Transcript Students With Behavioural Exceptionalities Students with AD/HD

Students
With
Behavioural
Exceptionalities
By:
Kayla, Jenessa, Cristina & Diana
Video
http://www.youtube.com/watch?v
=c-KC9tkn0_Y&feature=related
What is Behaviour ?
A learning disorder characterized by specific behaviour
problems over such a period of time, and to such a
marked degree, and of such a nature, as to adversely
affect educational performance, and that may by
accompanied by one or more of the following:
1) an inability to build or to maintain interpersonal
relationships
2) excessive fears or anxieties
3) a tendency to compulsive reaction
4) an inability to learn that cannot be traced to
intellectual, sensory, or other health factors
Behavioural Disorders,
Emotionally/Behaviourally Disturbed or
Behavioural Exceptionalities
What Should It Be Called?
In the USA in 1975- ‘seriously emotionally disturbed’
In 1997 it was changed- ‘emotionally disturbed’
In Canada, the terminology varies by province.
In Ontario, the term ‘behavioural exceptionality’ is used.
Continue…
Social and cultural conditions influence our understanding of
‘normal behaviour’ and ‘behavioural exceptionalities’. Even in a
single school, wide differences can exist. The same behaviour may
be seen as disruptive by one teacher, and normal by another.
To create a common ground of understanding, Mental Health
professionals tried to organize behaviour exceptionalities by
classification, but consensus is limited. Teachers have a more
common understanding.
Misconceptions About Emotional/Behavioural Disorders
EXPLAINED
 It is too difficult to confirm whether or not youth violence has increased.
 Services for students with emotional/behavioural disorders vary across the province.
 Developments in mental health science have not made it easier for educators to identify
and classify behavioural disorders. The American Psychiatric Association’s Diagnostic
and Statistical Manual of Mental Disorders classifies disorders as present or absent.
Emotional/behavioural problems are more subtle to classroom teachers.
 Bullying is not just something students must deal with while growing up. It can have
long-term consequences for both the bully and the victim. Students with behavioural
difficulties (especially ADHD) are more likely to be involved with bullying, either as the
‘bully’ or the ‘bullied.’
 Most studies show identified cases where males outnumber females by ratios of up to
5 to 1. Recently there have been increases in girls over boys, both in identified behaviour
and in crime.
Misconceptions About Emotional/Behavioural Disorders
continue…
 Behavioural disorders can be expressed through withdrawal, not just through
aggression or frustration.
 Available data suggests a correlation between behavioural disorders and
average to low IQ scores. A behavioural disorder does not often indicate a
student who is bright but frustrated.
 Inappropriate behaviour is not always an external manifestation of something
deeply rooted. In fact, it is most likely to be spontaneous and temporary.
 Highly structured, ordered, predictable environments bring about the greatest
change in students with behavioural disorders.
 To deal effectively with a behavioural issue, it is important to consider
motivation. This way, consequences, rewards, and the teaching of new
behaviour can be aligned with the needs of the individual student.
Causes of Behavioural Exceptionalities
Biophysical:
- Possible link between biological make-up and behaviour
- Biological processes have a pervasive influence on behaviour;
they affect behaviour only in interaction with environmental
factors
Allergies:
- Allergenic reactions can generate learning and behavioural
problems
- Students’ intolerance to a combination of stale air, chalk dust,
moulds and fungi
Continue…
Speech and Language
- Higher incidence of behavioural exceptionalities among student
with speech and language impairment
- Students often act out due to their inability to express their
needs.
Psychological
- Home and school are the most powerful influences on a
student’s behaviour
- Students often act out when discipline are inconsistent
Assessment of Behavioural Exceptionality
Informal Assessment:
Informal screening by teachers and educational
assistant; based on their experience and
common sense to recognize behaviours that are
out of the norm
Formal Assessment based on the School Board’s
Plan and Procedure
Formal Assessment
1
• Behaviour observation checklist completed by
teacher, assistant or parents
2
• Projective test to gather information about the
student’s behaviour
3
• In school team meeting which includes
classroom teacher, SERT, principal and school
psychologist. Decision about the next phases of
program or placement for student
Longstanding issues
still remain
Longstanding issues
 An acceptable term
 Developing a useful definition
 Are needs being met?
 School standards are too high
 Socioeconomics and class distractions
 Stigma of being identified
 Legal requirements
 The use of drugs
Longstanding issues
 An acceptable term
Socially maladjusted, emotionally disturbed, mentally ill, predelinquent, emotionally
handicapped, socially handicapped,
- In education: behaviour disorder, behaviour exceptionality (Ontario)
- “Behaviour exceptionality”
inclusive, less negative, and warrants professional
attention
(label based on who was writing on the subject)
-
 Developing a useful definition
What is reasonable/normal behaviour? Frequency and degree.
- Would a more accurate definition assist in identifying students with this exceptionality
and help with effective intervention?
- Hard to identify as there are no real set of symptoms.
-
 Are needs being met?
Prevalence across Canada varies (uneven rates)
- Ontario’s rate has decreased to 1%
- The exceptionality is getting less attention than in the past, and students are being
underserved.
-
Longstanding issues
 School standards are too high
- Unrealistic and unnatural standards for acceptable behaviour
- Behaviour is a result of how a student is treated
 Socioeconomics and class distractions
- Adolescents, and students from lower income families report a greater number and a
variety penalties for their behaviour. Students from high income response to the same
situation are seen as acceptable responses.
 Stigma of being identified
- An students that is identified changes the opinion of the teachers, peers.
- Hard to escape history
less students being identified
receiving the appropriate support.
students not
Longstanding issues
 Legal requirements
- Student involved in a crime – educational disruption –moved through custody settings, and
schools (varied educational approaches).
- Being moved around does not allow for continuity and make the situation worse for the
student.
- Canadian law does not allow the teacher rights to the knowledge of student’s involvement
of a crime, although is could be important information for the well-being of the teacher and
other students.
 The use of drugs
- Drugs to manage behaviour – moral and ethical values violated by chemically altering
a person’s natural function.
Thought - Drug therapy puts the responsibility of teachers and parent on chemicals.
Thought- drug therapy will lead to drug abuse later in life – no evidence
Drug Therapy can have psychological effects (self esteem)
Positive outcome--- decrease impulsivity and improve concentration
More drug therapy, less drugless therapy
Ritalin prescription increase 460% from 1991 to 1997
Conceptual Models
and their
Educational Implications
Conceptual Models and their
Educational Implications
 Mental health professional have a narrow and
particular school of thought/approach for
treatment of students with behavioural
exceptionalities.
 In the classroom, one singular view is not
common.
Conceptual Models and their
Educational Implications
 Psychodynamic Approach
 Biophysical Approach
 Environmental Approach
 Behavioural Modification Approach
 Drug Therapy Approach
 The classroom reality: Flexible Common Sense
Conceptual Models and their
Educational Implications
 Psychodynamic Approach
- Behavioural disorder within the individual.
- Teacher is part of a mental health team
- Develop warm supportive atmosphere in which the student
may overcome his inner turmoil
- Acceptance and toleration, at the expense of direct instruction
and acquisition of academic
skills
- A.K.A. Psychoeducational approach- practical classroom
outcomes
-Decline in the use of this approach – does not improve
academic achievement and limited evidence that it helps
behaviour.
Conceptual Models and their
Educational Implications
 Biophysical Approach
- Direct relationship between behaviour and things like physical
defects, illnesses, diet, and allergies.
- Responsive therapy - megavitamin therapy, diet control, symptom
control medication, removal of offending substances (e.g. carpets)
- In classroom this is combines with behaviour style approach
(routine, scheduling, frequent repetition of tasks presented in
sequence, & eliminating environmental that is unnecessary stimuli.
-Studies are unable to identify which of the two treatments (teaching
or therapy) is responsible for the impact.
Conceptual Models and their
Educational Implications
 Environmental Approach
- Students are a product of their environment (family, school, neighbourhood, and
community)
- Teachers are expected to instruct the student in social and interpersonal
environment skills.
- School also attempts to modify the school environment to meet the needs of the
student.
- Goal to create in all parts of the environment, an awareness of the reciprocal
relationships and monitoring these relationships to benefit the student with the
behavioural exceptionality.
Conceptual Models and their
Educational Implications
 Behaviour Modification Approach
Dominant intervention style in education.
Assumption- all behaviour is modifiable by using reinforcement.
Believe that behaviour is controlled by the impact of stimuli
Possible to
1) create behaviours that currently do not exist
2) maintain behaviours that are established
3) eliminate inappropriate behaviours
- Reinforcers
concrete e.g. food, toys
absteract e.g. checks, stars, coupons that can be traded for something. (token
economy)
- Reinforcers paired with social reinforcer (praise, smile) so the token reinforcer can be
-
phased out.
Conceptual Models and their
Educational Implications
 Drug Therapy Approach
-
Psychotrophic drugs (pills) to help control behaviour
Evidence that it does control behaviour and has a positive/improved outcome for
student and others.
If drug therapy is introduced for the first time, the side effects must be
monitored (modify to optimal dose)
It is possible to treat attention deficit and hyperactivity with out chemicals.
Medication along with appropriate behavioural and academic interventions can
help social , academic performance.
Conceptual Models and their
Educational Implications
 The Classroom Reality: Flexible Common Sense
-
Teachers combine a variety of approaches and apply them on individual basis.
Teachers value a warm supportive atmosphere for all their students.
Teachers are aware of the environmental impact on student learning and social
development
Doing what is effective at the time and what makes sense at the time.
Teachers need to establish a baseline for a student (frequency, intensity, and
duration of a particular behaviour) to tell if the intervention is effective or not.
http://www.pbs.org/wgbh/misunderstoodminds/atten
tion.html
Behavioural Exceptionalities:
Attention Deficit
Hyperactivity Disorder
(AD/HD)
What are the symptoms of AD/HD?
AD/HD or attention deficit/hyperactivity disorder is
diagnosed by medical practitioners by looking at 3
symptoms.
1. The inability to sustain attention at age-appropriate
level.
2. Impulsivity which the student does things without
considering consequences, and often repeats the
behaviour.
3. Hyperactivity which the student engages in nonpurposeful movement and activity that is usually not
age appropriate, and often at an accelerated level.
Are AD/HD symptoms the result of
other factors?
 Disruptive or unresponsive behaviour may be the result of
anxiety or depression.
 Fetal alcohol syndrome sometimes produces hyperactive
behaviour.
 Chronic inner ear infections, hearing loss, or undetected
hearing problem might leave the student uncooperative.
However, professional educators see the same symptoms
every day in students who are not identified as AD/HD.
What causes AD/HD?
 Advocates argue that AD/HD has been around for a
long time under other titles like “hyperkinesis” and
“minimal brain dysfunction”, and “moral deficit”.
 It is said that what makes AD/HD real is a biological or
psychological basis, or both.
 Advocates also argue that there are some individuals
who, through no fault of their own, cannot use their
human will and self control to manage themselves
from within, and that the pace of modern life
aggravates this lack of a central control mechanism.
 It is seen as a neurologically-based medical condition.
What causes AD/HD?
 Specific genes such as dopamine transporter gene on
chromosome 5 and dopamine receptor D4 gene on
chromosome 11 have appeared to be related to AD/HD.
 Dopamine deficiency may be the cause of AD/HD but it is
unclear as to whether individuals with AD/HD do not
produce enough of it or are unable to properly use what
they do produce.
 Other chemical deficiencies that may be associated with
AD/HD are noradrenaline and serotonin.
 Noradrenaline is a substance that may act on the brain
during times of stress and serotonin is a chemical that
helps the brains ability to detect and/or possibly regulate
other chemicals.
Just a confusion with other special needs?
 AD/HD has long been associated with learning
disabilities because of the inattentiveness factor.
 Studies suggests that about one-third of students with
learning disabilities may have some degree of
attention disorder.
 The rate of learning disabilities is high in students who
are diagnosed with AD/HD because lack of attention
and off-task behaviour are detrimental to mastering
basic skills.
 However, one special need does not imply the other.
Another “Modern Day” phenomenon?
 AD/HD did not capture the public eye until the late
20th century.
 A German doctor. Heinrich Hoffman, first described
hyperactivity in 1845.
 In 1902, George Still, a British physician described
hyperactivity that is somehow associated with evil.
 He described “sick” children of average or higher
intelligence who had an “abnormal deficit of moral
control.”
 In 1968, AD/HD was clinically classified.
Continue…
 When matched against other, more recent types of
special need, there continues to be intense
disagreement other whether it should be seen as a
distinct clinical entity, or even whether it really exists.
 Critics say that AD/HD has become a label in North
America resulting in the increasing rate of diagnosis.
 In 1997, the Globe and Mail reported that an estimated
half million Canadians, mostly students, had been
diagnosed.
What does having students with
AD/HD mean to the classroom?
 Teachers can expect a high level of physical activity,
inappropriate responses, low frustration tolerance when
AD/HD is present in the classroom.
 The student’s lack of restraint and acting out will invariably
draw in the student’s peers, or distract them, or cause
conflict, or interrupt their work.
 There is no sure remedy in the classroom and no universal
accepted way to deal with AD/HD in school.
 Isolating the student with AD/HD may be beneficial for the
student’s peers, but it is not a solution for the student who
has AD/HD.
Continue…
 The most effective management technique usually
turn out to be those that the teacher and educational
assistant work out creatively, often with the parent’s
help, and these techniques, most of the time are
unique for that particular student.
 Research has found that the most effective treatment
is a combination of medication, effective behaviour
modification practices, and if possible individual and
family counseling.
 Teachers do find through experience that flexibility
and setting modest goals are essential in successful
management.
Additional
Behavioural
Exceptionalities
Childhood Depression
Symptoms
 quiet, withdrawn students are often overlooked.
 regularly appear sad
 show limited academic gain
 may not sleep well
 feelings of worthlessness or hopelessness
Treatment
 Educators must refer the student for more intensive mental
health evaluation.
 Treatment usually involves psychotherapy and medication
 Teachers can help student develop social skills, and encourage
an increase in activity level.
Reactive Attachment Disorder
(RAD)
 Believed to be a result of a failure to bond with other humans
very early in life.
 Lack of nurture and attention.
 Protective shell against what they feel is an unsafe world.
They believe no adults can be trusted to take care of them.
 Symptoms: rage, destructiveness, frequent lying, cheating,
stealing, obsessive, manipulative, unaware/unconcerned with
consequences, limited empathy.
 Confused with; bipolar disorder, ADHD, tourette syndrome,
learning disability. (RAD poorly undersood)
 No suggestion for treatment and for the classroom
Conduct Disorder
Symptoms
 This disorder applies to children who may have great
difficulty following rules, throw temper tantrums, destroy
property, bully, or regularly act in deceitful ways.
Treatment
 Often involves behaviour therapy and psychotherapy, and
extends over a long period of time.
 The earlier the child is identified, the better likelihood for a
positive outcome and a more productive adult life.
Oppositional Defiant Disorder
(ODD)
 Similar to conduct disorder but less severe
 Symptoms: persistently oppositional, negative, and/or
hostile to authority.
 Must be present 6+ months and accompanied by temper
tantrums, aggressiveness towards peers, and annoying
others.
 Treatment: training for parents and teachers to respond
effectively to the student. Time-outs, avoid power
struggles, and remain calm.
Groups Discussion: Case Study
1.
2.
3.
4.
The case of Scott. Pg. 114
The case of Suzette Pg. 119
The case of Logan Pg. 122
The case of Hannah Pg. 125
Summarize the case.
What approaches/strategies would you use if you
were the classroom teacher?
Present in 10 minutes.
Notes and Suggestions
 The Case of Scott
 Go to the first school so they will accommodate Scott
 The Case of Suzette
 Bring the idea of maps-student is involved in planning
their own learning, setting goals
 The Case of Logan
 He would benefit from going to family counselling
 The Case of Hannah
 Ask mother what strategies she uses at home
 Diet/nutrition
 Positive reinforcement
Strategies for Students with
Behavioural Exceptionalities
 Manage the environment, reducing distractions
 Instruction should be simple and concise
 Organize the day
 Enforce classroom routines and procedures consistently.
 Develop sense of personal responsibility
 Note improvements
Strategies for
Effective Classroom Management
A teacher who is effective with ‘regular’ students is usually more
effective with ‘behavioural’ students.
 Effective attitude includes patience, flexibility, creativity, humour, and
respect
 Recognize where students are ‘at’ and do not let their history shape
your expectations. Help students by being an adult mentor.
 Realize the importance of personal conduct. Adults are role models.
 Establish a realistic, consistent, and predictable learning environment.
Structure, organization, and sequence are important.
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 Catch a student doing something good. Discreet positive
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praise that is proportionate to the accomplishment.
Treat democracy as a fine line.
Establishing momentum is more important than
motivating. Get kids rolling on their own.
Keeping academics front and centre.
Working hard is better than sitting around.
Establish and maintain consistent routines for entering the
classroom
Sets up and insists on specific seating arrangements
Highly visible.
Continue…
 Uses ‘antiseptic bouncing’. When a student is worked up or aggressive, give
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him/her an errand to run outside of the class, or another activity that would
let off steam.
Use merits, not just demerits
Uses proximity control.
Is not sarcastic, and always avoids yelling.
Never uses corrosive discipline techniques (writing out lines, detention, or
using curriculum content as a punishment)
Avoids confronting students with behavioural exceptionalities in front of
peers.
Informs students of high expectations (occasionally manipulates
components of a task to ensure a positive outcome for students needing a
boost)
Sets short term goals for students who cannot yet defer gratification
Uses reward systems. The time spent in school should produce something
of consequence.
RESOURCES
1.Teachers’ Gateway to Special Education
www.teachspeced.ca
2. American Academy of Child and Adolescent Psychiatry
www.aacap.org
3. Canadian Attention Deficit Disorder Research
www.caddra.ca
4. Children and Adults with Attention Deficit
www.chadd.org
5. Focus Adolescent Services
www.focusas.com
Caring and Safe Schools in Ontario
http://www.edu.gov.on.ca/eng/general/elemsec/speced/C
aring_Safe_School.pdf
Supportive Behaviour Management
http://behaviourmanagement.ning.com/
Behaviour Management Site
http://www.behavioradvisor.com/
Positive Behaviour Intervention & Supports
http://www.pbis.org/
Thank You !!