development

What is the History of Emotional and Behavioral Disorders?

1600s Segregated in asylums 1700-1800s Mental hospitals 1900s Advocacy, collaboration, research

Source: Taylor/Smiley/Richards, Exceptional Students

Historical Context
People with emotional or behavioral disorders have been recognized throughout time; however, their care and treatment was usually neither good nor humane. 1547: St. Mary of Bethlehem in London (also called Bedlam), the first institution for people with emotional or behavioral disorders, is established. 1792: Philippe Pinel, a French psychiatrist, orders humanitarian reform. 1700s1800s: Benjamin Rush, the father of American psychiatry, proposes humane methods for caring for children with emotional or behavioral disorders. Late 1800s: The first public school class opens for children with emotional or behavioral disorders.

History of the Field

1957: Leo Kanners book Child Psychiatry brought the issue of services to forefront. 1960: Nicholas Hobbs of Vanderbilt University initiates Project Re-Ed. 1961: Eli Bower develops a definition of emotional disturbance that is the basis for the federal definition used today. 1964: Study is done on the effects of teacher attention on a preschoolers social interactions with his peers during play. 1999: IDEA97 removes the term serious from this category.

What is the IDEA 04 Definition of Emotional Disturbance?

(continued on the next slide)

(i). 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 childs educational performance
(A). An inability to learn which 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
Source: Taylor/Smiley/Richards, Exceptional Students

History of EBD
In 1950s, Eli Bower conducted research involving a thousand students in California. In his book The Early Identification of Emotionally Handicapped Children in the School, (1960/1981), Bower proposed (1981) the definition of emotional disturbance that was adopted by the U.S. Department of Ed and included in PL 94-142 and IDEA 2004. National Mental Health and Special Education Coalition, a group comprised of at least 30 professional mental health and education associations, and led by Steve Forness and Jane Knitzer the proposed definition (discussed in Forness & Knitzer, 1992) which uses the term Emotional or Behavior Disorder instead of Emotionally Disturbed.

Emotional Disturbance Definition:

Source:Federal Government; U.S. Department of Education (2006, p. 1262)

A child exhibiting one or more of the following characteristics to a marked degree (how serious?) for a long duration of time (how long?) that adversely affects their education (academic? Can include social skills since work along /comply with others affect academic performance) : 1. Difficulty to learn that cannot be explained by intellectual, sensory, or health factors. 2. Difficulty to build or maintain satisfactory interpersonal relationships with peers and teachers. 3. Inappropriate types of behavior or feelings under normal circumstances. 4. A general pervasive mood of unhappiness or depression. 5. A tendency to develop physical symptoms or fears associated with personal or school problems. Emotional Disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.

Critics of ED Definition: Vague and subjective: terms are problematic and subjective as emotional disturbance is defined as a social construct that is perceived according to societal rules a long period of time (how long?) marked degree (how serious?) adversely affects educational performance (academic? Can include social skills since work along /comply with others affect academic performance) Does not include students who are socially maladjusted

Emotional or Behavioral Disorder Definition:

i. The term Emotional or Behavioral Disorder (EBD) means a disability characterized by behavioral or emotional responses in school so different from appropriate, age, cultural, or ethnic norms that they adversely affect educational performance. Educational performance includes academic, social, vocational, and personal skills. Such a disability (a) is more than a temporary, expected response to stressful events in the environment; (b) is consistently exhibited in two different settings, at least one of which is school related; and (c) is unresponsive to direct intervention in general education or the childs condition is such that general interventions would be insufficient.
ii. Emotional and behavioral disorders can co-exist with other disabilities. iii. This category may include children or youth with schizophrenic disorders, affective disorders, anxiety disorders, or other sustained disturbances of conduct or adjustment when they adversely affect educational performance in accordance with section i.

Critics of EBD
There does seem to be widespread preference for it over the current federal definition among professional organizations (Forness & Kavale, 2000). Retaining the key features of a general definition, the proposed Coalition definition better operationalizes certain aspects of the federal definition, such as EBD can co-exist with other disability conditions and the problems must be exhibited in a school-related setting as well as at least one other setting. The term Emotional or Behavioral Disorder itself has the face validity of being more descriptive and less stigmatizing than ED. Analogue studies comparing the current ED and proposed EBD definitions, conducted by Cluett and colleagues (1998), demonstrated that the Coalition EBD definition not only resulted in a slightly smaller total number of identified students than the current ED definition, but also identified a diagnostic sample that was less likely to be mis-identified in other special education categories or over-represented with members of ethnic minority groups than the current definition.

What is the IDEA 04 Definition of Emotional Disturbance?

(continued) (D). A general pervasive mood of unhappiness or depression (E). A tendency to develop physical symptoms or fears associated with personal or school problems

(ii). Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted unless it is determined that they have an emotional disturbance
Taylor/Smiley/Richards, Exceptional Students

What are Some Controversies Over the IDEA 04 Definition?

Vague, internally inconsistent, incomplete, nebulous, often illogical, and self-contradictory
Requirement that the disorder must adversely affect educational performance Omission of students with social maladjustment from the emotional disturbance category

Subjectivity involved in determining what is meant by "a long period of time" and "to a marked degree
Taylor/Smiley/Richards, Exceptional Students

What is an Alternative Definition?

Forness and Knitzer (1992) proposed a new definition based on the findings of the National Mental Health and Special Education Coalition.
They suggested replacing the term emotional or behavioral disorder (EBD) with the term serious emotional disturbance (SED), used in IDEA.

How are Students with EBD Classified?

Educational
Internalizing and externalizing disorders

Dimensional
Conduct disorder, socialized aggression, attention problems-immaturity, anxiety withdrawal, psychotic behavior, motor tension-excess

Medical

What is the Prevalence of EBD?

2% of the school-age population (USDOE estimate) The actual number of students ages 6-21 being identified and served under the IDEA 04 category of emotional disturbance is less than half the USDOE estimate. 8% of students with disabilities fall under the emotional disturbance label, the fourth largest IDEA 04 disability category More males than females Older students identified more than younger Poverty appears to double the risk of EBD African American males are overrepresented

Challenges that EBD Present

Students are difficult to teach and struggle behaviorally, socially, and academically, When compared to their general education peers, students with EBD experience the least success. Students with EBD have greater academic deficits than students with learning disabilities. Struggles continue in post-school settings. Unemployment Poor interpersonal relationships Need for mental health services