| EMOTIONAL and BEHAVIORAL DISORDERS (Emotional Disturbance--IDEA category) |
| EMOTIONAL DISTURBANCE -- IDEA DEFINITION: A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which adversely affects a child's educational performance: a. An inability to learn which cannot be explained by intellectual, sensory, or health factors; b. An inability to build or maintain satisfactory relationships with peers and teachers; c. Inappropriate types of behavior or feelings under normal circumstances; d. A general pervasive mood of unhappiness or depression; or e. A tendency to develop physical symptoms or fears associated with personal and school problems. The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance under [the first part of this definition]. Council of Exceptional Children definition: [The term] emotional/behavioral disorders (EBD) refers to a condition in which behavioral or emotional responses of an individual in school are so different from his/her generally accepted, age-appropriate, ethnic, or cultural norms that they adversely affect educational performance in such areas as self-care, social relationships, personal adjustment, academic progress, classroom behavior, or work adjustment. EBD is more than a transient, expected response to stressors in the child's or youth's environment and would persist even with individualized interventions, such as feedback to the individual, consultation with parents or families, and/or modification of the educational environment. The eligibility decision must be based on multiple sources of data about the individual's behavioral or emotional functioning. EBD must be exhibited in at least two different settings, at least one of which must be school related. EBD can coexist with other disability conditions as defined elsewhere in this law (IDEA). This category may include children or youth with schizophrenia, affective disorders, or . . . other sustained disturbances of conduct, attention, or adjustment. The DSM-IV-TR identified ten major groups of disorders that may be exhibited by infants, children, or adolescents. Note that the first one listed would be served under a separate disability category (autism) under IDEA. The ten major groups are: PERVASIVE DEVELOPMENTAL DISORDERS Severe deficits in relating to parents, siblings, and others; very poor communication skills; unusual behaviors evidenced in gestures, postures, and facial expressions. May be accompanied by chromosomal abnormalities, structural abnormalities in the nervous system, and congenital infections. Generally evident at birth or present themselves very early in a child's life. Includes autism, Rett Syndrome, childhood disintegrative disorder, Asperger Syndrome. The DSM-IV-TR puts autism here. Autism is a separate category from Emotional Disabilities in IDEA. ATTENTION-DEFICIT and DISRUPTIVE DISORDERS Manifest in a variety of symptoms. The two disorders are listed here: 1. CONDUCT DISORDER is a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifest by the presence of two or more of the following criteria in the past 12 months, with at least one in the past 6 months: aggression to people or animals ~often bullies, threatens, or intimidates ~often initiates physical fights ~has used a weapon that can cause physical harm to others (bat, brick, broken bottle, knife, gun, etc.) ~has been physically cruel to people ~has been physically cruel to animals ~has stolen while confronting a victim ~has forced someone into sexual activity destruction of property ~has deliberately engaged in fire setting with the intention of causing serious damage ~has deliberately destroyed another's property (other than setting fire) deceitfulness or theft ~has broken into someone else's home, building, or car ~often lies to obtain goods or favors or to avoid obligations ~has stolen items of nontrivial value without confronting a victim (shoplifting, forgery, etc.) serious violation of rules ~often stays out at night despite parental prohibitions, beginning before age 13 ~has run away from home overnight at least twice while living in parental or parental surrogate home ~is often truant from school, beginning before age 13. 2. OPPOSITIONAL DEFIANT DISORDER is a pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which 4 or more of the following are present: ~often loses tempter ~often argues with adults ~often actively defies or refuses to comply with adult's requests or rules ~often deliberately annoys people ~often blames others for his or her mistakes or behavior. ~is often touchy or easily annoyed by others ~is often angry and resentful ~is often spiteful or vindictive The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. The behaviors do not occur exclusively during the course of a Psychotic or mood disorder. Criteria are not met for Conduct Disorder, and, if the individual is 18 years or older, criteria are not met for Antisocial Personality Disorder. FEEDING and EATING DISORDERS Pica --the persistent eating of non-nutritive materials for at least a month. Cloth, string, hair, plastic, plaster, paint, etc. Anorexia nervosa --eating disorder in which the bodyweight is 15% below the norm; intensely afraid of weight gain and exhibit grossly distorted perceptions of their bodies. Bulimia --characterized by repeated episodes of binging, followed by self-induced vomiting or other extreme measures to prevent weight gain. Rumination disorder --characterized by repeated regurgitation and re-chewing of food. TIC DISORDERS Stereotyped movements or vocalizations that are involuntary, rapid, and recurring over time. Tics may take the form of eye blinking, facial gestures, sniffing, snorting, repeating certain words or phrases, or grunting. Includes Tourette Syndrome, chronic motor or vocal tic disorder, and transient tic disorder. NOTE!! While Tourette Syndrome is included in emotional disorders according to the DSM, IDEA includes it in the "Other Health Impairments" category of disabilities. ELIMINATION DISORDERS Elimination disorders entail soiling (encopresis) and wetting (enuresis) in older children. Children who continue to have consistent problems with bowel and bladder control past their fourth or fifth birthday may be diagnosed as having an elimination disorder, particularly if the condition is not a function of any physical disorder. SEPARATION ANXIETY DISORDER Separation anxiety disorder is characterized by inordinate fear of leaving home or being separated from persons to whom the child or adolescent is attached. Behaviors indicative of this disorder include persistent refusal to go to school, excessive worry about personal harm or injury to self or other family members, reluctance to go to sleep, and repeated complaints about headaches, stomach aches, and nausea. SELECTIVE MUTISM Selective mutism is a persistent refusal to talk in typical school, social, or work environments. This disorder is really quite rare, occurring less than 1% of the time in psychiatric referrals, but it may significantly affect the child's social and educational functioning. REACTIVE ATTACHMENT DISORDER OF INFANCY or EARLY CHILDHOOD This disorder is represented by noticeably abnormal and developmentally inept social relatedness. Reactive attachment disorders appear as a result of grossly inadequate care. STEREOTYPIC MOVEMENT DISORDER This disorder is characterized by recurring, purposeless motor behaviors. These behaviors interfere with the child's functioning and sometimes result in injuries. GENERAL ANXIETY DISORDER and SOCIAL PHOBIA Anxiety disorders of childhood or adolescence are very similar to the anxiety-withdrawal category included in the statistically derived classification system. Children and youth with anxiety disorders have difficulty dealing with anxiety- provoking situations and with separating themselves from parents or other attachment figures (e.g., close friends, teachers, coaches). Unrealistic worries about future events, overconcern about achievement, excessive need for reassurance, and somatic complaints are characteristic of young people who exhibit anxiety disorders. CHILDHOOD SCHIZOPHRENIA: Schizophrenia is rare in children, affecting only about 1 in 40,000, compared to 1 in 100 adults. Schizophrenia would be considered a Pervasive Developmental Disorder, but not part of the Autism Spectrum Disorder. Additional information about Childhood Schizophrenia can be found at the American Academy of Childhood and Adolescent Psychiatry, http://aacap.org. Terminology is a problem when discussing children with emotional disorders. There is always (correctly) the attempt to be respectful, while still descriptive. Several terms have been used: socially maladjusted, emotionally disturbed, conduct disordered, behavior disordered. What is the term you would feel most comfortable with when discussing a child with any disorder on this page? What would you feel the most comfortable with if it is YOU that is being discussed? IMPORTANT!!! Though Autism is included as a pervasive developmental disorder, autism is NOT considered to be into the emotional disturbance category of IDEA, as Autism is a separate category. ALSO, ADD and ADHD and Tourette Syndrome are listed as emotional disorders, but the diagnosis of these disorders is included under the OTHER HEALTH IMPAIRMENTS category in IDEA, as per amendment (PL 105-17). STATISTICALLY DERIVED CLASSIFICATION SYSTEMS FOR EMOTIONAL DISORDERS: Four distinct categories: 1. Conduct disorders. Conduct disorders involve such characteristics as overt aggression, both verbal and physical; disruptiveness; negativism; irresponsibility; and defiance of authority -- all of which are at variance with the behavioral expectations of the school and other social institutions. 2. Anxiety-Withdrawal. Anxiety-withdrawal contrasts sharply with conduct disorders. It involves overanxiety, social withdrawal, seclusiveness, shyness, sensitivity, and other behaviors that imply a retreat from the environment rather than a hostile response to it. 3. Immaturity. Immaturity characteristically involves preoccupation, short attention span, passivity, daydreaming, sluggishness, and other behaviors not consistent with developmental expectations. 4. Socialized Aggression. Socialized aggression typically involves gang activities, cooperative stealing, truancy, and other manifestations of participation in a delinquent subculture. |
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