Emotional Behavior Disorders: ADHD and Interventions for Positive Outcomes
Emotional Behavior Disorders: ADHD and Interventions for Positive Outcomes
Jennifer M. Miller
Seattle Pacific University
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Emotional Behavior Disorders: ADHD and Interventions for Positive Outcomes
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Emotional Behavior Disorders: ADHD and Interventions for Positive Outcomes
Introduction
Students that have learning disabilities and displaying problem behaviors comprise the
population of students that is receiving special education services. It is important to take steps in
the early stages of disruptive behavior because of the “important educational and mental-health
implications” (Scott, Anderson & Spaulding, 2008). The research indicates that students that are
identified with behavior problems have a higher risk for anxiety, depression and antisocial
behavior (Scott, Anderson & Spaulding, 2008). One example of a behavior disorder is ADHD,
which is commonly diagnosed during childhood. Behavior disorders are something a general
education teacher will have to deal with and need formal training so that they can assist their
students.
Research
ADHD is one of the most commonly diagnosed behavioral disorders of childhood. It is
estimated that about two million Americans have ADHD. This disorder can have a negative
impact on a student social, emotional and academic functioning. This is a disorder that is
lifelong, and the symptoms appear over a course of time that includes impulsiveness,
hyperactivity, and inattention. The main causes of ADHD are still unknown. However, there are
two theories. The first has to with genetics and ADHD seems to run in families. The second
theory had to do with exposure to toxins. Children that have a higher exposure rate tend to have
higher rates of ADHD. It was thought that children would outgrow ADHD; however, new
research has shown that this not the case. ADHD can continue into adulthood and have lasting
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effects. This behavior disorder has the greatest risk of interpersonal problems and educational
functioning than any other disorder (Mattox & Harder, 2007).
The importance of ADHD and diverse populations as has been overlooked. It would seem
that students from the African American community had the highest rates of hyperactivity while
Asian students had the lowest rates. The reason the so many African Americans are being
diagnosed may have to do with their stressful and unpredictable environments. (Mattox &
Harder, 2007). It is interesting to note that gender is also a factor. More boys than girls are tested
for ADHD in childhood. Girls are not tested as much as boys for ADHD but can have a higher
rate of depression and anxiety (Mattox & Harder, 2007). The main reason may have to do with
the way girls and boys are socialized.
The three best methods to treat ADHD are pharmacological, behavioral therapies and
parent training. Studies have found that using both pharmacological and behavioral therapies
help students be successful in the classroom. This also increases the chances of being more social
and emotional functioning for a student with ADHD. Parent-training is behavior therapy that
takes place in the home environment that brings about changes in behaviors. This model also
strengthens the child’s bond with the parent. Parent training can be difficult in diverse
populations because of the way these groups seek help. They tend not to go to professionals but
rather seek help from family, neighbors, faith- based leaders. Understanding the way certain
groups seek help could be a way to expand parent-training in community-based settings rather
than a clinical settings (Mattox & Harder, 2007).
Teachers are often the first to make referrals for ADHD-related assessments, and they
spend the most time with students in the school setting. The school psychologist plays an
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important role because they perform the assessment and treatment for students with behavior
disorders including medication management. The research was conducted discover the
knowledge base of general educators, special education educators, and school psychologist in the
state of Washington to verify the preparedness of each group when it comes to helping students
with ADHD. Little research was completed on this topic, and it is important to know if teachers
and school psychologist in the field have the proper training to assist students with ADHD. The
reason is that the role teachers and the school psychologist play with students that have ADHD.
The researchers were trying to find out three key points of information about professional
knowledge of ADHD. Do special education teachers have more knowledge than general
education teachers? Does school psychologist have more knowledge than the teachers? Do years
in the field play an important factor when it came to helping students with ADHD? The
researchers requested that 132 volunteers from various districts from Washington State
participate in the survey. These volunteers had a broad range of experience so they could
measure the knowledge of the school psychologists, special education teachers, and general
education teachers (Weyandt 2009). The researchers used a questionnaire to collect the data they
were seeking.
The results were that special education teachers and general education teachers did have
“accurate knowledge” but were limited in knowing all the facts when it came to ADHD.
Teachers seemed to think many myths were real. It would seem that special education teachers
did not receive any more training on the topic than the general education teachers and is an
interesting discovery. Both groups expressed concern for teaching students with ADHD because
of the lack of training, and more training needs to take place for the sake of the student (Weyand
al, 2009). Teachers without proper training can lack confidence in their ability teach students
Emotional Behavior Disorders: ADHD and Interventions for Positive Outcomes
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with ADHD. (Weyandt e al., 2009). The second question was school psychologist knowledge
was greater than teacher knowledge. The data collected supported that the school psychologist
does have more knowledge about ADHD than teachers. This comes from considerable amount of
training and experience. (Weyandt e al., 2009). The third question had to do with experience. It
would seem that teachers and school psychologist with fewer years of experience tend to have
more knowledge on the topic of ADHD. This would suggest that more training is taking place to
better prepare professionals that enter the field. More research on this topic has been completed,
and this has helped newer professionals gain the training they need prior to entering the field
(Weyandt e al, 2009).
Emotional Behavior Disorders (EBD) is defined by the same criteria that psychiatrists
use. This includes deficit hyperactivity disorders (ADHD), oppositional defiant or conduct
disorders (ODD or CD), depression, and mood disorders. Prevalence is a condition of being
prevalent or common. Forness and Kim (2012) researched how many school-age children have
an emotional or behavior disorder. From their research, it was discovered that the identification
rate is slightly less than one percent of the student population. More than ever, special educators
have a reason to collaborate much more with psychiatrists and other mental health professionals.
The reason is that psychiatric diagnoses may prove to be more helpful for special educators.
It is important to understand that the prevalence only shows a small window of time of
EBD across children’s ages. There is also cumulative prevalence that is not studied as much, and
this takes into account how many children ought to meet the criteria for a particular psychiatric
disorder at any point in their life. Both types are important for special education teachers as it
allows for planning of resources. However, these studies do have limits because they do not draw
from a representative sample or measure the level of impairment (Forness & Kim, 2012). The
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research has shown that prevalence in the last four decades is ten percent in kindergarten,
thirteen percent in elementary and sixteen in secondary. The overall prevalence is twenty-two
percent across the age span (Forness & Kim, 2012). It is interesting to note that prevalence is
also driven by income factors. In high-income communities have a prevalence of about eleven
percent. In middle - and low- income families have a prevalence of eighteen to twenty- one
percent. The authors do state that prevalence does not factor in racial or ethnic background
(Forness & Kim, 2012).
The significance of all this research is the impact on the general education classroom.
Class size increases as grade level increases. This will also have an impact on teachers and the
students in the general education classroom. The research has shown that the expected number of
students that will have EBD in a general classroom will be from one to three in the elementary
setting and three to five in the secondary setting. It should also be pointed out that students with
EBD can be misdiagnosed with learning or speech disabilities (Forness & Kim, 2012). General
education teachers can expect to receive some special education resources. However, the major
issue is that special education teachers are trained to assist with a child’s learning problem rather
than emotional or behavioral problems.
There is a shared understanding not all students in the EBD category are receiving the
resources they need to be successful. This gap can be felt by the general education teacher that
makes it difficult for the teacher depending on the severity. The students in the “EBD category
have been shown to have by far the worst outcomes of any of the major categories in special
education” (Forness & Kim, 2012). Teachers may see that students in the early grades have
social or academic problems, but many do not see this as an EBD even with no response to
classroom management. It is important to prevention with classroom-wide positive behavioral
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support to enhance the response of all children in the class (Forness & Kim, 2012). If the
problem persists for a particular student, the next step is functional behavioral assessment.
In 1997, amendments were made to Individuals With Disabilities Education Act (IDEA)
which included the use of functional behavioral assessment (FBA) in school settings. FBA is an
approach that is an analytic method to improve behavioral outcomes for individuals with
disabilities (Sugai, Lewis-Palmer, Hagen-Burk, 1999). In 2004, FBA was mandated by the
federal government to help students with behavioral problems. FBA’s has extended to ADHD
and other behavioral disorders. The research has shown that environmental events impact
behavior. By taking a look at these behaviors and see the triggers, the outcomes for student
success can be improved with a problem-solving strategy. FBA helps with collection of problem
identification information, analysis, intervention planning and monitoring (Sugai, Lewis-Palmer,
Hagen-Burk, 1999). FBA’s should be conducted by team that has direct experience with the
student. The team needs to have behavioral expertise and competence to lead the FBA process.
The behavioral expertise should be a school psychologists, school counselor or special educators.
The administration should be involved with the FBA process to aid with personal and resources.
Most importantly the student needs to be participating (Sugai, Lewis-Palmer, Hagen-Burk,
1999).
Some of the main problems with FBA’s are certain educators at the school may not have
knowledge about the FBA process. Staff may have knowledge but do not have enough fluency to
be able to implement the process. It can be difficult to manage the process with a large number
of students. It takes time to train professionals to be able to be effectively involved in the
process. It is also important to clarify what is best practice and policy (Sugai, Lewis-Palmer,
Hagen-Burk, 1999). To prevent problems during the FBA process, it is important for the
Emotional Behavior Disorders: ADHD and Interventions for Positive Outcomes
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behavior expert to decide who needs training and who will conduct the training (Scott,
Anderson, Spaulding, 2008). It would be in the best interest of the team to have someone with
extensive knowledge of behavior interventions to do the training of practitioners.
The person that is sitting in as the behavioral specialist must have enough knowledge
about Behavior Intervention Plan (BIP) strategies. This includes preventing and neutralizing the
impact of setting event. Setting events are factors that make the problem more intense. The
behavioral specialist must remove the events that trigger problem behaviors and add appropriate
replacement behaviors. Teaching appropriate behaviors would include self-management, social
skills, adaptive responses and removing events that maintain problem behaviors (Sugai, LewisPalmer, Hagen-Burk, 1999). FBA’s work best with the school has a school-wide and classroom
management systems for all students and staff. It is important to not just have one person at the
school that can play the role of the behavioral specialist. The first reason is logistical. One person
is not able to handle many interventions adequately. The second reason is that the individual
many have the skills or training of developing an effective intervention. Lastly, the individual
may have other job duties, or they can take on new responsibilities that will result in the lack of
services (Scott, Anderson, Spaulding, 2008).
FBA’s should be conducted when it is hard to understand the problem behavior or when
an intervention plan is needed to help the student. Once patterns are found, the intervention can
begin. This starts with FBA by collecting information that includes interviews, archival reviews,
and observations. There are two types of FBA’s, and the least time-consuming method should be
used to understand the behavior. The team is trying to come up with functional hypothesis by
asking the purpose of the behavior and why the student would engage in the behavior. The first
type is efficient, and this only takes a few days. The second type of FBA is formal and is more
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comprehensive as the methods used to gather information differ. A formal FBA should be
conducted if the team thinks that there will be harm to the student or to others. As well as if other
attempts have not worked. There are no set rules for determining which FBA should be used.
The problem behavior should guide the team is the most general rule (Scott, Anderson,
Spaulding, 2008).
Once the needs of the student are identified, the team works to develop an intervention
plan. The intervention should also be just as balanced as the FBA. Interventions cannot take
place until the team has a sound hypotheses statement. This helps the team arrange the
environments and consequences in order to achieve more appropriate behavior. The team
develops a replacement behavior plan in order to tell the team what will be taught. (Scott,
Anderson, Spaulding, 2008). When students are using replacement behavior, it is important to at
the functional outcomes is present each time. The outcomes need to be arranged by the team so
that contingencies always have a functional outcome. It is important to provide the student with
incentives for appropriate behavior that is desired. “The rule of thumb for both positive and
negative contingencies is to stay as natural as possible and to use the least amount necessary to
get the desired outcome “(Scott, Anderson, Spaulding, 2008). The final step is for the team to
decide how the intervention will be documented and monitored. The data can be collected in
various ways, but it must be accurate and regularly (Scott, Anderson, Spaulding, 2008).
Along with FBA and interventions, students with EBD need positive classroom
environment. Students that have EBD need tend to be noncompliant, aggressive and impulsive.
For these students, it is important to create positive interactions so that students can build selfesteem and optimistic outcomes. Students with EBD’s have a difficult time in a school setting
because what is valued is academic abilities and social skills. Students with externalizing
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behaviors are likely to deficient in both areas, and they do not have an affirmative experience
while they are in a school setting. Without a positive outlook, it is difficult to be able to
effectively problem solve and have academic success. EBD students are characterized as
unmotivated and have limited educational choices. Many decisions are made for them due to the
behavior problems. EBD students tend to have the highest dropout rate. (Jenson e al., 2004).
Studies have been conducted on teacher behavior in the classroom. Teachers tend to
focus on the negative behaviors instead of the positive behaviors of EBD students. Also, praise is
lower for students with EBD than any other learning disability (Jenson e al., 2004). Creating a
positive environment is not as easy as it sounds. It is important to have the three C’s in the
classroom that includes a) academic content that is useful and interesting b) a cooperative
learning environment in which the student feels safe c) choice in which student is asked to think
about what they are doing (Jenson e al., 2004). Positive praise is not enough for students with
EBD. The study showed that teachers also need motivational strategies and negative
consequences. This gets harder to do as the student gets older. (Jenson e al., 2004). However, a
positive classroom environment is the most effective way to help students with EBD.
Implementation
Students with behavior disorders such as ADHD are important to special education
because as general education teachers will more to likely have a least one student in their
classroom with EBD. As the research showed the average classroom can have from one to five
students a year with EBD. It is important to know about the social and academic problems that
can take place with students that have behavior problems. General education teacher’s behavior
in the classroom with have a significant impact on students with EBD and it is important that a
Emotional Behavior Disorders: ADHD and Interventions for Positive Outcomes
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positive, and engaging classroom will help students with EBD. The research has also shown that
it is important to make sure that general education teachers collaborate with special education
teachers and school psychologist. The reasoning behind this is to help students with EBD to be
successful as the dropout rate is higher than any other category in special education.
This is an imperative topic for me because this year; I have two students with EBD. I see
that interventions are the right path to take. For one of my students, an FBA and intervention
have started to make an impact on this student, and he is turning the corner which has resulted in
a positive outcome. This intervention was research based and conducted by a team. The other
student, I have adjusted my behavior to increase positive outcomes and this small change has a
great impact on his behavior in the general classroom setting. Researching other emotional
behavior disorders would be a benefit for me as a general education teacher to have the greater
knowledge about EBD.
Conclusion
Students with emotional, behavior disorders such as ADHD are becoming more common
in the general classroom setting. It is important for general educators to have a greater
understanding of EBD students so that they can take steps to ensure they are thriving in the
classroom. EBD students need extra support that may include FBA and interventions. Positive
learning environments help students learn how to behave in a school setting and increase their
chance to be able to meet academic challenges and not become another statistic.
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References
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General
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Jenson, W., Olympia, D., Farley, M., & Clark, E. (2004). Positive Psychology and Externalizing
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Mattox, R., & Harder, J. (2007). Attention Deficit Hyperactivity Disorder (ADHD) and Divers
Populations. Child & Adolescent Social Work Journal, 24 (2), 195-207.
Scott, T., Anderson, C., & Spaulding, S. (2008). Strategies for Developing and Carrying Out
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Sugai, G., Lewis-Palmer, T., & Hagan-Burke, S. (1999). Overview Of The Functional
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