Academic journal article Education & Treatment of Children

School-Based Prevention and Intervention Programs for Children with Emotional Disturbance

Academic journal article Education & Treatment of Children

School-Based Prevention and Intervention Programs for Children with Emotional Disturbance

Article excerpt

Abstract

Children and adolescents with emotional disturbance (ED) exhibit chronic and diverse academic, emotional, behavioral, and/or medical difficulties that pose significant challenges for their education and treatment in schools. Historically, children with ED have received fragmented inadequate interventions and services that often yielded unfavorable school and community outcomes. Numerous child/family, diagnostic, and organizational barriers limit access to appropriate and effective treatment. Given this information, two U.S. Presidential commissions (U.S. Surgeon General Report, 2000; President's Freedom Commission on Mental Health, 2003) have called for the transformation of the mental health system emphasizing the early identification and intervention of children at risk for and with ED in school and public health care settings. In this manuscript, three school-based prevention and intervention programs for children at risk for and with ED are presented as examples of exemplary programs. These programs were selected based on a review of over 26 published school-based outcome studies with this population and the availability of at least three published outcome studies (including follow-up data) for each. Considerations for future school prevention and intervention programs are offered. Finally, priorities for training school personnel are outlined.

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Children with emotional disturbance (ED) are one of the most underidentified and untreated child clinical subpopulations (Wagner, 1995; Forness & Kavale, 2001; President's New Freedom Commission, 2003). As indicated in the Surgeon General's report on mental health (U.S. Department of Health and Human Services, 2000), one in five children display a diagnosable mental disorder each year and approximately 5% have an ED that significantly impacts their daily functioning at home and school. Similarly, children with ED represent about 5% of youth diagnosed with mental disorders and about 1% of those children diagnosed with ED are treated (Oswald & Coutinho, 1995; Walwarth, Nickerson, Crowel, & Leaf, 1998). Research has found that the number of students classified as ED varies by state and school district. For example, in a study representing over 14,000 school districts, Coutinho and Oswald (2005) found that state and local variations in ED classification are due, in part, to the child's gender with males overrepresented as ED (e.g., male: female odds ratios ranged from approximately 2 to 6 for ED in comparison to 1.7 to 2.7 for LD students). It is unknown whether gender differences are due to a higher prevalence rate of ED among males and/or under diagnosis of ED among females.

The identification of children with ED is hindered by vague diagnostic/eligibility criteria which impacts access to effective school-based interventions (Forness & Kavale, 2001; Reddy, 2001). Scholars have attributed the identification problem, in part, to the Individual Disability Education Act definition (IDEA, 1997, 2005). According to IDEA, ED is one of 12 disability categories that is defined as "a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree which adversely affects school performance: (a) an inability to learn which cannot be explained by intellectual, sensory, or health factors, (b) an inability to build or maintain satisfactory interpersonal relationships with peers and teachers, (c) inappropriate types of behavior or feelings under normal circumstances, (d) a general pervasive mood of unhappiness or depression, (e) a tendency to develop physical symptoms or fears associated with personal or school problems" (IDEA, 1997, 2005). The five ED criteria in IDEA are not supported by research on the subtypes of children with emotional and behavioral disorders (Schroeder & Gordon, 2002). In addition, there is a clause requiring "adverse educational performance" (e. …

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