Transcript 2014 Workshop - Jerome M. Sattler, Publisher, Inc.

RECENT DEVELOPMENTS IN
BEHAVIORAL, SOCIAL, AND
CLINICAL ASSESSMENT OF
CHILDREN
JEROME M. SATTLER
Copyright © 2014 Jerome M. Sattler, Publisher, Inc.
Snapshots of Our World in
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Police Begin Campaign to
Run Down Jaywalkers
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Local High School Dropouts Cut in Half
Snapshots of Our World in
Headlines
Drunk Gets Nine Months in Violin Case
Snapshots of Our World in
Headlines
New Study of Obesity Looks
for Larger Test Group
Cartoon
Revised, New, or Additional
Assessment Measures [1]




Behavior Dimensions Scale, Second
Edition: School Version and Behavior
Dimensions Scale, Second Edition: Home
Version, p. 347
Conners 3rd Edition, p. 351
Conners Comprehensive Behavior Rating
Scales, p. 352
Social Skills Improvement System, p. 359
Revised, New, or Additional
Assessment Measures [2]




Parenting Relationship Questionnaire, p.
366
Parenting Stress Index, Fourth Edition and
Parenting Stress Index, Fourth Edition–
Short Form, p. 368
Koppitz Developmental Scoring System
for the Bender Gestalt Test, Second
Edition, p. 406
Beery VMI, p. 407
Revised, New, or Additional
Assessment Measures [3]





Bruininks-Oseretsky Test of Motor
Proficiency, Second Edition, p. 409
Multidimensional Anxiety Scale for
Children, Second Edition, p. 439
Revised Children’s Manifest Anxiety
Scale, Second Edition, p. 439
Children’s Depression Inventory, Second
Edition, p. 442
Reynolds Child Depression Scale, Second
Edition, p. 443
Revised, New, or Additional
Assessment Measures [4]




Strengths and Difficulties Questionnaire,
p. 463
ADHD Questionnaire, p. 463
Attention Deficit Disorder Evaluation
Scale, Fourth Edition–Home Version,
p. 463
Attention Deficit Disorder Evaluation
Scale, Fourth Edition–School Version,
p. 463
Revised, New, or Additional
Assessment Measures [5]






BASC–2 Progress Monitor, p. 463
Comprehensive Executive Function
Inventory, p. 463
See Table 17-1 for examples of
standardized achievement tests
Autism Diagnostic Observation Schedule,
Second Edition, p. 608
Autism Observation Scale for Infants,
p. 608
Autism Spectrum Rating Scale, p. 608
Revised, New, or Additional
Assessment Measures [6]





Checklist for Autism Spectrum Disorder,
p. 608
Childhood Autism Rating Scale, Second
Edition, p. 608
PDD Behavior Inventory, p. 608
Psychoeducational Profile–Third Edition,
p. 608
Scale of Pervasive Developmental
Disorder in Mentally Retarded Persons,
Revised, New, or Additional
Assessment Measures [7]





Screening Tool for Autism in Toddlers and
Young Children, p. 608
Social Responsiveness Scale, p. 608
SCAT3 (Sport Concussion Assessment
Tool 3), p. 635
NEPSY–II, p. 665
NIH Toolbox, p. 669
Revised, New, or Additional
Assessment Measures [8]

Also see the Resource Guide for revised
questionnaires, semistructured interviews,
observation forms, self-monitoring forms,
FBA forms, ADHD forms, SLD forms, ASD
forms, Instructional handouts,
miscellaneous tables, and formal and
informal measures of executive functions
(p. 251 and p. 258 in Resource Guide)
Video
Video Link

Fetal Alcohol Spectrum Disorders
Prevention PSA
 http://www.youtube.com/watch?v=mRf2
Kjz0hAg&feature=share&list=UU7PjTluf
hDCfET974TcMWmA&index=18
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [1]






Abbreviations Used in the Table
NA = National Average
EA = European American
AA = African American
As = Asian American
HA = Hispanic American
AI = American Indian
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [2]
Indicator
NA
EA
AA
As HA AI
Children in poverty
23
14
40
15
34 24
Teens not in school 8
and not working
Children not
54
attending preschool
Fourth graders not 66
proficient in reading
6
12
4
10
51
51
48
63 53
55
83
49
81 61
8
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [3]
Indicator
NA
EA
AA
As HA AI
Eight graders not
proficient in math
High school
students not
graduating on time
Low-birthweight
babies
66
56
86
40
79 63
19
15
32
7
24 NA
8
7
12.8 8.2
7
NA
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [4]
Indicator
Child and teen
death per
100,000a, b
Children in singleparent families
Teen birth per
1,000a
a Not in percent.
b 2010.
NA
EA
AA
As HA AI
26
25
36
14
21 NA
35
25
67
17
42 43
29
20
44
10
46 NA
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [5]


Source:
Annie E. Casey Foundation. (2014). 2014
data book: State trends in child well-being
(25th Ed.). Retrieved from
http://www.aecf.org/m/resourcedoc/aecf2014kidscountdatabook-2014.pdf
Paternal Age at Childbearing [1]


Sample
All individuals born in Sweden in 1973–
2001 (N = 2,615,081)
Results
Offspring of fathers 45 years and older,
compared with offspring born to fathers
20–24 years old, were at heightened risk
of
 ADHD (13.13 times greater)
 Autism (3.45 times greater)
Paternal Age at Childbearing [2]






Results (Cont.)
Bipolar disorder (24.70 times greater)
Psychosis (2.07 times greater)
Suicide attempts (2.72 times greater)
Substance use problems (2.44 times
greater)
Failing a grade (1.59 times greater)
Low educational attainment (1.70 times
greater)
Paternal Age at Childbearing [3]


Conclusions
Advancing paternal age is associated with
increased risk of psychiatric and academic
morbidity in children
In older fathers
 Sperm may not develop fully
 Sperm may have some form of genetic
mutation
Paternal Age at Childbearing [4]
Conclusions (Cont.)
Older fathers also may have been exposed
to
 Environmental toxins longer than
younger fathers and
 Long exposure to toxins may affect the
DNA in the father’s sperm
Paternal Age at Childbearing [5]

Source
D’Onofrio, B. M., Rickert, M. E., Frans, E.,
Kuja-Halkola, R., Almqvist, C., Sjölander,
A., Larsson, H., & Lichtenstein, P. (2014).
Paternal age at childbearing and offspring
psychiatric and academic morbidity. JAMA
Psychiatry. Advanced online publication.
doi:10.1001/jamapsychiatry.2013.4525
Adverse Childhood Experiences
(ACEs) California Study [1]




Year 2008
Representative sample of 9,500 adults
Aim of study: Effects of childhood trauma
on later health problems
Childhood trauma defined as experiencing
 Physical abuse
 Sexual abuse
 Emotional abuse
Adverse Childhood Experiences
(ACEs) California Study [2]



Living in a household with
 Mental illness
 Substance abuse
 Domestic violence
Having separated or divorced parents
Having an incarcerated parent
Findings of ACE Study [1]


61% suffered at least one ACE
25% experienced three or more ACEs
(referred to as polyvictimization)
Findings of ACE Study [2]

Adults who suffered from childhood
trauma (compared to those who did not)
were
 500% more likely to suffer from
depression
 350% more likely to smoke tobacco
 90% more likely to engage in binge
drinking
 63% more likely to have a heart attack
 60% more likely to be obese
Findings of ACE Study [3]

Income level also associated with negative
effects of ACEs
 52% of low-income adults exposed to
four or more ACEs had serious
psychological distress
 Fewer than 25% of high-income adults
with same exposure levels had similar
levels of psychological distress
Findings of ACE Study [4]

Source:
http://tcenews.calendow.org/releases/state
-assembly-hearing:-childhood-trauma-iscommon-and-can-be-devastatingbutdamage-can-be-overcome
Life Expectancy Tied To Education
[1]


Life expectancy is 82 for individuals with
more than 12 years of education
Life expectancy is 75 for individuals with
12 or fewer years of education
Life Expectancy Tied To Education
[2]

Possible Reasons
Those with less education:
Are likely to have more smoking-related
diseases, such as lung cancer and
emphysema—35% of Americans with an
9th to 11th grade education smoke, while
only 7% with a graduate degree smoke
 Are likely to have lower incomes

Life Expectancy Tied To Education
[3]

Possible Reasons (Continued)
Are likely to live in areas that have their
own health threats, either through crime or
poor housing conditions
Are likely to have limited health insurance
and limited access to health services
 Are more likely to agree with the
statement: “It doesn't matter if I wear a
seat belt, because if it’s my time to die, I'll
die.”

Life Expectancy Tied To Education
[4]



Summary and Recommendations
The less affluent and less educated are
also, invariably, less healthy
Disparities in health are a major challenge
in the United States
Health is not a product of health care per
se, but of one's life course and
opportunities
Life Expectancy Tied To Education
[5]
Summary and Recommendations (Cont.)


The less educated must learn the
following: “It does matter. Life is uncertain,
but that's no reason to surrender to fate”
Fighting poverty and improving education
are keys to increasing life expectancy
among less-advantaged Americans
Life Expectancy Tied To Education
[6]
Summary and Recommendations (Cont.)

Source: Meara, E. R., Richards, S., &
Cutler, D. M. (2008). The gap gets bigger:
Changes in mortality and life expectancy,
by education, 1981–2000. Health Affairs,
27, 350–360.
Equity and Educational
Opportunities In US Schools [1]




Office for Civil Rights, Civil Rights Data
Collection
Sample Statistics
Year of study: 2009–2010
Representative sample
Covering approximately 85% of nation’s
students
Equity and Educational
Opportunities US Schools [2]
Key Findings
African-American students represent 18% of
students in sample and
 35% of students suspended once
 46% of students suspended more than
once
 39% of students expelled
Equity and Educational
Opportunities In US Schools [3]
Key Findings (Cont.)
Hispanic-American students represent 24%
of students in sample and
 25% of students suspended once
 25% of students suspended more than
once
 24% of students expelled
Equity and Educational
Opportunities In US Schools [4]
Key Findings (Cont.)
Asian-American students represent 6% of
students in sample and
 3% of students suspended once
 1% of students suspended more than
once
 2% of students expelled
Equity and Educational
Opportunities In US Schools [5]
Key Findings (Cont.)
American-Indian-American students
represent 1% of students in sample and
 1% of students suspended once
 1% of students suspended more than
once
 1% of students expelled
Equity and Educational
Opportunities In US Schools [6]
Key Findings (Cont.)
European-American students represent 51%
of students in sample and
 36% of students suspended once
 29% of students suspended more than
once
 33% of students expelled
Equity and Educational
Opportunities In US Schools [7]
Key Findings (Cont.)
Referred to Law Enforcement
 25% of European American students
(51% in sample)
 42% of African American students
(18% in sample)
 29% of Hispanic American students
(24% in sample)
Equity and Educational
Opportunities In US Schools [8]
Key Findings (Cont.)
School Related Arrests
 21% of European American students
(51% in sample)
 37% of African American students
(18% in sample)
 35% of Hispanic American students
(24% in sample)
Equity and Educational
Opportunities In US Schools [9]
Key Findings (Cont.)
Sex of Students Expelled
 Males 74% (about 50% of sample)
 Females 26% (about 50% of sample)
Equity and Educational
Opportunities In US Schools [10]
Key Findings (Cont.)
Disability Status of Students
 Suspended
 13% of students with disabilities covered
by IDEA were suspended
 6% of Non-IDEA students were
suspended
Equity and Educational
Opportunities In US Schools [11]
Key Findings (Cont.)
Disability Status of Students (Cont.)
 Referred to Law Enforcement
 Students with disabilities covered by
IDEA 25% (but 12% of student
population)
 Non-IDEA students 75% (but 88% of
student population)
Equity and Educational
Opportunities In US Schools [12]
Key Findings (Cont.)
English Language Learners Suspended
 7% (but 10% of student population)
Equity and Educational
Opportunities In US Schools [13]



Sources:
http://www2.ed.gov/about/offices/list/ocr/d
ocs/crdc-2012-data-summary.pdf
http://www2.ed.gov/about/offices/list/ocr/d
ocs/crdc-disciplinesnapshot.pdf?utm_source=JFSF+Newslett
er&utm_campaign=0f6e101c7eNewsletter_July_2013&utm_medium=ema
il&utm_term=0_2ce9971b29-0f6e101c7e195307941
Reducing Suspensions
and Expulsions [1]


Education Development Center May 2011
Recommendations
Schools and mental health, juvenile
justice, and law enforcement agencies
 Must collaborate to improve outcomes
for youth, especially those at risk for
suspension or expulsion
Reducing Suspensions
and Expulsions [2]
Recommendations (Cont.)
Schools and mental health, juvenile justice,
and law enforcement agencies (Cont.)
 Must employ improved informationsharing and data collection systems to
identify, serve, and communicate about
at-risk students
Reducing Suspensions
and Expulsions [3]
Recommendations (Cont.)
State standards are needed to guide
schools’ practices related to
 Promoting students’ mental health
 Identifying students who need mental
health services
 Assisting students to access services
Reducing Suspensions
and Expulsions [4]
Recommendations (Cont.)
School districts should
 Focus on implementing, adapting, and
evaluating evidence-based interventions
 Have policies that require programs and
services for at-risk youth
 Consistently apply suspension and
expulsion policies so that existing racial
and ethnic disparities are not
perpetuated
Reducing Suspensions
and Expulsions [5]
Recommendations (Cont.)
School districts should (Cont.)
 Identify effective strategies to engage
and collaborate with parents
 Provide support to enable expelled
students to rejoin the school community
(and community partners)
Reducing Suspensions
and Expulsions [6]

Source:
http://www.promoteprevent.org/sites/www.
promoteprevent.org/files/resources/Califor
nia_Action_Steps_May_2011.pdf
Outcomes in Serious
Youthful Offenders [1]





Why do some serious adolescent
offenders stop offending while others
continue to commit crimes?
Investigators interviewed 1,354 young
offenders in the US
Mean age = 16.2 years
Years of offense: 2000 to 2003
Year of data collection: 2010
Outcomes in Serious
Youthful Offenders [2]

FINDINGS
Other than those with substance abuse
problems, those with behavioral health
problems were at no greater risk than
those without behavioral health problems
for
 Rearrest
or
 Engaging in antisocial activities
Outcomes in Serious
Youthful Offenders [3]

FINDINGS (Cont.)
More frequent aftercare services (e.g.,
frequent supervision and involvement in
community activities) significantly reduced
the odds of
 An arrest
or
 Return to an institution during the 6month aftercare period
Outcomes in Serious
Youthful Offenders [4]

FINDINGS (Cont.)
Those with substance use disorders, in
comparison with those without substance
abuse, disorders had more negative
outcomes
Outcomes in Serious
Youthful Offenders [5]

Source
Schubert, C. A. & Mulvey, E. P. (2014).
Behavioral health problems, treatment,
and outcomes in serious youthful
offenders. Retrieved from
http://ojjdp.gov/pubs/242440.pdf
Executive Functions
(EF; Appendix M,
pp. 246–262 in RG)
Executive Functions [1]
Cognitive abilities responsible for
 Complex goal-directed behavior
 Adaptation to environmental changes and
demands
 Development of social and cognitive
competence
 Development of self-regulation of behavior
Executive Functions [2]
EF enable individuals to modulate, control,
organize, and direct
 Cognitive activities
 Emotional activities
 Behavioral activities
Executive Functions [3]
EF help individuals
 Make personal and social decisions
 Distinguish relevant from irrelevant
material
 Follow general rules
 Make use of existing knowledge in new
situations
Executive Functions [4]
EF important for
 Daily living
 Academic performance
 Work-related activities
 Social relationships
Primary Executive Functions
(RG, p. 247)[1]
1.
2.
3.
4.
Planning and goal setting: ability to plan
and reason conceptually, monitor one’s
actions, and set goals
Organizing: ability to organize ideas and
information
Prioritizing: ability to focus on relevant
themes and details
Working memory: ability to temporarily
hold and manipulate information in
memory
Primary Executive Functions
(RG, p. 247) [2]
5.
6.
7.
Shifting: ability to alternate between
different thoughts and actions, to devise
alternative problem-solving strategies,
and to be cognitively flexible
Inhibition: ability to inhibit thoughts and
actions that are inappropriate for a
situation
Self-regulation: ability to regulate one’s
behavior and monitor one’s thoughts and
actions
Developmental Aspects of
Executive Functions [1]


EF most closely associated with the frontal
lobes of the brain
Maturational changes in brain structure
and function and in social experiences
govern the development of EF (see Table
M-1 on p. 249 in RG)
Developmental Aspects of
Executive Functions [1]


Begin to develop as early as 2 months of
age
 Self-exploration
 Emerging understanding of volitional
actions
At 1 year of age
 Working memory
 Ability to detect another’s attentional
and intentional states
Developmental Aspects of
Executive Functions [2]

EF improves throughout development;
gains noted in
 Working memory
 Strategic thinking and fluency
 Goal-directed behavior
 Monitoring of behavior
 Flexibility
Developmental Aspects of
Executive Functions [3]

EF improve throughout development gains
in (Cont.)
 Understanding of emotions, intentions,
beliefs, and desires
 Deciphering of metaphors and
understanding of faux pas
 Processing speed
 Problem solving
Developmental Aspects of
Executive Functions [4]

Overall EF has elements
 Of uniformity—common evolution
across EF
 Of individuality and variation—unique
evolution across EF
Intelligence and EF [1]
Tests of intelligence correlate moderately—
about .40 to .60—with tests of EF
 Working memory more closely related to
fluid and crystallized intelligence
 Inhibition and flexibility less closely related
to fluid and crystallized intelligence
Intelligence and EF [2]
Correlations moderate because IQ tests do
not require
 Shifting between different tasks
 Shifting between competing demands
 Using self-regulation strategies to
maximize long-term objectives
 Inhibiting less favorable responses
Achievement and EF [1]




Writing Essays
Planning and defining the first step
Rephrasing and paraphrasing one’s own
work and the work of others (cognitive
flexibility)
Organizing and prioritizing
Using accurate syntax
Achievement and EF [2]



Reading Comprehension
Planning what to read first and which
sections to focus on most
Organizing the material mentally by its
most important points
Monitoring one’s comprehension by
summarizing material
Achievement and EF [3]




Independent Studying, Completing
Homework, and Long-Term Projects
Planning ahead (time management)
Acquiring materials and information
(information processing)
Setting long-term goals (completing tasks)
Self-regulation (balancing needs)
Achievement and EF [4]


Independent Studying, Completing
Homework, and Long-Term Projects
(Cont.)
Self-monitoring (remembering to submit
completed assignments by a specific time)
Cognitive flexibility (ability to modify how
one goes about doing projects)
Achievement and EF [4]


Test-Taking
Prioritizing and focusing on relevant
themes
Managing time to study and answer
questions
How EF Are Compromised?
By
 Mental disorder
 Brain injury
 Learning disability
 Attention difficulties
 Fatigue




Anxiety
Stress
Depression
Motivational
deficits
Examples of Disabilities Where
EF are Compromised








Planning: ASD, TBI, SLD
Goal setting: ASD, TBI, SLD
Inhibition: ASD, ADHD, TBI
Self-regulation: ASD, ADHD, TBI, SLD
Shifting: ADHD, TBI, SLD
Prioritizing: SLD
Working memory: TBI
Organizing: ADHD, SLD
Assessment of EF [1]


Neuropsychological tests (see Table M-2 on
pp. 251–257 in RG)
Psychological tests (see Table M-2 on pp.
251–257 in RG)
Assessment of EF [2]

Interviews with
 Child (see Table M-3 on pp. 258–259 in
RG)
 Parents (see Tables M-3 on pp. 258–
259 in RG and B-9 on pp. 40–43 in RG)
 Teachers (see Table B-15 on pp. 67–70
in RG)
Assessment of EF [3]



General Assessment Considerations
Measures of information processing and
academic skills are indirect measures of
EF
Amount and nature of EF involved in each
task varies
No single measure provides an accurate
estimate of all types of EF
Assessment of EF [4]



Observing child at school, home, and
during the assessment (see Table M-3 on
pp. 258–259 in RG)
Analyzing samples of the child’s
schoolwork and written homework
assignments (see Table H-8 on p. 137 in
RG)
See Table L-18 (p. 242 in RG) for a
checklist for rating EF
Assessment of EF [5]

Conclusion
A multifaceted, comprehensive
assessment is required for the
assessment of EF
Improving Deficits in EF


See pp. 259 and 260 in RG
See Handout K-1 (for parents, begins on
p. 162) and Handout K-3 (for teachers,
begins on p. 185) in RG
Cartoon
IDEA 2004—Sec. 614.
EVALUATIONS PROCEDURES
(Chapter 1)[1]



Assessment Considerations
Information about
 Functional
 Developmental
 Academic functioning
No single measure as the sole criterion for
determination of a disability
Use of technically sound instruments
IDEA 2004—Sec. 614.
EVALUATIONS PROCEDURES
(Chapter 1)[2]



Assessment Considerations (Cont.)
Selected and administered so as not to be
discriminatory on a racial or cultural basis
Administered in the language and form
most likely to yield accurate information
Child is assessed in all areas of suspected
disability
IDEA 2004—Sec. 614.
EVALUATIONS PROCEDURES
(Chapter 1)[3]

Assessment Considerations (Cont.)
Consider information obtained from
 Parents
 Current classroom-based, local, or state
assessments
 Classroom-based observations
 Present levels of academic achievement
 Developmental needs of child
IDEA 2004 and Specific Learning
Disabilities (SLD; Chapter 16)[1]


SEC. 602. DEFINITIONS
(30) SPECIFIC LEARNING DISABILITY—
(A) IN GENERAL—The term “specific
learning disability” means a disorder in 1 or
more of the basic psychological processes
involved in understanding or in using
language, spoken or written, which disorder
may manifest itself in the imperfect ability to
listen, think, speak, read, write, spell, or do
mathematical calculations.
IDEA 2004 and SLD (Chapter 16)[2]

SEC. 602. DEFINITIONS (Cont.)
(B) DISORDERS INCLUDED—Such term
includes such conditions as perceptual
disabilities, brain injury, minimal brain
dysfunction, dyslexia, and developmental
aphasia.
IDEA 2004 and SLD (Chapter 16)[3]

SEC. 602. DEFINITIONS (Cont.)
(C) DISORDERS NOT INCLUDED—Such
term does not include a learning problem
that is primarily the result of visual, hearing,
or motor disabilities, of intellectual disability,
of emotional disturbance, or of
environmental, cultural, or economic
disadvantage.
Some Facts About SLD [1]



In 2010, almost 5 million U.S. children
ages 3–17 years had a SLD (8%).
About 2.4 million students diagnosed with
SLD receive special education services
each year, representing 41% of all
students receiving special education
Approximately 80% of children with a SLD
have a reading disorder
Some Facts About SLD [2]



Approximately 7% of children with a SLD
have an arithmetic disorder
Approximately 6% to 15% of children with
a SLD have a disorder of written
expression
The prevalence rate of SLD is higher for
boys than for girls by a ratio of about 1.5 to
1 (9% vs. 6%)
Some Facts About SLD [3]


Ethnic composition
 African American children (10%)
 European American children (8%)
 Asian American children (4%)
In families with incomes of $35,000 or
less, the percentage of children with a
SLD (12%) is twice that in families with
incomes of $100,000 or more (6%)
Some Facts About SLD [4]

Close to half of secondary students with
SLD perform at more than three grade
levels below their enrolled grade in
essential academic skills (45% in reading,
44% in math)
Some Facts About SLD [5]


Children in single-mother families are
about twice as likely to have SLD as
children in two-parent families (12% vs.
6%)
Children with poor health are almost five
times more likely to have SLD than
children in excellent or very good health
(28% vs. 6%)
DSM-5



The affected academic skills are
substantially and quantifiably below those
expected for the individual’s chronological
age
Cause significant interference with
academic or occupational performance, or
with activities of daily living
Confirmed by individually administered
standardized achievement measures and
comprehensive clinical assessment
Reasons for Poor Performance of
Children with Readings Disorders
[p. 483-1]
Problem areas
 Attention and concentration
 Phonological awareness
 Orthographic awareness
 Word awareness
 Semantic or syntactic awareness
 Rapid decoding
Possible Reasons for Poor
Performance With Children with
Readings Disorders [p. 483-2]
Problem areas (Cont.)
 Rapid naming
 Verbal comprehension
 Pragmatic awareness
Overall Comment on SLD [1]



Academic underachievement is a key
characteristic usually shared by children
with SLD
Language-based dysfunctions underlie
many children with SLD
Reading disability most frequent disability
Overall Comment on SLD [2]




Examine patterns of cognitive and
linguistic functioning
Don’t rely on somewhat arbitrary cutoff
scores
Don’t depend exclusively on RTI
Use the child’s unique pattern of abilities
and other assessment results to serve as
the foundation for developing interventions
Overall Comment on SLD [3]

Important to evaluate
 Cognitive-academic deficits
 Information-processing and executive
functioning deficits
 Perceptual deficits
 Social-behavioral deficits
 See Table 16-1, p. 481 in main text for
list of deficits in each of above areas
SLD and English Language
Learners (ELL) [1]

Assessment Considerations
Experiential background. Consider their:
 Length of residence in their new country
 Quality of instruction in school
 School attendance record
 Health history
 Family history
SLD and ELL [2]

Assessment Considerations (Cont.)
Language ability of peers. Compare their
language abilities with peers with similar
 Linguistic/cultural backgrounds
 Exposure to second language
instruction
SLD and ELL [3]


Assessment Considerations (Cont.)
Language ability of siblings. Compare their
language abilities with those of their
siblings when they were of the same age
Typical difficulties in learning a second
language. Compare their learning
difficulties with those of other English
language learners
SLD and ELL [4]


Assessment Considerations (Cont.)
Linguistic proficiency. Compare their
linguistic proficiency in their primary
language and in English
Appropriate assessment battery
 Standardized tests
 Checklists
 Language samples
 Interviews
SLD and ELL [5]

Assessment Considerations (Cont.)
Appropriate assessment battery (Cont.)
 Questionnaires
 Observations
 Portfolios
 Journals
 Work samples
 Curriculum-based measures
 Language-reduced measures
Reasons for Poor School
Performance of ELL





Experiential differences
Family expectations
Limited English proficiency
Stress associated with acculturation and
discrimination
Cognitive styles and learning strategies
that differ from those of the majority group
Children with Reading Disorder


Children with reading disorder may have
difficulties in cognitive, perceptual, and
linguistic areas
See p. 483 in main text for a listing of
these difficulties
Nonverbal Learning Disability [1]

Definition: A subtype of learning disability
associated with a dysfunction in the right
cerebral hemisphere
Nonverbal Learning Disability [2]






Strengths
Auditory perceptual ability
Receptive language
Vocabulary
Verbal expression
Rote verbal memory
Attention to small details
Nonverbal Learning Disability [3]






Weaknesses
Reading comprehension
Interpreting messages literally
Math ability
Abstract reasoning ability
Coordination and psychomotor skills
Ability to interact with others
Nonverbal Learning Disability [4]




Weaknesses (Cont.)
Ability to correctly perceive gestures, facial
expressions, and other nonverbal social
cues
Ability to adapt to changes and new
situations
Common sense
Self-esteem
IDEA 2004 and SLD [1]


Assessment Process
A local educational agency shall not be
required to take into consideration whether
a child has a
 Severe discrepancy between
achievement and intellectual ability in
various academic areas
But it may use a process that determines if
the child responds to scientific, researchbase intervention as a part of the
evaluation procedures
IDEA 2004 and SLD [2]


Limitations of IDEA Guidelines
IDEA does not define how a severe
discrepancy between achievement and
intellectual ability should be determined.
IDEA does not provide any guidance as to
how the response to intervention process
should be conducted.
Identifying SLD: RTI [1]



Problem-Solving Approach
The teacher uses achievement test scores
to identify children who are at risk
The teacher consults with others about
needed instructional modifications
If the interventions are not successful, the
school support team considers possible
causes and selects, implements, and
evaluates interventions
Identifying SLD: RTI [2]

Problem-Solving Approach (Cont.)
If additional interventions not successful a
comprehensive assessment will be
needed
Identifying SLD: RTI [3]


Standard Protocol Approach
Involves intensive tutoring using a
standard method of teaching
All children who have similar difficulties
are given the same intensive instruction
Identifying SLD: RTI [4]




RTI and Needed Implementation
Decisions
Timing of the assessment (e.g., pre- and
post-treatment, weekly, daily)
Method for measuring responsiveness
Norms (national norms, local norms, or
norms for children who are at risk)
Method for training teachers or tutors
Identifying SLD: RTI [5]



RTI and Needed Implementation
Decisions (Cont.)
Intensity of interventions
Procedures to use with culturally and
linguistically diverse children
Need for a comprehensive evaluation for
the identification of SLD
Identifying SLD: RTI [6]



Comment on RTI
How does RTI help in distinguishing
underachieving students from those with
neurologically based SLD?
Is RTI working effectively in diagnosing
SLD?
See discussion of RTI on pp. 494–496 in
main text
Identifying SLD:
Discrepancy Model



Simple difference method
Regression method
See pp. 496–497 in main text
Identifying SLD:
Patterns of Strengths and Weaknesses
(PSW) Models [1]




Discrepancy-Consistency Model
Aptitude-Achievement Consistency Model
Cognitive Hypothesis Testing Model
See pp. 497–498 in main text
Identifying SLD:
Patterns of Strengths and Weaknesses
(PSW) Models [2]
PSW models assume that in children with
SLD:
 There are strengths and weakness in
academic areas and psychological
processing areas
 There is a relationship between areas of
weakness in psychological processing and
academic deficits
Identifying SLD:
Patterns of Strengths and Weaknesses
(PSW) Models [3]
Determining Weaknesses
Below Average Academic Performance
(Below 10th or 15th percentile rank)
 Classroom tests
 National standardized achievement tests
 State standardized tests
 Significant intraindividual differences on
cognitive ability subtests that relate to the
academic deficits
Identifying SLD:
Patterns of Strengths and Weaknesses
(PSW) Models [4]
Determining Weaknesses (Cont.)
Below Average Psychological Processing
(Below 10th or 15th percentile rank)
 Measures of phonological processing
 Measures of working memory
 Measures of processing speed
 Measures of rapid automatic naming.
Examples of Standardized
Achievement Tests [1]





Phonological Awareness and Phonological
Memory Tests
Rapid Naming and Retrieval Fluency
Tests
Orthographic Processing Tests
Print Awareness, Word Recognition, and
Decoding Tests
Reading Fluency Tests
Examples of Standardized
Achievement Tests [2]






Reading Comprehension Tests
Reading Inventories
Written Expression Tests
Oral Language Tests
Mathematics Tests
See Table 17-1 on pp. 500–501 in main
text for a list of tests
Interviewing for SLD:
Written Expression

See p. 504 in main text for interview
questions
Interventions for SLD



Table 17-6 (p. 508 in main text) for young
children with reading disorders
Table 17-7 (p. 508 in main text) for
children with SLD
Table 17-8 (p. 509 in main text) for
examples of metacognitive strategies for
children with reading disorders
Older Adolescents and Young
Adults with SLD [1]
Help with (by using role-playing and
supervised job training):
 Filling out applications for college
 Finding job training
 Reading want ads
 Filling out job applications
 Interviewing
Older Adolescents and Young
Adults with SLD [2]
Help with (by using role-playing and
supervised job training): (Cont.)
 Following directions on the job
 Learning job skills
 Taking criticism
 Finishing work on time
 Paying attention on the job
 Working carefully
Older Adolescents and Young
Adults with SLD [3]
Help with (by using role-playing and
supervised job training): (Cont.)
 Learning about their legal rights on the job
 Learning how to advocate for necessary
job accommodations
Older Adolescents and Young
Adults with SLD [4]
Adjustment and Employment Success
Consider:
 Abilities required in a particular career
 Ability to set reasonable goals
 Access to appropriate guidance
 Attitude toward life challenges
 Available support systems
Older Adolescents and Young
Adults with SLD [5]
Adjustment and Employment Success
(Cont.)
Consider:
 Awareness of limitations and strengths
 Coping skills
 Cognitive ability
 Family’s, peers’, and teachers’ attitudes
toward them
Older Adolescents and Young
Adults with SLD [6]
Adjustment and Employment Success
(Cont.)
Consider:
 Motivation and perseverance
 Presence of comorbid disorders
 Self-concept
Functional Behavioral
Assessment
(FBA; Chapter 13)
Functional Behavioral
Assessment [1]

A comprehensive, multimethod, and
multisource approach designed to help
you
 Arrive at an understanding of the
relationship between the problem
behavior and the specific environmental
events
 Develop a behavioral intervention plan
(BIP)
Functional Behavioral
Assessment [2]
Need to consider
 Type of problem behavior
 Conditions under which the problem
behavior occurs
Functional Behavioral
Assessment [3]
Need to consider (Cont.)
 Probable reasons for the problem behavior
 Biological
 Social
 Cognitive
 Affective
 Environmental
 Functions served by problem behavior
Guidelines for Conducting FBA [1]
1.
Define the problem behavior
 See Tables F-1, F-2, and F-3 (pp. 113–
118 in RG) for FBA forms
Guidelines for Conducting FBA [2]
2.
Perform the assessment.
 Review
 Prior psychological or
psychoeducational evaluations
 Teachers’ comments on report cards
 Disciplinary records
 Anecdotal home notes
 Medical reports
 Prior interventions and results
Guidelines for Conducting FBA [3]
2.
Perform the assessment. (Cont.)
 Conduct systematic behavioral
observations (see Chapters 8 and 9)
 Interview student, teacher, parents, and
others as needed (see Chapters 5, 6,
and 7)
 Conduct other formal and informal
assessments as needed
Guidelines for Conducting FBA [4]
3.
Evaluate assessment results and also
consider the questions on p. 416 in main
text
Guidelines for Conducting FBA [5]
4.
5.
6.
7.
Develop hypotheses to help explain
relationship between problem behavior
and situations in which problem behavior
occurs
Formulate a behavioral intervention plan
Start the behavioral intervention as soon
as possible
Evaluate the effectiveness of the
behavioral intervention
Assessing Problem Behavior
Through Observations


See Chapters 8 and 9 in main text
See Tables C-1 and C-2 (pp. 78–80 in
RG)
Assessing Problem Behavior
Through Interviews [1]




See Chapters 5, 6, and 7 in main text
See Table B-1 (p. 20 in RG)
Examples of questions to ask a student
(See pp. 417–418 in main text)
Example of questions to ask a teacher (See
p. 418 in main text)
Assessing Problem Behavior
Through Interviews [9]



See Table B-15 (p. 67 in RG) to interview
teacher
See questionnaires in Tables A-1, A-2,
and A-3 (pp. 1–17 in RG) for parent, child,
and teacher to complete
See Table B-9 (p. 40 in RG) to interview
parent
Formulating Hypotheses About
Problem Behavior

See guidelines on pp. 419–420 in main
text for formulating hypotheses
Monitoring the Behavioral
Intervention Plan (BIP)

See p. 423 in main text for a list of
questions to aid in monitoring the BIP
Extensive PowerPoint
Presentation

See www.sattlerpublisher.com for a more
detailed FBA PowerPoint presentation
Cartoon
Bullying and
Cyberbullying
(Appendix N in RG)
Video
Court Strikes Down
Cyberbullying Law [1]



Decision
On July 1, 2014, New York Court of
Appeals (5 to 2) struck down an Albany,
NY law that made cyberbullying a crime
Court said that the law violates the First
Amendment of the US Constitution
Law made it a crime to engage in
cyberbullying against any minor or person
Court Strikes Down
Cyberbullying Law [2]

Cyberbullying defined in the law as:
 Any act of communicating by
mechanical or electronic means,
including
 Posting statements on the internet or
through a computer or email network
 Disseminating embarrassing or
sexually explicit photographs
 Disseminating private, personal, false
or sexual information
Court Strikes Down
Cyberbullying Law [3]

Cyberbullying defined in the law as:
 Or sending hate mail with no legitimate
private, personal, or public purpose
 With the intent to
 Harass
 Annoy
 Threaten
 Abuse
 Taunt
Court Strikes Down
Cyberbullying Law [4]

Cyberbullying defined in the law as:
 With the intent to (Cont.)
 Intimidate
 Torment
 Humiliate
 Or otherwise inflict significant
emotional harm on another person
Court Strikes Down
Cyberbullying Law [5]



Case
Marquan W. Mackey-Meggs, a 15-year-old
student, was the first to be charged under
the Albany law
He posted photos on Facebook of other
teenagers with captions that included
graphic and sexual comments
Majority of the court ruled that the law was
not drafted properly
Court Strikes Down
Cyberbullying Law [6]


Source:
People v. Marguan M., NY Slip OP 04881
(NY. Ct. App. 2014)
Are Anti-Bullying Laws
Unconstitutional or Unneeded?[1]

MLA Jansen, a Calgary Associate
Minister, says bullying laws do not
necessarily address the complexities of
the issue
 “It’s much more effective to teach
people resilience so they can stand up
to bullying and encourage others to
stand up too.”
Are Anti-Bullying Laws
Unconstitutional or Unneeded? [2]

Source:
http://www.thestar.com/opinion/commentar
y/2014/02/10/more_antibullying_laws_not_
the_answer_in_alberta_steward.html
Examples of Bullying [1]

See Table N-1 (p. 264 in RG) for
examples of types of bullying
Effects of Bullying [1]


Physical and mental health
 Of victim
 Of victim’s peers, family, schools,
community, and society
Short- and long-term psychological,
academic, and physical consequences for
 Victim
 Perpetrator
 Bystanders
Effects of Bullying [2]




Short-Term Effects
Physical effects
Behavioral effects
Emotional effects
See Table N-4 on p. 269 in RG for signs of
distress displayed by victims of bullying
Effects of Bullying [3]

Long-Term Effects: Research Study
Sample: British children (N = 7,771)
 Bullied at ages 7–11 years
 Followed up at ages 23–50 years
Effects of Bullying [4]

Long-Term Effects: Reasearch Study
(Cont.)
Results:
 At age 23 years and at age 50 years,
victims, in comparison to their
nonvictimized peers, had higher rates of
 Depression
 Anxiety disorders
 Suicidality
Effects of Bullying [5]

Long-Term Effects: Research Study
(Cont.)
Results (Cont.):
 At age 50 years, victims also had poor
 Social relationships
 Economic hardship
 Quality of life
Effects of Bullying [6]

Long-Term Effects: Research Study
(Cont.)
Conclusion:
 Children who are bullied at a young age
are at risk for a wide range of social,
health, and economic problems nearly
four decades after victimization
Effects of Bullying [7]


Long-Term Effects: Research Study
(Cont.)
Source:
Takizawa, R., Maughan, B., & Arseneault,
L. (2014). Adult health outcomes of
childhood bullying victimization: Evidence
from a five-decade longitudinal British birth
cohort. American Journal of Psychiatry,
171(7), 777–784. doi:
10.1176/appi.ajp.2014.13101401
Dear Colleague Letter
Aug. 20, 2013 [1]
US Dept of Education
Office of Special Education and
Rehabilitative Services
Melody Musgrove, Ed. D., Director, Office of
Special Education Programs
Michael K. Yudin, Acting Assistant Secretary
Dear Colleague Letter
Aug. 20, 2013 [2]



Students with disabilities are
disproportionately affected by bullying
Bullying may prevent students from
receiving free and appropriate education
under IDEA
IEP Team needs to determine whether
students’ needs have changed as a result
of bullying
Dear Colleague Letter
Aug. 20, 2013 [3]



If so, what extent additional or different
special education or related services are
needed
If students with a disability engaged in the
bullying, IEP Team needs to address the
inappropriate behavior
IEP Team needs to study environment
where bullying occurred to see if changes
are warranted
Rate of Victimization
Students with Disabilities [1]



Rate for all students between
15% to 28%
Rate for students with disabilities
25% to 34%
 Elementary school 25%
 Middle school 34%
 High school 27%
Rate is 1 to 1½ times higher than for all
students
Rate of Victimization
Students with Disabilities [2]


Highest rates for students with
 Emotional disturbance 39% to 52%
 Other health impaired 29% to 40%
Highest rates for repeated victimization
 Autism spectrum disorder (in elementary
and middle school)
 Orthopedic impairments (in high school)
Rate of Victimization
Students with Disabilities [3]

Source: Blake, J. J., Lund, E. M., Zhou,
Q., Kwok, O., & Benz, M. R. (2012).
National prevalence rates of bully
victimization among students with
disabilities in the United States. School
Psychology Quarterly, 27(4), 210–222.
doi:10.1037/spq0000008
Various Roles in Bullying






Bully who takes the initiative
Follower who joins in
Reinforcer who encourages the bully or
who laughs at the victim
Intervener who tries to stop the bullying
Bystander who looks on but does not
participate
Victim who is the object of the bullying
Characteristics of Bullies [1]


Attempt to
 Control
 Dominate
 Subjugate others
 Through the use of power
Bullies aim to disempower their victims by
undermining their worth and status
Characteristics of Bullies [2]

Two key components of bullying
 Repeated harmful acts
 An imbalance of power
Characteristics of Bullies [3]

Their families
 Less cohesive (low parent-child
involvement, warmth, and affection)
 More conflictual (angry, hostile parentchild interactions)
 Less organized
 More disadvantaged
Characteristics of Victims [1]




Displays vulnerability or insecurity
Dresses differently and doesn’t conform to
the norm
Has learning, speech, or other physical or
mental disabilities
Has low self-esteem
Characteristics of Victims [2]



Has physical attributes that differ from the
norm
 Overweight
 Underweight
 Very short
 Very tall
Has poor communication skills
Has poor social skills
Characteristics of Victims [3]



Is a member of an ethnic or religious
group viewed as different
Is bright, talented, or gifted
Is clumsy or immature
Characteristics of Victims [4]




Is or is perceived to be
 Lesbian
 Gay
 Bisexual
 Transgendered
Is new to the school
Is nonasssertive and refuses to fight
Is physically weak
Characteristics of Victims [5]




Is annoying, provocative, or aggressive
Is richer or poorer than the majority of
classmates
Is shy, reserved, timid, or submissive
Is the smallest or youngest child in school
Children with Special Needs [1]
May also act as bullies if they:
 Want to protect themselves from further
victimization
 Feel extremely anxious and have limited
frustration tolerance
 Cannot size up a situation realistically and
distinguish good-natured kidding from
bullying
Bullying and Children with
Disabilities [1]



Students with disabilities are
disproportionately affected by bullying
Bullying may prevent students from
receiving free and appropriate education
under Individuals with Disability Education
Act (IDEA)
Individualized Education Program (IEP)
Team needs to determine whether
students’ needs have changed as a result
of bullying
Bullying and Children with
Disabilities [2]



If needs have changed, what extent
additional or different special education or
related services are needed?
If students with a disability engaged in the
bullying, IEP Team needs to address the
inappropriate behavior
IEP Team needs to study environment
where bullying occurred to see if changes
are warranted
Children with Disabilities [1]
May also act as bullies if they:
 Want to protect themselves from further
victimization
 Feel extremely anxious and have limited
frustration tolerance
 Cannot size up a situation realistically and
distinguish good-natured kidding from
bullying
Children with Disabilities [2]
May also act as bullies if they: (Cont.)
 Feel they are being pushed too far or feel
that their resources are exhausted
 Fail to realize that their “playful” behavior
can hurt others
Children with Disabilities [3]
Bullying may have harmful effects on
children with disabilities:
 Limit motivation to achieve and lower their
grades
 Interfere with their compliance with
treatment regimens and use of assistive
technology
 Increase frequency and strength of their
symptoms
“Welcome to My Life”
by Simple Plan[1]
Lyrics (Partial)
Do you ever feel like breaking down?
Do you ever feel out of place,
Like somehow you just don't belong
And no one understands you?
Do you ever wanna run away?
Do you lock yourself in your room
With the radio on turned up so loud
That no one hears you're screaming?
“Welcome to My Life”
by Simple Plan[2]
No, you don’t know what it’s like
When nothing feels all right
You don’t know what it’s like
To be like me
“Welcome to My Life”
by Simple Plan [3]
To be hurt
To feel lost
To be left out in the dark
To be kicked when you’re down
To feel like you’ve been pushed around
To be on the edge of breaking down
And no one’s there to save you
No, you don’t know what it’s like
Welcome to my life
Bullying and Morality [1]


Bullying has been described as an
immoral action because it humiliates and
oppresses innocent victims (Gini, Pozzoli,
& Hauser, 2011)
Bullies have adequate moral competence–
that is, they have knowledge of right and
wrong and an understanding of moral
norms
Bullying and Morality [2]


But paradoxically they do not have moral
compassion–that is, emotional awareness
and sensitivity about their moral infractions
In fact, bullies may disregard the harmful
effects of their actions and blame the
victim for causing the bullying behavior
Bullying and Morality [3]

Source: Gini, G., Pozzoli, T., & Hauser, M.
(2011). Bullies have enhanced moral
competence to judge relative to victims,
but lack moral compassion. Personality
and Individual Differences, 50(5), 603–
608. doi:10.1016/j.paid.2010.12.002
Factors That May Lead to
Bullying

See Table N-2 on p. 265 in RG
Differences Between Bullying
and Cyberbulling [1]




Bullying
Victim can hide from bully when at home
Event is discrete and audience limited
Bully is present, not anonymous, and can
see suffering of victim
Bully has opportunities for empathy and
remorse
Differences Between Bullying
and Cyberbulling [2]


Bullying (Cont.)
Bystanders can intervene
Bully may gain status by showing abusive
power
Differences Between Bullying
and Cyberbulling [3]




Cyberbullying
Victim cannot hide from bully when at
home
Event can be continuous and audience
potentially large
Bully is invisible, may be anonymous, and
cannot see suffering of victim
Bully has few opportunities for empathy
and remorse
Differences Between Bullying
and Cyberbulling [4]


Cyberbullying (Cont.)
Bystanders have little opportunity to
intervene
Bully lacks opportunity to show his or her
abusive power immediately
Cyberbullies

But…
Cyberbullies are not a new class of
bullies—they also may engage in overt
aggressive and social bullying
Incidence of Bullying [1]


Sound statistics difficult to obtain
Victims may be reluctant to report
 Fearing retaliation
 Feeling shame at not being able to
stand up for themselves
 Fearing they would not be believed
 Not wanting to worry their parents
Incidence of Bullying [2]

Victims may be reluctant to report (Cont.)
 Having no confidence that anything
would change as a result
 Thinking their parents’ or teacher’s
advice would make the problem worse
 Fearing their teacher would tell the bully
who told on him or her
 Thinking it would be worse to be thought
of as a snitch
USA Cyberbullying Surveys



In 2010 11% of children ages 10–17 years
harassed online
 Majority (69%) being female
1999–2000 6% of online users were
harassed
Over a 10-year period, online harassment
increased by about 83%
Jamey Rodemeyer [1]


On Sept. 8, 2011 Jamey Rodemeyer, a 14
year old, wrote on his website: “No one in
my school cares about preventing suicide,
while you're the ones calling me [gay slur]
and tearing me down.”
A day later he wrote: “I always say how
bullied I am, but no one listens. What do I
have to do so people will listen to me?"
Jamey Rodemeyer [2]

Then he posted the lyrics to a song by the
Hollywood Undead:
“I just wanna say good bye, disappear with
no one knowing
I don't wanna live this lie, smiling to the
world unknowing
I don’t want you to try, you've done enough
to keep me going
I'll be fine, I'll be fine, I'll be fine for the very
last time”
Jamey Rodemeyer [3]
Video
Jamey Rodemeyer [4]

About 10 days later, on Sept. 18, 2011
Jamey Rodemeyer committed suicide.
Why are Bystanders Reluctant to
Report Bullying? [1]
They know that bullying is wrong but . . .
 Don’t want to raise the bully’s wrath and
become the next target
 Don’t want to be thought of as a snitch and
be rejected by their peers
 May wrongly believe that they are not
responsible for stopping the bullying
 May think that bullying is acceptable
Why are Bystanders Reluctant to
Report Bullying? [2]




May assume that school personnel don’t
care enough to stop the bullying
May feel guilty for not reporting the
bullying
May have heightened anxiety, depression,
or substance abuse
May become bullies themselves because
they think that this is a way to become part
of a group
Why do Some Bystanders
Intervene?




Are victim’s friends
Believe that their parents expect them to
support victims
Believe that it is the moral and proper thing
to do
Believe that their peer group supports their
actions
Quotes


The bully survives on your silence.
—Christine Farrell Crotty
Bystanders who are helpless in the
presence of another student’s victimization
learn passive acceptance of injustice.
—Linda R. Jeffrey, DeMond Miller, and
Margaret Linn
Assessment of Bullying

See Tables B-17 to B-20 in RG (pp. 71–
75) for four semistructured interviews on
bullying
Helping Victims of Bullying [1]
Help them develop:
 Problem solving skills
 Conflict resolution skills
 Emotional regulation skills, including how
to handle anxiety, depression, and anger
Helping Victims of Bullying [2]
Help them develop: (Cont.)
 Self-adequacy skills, including
assertiveness skills and ability to say “no”
or “stop that”
 Ability to know when to go to a safe room
when under severe stress
Helping Bullies [1]

Change habitual patterns of thought and
action that support bullying
 Develop new skills
 Challenge old beliefs
 Replace impulsive with reflective
decision-making
Helping Bullies [2]

Helping children who are bullies
 Develop anger management skills
 Develop empathy skills and appreciate
the harm they cause their victims
 Recognize that they can engage in
responsible and moral behavior
 Give up self-justifying mechanisms,
egocentric reasoning, and distortions in
morality
Effective Strategies To Counter
Bullying In Schools [1]


Designing comprehensive intervention
strategies involving students, teachers,
administrators, families, and communities
Building bullying prevention programs
based on principles of science and
supported by scientifically valid evidence
of effectiveness
Effective Strategies To Counter
Bullying In Schools [2]


Applying school discipline rules, policies,
and sanctions fairly and consistently
Implementing policies at all levels,
including primary, junior, intermediate, and
high school
Effective Strategies To Counter
Bullying In Schools [3]

Motivating students, teachers,
administrators, and parents to understand
that
 Bullying is a serious and preventable
problem
 Antibullying programs must be given a
chance to work
 They themselves can make a difference
Effective Strategies To Counter
Bullying In Schools [4]

Motivating students, teachers,
administrators, and parents to understand
that (Cont.)
 Having a defender means that victims
may be less likely to be bullied in the
future
Effective Strategies To Counter
Bullying In Schools [5]


Presenting strategies that are clear,
relevant, and comprehensible to both
teachers and students
Encouraging bystanders to report bullying
Effective Strategies To Counter
Bullying In Schools [6]


Partnering with law enforcement and
mental health agencies to identify and
address serious cases of bullying
Assessing the frequency of bullying, the
effectiveness of any intervention program,
and making adjustments as needed (see
Delaware Attorney General, n.d.;
Hamburger et al., 2011; Safe School
Survey, 2003)
Effective Strategies To Counter
Bullying In Schools [7]

Delaware Attorney General. (n.d.). Bully
Worksheet Questionnaire. Retrieved from
http://attorneygeneral.delaware.gov/school
s/bullquesti.shtml
Effective Strategies To Counter
Bullying In Schools [8]

Hamburger, M. E., Basile, K. C., Vivolo, A.
M. (2011). Measuring bullying
victimization, perpetration, and bystander
experiences: A compendium of
assessment tools. Atlanta, GA: Centers for
Disease Control and Prevention, National
Center for Injury Prevention and Control.
Retrieved from
http://www.cdc.gov/violenceprevention/pdf/
BullyCompendiumBk-a.pdf
Effective Strategies To Counter
Bullying In Schools [9]

Safe School Survey. (2003). Safe School
Survey sample menu. Retrieved from
https://sdfs.esc18.net/Sample_Surveys/SS
M.asp
Meta-Analysis of School-Based
Anti-Bullying Programs [1]


Objective
 Meta-analysis of 13 studies (N = 19,619)
published in 2005 to 2010 that
examined anti-bullying programs
conducted in several countries
Results
 School-based anti-bullying programs
have a small to moderate effect on
victimization
Meta-Analysis of School-Based
Anti-Bullying Programs [2]

Conclusion
 Best results were when anti-bullying
programs had
 Training in emotional control
 Peer counseling
 Establishment of a school policy on
bullying
Meta-Analysis of School-Based
Anti-Bullying Programs [3]


Source:
Lee, S., Kim, C. J., & Kim, D. H. (2013). A
meta-analysis of the effect of schoolbased anti-bullying programs. Journal of
Child Health Care. Advanced online
publication. doi:
10.1177/1367493513503581
Bystander Intervention



Needs to be taught in early school grades
Education needs to be continued in later
school grades
Accompanied by programs that encourage
peer support for victims of bullying
Video
10 Tips for Parents [1]
1.
2.
3.
Talk often with your child, listen carefully,
and note any changes in your child’s
behavior
Talk about what bullying and
cyberbullying means. See such websites
as www.stopbullying.gov and
www.stopbullyingnow.com
Remind your child that real people with
real feelings are behind screen names
and profiles
10 Tips for Parents [2]
Tell your child:
4. To tell you when he or she is being
bullied and discourage your child from
bullying others
5. To tell a member of the school staff if he
or she sees a child being bullied
6. To refuse to join in if he or she sees
another child being bullied
10 Tips for Parents [3]
Tell your child: (Cont.)
7. To learn about the school’s rules and
sanctions about bullying and
cyberbullying
8. To post only information that he or she is
comfortable with others seeing, and never
to share passwords with anyone except
you and another close family member
10 Tips for Parents [4]
Tell your child: (Cont.)
9. To take Internet harassment seriously
because it is harmful and unacceptable
10. That you may review his or her online
communications if you think there is
reason for concern about his or her safety
10 Tips for Teachers [1]
1.
2.
3.
Explain to students the difference
between playfulness and bullying or
cruelty
Let students know that bullying is
unacceptable and against school rules
Tell students, whether they are victims or
bystanders, to report bullying or
cyberbullying immediately to a member of
the school staff
10 Tips for Teachers [2]
4.
5.
6.
Emphasize the difference between
tattling and telling on someone who is
bullying another student
Identify and intervene upon undesirable
attitudes and behaviors that could be
“gateway behaviors” to bullying and
cyberbullying
Watch for signs of bullying and
cyberbullying and stop either one
immediately
10 Tips for Teachers [3]
7.
8.
9.
Listen receptively to parents who report
bullying or cyberbullying
Report all incidents of bullying and
cyberbullying to the school administration
Always respond to requests of help from
victims of bullying and make sure that
they know that being bullied is not their
fault
10 Tips for Teachers [4]
10.
Closely monitor students’ use of
computers at school and become familiar
with cyberbullying and its dangers
Resources


Strategies for Preventing and Dealing with
Bullying, Cyberbullying, and Other Internet
Issues in RG
 Handout K-2 for parents (pp. 177–184)
 Handout K-4 for teachers (pp. 210–217)
Bullying Preventions Programs and Other
Resources
 Exhibit N-2 (pp. 274–275)
Concluding Comment

John Palfrey (2010), a professor of law at
Harvard Law School, pointed out that “No
one federal law will prevent tragedies from
happening. Most of the time, we have the
laws on the books that we need. It’s a
commitment to teaching and mentoring, to
being supportive and to being tough where
we have to be, that can help.”
Video Links



President Obama speaking at White
House conference on bullying:
 http://youtu.be/kM0WDkevgrY
Jamey Rodemeyer
 http://youtu.be/-Pb1CaGMdWk
StopBullying.gov Webisode 11: Power in
Numbers
 http://youtu.be/WwD0Zgk8jGA
Cartoon
Cartoon
Views from the Teacher’s Desk
(Notes from Parents to Teachers)
[1]
Please excuse ray friday from school.
He has very loose vowels.
Views from the Teacher’s Desk
(Notes from Parents to Teachers)
[2]
Please excuse my daughter’s absence.
She had her periodicals.
Views from the Teacher’s Desk
(Notes from Parents to Teachers)
[3]
Please excuse mary for being absent
yesterday. She was in bed with gramps.
Views from the Teacher’s Desk
(Notes from Parents to Teachers)
[4]
Dear school: please ecsc's john being
absent on jan. 28, 29, 30, 31, 32
and also 33.
Views from the Teacher’s Desk
(Notes from Parents to Teachers)
[5]
Please exkuce lisa for being absent
she was sick and i had her shot.
Cartoon
Autism Spectrum
Disorder
(ASD; Chapter 22)
Video
Video Link

Bringing the Early Signs of Autism
Spectrum Disorders Into Focus
 http://youtu.be/YtvP5A5OHpU
DSM-5 Definition

A neurodevelopmental disorder
characterized by persistent deficits in
social communications and social
interactions and by repetitive or restricted
behaviors, interests, and activities
Prevalence Rates of ASD in
Four Countries [1]


Research Study
Western Australia, Denmark, Finland, and
Sweden
Compared rates of ASD in 2000 and 2011
in children aged 10 years
Prevalence Rates of ASD in
Four Countries [2]


Found increases in ASD diagnoses
 96% in Finland
 121% in Western Australia
 175% in Denmark
 354% in Sweden
Source: See next slide
Prevalence Rates of ASD in
Four Countries [3]
Atladottir, H. O., Gyllenberg, D., Langridge,
A., Sandin, S., Hansen, S. N., Leonard, H.,
Gissler, M., Reichenberg, A., Schendel, D.
E., Bourke, J., Hultman, C. M., Grice, D. E.,
Buxbaum, J. D., & Parner, E. T. (2014). The
increasing prevalence of reported diagnoses
of childhood psychiatric disorders: a
descriptive multinational comparison.
European Child and Adolescent Psychiatry.
Advanced online publication.
doi: 10.1007/s00787-014-0553-8
Some Facts about ASD [1]



In 2011–2012, about 1 in 50 children in the
United States had a diagnosis of ASD,
with a prevalence rate of about 2% for
children ages 6–17 years
ASD occurs in all ethnic and
socioeconomic groups
Parents of children ages 6–17 years with
ASD reported that 58.3% of cases were
mild, 34.8% were moderate, and 6.9%
were severe
Some Facts about ASD [2]



ASD is almost five times more common
among boys (3.23%) than among girls
(.70%)
Approximately 40% of children with ASD
do not speak
Approximately 25% to 30% of children with
ASD begin speaking at 12 to 18 months of
age but then stop speaking
Some Facts about ASD [3]

Before child’s first birthday, parents may
have concerns about child’s
 Social, communication, and fine-motor
skills
 Vision and hearing
Some Facts about ASD [4]

Children with higher IQs
 Tend to show fewer symptoms
 Usually are identified as having an ASD
at a later age
Some Facts about ASD [5]

Children with other developmental
disorders, such as
 Language disorder or
 Intellectual disability
may also exhibit behaviors that suggest a
possible ASD (see Table 22-1 on p. 601 in
main text)
Lifetime Costs of ASD
in USA and UK [1]



Research Study
Aim of study: Conduct a literature review
on the cost of ASD for individuals and
families.
Year: 2013
Countries: United States and United
Kingdom
Lifetime Costs of ASD
in USA and UK [2]
Findings
Costs associated with ASD:
 Special education services
 Loss of parental productivity
 Residential care as adults
 Supportive living services as adults
 Individual productivity costs
 Medical costs
Lifetime Costs of ASD
in USA and UK [3]


Results
Individuals with ASD and with intellectual
disability:
 $2.4 million in United States
 $2.2 million in United Kingdom
Individuals with ASD and without
intellectual disability:
 $1.4 million in United States
 $1.4 million in United Kingdom
Lifetime Costs of ASD
in USA and UK [4]



Comment
What are the most effective interventions
that make the best use of scarce societal
resources?
How can we best coordinate services
across many different service systems?
How can we best deal with the enormous
effect of ASD on children, their families,
their schools, and society?
Lifetime Costs of ASD
in USA and UK [5]

Source
Buescher, A. V. S., Cidav, Z., Knapp, M.,
& Mandell, D. S. (2014). Costs of autism
spectrum disorders in the United Kingdom
and the United States. JAMA Pediatrics.
Advanced online publication.
doi:10.1001/jamapediatrics.2014.210
Why Are More Children
Diagnosed with ASD?




Greater public awareness
More clearly defined public policies
Availability of more extensive social
services and education
Availability of better and more sensitive
diagnostic tools
Etiology of ASD [1]



Genetic Causes
Identical twins are more likely to have ASD
than nonidentical twins
Increased rates of ASD among siblings
and first-degree relatives
ASD tends to occur about 10% of the time
in children who have genetic or
chromosomal disorders
Etiology of ASD [2]



Genetic Causes (Cont.)
Genetic mechanisms may produce an
excessive number of brain cells in the
prefrontal cortex
Older fathers may pass on significantly
more random genetic mutations to their
offspring than younger fathers
Older mothers are at a 30% higher risk of
having a child with ASD than younger
mothers
Etiology of ASD [3]


Environmental Factors
Some children with ASD have
spontaneous DNA mutations
Adverse fetal environment may place the
fetus at increased risk for developing ASD
 Antibodies in the mother’s blood during
pregnancy may interfere with fetal brain
development by attacking healthy tissue
Etiology of ASD [4]

Environmental Factors (Cont.)
Toxic chemicals in the environment
 Lead and mercury can interfere with
normal brain development in the fetus
Etiology of ASD [5]

Environmental Factors (Cont.)
Variations in brain structure and function
are thought to play a role in ASD
 Rate of growth of the amygdala (an
almond-shaped mass of nuclei located
deep within the temporal lobe of the
brain) may be abnormal and
disproportionate to total brain growth in
very young children with ASD
Etiology of ASD [6]

Environmental Factors (Cont.)
Research Study on ASD and
Prenatal Pesticides
Sample: 970 children (developmental
delay, normal development, and ASD)
studied during 1997–2008
Etiology of ASD [7]

Environmental Factors (Cont.)
Results: Residential proximity to
organophosphate pestisides at some point
during gestation was found to be
associated
 With a 60% increased risk for ASD
 Highest during the 3rd trimester
Etiology of ASD [8]


Environmental Factors (Cont.)
Organophosate pestisides are
variety of organic compounds that contain
phosphorus and often have intense
neurotoxic activity
Conclusion: Results strengthen evidence
linking neurodevelopmental disorders with
gestational pesticide exposure,
particularly, organophosphates
Etiology of ASD [9]

Environmental Factors (Cont.)
Source: Shelton, J. F., Geraghty, E. M.,
Tancredi, D. J., Delwiche, L. D., Schmidt,
R. J., Ritz, B., Hansen, R. L., & HertzPicciotto, I. (2014). Neurodevelopmental
disorders and prenatal residential
proximity to agricultural pesticides: The
CHARGE study. Environmental Health
Perspectives. Advanced online
publication. doi:10.1289/ehp.1307044
Etiology of ASD [10]
Environmental Factors (Cont.)
Research Study on ASD and Prenatal
Exposure to Selective Serotonin Reuptake
Inhibitors (SSRIs)
 Sample: 968 mother-child pairs
 Results: Prenatal exposure to SSRIs
(antidepressants like Prozac and Zoloft) in
boys may increase their susceptibility to
ASD (effect stronger in boys than girls)
Etiology of ASD [11]

Environmental Factors (Cont.)
Conclusion: Research findings, however,
remain inconsistent about the relationship
between SSRIs and ASD
Etiology of ASD [12]

Environmental Factors (Cont.)
Source: Harrington, R. A. Lee, L-C., Crum,
R. M., Zimmerman, A. W., & HertzPicciotto, I. (2014). Prenatal SSRI use and
offspring with autism spectrum disorder or
developmental delay. Pediatrics, 133(5),
e1241–e1248. doi: 10.1542/peds.20133406
DSM-5 Diagnostic Criteria
for ASD [1]
A. Persistent deficits in social
communication and social interaction
across multiple contexts
1. Deficits in social-emotional reciprocity
2. Deficits in nonverbal communicative
behaviors used for social interaction
3. Deficits in developing, maintaining, and
understanding relationships
DSM-5 Diagnostic Criteria
for ASD [2]
B. Restricted, repetitive patterns of
behavior, interests, or activities
 1. Stereotyped or repetitive motor
movements, use of objects, or speech
 2. Insistence on sameness, inflexible
adherence to routines, or ritualized
patterns of verbal or nonverbal behavior
DSM-5 Diagnostic Criteria
for ASD [3]
B. Restricted, repetitive patterns of
behavior, interests, or activities (Cont.)
 3. Highly restricted, fixated interests that
are abnormal in intensity or focus
 4. Hyperreactivity or hyporeactivity to
sensory input or unusual interest in
sensory aspects of the environment
Features Associated with ASD [2]



Regression in development
Difficulties in eating or sleeping
Aggressive behavior (toward themselves
like self-injurious behavior or toward other
people)
Features Associated with ASD [4]

Savant skills
 Ability to calculate extremely difficult
mathematical equations without a
calculator but not calculate the correct
change when purchasing items
 Ability to draw highly accurate and
detailed perspective drawings
 Ability to sing with perfect pitch
Features Associated with ASD [5]

Savant skills (Cont.)
 Ability to state the day of the week for a
date far in the past or future
 Ability to play a piano concerto after
hearing it once
Research on Signs of ASD
Related to Age [1]
Early Identification
(Around ages 2–5 years)
Impairments in
 Nonverbal communication
 Pretend play
 Inflexible routines
 Repetitive motor behaviors
Research on Signs of ASD
Related to Age [2]
Later Identification
(Around ages 5–8 years)
Impairments in
 Peer relations
 Conversational ability
 Idiosyncratic speech
Research on Signs of ASD
Related to Age [3]

Authors concluded that the number of
diagnostic behaviors are inversely
associated with the age of identification of
children with ASD
Research on Signs of ASD
Related to Age [6]

Source: Maenner, M. J., Schieve, L. A.,
Rice, C. E., Cunniff, C., Giarelli, E., Kirby,
R. S., Lee, L.-C., Nicholas, J. S., Wingate,
M. S., & Durkin, M. S. (2013). Frequency
and pattern of documented diagnostic
features and the age of autism
identification. Journal of the American
Academy of Child & Adolescent
Psychiatry, 52(4), 401–413.
doi:10.1016/j.jaac.2013.01.014
Disorders Comorbid with ASD [1]

Medical
 Asthma
 Skin allergies
 Food allergies
 Ear infections
 Frequent severe headaches
 Sleep disorders
 Sensory processing problems
 Feeding disorders
Disorders Comorbid with ASD [2]

Psychiatric Disorder
 Social anxiety disorder
 ADHD
 Oppositional defiant disorder
 Anxiety disorder
 Language disorder
 Depressive disorder
Disorders Comorbid with ASD [3]



Neurological disorders
Chromosomal
Genetic disorders
Intellectual Functioning of
Children with ASD [1]



About 50% to 62% have IQs of 70 or
above
 “Low functioning” used to describe those
with IQs of 69 or below
 “High functioning” used to describe
those with IQs of 70 or above
IQs tend to be stable
No specific cognitive profile
Intellectual Functioning of
Children with ASD [2]


No cognitive profile can reliably distinguish
children with ASD from children with other
disorders
But children with ASD have relative
strengths on some Wechsler subtests
 Block Design
 Matrix Reasoning
 Picture Concept
Intellectual Functioning of
Children with ASD [3]


And have relative weaknesses on other
Wechsler subtests
 Comprehension
 Vocabulary
 Symbol Search
 Coding
IQs may improve as a result of intensive
early interventions
Intellectual Functioning of
Children with ASD [4]

Children with ASD have higher IQs when
they have
 Adequate conversational speech or
 Social relationships
Intellectual Functioning of
Children with ASD [5]

Poorly developed language skills in
children with ASD include
 Imitation
 Sequencing
 Organization
 Seeing relations between pieces of
information
Intellectual Functioning of
Children with ASD [6]

Poorly developed language skills in
children with ASD include (Cont.)
 Identifying central patterns or themes
 Distinguishing relevant from irrelevant
information
 Deriving meaning from the bigger
picture
Intellectual Functioning of
Children with ASD [7]

Relatively well-developed skills in children
with ASD include
 Perceptual discrimination
 Retrieval of visual knowledge
 Visual reasoning
 Attention to visual detail
 Rote memory
Intellectual Functioning of
Children with ASD [8]


Children with ASD and savant abilities
tend to have low IQs
Children with ASD usually have
 Selective memory deficits rather than
widespread and all-encompassing ones
Observing Children with ASD
[pp. 606–607; 1]
Areas to Observe



Use of
 Eye contact
 Facial expressions
 Gestures
 Vocalizations
Interactions with others
Interactions with examiner
Observing Children with ASD
[pp. 606–607; 2]






Areas to Observe (Cont.)
Transitions
Use of language
Play
Motor behavior
Attention and activity level
Awareness of social cues and
expectations
Tips for Testing
Children with ASD [1]






Adapt the environment
Select a room in a quiet area
Have comfortable lighting
Wear little or no perfume or cologne
Change room if sensory stimuli are
distracting (e.g., child is screaming,
avoiding, or covering ears)
Use tangible rewards (e.g., food
reinforcers with permission or games)
Tips for Testing
Children with ASD [2]







Use frequent breaks
Make sure you have the child’s attention
when you speak
Talk slowly
Use short and simple phrases
Be concrete
Avoid complex grammatical forms
Repeat or rephrase sentences
Tips for Testing
Children with ASD [3]




Avoid reliance on purely auditory cues
Use visual cues when possible to help
children understand language
Use simple written to-do lists
Use a picture schedule of activities
Learn about Child’s
Communication Skills




Ask parents and teachers for advice on
how to best work with the child
Observe the child in his or her classroom
See list of questions on p. 607 in main text
Under no condition should you use
facilitated communication to interview a
child with ASD (see pp. 607–608 in main
text)
Assessment Measures for ASD

See p. 608 in main text
Useful ASD Forms [1]



Table J-1. Observation Form for
Recording Behaviors That May Reflect
Autism Spectrum Disorder and Positive
Behaviors (p. 155 in RG)
Table J-2. Modified Checklist for Autism
Disorder in Toddlers (M-CHAT) (p. 157 in
RG)
Table J-3. Autism Spectrum Disorder
Questionnaire for Parents (p. 158 in RG)
Useful ASD Forms [2]


Table J-4. Checklist of Possible Signs of
an Autism Spectrum Disorder (p. 160 in
RG)
Table J-5. DSM-5 Checklist for Autism
Spectrum Disorder (p. 161 in RG)
Evaluating Assessment
Information

See questions in Table 22-3 for evaluating
assessment information in cases of ASD
(pp. 609–610 in main text)
Interventions for
Children with ASD [1]



See pp. 609–614 in main text for a
discussion of interventions for ASD
See Handouts K-1 to K-4 (pp. 162–217 in
RG) for parents and teachers
Interventions are designed to improve
 Communication skills
 Executive functions skills
 Problem-solving skills
 Organizational skills
Interventions for
Children with ASD [2]

Interventions are designed to improve
(Cont.)
 Interpersonal and social skills
 Learning readiness skills
 Academic skills
 Motor skills
Interventions for
Children with ASD [3]

And to reduce
 Restricted behaviors
 Repetitive behaviors
 Intense behaviors and interests that
interfere with functioning or cause harm
to the individual or to others
Alternative ASD Therapies [1]



The Following ASD Therapies Are Not
Supported By Research
Auditory integration training (listening
through headphones to electronically
modified music, voices, or sounds)
Chelation (heavy metal removal)
Gluten- and casein-free diets (gluten is a
protein found in wheat and other grains,
and casein is a protein found in milk and
milk products)
Alternative ASD Therapies [2]


The Following ASD Therapies Are Not
Supported By Research (Cont.)
Herbal remedies (e.g., St. John’s wart, ma
huang, kava kava)
Hyperbaric oxygen chamber treatment
(use of a pressure chamber to administer
oxygen at higher pressure than in the
atmosphere)
Alternative ASD Therapies [3]


The Following ASD Therapies Are Not
Supported By Research (Cont.)
Intravenous immunoglobulin (injection of
pooled antibodies separated from the
plasma of multiple donors)
Manipulation or craniosacral massage
(physical manipulation of the skull and
cervical spine)
Alternative ASD Therapies [4]


The Following ASD Therapies Are Not
Supported By Research (Cont.)
Melatonin treatment (a nutritional
supplement used to promote sleep)
Vitamins A, B6, and C, megavitamins, and
magnesium treatment (designed to
address supposed metabolic abnormalities
in children with ASD)
Prognosis for Children with ASD
[1]


Many behaviors associated with ASD may
change, diminish, or completely fade over
time
However, communication and social
deficits may continue in some form
throughout life
Prognosis for Children with ASD
[2]

More favorable prognosis is for children
with ASD who have
 Early and intensive intervention
 Some communicative speech before 5
years of age
 IQs above 70
Prognosis for Children with ASD
[3]

Prospect for employment is not
encouraging
 In 2009 about 53% worked for pay
outside the home since leaving high
school
Traumatic Brain Injury
(TBI; Chapter 23)
TBI [1]



Approximately 1 million children in the US
each year sustain head injuries from
 Falls
 Physical abuse
 Recreational accidents
 Motor vehicle accidents
Approximately 75% of TBIs are mild
Still, TBI account for 30.5% of all injuryrelated deaths among children
TBI [2]


TBI in infants under the age of 1 year
associated with
 Physical abuse
 Shaken baby syndrome
 Thrown infant syndrome
TBI in toddlers and preschoolers
associated with
 Falls
 Physical abuse
TBI [3]

TBI in children over the age of 5 years
associated with
 Bicycle injuries
 Motor vehicle injuries
 Sports-related accidents and injuries
TBI [4]

Children under 20 years who are treated in
emergency departments for TBI sustain
their injuries from
 Sports and recreation activities 30%
 Motor vehicle collisions 20%
Observable Effects of
TBI in Children [1]


TBI may produce physical, cognitive, and
behavioral symptoms (see Table 23-2 on
p. 632 in main text)
Contact health care provider if a child
shows any of these symptoms after
sustaining a head injury
 Changes in play
 Changes in school performance
 Changes in sleep patterns
Observable Effects of
TBI in Children [2]

Contact health care provider if any of
these symptoms show after a child
sustains a head injury (Cont.)
 Convulsions or seizures
 Persistent headaches
 Inability to recognize people or places
 Irritability, crankiness, or crying more
than usual
Observable Effects of
TBI in Children [3]

Contact health care provider if any of
these symptoms show after a child
sustains a head injury (Cont.)
 Lack of interest in favorite toys or
activities
 Loss of balance or unsteady walking
 Loss of consciousness
 Loss of newly acquired skills
Observable Effects of
TBI in Children [4]

Contact health care provider if any of
these symptoms show after a child
sustains a head injury (Cont.)
 Poor attention
 Refusal to eat or nurse
 Slurred speech
 Tiredness or listlessness
 Vomiting
 Weakness, numbness, or decreased
coordination
Effects of TBI Related
to Several Factors




Location, extent, and type of brain injury
Child’s age
Child’s preinjury
 Temperament
 Personality
 Cognitive and psychosocial functioning
Type, promptness, and quality of
treatment
Sports-Related Concussions [1]

About 40 to 50 million children in US
participate in organized sports
Sports-Related Concussions [2]

Incidence of mild TBI in children who
participate in sports is high—about
1,275,000 annually
 Football (22.6%)
 Bicycling (11.6%)
 Basketball (9.2%)
 Soccer (7.7%)
 Snow skiing (6.4%)
Sports-Related Concussions [3]

Rates of Concussion
 Highest in full-contact sports (e.g.,
football, boy’s lacrosse, ice hockey,
rugby)
 Moderate in moderate-contact sports
(e.g., basketball, soccer)
 Lowest in minimal contact sports (e.g.,
volleyball, baseball, softball)
Sports-Related Concussions [4]



Consider the cumulative effects of sportsrelated concussions
Possibility of long-term permanent
damage in the form of chronic traumatic
encephalopathy
See Table 23-3 for list of symptoms of a
possible concussion (p. 636 in main text)
Sports-Related Concussions [5]


If one or more of these symptoms are
present, adults on the scene should
 Call 911
 Contact the child’s parents immediately
This is especially critical because
concussions can result in an intracranial
hemorrhage, which is life-threatening
Brief Mental Status and
Follow-UP Examinations




Use SCAT3 (see p. 635 in main text)
Or ask questions on p. 636 in main text
Ask follow-up questions on p. 636 in main
text
Refer child to a health-care provider if
coaching staff or parents report that the
child shows any of the symptoms on p.
637 in main text
Rehabilitation Programs
in Schools [1]


When child returns to school note the
behaviors shown on p. 637 in main text
Consider guidelines shown on p. 638, 640
in main text and in Exhibit 23-2 on p. 639
in main text in setting up a rehabilitation
program
Rehabilitation Programs
in Schools [2]
Help teachers carry out appropriate
strategies for
 Reducing or eliminating barriers to
learning
 Reintegrating the child into the classroom
 Establishing objectives
 Using effective instructional procedures
 Give teachers Handout K-3 (pp. 185–209
in RG)
Protecting Children from TBI


See list of suggestions on pp. 643–644 in
main text
Research should continue to focus on
ways to reduce the severity and
occurrence of sports-related injuries
NIH Toolbox [1]

A set of royalty-free neurological and
behavioral tests designed to assess in
children and adults between the ages
3–85 years
 Cognitive functions
 Sensory functions
 Motor functions
 Emotional functions
NIH Toolbox [2]



See Table 24-7 on pp. 670–671 in main
text
NIH Toolbox tests are also available in
Spanish
See reference—National Institutes of
Health and Northwestern University
(2012)— for link to tests
Cartoon
Attention-Deficit/
Hyperactivity Disorder
(ADHD; Chapter 15)
Definition of ADHD

A neurobehavioral syndrome marked by
inattention and/or hyperactivity and
impulsivity (DSM-5)
Video
Video Link

How to Recognize ADHD Symptoms in
Children
 http://youtu.be/1GIx-JYdLZs
Some Facts about ADHD [1]




In 2011 about 6.4 million children ages
4–17 years had parent-reported ADHD
(about 11% of the U.S. population)
69% were taking medications (3.5 million
children)
A 42% rate of increase from 2003 to 2011
Boys were more than twice as likely as
girls to have ADHD (12.1% vs. 5.5%)
Some Facts about ADHD [2]


Incidence in different ages
 Children younger than 10 years (6.8%)
 Children ages 11–14 years (11.4%)
 Children ages 15–17 years (10.2%)
33.2% fail to graduate from high school on
time vs. 15.2% of children without any
psychological disorder
DSM-5 Diagnostic Criteria for
ADHD


Two main types of symptoms
 Inattention
 Hyperactivity and impulsivity
Three types of ADHD
 Combined presentation
 Predominately inattentive presentation
 Predominately hyperactive/impulsive
presentation
Disorders Comorbid With ADHD
[1]


Children with ADHD represent a
heterogeneous population
Often display a diversity of behavior
problem and have a comorbid disorder
Disorders Comorbid With ADHD
[2]





Disorders Comorbid with ASD
Oppositional defiant disorder (about 40%
to 50%)
Conduct disorder (about 25%)
Disruptive mood dysregulation (majority of
children)
Specific learning disorder (50% or more)
Anxiety disorder (about 30%)
Disorders Comorbid With ADHD
[3]




Disorders Comorbid with ASD (Cont.)
Depressive disorder (about 20%)
Substance use disorder (minority of
children)
Obsessive-compulsive disorder (minority
of children)
Autism spectrum disorder (minority of
children)
ADHD and Conduct Disorder [1]


A distinct subtype and may have a genetic
basis
Increased risk for
 Antisocial behaviors
 Substance abuse
 Peer rejection
 Low self-esteem
 Depression
 Personality disorders
ADHD and Conduct Disorder [2]

Increased risk for (Cont.)
 Difficulties in processing social
information
 Suspension from school
ADHD and Conduct Disorder [3]

Parents and Familial Factors
 Parents face increased stress,
frustration, and despair
 Families tend to be nonintact and of lowincome
 Mothers are unhappy
 Parents are uninterested in their
children’s activities
Children with ADHD at
Adulthood






Adults have
Less education, including fewer college
degrees
Lower incomes
Higher divorce rates
More antisocial personality disorders
More substance-related disorders
Increased risk for criminal behavior
Other Types of Deficits in ADHD




Cognitive deficits
 Including deficits in executive functions;
see Appendix M in RG (p. 246)
Social and adaptive functioning deficits
 Difficulty assuming responsibility
Motivational and emotional deficits
 Limited interest in achievement
Motor, physical, and health deficits
 Fine and gross-motor deficits
Etiology of ADHD [1]



No single cause but likely multiple factors
Genetic factors
 Runs in families
Neurological factors
 Different brain structures
 Imbalance or deficiency in one or more
neurotransmitters
Etiology of ADHD [2]



Prenatal factors
Exposure of the fetus to
 Nicotine
 Alcohol
 Other drugs
 Maternal psychosocial stress during
pregnancy
Postnatal exposure to toxic substances
 Lead, methylmercury, and pesticides
Etiology of ADHD [3]


Study of Acetaminophen Use
During Pregnancy
Sample: Danish children (N = 64,322)
whose mothers used acetaminophen
during pregnancy (data from the Danish
National Birth Cohort during 1996-2002)
Results: Children were at higher risk for
receiving a diagnosis of ADHD
Etiology of ADHD [4]

Study of Acetaminophen Use
During Pregnancy (Cont.)
Source: Liew, Z., Ritz, B., Rebordosa, C.,
Lee, P.-C., & Olsen, J. (2014).
Acetaminophen use during pregnancy,
behavioral problems, and hyperkinetic
disorders. JAMA Pediatrics. Advanced
online publication.
doi:10.1001/jamapediatrics.2013.4914
Assessment of ADHD [1]


Comprehensive history
Review of the child’s cumulative school
records
 Attendance history
 Reports of behavioral problems
 School grades
 Standardized test scores
 Number of schools attended
Assessment of ADHD [2]





Review of relevant medical information
Review of previous psychological
evaluations
Interviews with parents, teachers, and
child
Observations of child in classroom and
playground
Administration of rating scales to parents,
teachers, and child
Assessment of ADHD [3]



Administration of psychological tests to
child
See Appendix G (pp. 119–126) in RG for
additional assessment forms
See pp. 460–465 in main text for
additional information about assessment
of ADHD
Evaluation of ADHD
Assessment Findings [1]





Presence of inattention, hyperactivity, and
impulsivity
Number, type, severity, and duration of
symptoms
Situations in which symptoms are
displayed
Verbal abilities
Nonverbal abilities
Evaluation of ADHD
Assessment Findings [2]






Short- and long-term memory abilities
Other cognitive abilities
 See Table L-18, p. 242 in RG for an
executive functions checklist
Comorbid disorders
Social competence
Adaptive behavior
Educational and instructional needs
Comment on
Assessment of ADHD [1]




Diagnosis of ADHD is not easy
Restlessness, inattention, and overactive
behavior are common in children
Parents may find it difficult to judge child’s
behavior
Rating scales usually do not provide for a
functional analysis of the variables that
interact with children’s behaviors
Comment on
Assessment of ADHD [2]


Teachers tend to assign more symptoms
consistent with ADHD to younger children
than to older children
Symptoms of ADHD can be displayed
 In different ways across different
settings
 In different relationships
Comment on
Assessment of ADHD [3]

A comprehensive assessment requires a
multi-method approach with
 Multiple informants
 Multiple contexts
 Multiple psychological tests
 Multiple use of rating scales
 See Table 25-1 in Chapter 25 (pp. 697–
701 in main text) for questions to
consider in preparing a report
Interventions for ADHD [1]

Pharmacological
 Approximately 70% to 80% of children
who exhibit hyperactive symptoms
respond positively to stimulant
medications
Interventions for ADHD [2]

Behavioral
 Positive reinforcement
 Verbal praise
 Withdrawal of reinforcement
 Time out
 A response-cost program
 Point system
 Token economy
Interventions for ADHD [3]


Behavioral (Cont.)
 Contracts between parents/teachers
and children
 Stipulate desired and expected
behaviors at home and/or at school
 Consequences for failure to perform
the desired behaviors
Cognitive-behavioral
 Self-monitoring programs
Interventions for ADHD [4]


Family
 Parent training programs
Educational
 Teaching new skills
 Establishing routines
 Promoting attention
 Improving study skills
 Improving memory
Interventions for ADHD [5]

Educational (Cont.)
 Improving listening skills
 See Handout K-3 for suggestions (pp.
185–209 in RG)
Interventions for ADHD [6]

Alternative interventions that have little
scientific support
 Dietary interventions
 Antimotion sickness medicines
 Manipulation of bones in the body
 Exercises to improve eye tracking
 Enhancing the ability to hear certain
frequencies of sound
 Neurofeedback
INTELLECTUAL
DISABILITY
(ID; Chapter 18)
American Association on
Intellectual and Developmental
Disabilities (AAIDD) Definition

“Intellectual disability is characterized by
significant limitations both in intellectual
functioning and in adaptive behavior as
expressed in conceptual, social, and
practical adaptive skills. This disability
originates before age 18” (AAIDD, 2010,
p. 5).
AAIDD Definition
of Intellectual Functioning

“. . . an IQ score that is approximately two
standard deviations below the mean,
considering the standard error of
measurement for the specific assessment
instruments used and the instruments’
strengths and limitations” (AAIDD, 2010, p.
27)
AAIDD Definition of
Adaptive Behavior

“. . . approximately two standard
deviations below the mean of either (a)
one of the following three types of
adaptive behavior: conceptual, social, and
practical or (b) an overall score on a
standardized measure of conceptual,
social, and practical skills” (AAIDD, 2010,
p. 27)
Age of Onset

Limitations must be manifest prior to the
age of 18 years
ID Categories Not Used

AAIDD classification system does not use
categories (e.g., mild, moderate, severe,
profound) to classify intellectual disability,
but the World Health Organization does
recommend their use (See slide later in
presentation)
AAIDD and Other
Considerations [1]
1.
2.
Limitations in present functioning must be
considered within the context of
community environments typical of an
individual’s age, peers, and culture
Valid assessment considers cultural and
linguistic diversity as well as differences
in communication, sensory, motor, and
behavioral factors
AAIDD and Other
Considerations [2]
3.
4.
5.
Limitations often coexist with strengths;
individuals with intellectual disability have
gifts as well as limitations
An important purpose of describing
limitations is to develop a profile of
needed supports
The life functioning of individuals with
intellectual disability generally will
improve with appropriate supports over a
sustained period (AAIDD, 2010, p. 7, with
changes in notation)
DSM-5 [1]


Definition similar to AAIDD
Adds two related diagnostic categories
 Global developmental delay for children
under the age of 5 years when
evaluation is not possible
 Unspecified intellectual disability for
children over the age of 5 years when
assessment is not possible
DSM-5 [2]


Diagnosis of ID does not rule out the
coexistence of other disorders
A diagnosis of intellectual disability is
inappropriate when an individual is
meeting the demands of his or her
environment adequately
World Health Organization’s
Working Group on ICD-11


Severity level of intellectual developmental
disorder needs to be considered
 85% in mild level
 10% in moderate level
 3.5% in severe level
 1.5% in profound level
See Tables 18-1 and 18-2 on p. 520 in
main text for severity levels and adaptive
behavior examples
Some Facts about ID [1]



Prevalence about 1% in general
population
During the 2009–2010 school year,
463,000 children between ages 3–21
years in special education programs
Prevalence about 7.1% in special
education population
Some Facts about ID [2]



More males than females receive
diagnosis
 1.6:1 for mild ID
 1.2:1 for severe ID
Mild ID more common in rural areas and in
low-income groups
Correlation between measured intelligence
and adaptive behavior ranges from about
.30 to .50
Etiology of ID [1]







Genetic disorders
Chromosomal anomalies
Cranial malformations
Perinatal disorders
Postnatal disorders
Unknown causes
See Table 18-3 on pp. 523–528 in main
text for a list of disorders and conditions
associated with ID
Co-Occurring Disorders with ID







Attention-deficit/hyperactivity disorder
Depressive and bipolar disorders
Anxiety disorders
Autism spectrum disorder
Stereotypic movement disorder
Impulse control disorders
Major neurocognitive disorder
Support Areas and Goals for ID

See Table 18-4 on p. 532 in main text
Concluding Comment on ID [1]

Measures of intelligence and adaptive
behavior are for example used to
 Determine eligibility for disability
benefits by Social Security
Administration
 Determine whether an individual can
stand trial and whether a defendant can
be sentenced to death
Concluding Comment on ID [2]

Evaluation of intellectual disability thus has
extremely far-reaching consequences
Additional Resources [1]

Morgan, E., Salomon, N., Plotkin, M., &
Cohen, R. (2014). The school discipline
consensus report: Strategies from the field
to keep students engaged in school and
out of the juvenile justice system. New
York, NY: The Council of State
Governments Justice Center. Retrieved
from http://csgjusticecenter.org/wpcontent/uploads/2014/06/The_School_Dis
cipline_Consensus_Report.pdf#page=10
Additional Resources [2]

Williams, S. T. (2008). Mental health
screening and assessment tools for
children: Literature review. Retrieved from
http://humanservices.ucdavis.edu/academ
y/pdf/final2mentalhealthlitreview.pdf
Additional Resources [3]


Willamette Education Service District.
(n.d.). Student threat assessment.
Retrieved from
http://www.wesd.org/siis/safe/threat
Synapse. (2013). Acquired brain injury:
The facts (4th ed.). Retrieved from
https://synapse.org.au/media/71265/acquir
ed_brain_injury_-_the_facts__forth_edition__2013_.pdf
Additional Resources [4]

Also see SPsych Everything for valuable
links
https://sites.google.com/site/spsycheveryt
hing/ (Also on www.sattlerpublisher.com)
Spelling Chequer [1]
Eye halve a spelling chequer
It came with my pea sea
It plainly marques four my revue
Miss steaks eye kin knot sea.
Eye strike a key and type a word
And weight four it two say
Weather eye am wrong oar write
It shows me strait a weigh.
Spelling Chequer [2]
As soon as a mist ache is maid
It nose bee fore two long
And eye can put the error rite
Its rare lea ever wrong.
Eye have run this poem threw it
I am shore your pleased two no
Its letter perfect awl the weigh
My chequer tolled me sew.
Children Learn What They Live
by Dorothy Law Nolte [1]
If children live with criticism,
They learn to condemn.
If children live with hostility,
They learn to fight.
If children live with ridicule,
They learn to be shy.
If children live with shame,
They learn to feel guilty.
If children live with encouragement,
They learn confidence.
Children Learn What They Live
by Dorothy Law Nolte [2]
If children live with tolerance,
They learn to be patient.
If children live with praise,
They learn to appreciate.
If children live with acceptance,
They learn to love.
If children live with approval,
They learn to like themselves.