BUILDING SCHOOLWIDE PARTNERSHIPS TO SUPPORT STUDENT SOCIAL COMPETENCY A Project Presented to the faculty of the Department of Special Education, Rehabilitation, School Psychology, and Deaf Studies California State University, Sacramento Submitted in partial satisfaction of the requirements for the degree of SPECIALIST in EDUCATION in School Psychology by Catherine Anne Teller Danielle Nicole Harrington SPRING 2012 ©2012 Catherine Anne Teller Danielle Nicole Harrington ALL RIGHTS RESERVED ii BUILDING SCHOOLWIDE PARTNERSHIPS TO SUPPORT STUDENT SOCIAL COMPETENCY A Project by Catherine Anne Teller Danielle Nicole Harrington Approved by: __________________________________, Committee Chair Catherine Christo, Ph.D. ____________________________ Date iii Students: Catherine Anne Teller Danielle Nicole Harrington I certify that these students have met the requirements for format contained in the University format manual, and that this project is suitable for shelving in the Library and credit is to be awarded for the project. __________________________, Department Chair ___________________ Bruce A. Ostertag, Ed.D Date Department of Special Education, Rehabilitation, School Psychology, and Deaf Studies iv Abstract of BUILDING SCHOOLWIDE PARTNERSHIPS TO SUPPORT STUDENT SOCIAL COMPETENCY by Catherine Anne Teller Danielle Nicole Harrington The authors collaborated and shared equal responsibility in all aspects of the development of this project. The project focuses on social competency from a developmental perspective and the role of educators in supporting student social, emotional, and behavioral needs. Students who lack social competency are at risk for long-term negative outcomes; however, many educators do not feel that they have the training needed to support student social, emotional, and behavioral needs. The purpose of this project is to provide educators with an understanding of current research on social competency and its development. In addition, the project provides specific intervention from a tiered approach in a straightforward and practical format. Altogether, this project aims to educate and empower teachers, administrators and other school staff members so that they can recognize and support students who may lack social competency. The prepared project is a series of five 75-minute training presentations with a presenter’s manual, slides, presenter’s notes, and handouts. Any school psychologist v may deliver the presentations. Workshop participants will have a better understanding of social competency development and effective interventions to help struggling students. _______________________, Committee Chair Catherine Christo, Ph.D. _______________________ Date vi ACKNOWLEDGEMENTS We would like to thank our wonderful professor and supervisor, Catherine Christo, for her support and guidance in creating this project. In addition , we would like to thank our professors Stephen E. Brock, Leslie A. Cooley, and Melissa A. Holland, for not only providing us with the foundational knowledge to become effective school psychologists, but also for encouraging us to use our own strengths to promote the wellbeing of all students. Finally, a warm thanks to our families for your never-ending encouragement and patience for the last three years! vii TABLE OF CONTENTS Page Acknowledgments....................................................................................................... vii Software Specifications .................................................................................................x Chapter 1. INTRODUCTION ...................................................................................................1 Background of the Problem ...............................................................................1 Statement of the Problem ...................................................................................1 Purpose of the Project ........................................................................................2 Definition of Terms............................................................................................3 Assumptions.......................................................................................................4 Limitations .........................................................................................................4 Statement of Collaboration ................................................................................5 2. LITERATURE REVIEW ........................................................................................6 Positive Effects of Social-Emotional Support ...................................................6 Absence of Social-Emotional Support ...............................................................7 Social Competency ............................................................................................8 Social Skills .......................................................................................................9 Development of Social Competency ...............................................................10 Signs of Social Deficits or Dysfunction...........................................................16 Internalizing Disorders.....................................................................................18 Externalizing Disorders ...................................................................................21 Autism Spectrum Disorders .............................................................................25 Intervention at School ......................................................................................26 3. METHODOLOGY ................................................................................................36 Research ...........................................................................................................36 Development of the Presentation .....................................................................37 viii 4. FINDINGS AND INTERPRETATIONS ..............................................................39 Workshop Objectives .......................................................................................40 Recommendations ............................................................................................40 Conclusions ......................................................................................................40 Appendix A. Presentation Slides ..............................................................................43 Appendix B. Presenter’s Manual ...............................................................................76 Appendix C. Targeted Intervention: Bibliotherapy ...................................................81 Appendix D. Supporting Student Social Competency: Special Populations .............84 Appendix E. Initial Consultation Request Form ........................................................88 References ....................................................................................................................90 ix SOFTWARE SPECIFICATIONS The presentations in this project were created using Microsoft® PowerPoint 2007 software. Slides should be viewed using Microsoft® PowerPoint 2007 or PowerPoint Viewer 2007 (or newer editions of this software). x 1 Chapter 1 INTRODUCTION There is growing emphasis in schools on educating the “whole child,” which extends farther than educating the child academically. A fundamental part of this “whole child” approach is addressing students’ mental health, which includes students’ social, emotional, behavioral, and environmental needs. Background of the Problem Developing social competency is instrumental in navigating the social and academic world in school and beyond. Social competence is typically built as a part of social development in childhood and adolescence. When a child possesses social competence, he or she is thought to have the skills and knowledge necessary to successfully navigate the social world and to build and maintain positive relationships with others. Successful peer relations can have a lasting positive impact on the student’s self-esteem, ability to recover from stress and other setbacks, and perception of school and learning (Doll, Zucker, & Brehm, 2004; Howard & Landau, 2010a). In contrast, children who have difficulty developing age-appropriate social skills and emotional coping skills, and therefore lack social competency, are at risk for negative outcomes such as dropping out of school or developing learning, behavioral, or mental health problems (McClelland, Morrison, & Holmes, 2000; Whelley, Cash, & Bryson, 2002). Statement of the Problem Given the time that students spend in school environments during development, teachers and other school staff are in an excellent position to support basic mental health 2 and social skills development. Furthermore, due to the time that teachers and other school staff spend with students, there are ample opportunities to recognize socially struggling students and to intervene. However, several recent research studies have found that many teachers do not feel adequately trained or prepared to support students who struggle with social-emotional or behavioral problems (Reinke, Stormont, Herman, Puri, & Goel, 2011). With this in mind, there appears to be a need for training for teachers and other school staff regarding how to best support student social competency. Purpose of the Project This project aims to deliver straightforward, useful information to educators that will enable them to support student social competency. The primary goal of the project is to identify and consolidate relevant research and present it in a format that is easily understood and relevant to teachers and other school staff. A secondary purpose of this project is to improve peer relations among students in an effort to reduce negative outcomes for students who struggle socially, emotionally, and behaviorally. The trainings within this project are organized in a developmental context as to ensure that the information provided is relevant to the attendees. Trainings containing specific information pertaining to age groups from Pre-K through 12th grade are included. These targeted trainings can be selected for use based on the needs of the school. In all, these trainings allow school psychologists to efficiently disseminate knowledge and practical intervention ideas on a broad scope. 3 Definition of Terms Social Competence Social competence is a broad term that involves using specific social skills and past experience and knowledge to navigate the social world. Siegler, DeLoache, and Eisenberg (2003) define social competence as “the ability to achieve personal goals in social interactions while simultaneously maintaining positive relationships with others” (p.386). Margaret Semrud-Clikeman (2007) defines social competence as the “ability to take another’s perspective concerning a situation, to learn from past experience and to apply that learning to the ever-changing social landscape” (p. 1). Social Skills The term social skills refers to a set of “socially acceptable learned behaviors that enable a person to interact with others in ways that elicit positive responses and assist in avoiding negative responses” (Gresham, 2002, p. 406). Internalizing Disorders Merrell (2008) defines internalizing disorders as covert, over-controlled behaviors, social withdrawal, somatic (i.e., physical) problems, anxious symptoms, and depressive symptoms. Two of the most common groups of internalizing disorders are depression and anxiety. Externalizing Disorders Externalizing disorders is a classification of disorders characterized by behavioral symptoms. Attention-Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) are included in this group of disorders. 4 Autism Spectrum Disorders Autism Spectrum Disorders refers to a group of pervasive developmental disorders that range in severity from very low to very high functioning (Ruble & Gallagher, 2010). Under the broad term of Autism Spectrum Disorders (ASDs), the two most commonly seen in schools are autistic disorder and Asperger’s disorder. Assumptions There is a substantial body of research indicating that school-wide interventions with teacher training components are effective for not only promoting positive peer relations, but also for creating a positive school climate (Battistich, Solomon, & Deluchhi, 1990; Battistich, 2001; Durlak, Weissenberg, Dymnicki, Taylor, & Schellinger, 2011; Siegler et al., 2003). Training presentations are an effective way to provide lasting knowledge and skills within a short period of time. A person’s social competence can essentially shape his or her ability to handle social challenges that arise as well as to define expectations for future interactions (Semrud-Clikeman, 2007). Research has demonstrated that social competence has a strong relationship with overall socialemotional well-being and positive peer group adjustment (Smith & Hart, 2005). Given this, school-based interventions aimed at improving social competence may improve both interpersonal relationships and internal well-being. Limitations This training program is designed for an audience of teachers and other school staff that has regular contact with students, such as para-educators, instructional assistants, administrators and specialists. The presenter’s manual included in the 5 appendix of this project allows the workshops to be delivered by any trained school psychologist. In an effort to research interventions to support and boost social competency, the authors encountered some difficulty in locating ample sources. Although there is much attention given to the need for socially-based interventions for students, most interventions center on specific social skill deficits rather than a broader social competency deficit. Statement of Collaboration The authors of this project collaborated on all aspects of the project. In designing the training program and related materials, each author contributed equally in the research for and writing of the final product. Specific sections and subtitles were divided between the two individuals and were then edited collaboratively. For instance, the two presenters collaboratively researched, created, and edited all of the content in the training presentation for grades 3 to 5, and the rest of the presentations were divided equally between the two presenters and then finally edited together. All work put into the development of the final project and training program was shared equally. 6 Chapter 2 LITERATURE REVIEW A primary goal of education is for each student to gain the basic knowledge and skills to someday become a productive and independent member of society. While schools have traditionally focused on preparing students academically, more recently, there is growing emphasis on educating the “whole child.” This approach recognizes the importance of addressing students’ mental health. Mental health is commonly understood as the presence or absence of diagnosable disorders, but good mental health also refers to the possession of skills necessary to navigate through life’s challenges (Whelley, Cash, & Bryson, 2002). Thus, educating the “whole child” includes students’ social, emotional, behavioral, and environmental needs. Positive Effects of Social-Emotional Support There is little doubt that the quality of a child’s social interactions can greatly impact his or her life. Successful peer relations are recognized as one of the most significant developmental tasks with the most enduring consequences (Howard & Landau, 2010). Positive peer relations help students enjoy daily activities in the classroom, foster self-esteem, build resiliency, serve as protective factors against mental illness, alleviate the effects of stress, and can even serve as an alternative to parental support (Howard & Landau). They can also make it easier for students to ask for help in times of stress and make it more likely that they will receive help when it is asked for (Doll, Zucker, & Brehm, 2004; Heller & Swindle, 1983). Friendships can play a role in the promotion of academic success as well. As students’ peer groups become more 7 influential, friends can impact students’ perception of and commitment to school and learning (Doll et al.). Absence of Social-Emotional Support McClelland, Morrison, and Holmes (2000) found that children who struggle socially or behaviorally when they enter school are at risk for later learning problems. Furthermore, many students who lack social-emotional competencies become less and less connected to their schools as they progress from elementary through high school. This lack of connection can create serious problems for these students by impacting their behavior, their mental health, and their academic performance. Moreover, when a student is poorly connected to the school community, efforts to intervene are impeded (Durlak et al., 2011). If efforts to address students’ social-emotional struggles fail or these struggles go unaddressed, the consequences can be quite serious. Special education referrals, school violence, increased dropout rates, suicide, and criminal activity are all outcomes that have been found to be associated with schools’ failure to address socialemotional struggles in their students (Whelley et al., 2002). In addition, social problems in childhood can become a lifelong issue because the presence of such early struggles may predict academic, social, or psychological problems in adolescence and even adulthood (Howard & Landau, 2010). According to Howard and Landau’s research, “disturbed peer relations may be one of the most important factors associated with child psychopathology” (p. 69). Among students with disabilities, persistent and marked difficulties with peers is one of the most common reasons for placing students in self-contained special education classrooms rather than receiving 8 services while still in general education classrooms (Doll et al., 2004). Given the range and severity of these outcomes, schools have clear motivation to take part in prevention and intervention for social-emotional difficulties. Social Competency Social Competency is a concept tying together peer relations and social-emotional well-being. Siegler et al. (2003) define social competence as “the ability to achieve personal goals in social interactions while simultaneously maintaining positive relationships with others” (p.386). With this in mind, being socially competent can be equated with knowing how to successfully navigate the social world. Margaret SemrudClikeman (2007) defined social competence as “an ability to take another’s perspective concerning a situation, to learn from past experience and to apply that learning to the ever-changing social landscape” (p.1). An individual’s social competence shapes his or her ability to handle social challenges that arise as well as define expectations for future interactions (Semrud-Clikeman). Essentially, a socially competent person is someone who makes use of internal and environmental resources in order to achieve positive social outcomes (Waters & Stroufe, 1983). Research has demonstrated that social competence has a strong relationship with social-emotional well-being and positive peer group adjustment (Smith & Hart, 2005). Given this, interventions targeting social competency may improve both interpersonal relationships and internal well-being. With this in mind, the impact that social competency can have on social functioning is monumental. Cavell, Meehan, and Fiala (2003) suggested a three-tiered model for conceptualizing the development of social competence. The most basic level, called 9 social skills, consists of the specific skills a child uses in a particular social situation, such as sharing a toy. The next level, called social performance, involves a child’s style of interaction and how well he or she performs in social situations. In the most advanced level, called “social adjustment,” the child is meeting social goals for his or her developmental level, and is also meeting expectations of parents, teachers, and society. Social Skills Since possessing and using social skills is an integral part of developing social competence, understanding the term social skills is critical. This term has been re-framed many times by different schools of thought within psychology. One definition, termed the peer acceptance definition, states that a person is socially skilled if accepted by peers (Asher & Hymel, 1981; Gresham, 2002). Although this view was prominent historically in child development research, it is limited because it does not identify specific behaviors or skills that lead to peer acceptance (Gresham). Another definition comes from research in applied behavioral analysis and defines social skills as behaviors that are situation specific and are likely to be reinforced and unlikely to be punished or extinguished (Bellack & Hersen, 1979; Foster & Ritchey, 1979; Gresham). This definition too has significant limitations because of its focus on high frequency behaviors without consideration of their social validity (Gresham). A definition that does take into account the behavior outcomes is termed the social validity definition, and is based on the 1982 work of McFall. This definition says that social skills are “specific behaviors or behavior patterns that predict or otherwise result in important social outcomes for children and youth. Socially important outcomes are those that make a difference in terms of an 10 individual’s functioning or adaptation to societal expectations” (Gresham, p.406). Examples of “socially important outcomes” might include: peer acceptance and friendships, teacher and parental acceptance, and school adjustment (Gresham). Another, more general, definition conceives social skills as “socially acceptable learned behaviors that enable a person to interact with other in ways that elicit positive responses and assist in avoiding negative responses” (Gresham, p.406). Gresham and Elliot (1990) identified five major clusters of social skills consistently found to be in socially competent individuals, creating the acronym CARES: cooperation, assertion, responsibility, empathy and self-control. Interacting with others is an essential part of human development. Learning to interact effectively is a complex process dependent on the development of social competency. After gaining a general understanding of social competency and social skills, it is important to examine how each are typically acquired throughout development. This knowledge provides a basis for understanding how disruption or dysfunction of social development can manifest itself during childhood and adolescent development. Development of Social Competency Research has illuminated core skills necessary for developing social competence that are acquired during typical development (Calderella & Merrell, 1997; Gresham, 2002; Semrud-Clikeman, 2007). These core skills generally include: emotional awareness, emotional self-regulation, empathy, the ability to correctly perceive and interpret social situations (including nonverbal cues), and the ability to work 11 cooperatively with others (Semrud-Clikeman). Many of these skills build on one another as the way a child thinks about and approaches social situations changes over time (Smith & Hart, 2005). Similarly, social skills deficits at certain points in childhood may impact later functioning and development (Semrud-Clikeman). If a child does not meet social expectations, he or she may be seen as “different” and may experience rejection or isolation from peers. Therefore, it is important to begin fostering social competence from a young age and to continue to support children in an increasingly complex social world as they grow. It is equally important to understand the typical stages of social development and signs of a breakdown in these stages in order to intervene in appropriate ways. Early Childhood (Preschool-Age 6) Young children initially develop beliefs, values, and attitudes about social concept and self-concept mostly through primary caregivers (Slaughter-DeFoe, 1995). Once in school, the preschooler’s primary challenge is meeting the expectations of his or her teacher, peer group and parents. Preschool is the developmental stage at which children typically begin to learn play skills such as sharing, emotional regulation, conflict management, and assertiveness (Semrud-Clikeman, 2007). Preschoolers typically develop these skills through group activities, exercises in conflict management, shared pretend play, and an emphasis on cooperation and harmony (Smith & Hart, 2005). Toddlers are able to engage in simple cooperative play mostly with adults, while kindergarteners are typically able to join a peer play group and have a sense of another student’s likability and friendliness (Howard & Landau, 2010). Emotional understanding 12 and quality of play are two factors that can greatly impact peer relationships during these years (Semrud-Clikeman). In the school environment, specific behaviors such as the ability to take turns, follow directions and to be empathic towards others have all been rated by kindergarten teachers as more important than knowledge of colors, letters and numbers (Diener & Kim, 2003). Emotional regulation is also critical for social competence development during early childhood. Young children are beginning to understand the consequences of their emotions and actions and eventually begin to recognize that their ability to regulate these emotions and behaviors can impact interactions with others (Semrud-Clikeman, 2007). Understanding the emotions of others can also influence a young child’s social success. For example, young children who react to perceived anger in another, when no anger is actually present, have limited social success (Barth & Bastiani, 1997). Children who are unable to regulate emotions, adjust behavioral reactions, or are aggressive or withdrawn may become socially isolated, rejected outright by peers and tend to have low self-esteem (Semrud-Clikeman). Middle Childhood (Ages 6-12) In middle childhood, roughly ages 6 to 12, the child’s social sphere shifts from focusing on family relationships to peer relationships (Smith & Hart, 2005). Children become aware of a wide social network of friends, acquaintances, teachers, caregivers, and others (DeBord, 2004). There are more complex social norms for social acceptance, with a desire for inclusion and avoidance of rejection and embarrassment (Lavoie, 2005). Emotional regulation continues to be integral to the development of social competence 13 and basic social skills are becoming more important (Wang, He, & Liu, 2002). Play is the cornerstone of social interaction and friendships during these years. While there do appear to be gender differences in types of play, most games are rule governed and the ability to remember and abide by these rules is an important aspect of social competence in middle childhood (Samter, 2003). In the later years of middle childhood, friendship connections deepen. Being able to confide in friends becomes more important than simply sharing participation in activities and games (Semrud-Clikeman, 2007). Perspective taking and the recognition that others have thoughts, ideas and feelings separate from one’s own are two skills emerging during these years. Children may be able to understand the point of view of a peer, but may not yet be able to put that knowledge to use in the heat of a conflict or other problem situation (Samter). Middle childhood is also when brain structures used for problem solving develop, which aides in emotional regulation, learning to listen to others and take turns, and learning to compromise (Semrud-Clikeman, 2007). During these years children are better able to negotiate solutions to problems and to recognize when to disengage themselves when conflict threatens friendships (Putallaz & Sheppard, 1990). Language also plays an important role, as language itself is acquired through social means, and the knowledge and understanding that children gain about how to perform social interactions is verbally mediated (Semrud-Clikeman). Likewise, conversational ability becomes important. Socially competent children show a sense of humor, can be entertaining, and are able to handle teasing (Howard & Landau, 2010). Children who are able to successfully integrate their behavior and verbalizations into ongoing conversations and 14 activities experience higher levels of social success than their peers who tend to talk solely about themselves, interrupt or disagree (Black & Hazenm 1990; SemrudClikeman). Children may still have difficulty managing failure or loss and their feelings can become hurt easily during middle childhood (Semrud-Clikeman, 2007). They may feel more self-conscious about differences than preschoolers, and some stressful situations may have a negative impact on their self-esteem (DeBord, 2004). Also during these years, children who are excessively shy, become angry easily and are not able to handle playful teasing can become socially isolated through peer avoidance or outright rejection (Parker & Seal, 1996). Specific social and emotional problems with anxiety and aggression have been found to negatively impact social competence during middle childhood and this impact often continues into adolescence (McGee & Williams, 1991). Adolescence (Ages 13-19) During adolescence, becoming independent, establishing an identity, and forming close relationships with significant others are ongoing processes (Steinberg, 2007). Adolescents desire more autonomy from their parents and more acceptance from their peers (Howard & Landau, 2010). They begin to create an identity through integrating others’ perceptions of them with their own opinions and preferences. Successful integration of these influences produces a clear sense of beliefs, goals, and relationship expectations. As Ruffin (2009) states, “people with secure identities know where they fit (or where they don’t want to fit) in their world” (p.4). Adolescents are better able than younger children to make decisions about how to begin, maintain, and end friendships 15 (Lavoie, 2005). As with earlier stages of development, emotional regulation continues to be important for social competence. Adolescents who struggle to regulate their emotions, especially negative ones, may overreact to emotionally charged situations, leading to inappropriate reactions or behaviors (Eisenberg, Fabes, Guthrie, & Reiser, 2000). Specific social skills also remain important. Adolescents who lack social skills may continue to be isolated socially. This isolation is partly due to the lack of social skills, but is also influenced by peer perceptions that these individuals are not approachable or sociable (Semrud-Clikeman, 2007). An especially critical social skill developed during adolescence is the ability to remove oneself from a situation in order to objectively interpret what is happening. This allows the individual to understand another’s motivations and perspective, so that he or she can adjust behavior and reactions accordingly. Development of this skill coincides with brain development that is associated with abstract thinking (Semrud-Clikeman). As children enter adolescence, there is an even greater importance placed on peer relationships. Friendships in adolescence have evolved from relationships built on shared interests to a bond strengthened by self-disclosure and mutual support. The ability to open up and confide in close friends is important to the formation and maintenance of friendships in adolescence, as is feeling supported and understood by friends (SemrudClikeman, 2007). Trust, empathy, companionship, positive regard, understanding, and support are all characteristics of adolescent friendships (Howard & Landau, 2010). Friends help each other navigate the trials of adolescence, and adolescents typically choose friends who share common interests, talents, and behavioral interests (Howard & 16 Landau). Adolescents seek to not be alone and research has shown that teens tend to describe themselves as less happy when alone (Semrud-Clikeman). Similarly, teens are highly vulnerable for negative outcomes if they experience little social support and are victimized by peers (Murdock & Bolch, 2005). Signs of Social Deficits or Dysfunction Unfortunately, children and adolescents sometimes struggle to acquire the skills necessary for social competence at developmentally appropriate stages. In early childhood, children who cannot regulate their behavior or emotions, or are extremely shy are at-risk for lasting social and emotional problems. In middle childhood, children who are shy, are easily angered, or have difficulty communicating are at-risk. And across developmental stages, lacking specific social skills can be quite problematic. Gresham (2002) noted that there can be deficits in the areas of social skills acquisition, performance, or fluency. Whereas an acquisition deficit is something that the child “can’t do,” a performance deficit is something the child knows how to do but “won’t do.” A child may have a fluency deficit if he or she knows how to perform the behavior but has a lack of practice in using it or has a lack of exposure to competent models. Children at-risk for disrupted or delayed social competence development may exhibit the following signs of dysfunction: excessive aggression, disruptive behavior, a lack of friends, social awkwardness, difficulty identifying and recognizing emotions, and difficulty seeing a situation from another person’s perspective (Howard & Landau, 2010). Children who display disruptive behavior at school are often the students most in need of intervention, as their behavior may interfere with the learning of others. 17 Aggressive children may have deficits in their ability to process information, providing them with a lowered ability to adapt to frustrating situations. This can lead them to act aggressively as a method of coping with frustration and solving social problems (Pakaslahti & Keltikangas-Jarvinen, 2000). Environmental influences that contribute to aggression include low parental support, poor monitoring of behavior, abusive or inconsistent discipline, and stress or conflict in the home (Siegler et al., 2003). These children, if rejected by their peers as a result of their aggressive behavior, may in turn display more aggressive behavior, have achievement delays, be victims of teasing, be stigmatized and develop a bad reputation, or develop low self-esteem (Howard & Landau, 2010). The acquisition of appropriate social behaviors can also be significantly impeded by the presence of mental or behavioral disorders. While positive peer relationships promote self-esteem and psychological well-being, significant difficulties in forming and maintaining peer relationships are associated with childhood development of mental or behavioral disorders and long-lasting negative outcomes (Howard & Landau, 2010). About one in five children suffer from a significant mental health problem, and about 70 percent of those who would benefit from mental health services do not receive the treatment they need (Whelley et al., 2002). Children with certain disorders and diagnostic characteristics are more likely to have difficulties navigating the social world than their typically developing peers. These include internalizing disorders, externalizing disorders, and autism spectrum disorders. Internalizing disorders are characterized by internal distress and relatively subtle 18 observable symptoms. Externalizing disorders are characterized by overt behavioral symptoms such as aggression or difficulty with self-regulation. The term autism spectrum disorders refers to pervasive developmental disorders characterized by impairments in communication, social functioning, and perception (Semrud-Clikeman, 2007). These disorders and their impacts on social development will be discussed in turn. Internalizing Disorders The term internalizing disorders refers to a group of disorders that are characterized by covert, over-controlled behaviors, depression, anxiety, social withdrawal and somatic (i.e., physical) problems (Merrell, 2008). As the signs and symptoms of internalizing disorders are not always observable, they sometimes go unnoticed and undiagnosed (Miller & Jome, 2010). Two of the most common internalizing disorders experienced in childhood are depression and anxiety. In addition, there are other disorders that have symptoms of anxiety or depression as associated features, such as post-traumatic stress disorder (PTSD) or autism spectrum disorders. Anxiety Disorders Anxiety disorders are characterized by excessive worry, fear, or distress that may manifest in both physical and emotional symptoms. Anxiety is estimated to be the most common internalizing problem, with 8 percent of referrals for mental health help among the general population due to anxiety symptoms (Merrell, 2008). The prevalence rate for diagnosable anxiety disorders is estimated to be between 3 and 4 percent (Merrell). The anxiety disorders most commonly seen in schools are: Generalized Anxiety Disorder, Social Phobia, Separation Anxiety, and Specific Phobia Disorder (commonly in the form 19 of school phobia) (Merrell). According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), Generalized Anxiety Disorder is marked by persistent and excessive anxiety and worry for a period of at least 6 months (American Psychiatric Association (APA), 2000). Social Phobia is characterized by extreme anxiety provoked by specific social or performance situations, which often leads to behaviors to avoid such situations. Among anxiety disorders, specific symptoms include excessive worrying, restlessness, irritability, sleep disturbance, avoidance of activities or certain situations, or somatic symptoms such as headaches or nausea (APA). While many children may experience some anxiety at one time or another, diagnosable anxiety disorders are set apart by their duration (usually at least 6 months) and their severity, as individuals with anxiety have little control over their symptoms. Children with high levels of anxiety often have difficulty approaching and solving problems, which may increase the disruption to social and academic functioning (Hanie & Stanard, 2009). For instance, a child with test anxiety may become so distressed before an exam that he or she may avoid coming to school or may develop headaches or stomach aches severe enough to be sent home. Though students with mild symptoms of anxiety can function well with persistence and hard work, about half of students with anxiety disorders have difficulty functioning at school. Anxiety can lead to school avoidance, perfectionism, academic failure, and problems relating to others (Hanie & Stanard; Huberty, 2010). 20 Depression Depression is characterized by a pervasive feeling of sadness or hopelessness that adversely affects one’s ability to function (Miller & Jome, 2010). A conservative estimate of the prevalence of depression among children and adolescents is 4 to 6 percent (Merrell, 2008). Though depression may affect people of all ages and backgrounds, there are certain populations with higher rates of depression. These include: teen girls, gay and bisexual youth, and American Indians (Cash, 2003). The DSM-IV-TR includes two types of Major Depressive Disorder: Single Episode and Recurrent. These disorders share similar symptoms, but differ in terms of frequency. Major Depressive Disorder, Recurrent is the appropriate diagnosis when more than one Major Depressive Episode is experienced (APA, 2000). Students with depression may have difficulty paying attention in class, drop out of activities they once enjoyed, argue more with friends, or withdraw from friends. In addition, depression in children is often associated with poor academic performance, disruptive behavior, poor social relationships, school absenteeism, dropping out of school, and school violence (Cash, 2003). Although many teens experience symptoms of depression, those with major depressive disorder have these symptoms for a longer duration and with increased intensity, which causes more dysfunction in their lives (Cash). Posttraumatic Stress Disorder (PTSD) Another disorder that has associated features of anxious or depressive symptoms is post-traumatic stress disorder (PTSD). Individuals with PTSD have experienced a 21 traumatic event (either directly or indirectly) such as abuse, assault, loss of a loved one, or a disaster that continues to affect their daily lives for longer than one month after the event (Nickerson, Reeves, Brock, & Jimerson, 2009). Symptoms of PTSD include: reexperiencing the trauma due to reminders of it; increased arousal (e.g., exaggerated startle response, hypervigilance); and avoiding reminders of the trauma or emotional numbing (Huberty, 2010). In children, these symptoms can manifest as anxious behaviors, social withdrawal, inattention, somatic complaints (e.g., stomach aches), developmental regression (e.g., bedwetting), or aggressive play (Nickerson et al.). For instance, a young child with PTSD whose house burned down may have an intense fear reaction during a school fire drill, or a child with PTSD who has been abused at home may play hit other children while playing “house.” Autism Spectrum Disorders It is also common for children with autism spectrum disorders to have anxiety that revolves around the inability to cope with changes or stress. This group of disorders, as well as specific symptoms and their relation to social development, will be discussed later in the chapter. Externalizing Disorders Externalizing disorders is a classification of disorders characterized by behavioral symptoms and includes Attention-Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). Combined, these three disorders account for the majority of clinical referrals in childhood (Brinkmeyer & Eyberg, 2003; Matson, 2010). Research has established that there is a strong link between social 22 competence deficits and externalizing disorders. Social competence deficits are not only accompanied often by externalizing behavior patterns, but they are even involved in the development and maintenance of externalizing disorders (Gresham, 2002). According to the DSM-IV-TR, ADHD is estimated to be present in 3 to 7 percent of children in the United States (APA, 2000). There are three types of ADHD: Primarily Inattentive Type, Primarily Hyperactive/Impulsive Type, and a Combined Type. Examples of behaviors associated with the Primarily Inattentive Type include: having difficulty sustaining attention; struggling to follow through on instructions; having difficulty with organization; becoming easily distracted; avoiding or disliking tasks requiring sustained mental effort; and failing to focus attention on details, or making careless mistakes. Behaviors associated with the Primarily Hyperactive/Impulsive Type include: fidgeting with hands or squirming while seated; having difficulty remaining seated; running around or climbing excessively; talking excessively; having difficulty waiting or taking turns; and blurting out answers before questions have been completed. When behaviors are present from both Hyperactive/Impulsive ADHD and Inattentive ADHD, a diagnosis of ADHD-combined type is made (APA). Additionally, in order for an ADHD diagnosis to be made, the behaviors must have been present before the age of 7, must be present across multiple settings (for example: home and school), and cannot be explained by any other psychiatric condition (APA). Although not a clinical aspect of ADHD, individuals with the disorder often experience some degree of social impairment. Research indicates that children with ADHD frequently experience conflicts with peers and adults, peer rejection, and social 23 isolation (de Boo & Prins, 2007). Children with ADHD also frequently exhibit significant deficits in social competence (Gresham, 2002). Many of the social problems experienced by children with ADHD are a result of the core symptoms of the disorder; however, there is also research that indicates that the commonly associated features of ADHD, such as verbal and physical aggression, can lead children with ADHD to be misunderstood and rejected by peers (Lavoie, 2005). Oppositional Defiant Disorder (ODD) is a disorder with an estimated prevalence rate of 2 to 15 percent of children in the United States (Loeber, Burke, Lahey, Winters, & Zera, 2000). ODD is characterized by a pattern of persistent hostile, defiant and other negative behaviors associated with noncompliance. Symptoms of ODD, as outlined in the DSM-IV-TR, include arguing with adults, losing one’s temper, defiance or noncompliance with rules, purposefully annoying others, blaming others for mistakes, and being “angry and resentful” or “spiteful or vindictive.” Since these symptoms can be experienced by many people on occasion, the DSM-IV-TR also specifies that symptoms must be present for at least six months to warrant a diagnosis (APA, 2000). ODD is also considered a precursor, or less severe form of Conduct Disorder (CD). In fact, it is estimated that if left untreated, one quarter of children with ODD will develop CD (Hinshaw & Lee, 2003). Conduct Disorder is described as a persistent pattern of deviant behavior that involves serious violation of social norms. The definition alone demonstrates the link between Conduct Disorder and social impairment. The behaviors of CD, as outlined in the DSM-IV-TR, fall into four categories: aggressive behaviors (e.g., threatening or harming other people or animals); non-aggressive 24 behaviors (e.g., defacing or destroying property, setting fires); deceitful behaviors (e.g., lying and stealing); and rule violations (e.g., disobeying rules at home and school) (McCurdy, 2010). As with ODD, the DSM-IV-TR also specifies that symptoms of CD must be present for at least six months to warrant a diagnosis (APA, 2000). Each externalizing disorder by itself can significantly stifle development of social competency, and these effects become increasingly serious when externalizing disorders occur together. Gresham (2002) found that children who exhibit behavior patterns of hyperactivity-impulsivity-inattention (i.e., ADHD), along with conduct problems characterized by fighting, stealing, truancy, noncompliance, and arguing (i.e., CD), are at extreme high risk for developing a lifelong pattern of antisocial behavior. Gresham also determined that these children with ADHD and CD are significantly more at risk than children with ADHD or CD alone (Lynam, 1996; Gresham, 2002). Antisocial behavior patterns become a lifetime issue for these children because they likely exhibit the most negative features of both domains. They tend to be “more physically aggressive, persist longer in antisocial behavior, display more severe achievement deficits, and have higher levels of peer rejection” than children with ADHD and CD alone (Gresham, 2002). Although all three types of externalizing disorders can significantly impact social functioning, the school’s role in intervening to help improve social competency needs to be determined on a case by case basis. Due to the aggressive and hostile nature of ODD and CD in particular, intervention would likely need to involve specialized programs led by specially trained professionals. Among students with ADHD, however, teachers and 25 other school staff can be more involved in supporting and intervening to help improve social competency. Autism Spectrum Disorders Autism Spectrum disorders are a group of pervasive developmental disorders that range in severity from very low to very high functioning (Ruble & Gallagher, 2010). Under the broad term of Autism Spectrum Disorders (ASDs), the two most commonly seen in schools are autistic disorder and Asperger’s disorder. Autistic Disorder (also known as “classic” autism) is categorized by the DSM-IV-TR into three core areas: deficits in social interaction; impairments in communication (including a severe delay in language acquisition); and restrictive, repetitive or stereotyped behaviors. Asperger’s disorder is also defined by impairment in social interaction and the presence of repetitive and stereotyped patterns of behavior, but does not include language deficits (APA, 2000). As evident by their definitions, social competency is greatly affected when any of these disorders is present (Stichter, Randolph, Gage & Schmidt, 2007). As previously noted, children with an Autism Spectrum Disorder (ASD) often show symptoms of internalizing disorders. It is common for children with an ASD to exhibit anxious or nervous behaviors such as picking at clothes or reluctance to try something new (Whelley et al., 2002). As these children grow into adolescence, it is also common for them, especially for the higher-functioning adolescents, to experience depression due to difficulties relating to peers. They may also exhibit avoidance and withdrawal; however, in the child with autism, this is most likely due to limitations in social skills (Cadigan & Estrem, 2010). 26 As mainstreaming into general education classrooms has become increasingly common for students with ASDs, their social deficits have become more evident, and also more relevant to general education teachers (Fisher & Meyer, 2002). Without interventions aimed to build social competency in students with ASDs, they are likely to become socially withdrawn or to exhibit problematic social behavior (Weiss & Harris, 2001). This increased social isolation, combined with social competence deficits, can significantly impact the quality of these students’ lives as well as lead to deficits in other areas, such as language and cognition (Lavoie, 2005). Intervention at School The School’s Role A major advantage that schools have in helping struggling students is the nature of the school environment and the way it lends itself to the intervention process. First, the sheer time that children spend at schools gives educators the unique opportunity to both observe and address children’s needs (Whelley et al., 2002). In addition to time, the school environment also provides ample opportunity for social learning to occur, as learning occurs through collaboration with teachers and peers (Durlak et al., 2011). This allows for intervention to be folded into the many interactions that naturally occur throughout the school day. Students with social-emotional difficulties can get support and practice in a more naturalistic environment within the school rather than in a more clinical setting. There are three types of supports that schools can provide to students who experience social-emotional struggles: environmental, programmatic and individual 27 (Whelley et al., 2002). Environmental supports are school-wide and involve creating a school climate that is supportive and encourages traits such as respect for others, connectedness, and self-esteem. Programmatic supports are more targeted to students with specific needs and might include implementing programs or curricula for bullying prevention or social skills. Individual supports should be used for those students who either have needs that cannot be met through environmental or programmatic supports, or who do not respond to either of these approaches. Individual supports might include individual counseling for students with chronic or acute mental health needs. Each of these support types can impact students by simultaneously building and fostering protective factors, which in turn can increase positive behavior, social competency, academic achievement, and emotional well-being (Whelley et al.). Addressing resiliency at any level of support is a powerful way that schools can help students build social competence. All people encounter adversity and conflict, and they draw on the social-emotional resources available in order to handle these difficulties. These resources can include an external network of support as well as internal factors, such as resiliency. Resiliency is “the ability to bounce back from defeat by resetting one’s compass, redefining goals, and continuing on course” (Whelley et al., 2002, p.3). Resiliency has also been described as a way of coping that can help prevent negative outcomes, such as depression, anxiety, or low achievement (Smith Harvey, 2007). Research shows that children who encounter similar obstacles in life may have different outcomes depending on how resilient they are (Whelley et al.). 28 Research has shown that resilient children often possess two factors that strengthen their resiliency. First, they experience consistent, responsive care from someone. Secondly, they possess certain personal characteristics, including intelligence, responsiveness to others, and a sense of competence (Siegler et al., 2003). There are certain factors that make some individuals at-risk for low resiliency. Research indicates that children who come from unstable homes or are victims of any form of abuse or neglect are at especially high risk for low resiliency (Werner, 1993). However, there is hopeful research that indicates that the presence of just one caring adult in the lives of these at-risk children can boost resiliency significantly. Most famous is Werner’s 1989 study among children in Kauai. Werner’s research demonstrated that one of the most crucial factors in the outcome of at-risk children who had experienced a problematic start in life was whether at least one person took an active interest in their welfare (Werner, 1989). According to her research, this pivotal person could be any caring and supportive adult. There are ample opportunities for caring and supportive adults in schools to foster resiliency in children. Efforts that schools make to enhance resiliency can have great benefits for all students. Those with low resiliency can clearly benefit greatly, and since resiliency is a limitless quality, students who already show strong resilience can continue to build their supply. Efforts targeted at building resilience can also have other indirect positive benefits as well. When resilience is promoted, positive peer relationships and prosocial behaviors are also promoted, thereby creating a more positive school climate (Smith Harvey, 2007). 29 Smith Harvey’s (2007) work outlined a number of specific ways that schools can help students build resiliency. First, schools can help by providing a caring and supportive learning environment through the promotion of positive social connections between staff and students, among students themselves, and also between families and the school. Improving relationships in the school’s community and creating opportunities for students to help each other can help create such a climate. When teachers, administrators, and parents have positive relationships with each other, children’s and adolescents’ resilience is boosted (Smith Harvey). Fostering positive attitudes and emotions in students can also increase resiliency. This can be accomplished by: encouraging students to believe that they can succeed if they try; framing failure as an opportunity from which to learn; and modeling respect for others, optimism, and forgiveness. Creating environments with consistent, clear expectations that aim to foster academic competence is another way educators can boost resiliency. These can all be characterized as environmental, or universal, supports. Programmatic supports to boost resiliency might include programs that have children helping each other, such as with peer mediation groups and programs aimed at preventing bullying or violence (Smith Harvey, 2007). On the individual level, promoting positive stress control strategies such as meditation, yoga, and physical exercise can also boost resiliency (Smith Harvey,). Aside from building resiliency, there are a number of other avenues that schools can take to support students who are struggling socially. Teachers in particular can play a pivotal role in fostering social competence. As teachers are with their students for most 30 of the day and witness countless social interactions, they can take advantage of naturally occurring situations to incorporate social skills trainings on an environmental level. In addition, these informal environmental interventions cost less – in terms of both resources and time – than more intensive interventions (Gresham, 2002; Merrell, 2008). They can be more efficient in addressing problems on a large scale and have the added benefit of increasing the likelihood of preventing problem behaviors from escalating in the future. However, students at high risk for developing social problems may still need more intensive intervention (Gresham). Through effective, research-based teaching practices, teachers can provide a structured and caring environment from which all students may benefit (Hanie & Stanard, 2009). Students do not need special education services or an official diagnosis to receive support at school. Teachers can strive to create a nonjudgmental, accepting learning environment in which students are considered a “community of learners.” In addition, teachers can encourage students to use a wide variety of resources and work together to learn; efforts that can promote personal responsibility and mutual respect (Siegler et al., 2003). Other strategies that teachers and other staff members can use to promote social skills in the classroom and on the playground involve modeling, coaching, and practicing prosocial behaviors (Bandura, 1977; Gresham, 2002). Modeling can be an extremely effective and efficient method of teaching social behavior. It involves learning an integrated sequence of behaviors, or a behavior pattern, through the observation of another person performing the behavior (Gresham). Coaching is actively teaching a child 31 what to do or say in a particular situation, such as how to join a group of peers (Siegler et al., 2003). Once a child learns a behavior, it is important that the child be able to practice the behavior on a regular basis to ensure that he or she will be able to use it fluently in the future. Teachers can play a role in actively looking for situations in which a child can practice a learned social skill, and can encourage the child to use the skill (Gresham). A more structured way to conceptualize the acquisition of social skills is an information processing model, which contains six steps in developing social competence. These steps are: (a) encoding relevant stimuli (i.e., perceiving subtle and overt verbal or nonverbal cues), (b) interpreting cues (i.e., what happened, cause, and intent), (c) establishing goals (i.e., what the child wants and how he or she will achieve it), (d) developing a representation of the situation (i.e., comparing current experience with similar past experiences, reactions, and outcomes), and (e) selecting possible responses based on the event and the child’s skill set, and acting on a choice or evaluating the outcome (Crick & Dodge, 1994). Many effective social and emotional learning programs utilize similar processes in teaching social skills, such as problem solving or conflict resolution (Durlak et al., 2011). Using these programmatic supports, teachers can be trained to guide students through these steps so that they understand the processes involved in social competence and will be more likely to use prosocial strategies in the future. Some studies suggest that schools involved in programs designed to promote a caring community produce many positive lasting outcomes for students (Durlak et al., 2011; Siegler et al., 2003). These programs emphasize supporting one another, sharing 32 values and goals, fostering a sense of belonging, and participating in group decisions. Battistich and others conducted several studies in the 1990’s designed to implement and evaluate these types of schoolwide interventions (Siegler et al., 2003). The interventions were used at elementary schools with children from a variety of cultural and economic backgrounds. They found that schools that participated in these interventions reported a decrease in behavior problems and drug use and an increase in academic motivation, spontaneous use of prosocial behavior, use of conflict resolution skills, and use of ethical reasoning (Battistich et al, 1990; Battistich, 2001). Similarly, Durlak et al. (2011), in a meta-analysis of over 200 social and emotional learning programs in schools, found that students who participated in the programs significantly improved in academic performance, behavior, attitude, and social and emotional skills. As discussed previously, the risks involved in not implementing schoolwide interventions to build social competence may include lasting negative consequences for students, such as increases in dropout rates, school violence, and criminal activity (Whelley et al., 2002). It is clear from the research that the benefits of developing and implementing these interventions far outweigh the risks. Such interventions should be an integral part of the school’s responsibility in educating the whole child. If a student has participated in a classroom or schoolwide intervention to promote social competence and his or behaviors continue to interfere with academic or social functioning, the teacher should make a referral to trained mental health professionals such as the school psychologist or school counselor (Whelley et al., 2002). In addition, Hanie & Stanard (2009) state that the threshold from normal to problematic behavior is 33 crossed when the problem is present for an extended period of time (i.e., at least one month), causes distress, disrupts routines and typical functioning, and is disproportionate to the situation. In these circumstances, it is appropriate to refer the student to the school psychologist or counselor to proceed with the next steps in individualized treatment and diagnosis (Hanie & Stanard). Training program for school staff As discussed previously, there is a clear need for intervention with students who struggle socially and schools are prime environments in which effective interventions can occur; however, there is no clear protocol of how to do so. From district to district and even from school to school within the same district, what is done to help such students varies. There is abundant research that points to numerous approaches to help students with social difficulties, yet often teachers feel unprepared to help the students for whom they have concerns (Reinke et al, 2011). School psychologists are in a unique position to train teachers and other school staff due to their knowledge of the learning process as well as mental health issues, behavior, and effective interventions across these areas. With this knowledge and background, school psychologists can help school staff to be aware of and be able to effectively address the social challenges that their students face. While this kind of knowledge transfer happens on a daily basis through consultation with individual teachers regarding individual students, taking a more proactive approach by giving teachers and other school staff information and interventions as a group can be more effective. According to Merrell, Ervin, and Gimpel (2006), a major advantage of group education is that it extends the school psychologist’s sphere of influence beyond 34 the traditional model of treating one child at a time. This project addresses this via a series of brief trainings that have been developed to educate and empower teachers and school staff to be able to help students who are struggling socially. Though research is limited on the effectiveness of such trainings, the outlook is promising (Robinson, 2011; Tompkins, Witt, & Abraibesh, 2009). Research does indicate that professional development programs can impact and enhance teachers’ knowledge, skills and attitudes in the workplace (Brown, 2008). Because the amount of time available for staff development may be limited, school psychologists must make presentations as efficient and effective as possible. With this in mind, a series of five, 75-minute training presentations have been developed under the theme of social competency. These presentations focus on children and adolescents, grouped by grade level, and are designed to be given to teachers and school staff members who work with each group. The specific groups are: Pre-K and Kindergarten, 1st and 2nd grade, 3rd through 5th grade, middle school (6th through 8th grade), and high school (9th through 12th grade). Each of these grade specific presentations follows a similar outline, beginning with an overview of social competency and its importance. Next, for each grade range, specific social skills and signs of social competency development are covered. Finally, the presentations cover how to recognize socially struggling students, how teachers and other school staff can help these struggling students, and when to refer them for further help. Each presentation also includes information about specific diagnosable disorders that can significantly impact social functioning. Altogether, these trainings aim to help teachers and school staff members 35 feel empowered and educated to support socially struggling students and to recognize when problems are outside their scope of training. Overall, this project focuses on developing a training program that delivers straight-forward, useful information organized in brief training presentations, allows for certain age groups to be targeted based on the needs of the school, and provides options to choose from for staff development. Furthermore, these trainings allow school psychologists to efficiently disseminate knowledge and intervention ideas on a broad scope. 36 Chapter 3 METHODOLOGY Research Several source types were used as the research basis for this project. These sources included books, informational handouts used in professional practice, and scholarly and professional journal articles, both print and electronic. To locate these sources, several techniques were utilized. EBSCO online article databases including PsychInfo, Academic Search Premier, PsychArticles and ERIC databases were the main source of scholarly journal articles. Within these databases, many different combinations of key words were used to refine the search. The term “social competency” was the main term that was used in conjunction with other key words that included: definition, deficits, signs, interventions, social skills, social development, externalizing disorders, internalizing disorders, and autism spectrum disorders. Several texts used in graduate level courses and in professional practice were used as sources for this project. In addition, books that were cited as sources in utilized scholarly journal articles were also located and used. These titles include Social Behavior and Skills in Children (Matson, 2010) and Resilient Classrooms: Creating Healthy Environments for Learning (Doll, Zucker & Brehm, 2004). A general outline was created for the project and all sources were then appropriately distributed within the project outline where they best fit. Some sources applied to multiple sections within the outline while others were narrower in scope. During this process the outline was adapted and adjusted as needed. The final outline 37 was used as a guide to develop the literature review and each author took the lead on evenly divided specific sections. Development of the Presentation The in-service training program was developed to provide age-specific information about social competency, its importance, signs of social competency struggles and specific interventions to increase social competency. Research demonstrating the positive outcomes for strong social competency and the possible negative outcomes of poor social competency were summarized in order to give weight to the importance of fostering social competency and to motivate intervention efforts. Each grade-specific in-service includes an overview of what social competency is, and what it “looks like” in the specific age range. Next, specific signs of possible problems with a student’s social competency were outlined, including when these signs warrant intervention. Then, specific interventions and approaches to giving support were provided to teachers and other school staff. Finally, specifics regarding when social competency difficulties warrant interventions from a trained professional were supplied. Each of the training presentations is designed to be a stand-alone training, 75 minutes in length, to be presented to the teachers and school staff members that work with the specific grade range. Each presentation includes lecture and interactive activities. These activities include small group discussion and brainstorming, case study vignettes and guided role play practice. The intended audience for these training presentations includes teachers, administrators, instructional assistants, para-educators, yard duties, and any other school 38 staff members who regularly interact with students and could provide support to them. During the development of this training program, an overview of the research basis and the program itself was presented to a group of fellow school psychologist graduates with completed master’s degrees along with a graduate program faculty member. Feedback was provided by this group along with feedback from several practicing school psychologists and school psychology faculty members during later stages of development. All materials needed by presenters to implement these trainings including PowerPoint slides, handouts, and a presenter’s manual are included as appendices at the end of this project. All presenter materials are also included on a CD in order for the trainings to be presented using a computer-linked projector. 39 Chapter 4 FINDINGS AND INTERPRETATIONS The training program for Supporting Social Competency at School was developed from the literature review to create a series of practical and user-friendly training presentations designed to enhance the knowledge and skills of individuals who work with students from pre-kindergarten through high school. The training program consists of five stand-alone interactive presentations that are designed to last approximately 75 minutes each. The materials contained in this project (i.e., the presenter’s manual, slides with presentation notes, and handouts) are designed to be straight-forward and manageable for any trained school psychologist to act as presenter. Each training presentation will help attendees be able to recognize when a student’s social difficulties may warrant intervention and also to recognize that they have the tools to help such students. A tiered approach to intervention is presented, with emphasis on the large majority of students who can be helped with environmental, naturalistic, and specific targeted interventions, which can be provided by any adult who has regular contact with the students. These presentations also include information about specific diagnosable disorders that commonly impact social competency, and how this impact typically manifests. Lastly, the presentations outline when it may be necessary to seek outside help from other professionals, such as school psychologists, and how to go about finding that extra help. The supplemental handouts in Appendices C, D, and E provide additional easy-to-use tools and recommendations for educators. 40 Workshop Objectives The ultimate goal of these presentations is to provide educators with the knowledge and skills to effectively support student social competency at school. Specifically, the presentations are designed to help attendees (a) have a clear understanding of what social competency is; (b) be able to identify students who are struggling socially; (c) be able to use research-based interventions to support these students; and (d) be able to recognize the limits of their training and refer students who may need more intensive support. It is hoped that the strategies and skill practice provided in the training workshops will help teachers and other school staff to feel empowered to engage in the early identification of, and intervention for students who would benefit from extra support in developing social competency. Recommendations It is important for educators to understand that the contents of this project were developed using current knowledge of research-based practices for promoting social competency in the school setting. With this in mind, presenters and educators may need to adapt or modify the recommended intervention strategies to meet the diverse needs of each school or community. Therefore, it is imperative that educators be aware of how to adapt these interventions without compromising the integrity of the recommended practices. Conclusions Social connectedness and support are vital to student well being and success in school and beyond. Students who lack social competency lack positive interpersonal 41 relationships that can provide social-emotional support. The absence of social-emotional support has been linked to negative outcomes ranging from poor academic achievement to serious mental health problems lasting into adulthood. In evaluation of this project, it is hoped that it contains information that provides teachers and other school staff with foundational knowledge to recognize students who may lack social competency and skills to support and intervene with these students. 42 APPENDICES 43 APPENDIX A SUPPORTING SOCIAL COMPETENCY AT SCHOOL PRESENTATION SLIDES 44 A Note to Readers The slides and corresponding presenter’s notes only from the Grades 3-5 presentation are included in this appendix. Given the uniformity of this training program and the overlap of much of the contained information, the decision was made to include just one presentation in print to provide readers with a better idea of what this training program actually looks like. Slides containing information that varies by age group will be designated with an asterisk (*) next to the slide number. Please note that the slide numbers may vary between presentations. All five grade group-specific presentations are included on the accompanying CD. 45 Slide 1* Supporting Social Competency at School: Grades 3-5 PRESENTATION CREATED BY: CATHERINE TELLER, M.A. & DANIELLE HARRINGTON, M.A. CALIFORNIA STATE UNIVERSITY, SACRAMENTO PRESENTED BY: [NAME] Sample language: "Today I will be leading you through a training focusing on social competency in middle childhood and more specifically in the 3rd through 5th grades.” Slide 2 Presentation Overview Introduction Social Competency in Middle Childhood (Grades 3-5) Signs of Social Problems What Can I Do to Help? When to Seek Outside Help Sample language: “This training will follow this outline of topics. We will begin with an introduction of the concept of social competency, followed by a look at how social competency develops in early childhood. Next, we cover what behaviors or signs suggest there may be a problem in the development of social competency. Then, a variety of approaches and interventions that you can use to support social competency development will be covered and opportunities to discuss and practice some strategies will be included. Finally, instances when outside help may be needed to help students will be discussed." 46 Slide 3 Proposed Outcomes The goal of this training is to help you to: Have a clear understanding of what social competency is. Be able to recognize students lacking social competency who may need your support & guidance. Learn strategies to support students who are struggling socially. Better understand when students may need more intensive help beyond what you can provide. Feel empowered to support student social competency at school! (Paraphrase each outcome on this slide) Slide 4 Introduction Sample language: “With those outcomes in mind, let’s get started.” 47 Slide 5 Educating the “Whole Child” A growing approach to education recognizing that… Academic preparation is one of many important pieces to preparing students to become successful, independent members of society Addressing social, emotional, behavioral & environmental needs can lead to long-lasting, positive outcomes SAY: 1) There is an ever-increasing need to educate the “whole child” so that each student will someday be a productive and independent member of society. 2) This includes social, emotional, behavioral, and environmental needs. Slide 6 Powerful Implications Presence of social-emotional support has been shown to boost: Enjoyment of daily activities in the classroom Commitment to school and learning Self-esteem Protection against mental illness Recovery from setbacks (resiliency) Sample language: "Extensive research has linked the presence of social-emotional support to many positive effects and outcomes including…" (read/paraphrase/elaborate on each bullet) 48 Slide 7 Powerful Implications Absence of social-emotional support puts students at greater risk for: Learning problems Feeling disconnected from school Disruptive behavior Peer rejection Development of mental illness Long-term negative outcomes (e.g., dropping out of high school, criminal activity, social or mental health problems in adulthood) Sample language: “On the flipside, there is also broad research linking the absence of socialemotional support to many quite serious negative effects and outcomes, including…” (read/paraphrase/elaborate on each bullet) Slide 8 With this in mind… How can we make a difference? Sample language: “So now the question becomes, what can we do? Or how can we make a difference?” 49 Slide 9 Targeting Intervention Efforts Research indicates that there is a strong relationship between the presence of social competency and: Positive peer group adjustment Social-emotional well-being (Smith & Hart, 2005) SAY: Given this, interventions targeting social competency may improve both interpersonal relationships and internal well-being. Slide 10* What is Social Competency? Sample language: "Now we will take a closer look at the concept of social competency." 50 Slide 11 What is Social Competency? Social Competency involves: 1) Possessing and appropriately using social skills 2) Learning from past experience and applying that learning to the ever-changing social landscape Essentially: Combining social skills and past knowledge to build and maintain interpersonal relationships (paraphrase information on this slide) Slide 12 What is Social Competency? The acronym C.A.R.E.S. identifies five major clusters of social skills that socially competent people have: • Cooperation • Assertion • Responsibility • Empathy • Self-control (Gresham & Elliot, 1990) Sample language: “While there are numerous social skills that are acquired and used by socially competent people, the CARES acronym provides an easy was to remember five social skills that are core for social competency” Supplemental information that can be used for clarification as desired: Assertion is the ability to use emotional language, such as “I” statements Self-control involves behavior & emotions, including awareness of your emotional state and motivations, coping with distressing emotions, and managing your own behavior 51 Slide 13* Typical Social Development: What should we be seeing? SAY: Social competence develops over time. Social skills emerge at various points during development and build on previously learned skills and knowledge. Conversely, a breakdown along the way in social development will have a ripple effect on the development of social competency. Slide 14* Typical Social Development in Middle Childhood In 3rd-5th grade, typically developing children… Act nurturing and commanding with younger children but follow and depend on older children Are beginning to see the point of view of others more clearly Define themselves in terms of their appearance, possessions and activities Enjoy group adventures and cooperative play Are more able to endure frustration while accepting delays in getting things they “want.” (read/paraphrase each bullet, then CLICK mouse/pointer to show the next) 52 Slide 15* Typical Social Development in Middle Childhood Specific social skills that should be developed at or before this age: Ability to take turns, cooperate and compromise Recognizing and acknowledging the feelings and viewpoints of others Listening to another person speaking and nonverbally showing understanding/comprehension When social conflict inevitably arises children can usually distinguish between minor and major arguments, can resolve problems and can disengage when a conflict threatens a friendship. (read/paraphrase each bullet, then CLICK mouse/pointer to show the next) Information for clarification: Understanding comprehension nonverbally can involve nodding or appropriate facial expressions Slide 16* Typical Social Development in Middle Childhood Characteristics of friendships at this age: Same gender groups form based on commonalities Friendships increase in number and stability However, friendships can be terminated for no identifiable reason or for minor slights Reciprocity becomes more important The label of “best friend” emerges Towards the end of middle childhood, confiding in friends becomes more important than just “doing something” together (read/paraphrase each bullet, then CLICK mouse/pointer to show the next) Supplemental information that can be used for clarification as desired: Commonalities: likes and dislikes, abilities and personality traits Reciprocity: children do favors for each other and expect favors in return Resolving social problems: At this age,the necessary brain structures for developing problem solving strategies are formed. Children can resolve problems on their own, or with minimal adult support. 53 Slide 17* Typical Social Development in Middle Childhood The desire to belong and be accepted becomes very important during these years. Children at this age may appear more self-conscious about having friends and are more worried about being accepted, fearing rejection, and embarrassment. A large amount of time is spent thinking about the formation and maintenance of friendships. (read/paraphrase each bullet, then CLICK mouse/pointer to show the next) Slide 18 Cultural Considerations “Typical social development” can look different from culture to culture. Cultures can vary in their: Social norms Expectations for behavior (i.e., A behavior desired in one culture may be frowned upon in another) Interpretation of others’ behavior/ social cues Become familiar with the cultural makeup of your school and community, and keep this in mind when determining whether student behaviors are “typical.” (read/paraphrase each bullet) then… SAY: If social concerns are present for a child whose family is from another culture, talking with the family about the behaviors you are seeing, or not seeing, can help to determine if there are cultural implications for the child’s behavior. 54 Slide 19* Recognizing Children Who are Struggling Socially Sample Language: “Now we will take a look at specific behaviors and observable signs that may tell you that a student is struggling socially” Slide 20 Signs of Social Competency Problems Aggressive/hostile behavior Misinterpretation/overreaction to social situations Failure to convey empathy for others Difficulty regulating behavior Withdrawal from peers or social situations Poor, undeveloped sense of humor Excessive shyness/embarrassed easily Bossy, controlling, and/or dominating Sample Language: “Behavior patterns such as excessive shyness, bossiness, aggressive/hostile behavior, and withdrawn behavior leading to social isolation, are common indications of social competency problems.” 55 Slide 21 Signs of Social Competency Problems Other signs that intervention may be needed: Lack of friends Rejection from peers Rejected-withdrawn Rejected-aggressive Frequent teasing by peers Changes in physical appearance (e.g., grooming, dress) Crying in class Sample language: “Social isolation through withdrawn behavior or peer rejection are common indications of social competency problems. Supplemental information that can be used for clarification as desired: Peer rejection: can lead to low self-esteem, achievement delays, stigmatization. And peer rejection is not the same as friendship problems.” Rejected-withdrawn: -passive, submissive, lonely, vulnerable, and having low self-esteem -Their socially awkward nature prevents successful, appropriate interactions with peers, and makes them easy targets for teasing/name calling/exclusion/bullying -They are aware of their rejected status and hold negative expectations for how they will be treated by peers. Rejected-aggressive: (the more common subgroup) -Disliked because of their aggressive, argumentative, disruptive, impulsive, hostile, and confrontational nature -These children tend to be unaware of their rejected status and may even inflate their selfperception of social competence (in other words, they think they have good social skills and believe that the problem lies with their peers, not them) 56 Slide 22 Signs of Social Competency Problems Social Skills Deficits: Acquisition Deficits The student does not have the knowledge to perform a particular social skill. (“Can’t do”) Performance Deficits The student has the particular skill in his/her repertoire but rarely performs the skill or does not have the motivation to perform it. (“Won’t do”) Fluency Deficits The student has the skill in his/her repertoire but performs it inconsistently or awkwardly. SAY: Many students who are struggling socially have some type of social skill deficit. There are three types… (explain each) The type of deficit helps determine what kind of intervention is necessary. Elaborations for bullets: -Fluency deficits are usually due to lack of practice, lack of exposure to competent models, or inadequate rehearsal for newly learned skills. Slide 23 Signs of Social Competency Problems What else have you seen while working in schools that tells you a student is struggling socially? Ask members of the audience the question on the slide and allow for a few minutes of sharing from their experience. Encourage those who do share to keep their contributions to the discussion brief and general. 57 Slide 24 What Can I do to Help? Sample language: "Now that we’ve looked at what we should be seeing in young children and what signs may tell us individuals may lack age-appropriate social competency, we will examine how students struggling socially can be helped." Slide 25 Tiered Approach to Intervention 80% of students will not exhibit major behavior problems because of previous successful learning experiences. These children should respond to Environmental Supports (Core Interventions) 15% of students will be at-risk for severe behavior problems. These students engage in problem behaviors beyond acceptable levels and will not respond to basic school wide interventions. These students should respond to Programmatic Supports (Targeted Interventions) About 1 to 5% of students display chronic patterns of violent, disruptive, and destructive behavior that do not respond to either of the above approaches. These students need Individual Support (Intensive Interventions) (read/paraphrase each bullet and then CLICK mouse/pointer to reveal next bullet) Once all slide content is visible SAY: Social competence deficits are characteristic of the second and third groups of students described above. 58 Slide 26 Tiered Approach to Intervention Used by permission of School Specialty Inc., (800) 225-5750, http://eps.schoolspecialty.com SAY: Here is a visual representation of a tiered approach to intervention Slide 27 Positive Effects of Intervention In addition to boosting social competency, intervention efforts at each level can lead to increases in: Resiliency Positive behavior Positive relationships with peers and adults Academic achievement Emotional well-being Read the information on this slide and then to clarify… SAY: Resiliency is the ability to recover from setbacks and a way of coping that can prevent negative outcomes (e.g., depression, anxiety, low achievement) 59 Slide 28* What Can I do to Help? Core Interventions Environmental Supports (Tier I: helping 80% of students) Create a supportive school climate Promote positive social connections Encourage students to believe they can succeed if they try Frame failure as an opportunity from which to learn Model respect for others, optimism, and forgiveness Create an environment with clear, consistent expectations Encourage students to work together to learn, using a variety of resources (read/paraphrase the information on this slide) then…SAY: Environmental support strategies should be used on a school-wide level AND within each classroom environment. Elaborations for bullets: -Creating a supportive climate that encourages respect for others, connectedness, and selfesteem -Promote positive social connections between staff and students, among students, between families and school, and school-community -Create an environment with clear, consistent expectations (e.g., school-wide rules for behavior, worded positively) Nonjudgmental, accepting learning environment: a “community of learners” -Encourage students to work together to learn, using a variety of resources (can promote personal responsibility and mutual respect) 60 Slide 29 What Can I do to Help? Core Interventions Naturalistic Intervention “Informal social skills intervention . . . takes advantage of naturally occurring behavioral incidents or events to teach prosocial behavior . . . There are literally thousands of behavioral incidents that occur in home, school and community settings, thereby creating rich opportunities for using these behavioral incidents as the basis for social skills trainings.” (Gresham, 2002) This quote should be read in its entirety and then… SAY: Interventions folded into the course of the school day are also known as naturalistic interventions. Supplemental information tat can be used for clarification as desired: Naturalistic interventions can sometimes be more powerful than more intensive interventions (such as social skills groups) because they use real-life situations as learning opportunities as they occur throughout the day. It is important that these skills are consistently reinforced and practiced for them to “stick.” Slide 30* What Can I do to Help? Core Interventions Naturalistic strategies (Tier I: helping 80% of students) Encourage non-competitive games and help children set individual goals. Talk about self-control and making good decisions. Talk about why it is important to be patient, share, and respect others’ rights and what each “looks like” (e.g., taking turns). Teach children to learn from criticism. Ask, “How could you do that differently next time?” Have students evaluate their choices/actions by asking themselves: “Is it safe?” “Is it fair?” “Is it respectful?” Reinforce that these strategies can help 80% of students Sample language: “Specific examples of naturalistic strategies include…” (read/paraphrase/elaborate on each bullet) 61 Slide 31* What Can I do to Help? Targeted Interventions Programmatic supports (Tier II: helping 10-15% of students) Bibliotherapy As a preventative strategy To start a general discussion after an incident has occurred Social-Emotional Learning (SEL) curricula that can be used in a whole-class setting or in smaller groups Peer mediation groups Bullying/violence prevention programs Counselor or Psychologist-led social skills groups that students can be referred to (Refer back to the tiered approach to intervention and reinforce that these strategies can help those 15% of students who don’t respond to core/environmental/naturalistic interventions) Paraphrase/read all content, then …SAY: Included in the handouts, there is one that includes additional information on the bibliotherapy process and specific recommended resources Slide 32* What Can I do to Help? Targeted Interventions Specific Strategies promoting social skill acquisition (Tier II: helping 10-15% of students) Modeling Coaching Behavioral Rehearsal The 4 R’s SAY: When social skills are lacking, Modeling, Coaching and Behavioral Rehearsal are specific strategies that can help students learn and practice these skills. We will now review each of these strategies. 62 Slide 33* What Can I do to Help? Targeted Interventions Modeling involves learning by observing another person perform a behavior One of the most effective and efficient ways of teaching social behavior Steps for Modeling: Present the entire sequence of behaviors involved in a particular social skill 1. 1. 2. 2. First, demonstrate each step or part Next, model entire sequence together as it should look Teach the student how to integrate the behavior into their social interactions (read/paraphrase information from each bullet and CLICK mouse/pointer to reveal more information) Slide 34* What Can I do to Help? Targeted Interventions Coaching involves using verbal instructions to teach social behavior Steps for Coaching: 1. 2. 3. Explain social concepts or rules Provide opportunities for practice or rehearsal in controlled situation Provide specific informational feedback on the quality of behavioral performances (read/paraphrase information from each bullet and CLICK mouse/pointer to reveal more information) 63 Slide 35* What Can I do to Help? Targeted Interventions Behavioral Rehearsal involves practicing a newly learned behavior in a structured, protective situation of role playing Steps for Behavioral Rehearsal: Explain and model a new behavior Provide a role play prompt for students to practice the skill in 3. Have students switch roles within the role play to help reinforce learning 1. 2. Example -- Say: “Greg, you and Max are playing handball at recess and you see Julian sitting by himself. I want you to practice the ‘inviting a friend to play’ skill we just learned.” (read/paraphrase each bullet and CLICK mouse/pointer to reveal more information) Once all content is visible and has been reviewed, SAY: in these “role plays,” students can become more proficient and fluent with specific social skills without experiencing negative consequences. Slide 36* What Can I do to Help? Targeted Interventions The 4 R’s: a four-step process to teach and reinforce social rules Steps of the 4 R’s: 1. Reason: provide a reason for the rule 2. Rule: state the rule 3. Reminder: provide the student with a hint about the rule 4. Reinforce: recognize and praise (read/paraphrase info from each bullet and CLICK mouse/pointer to reveal more information) Example: A student, Julie, is having difficulty allowing others to take turns on a computer in the classroom. First, tell the student that the classroom computer is for everyone to use (reason), so one person can’t have it for the whole time. So, we need to take turns to be fair to the other students (rule). So, when Carlos comes over that means your time is up and it’s her turn on the computer (Reminder). If Julie steps aside when Carlos comes over, give her recognition/praise (reinforce). 64 Slide 37 A Note on Behavior Change Remember… Developing or learning a new social skill is a form of behavior change. Changing behavior takes time and is a gradual process. With this in mind, each step towards the goal behavior should be praised and reinforced. In other words . . . reward DIRECTION to guide towards PERFECTION Sample language: “When helping a student develop their social skills, keep in mind that this is a form of behavior change….” (read the remainder of the slide. Emphasize the rhyme of DIRECTION and PERFECTION to be used as a reminder of this information when helping a student) Slide 38 Vignettes & Practice Sample language: “Now you will have a chance to put what you have learned so far into action.” 65 Slide 39* Lucas Lucas is a 9 year-old, 4th grade boy. He loves being around other kids, but does not seem to have any consistent friends. While on yard duty at lunch, you notice that when he goes to play with other children he often becomes aggressive, pushing and bumping into other children more than the game calls for. Usually, the other children end up moving the game away from him. He then walks away, looking upset. This pattern repeats over several days with several different groups of children. (read the vignette and encourage the participants to read along to themselves on the slide in their handout) Slide 40* Vignette Discussion In your groups discuss the following: Based on what you have learned today… Is this a problem warranting intervention? Is there something you could do to help Lucas? If so, what do you think might help him? Instruct participants to break into small groups of 2-3 people to discuss the vignette and questions 66 Slide 41* Kiara Kiara is a 8 year-old 3rd grade girl who is new to the school this year and seems to be very shy. When the class does group work she never seems able to find a group on her own. At recess, she stands to the side and watches the other children play. When you ask her why she isn’t playing with the other children, she says, “They didn’t invite me.” Take turns practices one of the 3 strategies for building social skills: Modeling Coaching Behavior Rehearsal Stay in small groups for this practice. Again, read the vignette and then give help as needed to participants to complete the practice activity. Slide 42 When to Seek Outside Help Sample language: “Some students may have more severe social problems that may require more specialized supports and interventions “ 67 Slide 43 Tiered Approach to Intervention For those 1-5% of students who do not respond to core interventions and targeted interventions, more individualized intervention and support is likely needed. Used by permission of School Specialty Inc., (800) 225-5750, http://eps.schoolspecialty.com (read information on slide, referring to the tiered graphic), then… SAY: These more individualized interventions and supports should be handled by school psychologist or counselor Slide 44 Seeking Outside Help Make contact with school psychologist or counselor. Contact via email or other designated avenue (e.g.: observation/consultation form) Ask for an observation to be made of the student Make appointment to meet to talk about your concerns for the student read/paraphrase information on slide), then included supplemental information as desired… SAY: Background information related to specific concerns plus observational information can inform decisions as to what supports/interventions may help the student Mention handout: sample Initial Consultation Request form (optional). 68 Slide 45 At-Risk Populations Special populations at risk for significant deficits in social competency: Children with diagnosable disorders: Internalizing Disorders Externalizing Disorders Autism Spectrum Disorders Children with disabilities (physical, learning, etc.) Children with a lack of resiliency (read/paraphrase information on slide), then… SAY: a note about resiliency, studies have shown that children with low resiliency who may not have positive adult role models benefit from the support of at least one caring adult. Caring adult can be teacher, coach, principal, girl/boy scout leader, etc. and it only takes one person to make positive and lasting impact. Slide 46 Externalizing Disorders Externalizing Disorders include: Attention Deficit Hyperactivity Disorder (ADHD) Oppositional Defiance Disorder (ODD) Conduct Disorder (CD) Each of these disorders is: Marked by acting-out (externalizing) behaviors Set apart from typical development by the intensity, duration and frequency of such behaviors (read/paraphrase information on slide), then… SAY: We will go over specific examples of externalizing behaviors. 69 Slide 47 Externalizing Disorders: ADHD Children with ADHD can experience social difficulties due to excessive: • Distractibility • Hyperactivity • Impulsivity These behaviors affect a child’s ability to observe, understand, and respond to the social environment. Children with ADHD are often isolated and rejected from their peers (read/paraphrase information on slide), then…SAY: These behaviors are seen in small doses among most children during development. Diagnosable when the behaviors have been present since early childhood, across setting (school & home) and to a degree that it interferes with daily functioning (academic, social etc.) Slide 48 Externalizing Disorders: CD & ODD Children with Conduct Disorder & Oppositional Defiance Disorder can experience social difficulties due to: Excessive aggression and hostility The use of inappropriate social problem-solving strategies (e.g., aggressive actions) due misreading social situations Peers reject these children frequently due to their aggression and defiant rule-breaking behavior (read/paraphrase information on slide) SAY: The intensity and frequency of acting out behaviors negatively influence these children’s ability to form relationships. Supplemental information that can be used for clarification as desired: Example of misreading social situation: A student laughs at a joke his friend told him and a student with ODD interprets this as laughing at him. He approaches the students, yells at them for laughing at him, and threatens to “beat them up.” 70 Slide 49 Internalizing Disorders Internalizing Disorders include: Depression Anxiety Each of these disorders is: Marked by patterns of less observable (internalized) symptoms It is normal to experience depression & anxiety in smaller doses, diagnosable disorders are set apart by their intensity, duration and frequency (read/paraphrase information on slide) Supplemental information that can be used for clarification as desired: Clarifying Internalizing symptoms—thoughts, worries and fears Slide 50 Internalizing Disorders: Depression Signs of depression include: Excessively critical attitude about self or others Feelings of incompetence and/or inadequacy Withdrawal from social situations Significant changes in eating or sleeping habits Chronic fatigue Refusal to accept advice, help or constructive criticism Many of these symptoms can directly impact a child’s social functioning (read/paraphrase information on slide) then…SAY: Many people experience depression at one time or another, but when these feelings/behaviors persist and /or are severe enough to interfere with daily functioning, outside help is needed Supplemental information that can be used for clarification as desired: Example of social impact: increased arguing with friends, withdrawal from social activities 71 Slide 51 Internalizing Disorders: Anxiety Most Common Anxiety Disorders Generalized Anxiety Disorder Specific phobias (for example: school or social situations) Obsessive Compulsive Disorder Post-Traumatic Stress Disorder Each of the above involve severe reactions of worry and fear caused by situations or events that are typically perceived as harmless. These worries and fears can become so consuming that these students may avoid social situations and are unable to build or maintain friendships. read/paraphrase information on slide), then… SAY: The extreme degree and frequency of the worry or fears is what sets it apart from the normal anxiety that all people can experience. SAY: Children with anxiety disorder can also experience school avoidance, physical symptoms and an unrealistic need for perfection Slide 52 Autism Spectrum Disorders (ASDs) Autism Spectrum Disorders include: Autism Asperger’s Syndrome Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) Each of these disorders is: Characterized by deficits in communication and social functioning and patterns of stereotyped/ritualistic behaviors (read/paraphrase information on slide) 72 Slide 53 Autism Spectrum Disorders (ASDs) Social deficits among children with ASDs can include difficulties with: Understanding social rules such as taking turns and sharing Understanding and reading the emotions of others Taking the perspective of other people Initiating and maintaining interactions and conversations with other people (read/paraphrase information on slide), then…SAY: Children with ASDs may avoid eye contact and often display behaviors that are perceived as “odd” by their peers, this can impact the social success of these children. Please note that in your handout packet there is information about working with all of the special populations that we have just discussed. Slide 54 A note on diagnosable disorders… Keep in mind that Internalizing, Externalizing and Autistic Spectrum Disorders all range in severity and often look quite different in different children. Understanding the severity of a individual’s disorder may help determine what level of social support or intervention may be most appropriate. (read/paraphrase information on slide) then…SAY: If you have students with any of the mentioned diagnoses that have an IEP or 504 plan, reviewing their levels of functioning and accommodations is essential in providing appropriate levels of support. 73 Slide 55 Conclusion Keep in mind that most children, even those with diagnosable disorders, who are struggling socially can respond to core (school or classroom-wide) interventions and targeted interventions… Bottom Line: These types of interventions should always be tried first. YOU have the skills and knowledge to use these interventions and make a positive impact! (read/paraphrase information on slide) Slide 56 Questions/ Comments? [INSERT PRESENTER NAME, TITLE AND CONTACT INFORMATION] (Ask for questions and point out your contact information that can be used later if questions/concerns arise) 74 Slide 57 References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th ed., rev.). Arlington, VA: American Psychiatric Association. Brown, M. B. (2008). Best practices in designing and delivering training programs. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology (Vol. 6; pp.2029-2039). Bethseda, MD: National Association of School Psychologists. Caldarella, P., & Merrell, K. (1997). Common dimensions of social skills of children and adolescents: A taxonomy of positive behaviors. School Psychology Review, 26(2), 264-278. Retrieved from: http://proxy.lib.csus.edu/login?url=http://search.ebscohost.com.proxy.lib.csus.edu/login.aspx?direct=true&db=aph&AN=9708 120314&site=ehost-live Cavell, T. A., Meehan, B. T., & Fiala, S. E. (2003). Assessing social competence in children and adolescents. In C. R. Reynolds & R. W. Kamphaus (Eds.), Handbook of psychological & educational assessment of children (pp. 433-454). New York, NY: Guilford Press. de Boo, G., & Prins, P. (2007). Social incompetence in children with ADHD: Possible moderators and mediators in social-skills training. Clinical Psychology Review, 27(1), 78-97. doi: 10.1016/jj.cpr.2006.03.006 Doll, B., Zucker, S., & Brehm, K. (2004). Resilient classrooms: Creating healthy environments for learning. New York: Guilford Press. Durlak, J., Weissberg, R., Dymnicki, A., Taylor, R., & Schellinger, K. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82(1), 405-432. doi: 10.1111/j.14678624.2010.01564.x Eisenberg, N.A., Fabes, R.A., Guthrie, I.K., & Reiser, M. (2000). Dispositional emotionality and regulation: Their role in predicting quality of social functioning. Journal of Personality and Social Psychology, 78, 136-157. doi:10.1037//0022-3514.78.1.136 Elliot, S. N., McKevitt , B. C., & Clyde Diperna, J. (2002). Promoting social skills and development of socially supportive environments. In S. Brock, P. J. Lazarus & S. R. Jimerson (Eds.), Best Practices in School Crisis Prevention and Intervention (pp. 151-170). Bethesda, MD: National Association of School Psychologists. Gimpel, G. A., & Holland, M. L. (2003). Emotional and behavioral problems of young children. New York, NY: Guilford Press. Glick, G. C., & Rose, A . J. (2011). Prospective associations between friendship adjustment and social strategies: Friendship as a context for building social skills. Development Psychology, 47(4), 1117-1132. doi: 10.1037/a0023277 Gresham, F. M. (2002). Teaching social skills to high-risk children and youth: Preventative and remedial strategies. In M. R. Shinn, H. M. Walker, & G. Stoner (Eds.), Interventions for Academic and Behavior Problems II: Preventative and Remedial Approaches (pp. 403-432). Bethesda, MD: National Association of School Psychologists. Gresham F. M., & Elliot, S. N. (1990). Social skills rating system. Circle Pines, MN: American Guidance System. Slide 58 References Hanie, E. H., & Stanard, R. (2009). Students with anxiety: The role of the professional school counselor. Georgia School Counselors Association Journal, 16(1), 49-55. Retrieved from: http://www.gaschoolcounselors.com/displaycommon.cfm?an=1&subarticlenbr=139 Hinshaw, S. P., & Lee, S. S. (2003). Oppositional defiant and conduct disorder. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (2nd ed., pp. 144-198). New York: Guilford Press. Howard, A. M., & Landau, S. (2010a). Friendships in childhood. In A. S. Canter, L. Z. Paige, & S. Shaw (Eds.), Helping children at home and school III: Handouts for families and educators (pp. S5-53 - S5-56). Bethesda, MD: National Association of School Psychologists. Howard, A. M., & Landau, S. (2010b). Peer rejection: How parents and teachers can help. In A. S. Canter, L. Z. Paige, & S. Shaw (Eds.), Helping children at home and school III: Handouts for families and educators (pp. S5-69 - S5-72). Bethesda, MD: National Association of School Psychologists. Huberty, T. J. (2010). Anxiety and anxiety disorders in children: Information for parents. In A. S. Canter, L. Z. Paige, & S. Shaw (Eds.), Helping children at home and school III: Handouts for families and educators (pp. S5-1 - S5-4). Bethesda, MD: National Association of School Psychologists. Klem, A. M., & Connell , J. P. (2004). Relationships matter: Linking teacher support to student engagement and achievement. Journal Of School Health, 74(7), 262-273. doi:10.1111/j.1746-1561.2004.tb08283.x Kluth, P. (2009). Teaching students with autism & asperger’s syndrome in the inclusive classroom. Port Chester, NY: Dude Publishing. Kramer, P.A. & Smith, G.G. (1998). Easing the pain of divorce through children’s literature. Early Childhood Education Journal, 26(2), 8994. Lavoie, R. (2005). It's so much work to be your friend: Helping the child with learning disabilities find social success. New York, NY: Touchstone. Lichtenstein, D., Lindstrom , L., & Povenmire-Kirk, T. (2008). Promoting multicultural competence: Diversity training for transition professionals. Journal for Vocational Special Needs Education, 30(3), 3-15. McClelland, M. M., Morrison, F. J., & Holmes, D. L. (2000). Children at risk for early academic problems: The role of learning-related social skills. Early Childhood Research Quarterly, 15(3), 307–329. doi:10.1016/S0885-2006(00)00069-7 Meltzer, L. (2010). Promoting executive function in the classroom. K. R. Harris & S. Graham (Eds.). New York: Guilford Press. Merrell, K. W. (2008). Helping students overcome depression and anxiety. (2nd ed.). New York: Guilford Press. Miller, D. N., & Jome, L. M. (2010). School psychologists and the secret illness: Perceived knowledge, role preferences, and training needs regarding the prevention and treatment of internalizing disorders. School Psychology International, 31(5), 509-520. doi:10.1177/0143034310382622 75 Slide 59 References Ormrod, J. E. (2007). Human learning (5th ed.). Englewood Cliffs, NJ: Prentice-Hall. Parker, J.G., & Seal, J. (1996). Forming, losing, renewing and replacing friendships: Applying temporal parameters to the assessment of the children’s friendship experiences. Child Development, 67, 2248-2268. doi:10.2307/1131621 Putallaz, M., & Sheppard, B.H. (1990). Social status and children’s orientation to limited resources. Child Development, 61, 2022-2027. doi:10.23071130855 Samter, W. (2003). Friendship interaction skills across the lifespan. In J.O. Greene & B.R. Burleson (Eds.). Handbook of communication and social interaction skills (pp. 637-684). Mahweh, NJ: Lawrence Erlbaum & Associates. Semrud-Clikeman, M. (2007). Social competence in children. New York, NY: Springer Science Business Media, LLC. Shore, K. (2010). Classroom management: A guide for elementary teachers. Port Chester, NY: Dude Publishing. Siegler, R., DeLoache, J., & Eisenberg, N. (2003). How Children Develop. New York: Worth Publishers. Smith, E. K., & Hart, C. H. (2005). Blackwell handbook of childhood social development. Malden, MA: Blackwell Publishers Limited. Smith Harvey, V. (2010). Resiliency : Strategies for parents and educators. In A. S. Canter, L. Z. Paige, & S. Shaw (Eds.), Helping children at home and school III: Handouts for families and educators (pp. S5-79 - S5-82). Bethesda, MD: National Association of School Psychologists. Smith Harvey, V. (2007). Schoolwide methods for fostering resiliency. Principal Leadership: Middle Level Edition, 7(5), 10-14, Retrieved from www.nasponline.org Stichter, J. P., Randolph, J., Gage, N., & Schmidt, C. (2007). A review of recommended social competency programs for students with autism spectrum disorders. Exceptionality, 15(4), 219-232. doi:10.1080/09362830701655758 Wang, R., He, Y., & Liu, L. (2002). Social competence and related factors in primary school students. Chinese Mental Health Journal, 16, 791-793. Waters, E., & Stroufe, L.A. (1983). Social competence as a developmental construct. Developmental Review. 3, 79-97. doi: 10.1016/02732297(83)90010-2 Weiss, M. J., & Harris, S. L. (2001). Teaching social skills to people with autism. Behavior Modification, 25, 785-802. doi:10.1177/0145445501255007 Werner, E. E. (1989). Children of the garden island. Scientific American, 260(4). 106-111. doi:10.1038/scientificamerican0489-106 Whelley, P., Cash, G., & Bryson, D. (2002). The ABCs of children's mental health: Information for school principals. Here's How, 21(1), 14, Retrieved from http://www.nasponline.org/resources/handouts/abcs_handout.pdf 76 APPENDIX B PRESENTER’S MANUAL 77 Supporting Social Competency at School Introduction Developing social competency is instrumental to navigating the social and academic world in school and beyond. Social competence is typically built as a part of social development in childhood and adolescence. When a child possesses social competence, he or she is thought to have the skills and knowledge necessary to successfully navigate the social world and to build and maintain positive relationships with others. Successful peer relations can have a lasting positive impact on the student’s self-esteem, ability to recover from stress and other setbacks, and perception of school and learning (Doll, Zucker, & Brehm, 2004; Howard & Landau, 2010). Research has demonstrated that social competence has a strong relationship with overall socialemotional well-being and positive peer group adjustment (Smith & Hart, 2005). Given this, school-based interventions aimed at improving social competence may improve both interpersonal relationships and internal well-being. The information is based on a literature review performed between September and December of 2011. Nature of the Presentation The presentation is designed for an audience of teachers and other school staff who have regular contact with students and regular opportunities to support and intervene with socially struggling students. This training program is comprised of five stand-alone presentations that are developmentally organized by grade groups from Pre-K to 12th grade. Each presentation is designed to last for about 75 minutes. Interactive activities and audience participation are integral aspects of all presentations. To successfully deliver these presentations, presenters should incorporate presentation techniques such as encouraging and facilitating discussion, pausing for questions, and validating input from participants. Being properly prepared before these presentations is also important for successful training delivery. Preparing should include 78 familiarizing oneself with the content by thoroughly reading slides, presenter’s notes and citations beforehand and also photocopying handouts for all participants. In addition, it is recommended that presenters become familiar with the information cited and referenced at the end of the presentation. The presenter’s name and contact information should be added to the first and last presentation slides and the participant handouts before printing. It is especially important to include contact information because participants may have questions or need clarification after the presentation and should be able to contact the presenter later. Guidance for Presenters Each presentation in this training program was created as a series of Microsoft PowerPoint slides. The presentations include prepared slides with the actual presentation content and slide notes sections that provide further information for the presenter to help guide presentation delivery. The presenter’s notes contain two types of information. In italics there are two types of information. First, there is sample language to help guide the flow of the presentation. When this type of information is included, the phrase, “sample language:” precedes the suggested wording. The second type of information provided in italics is supplemental information that clarifies and elaborates on the slide content. It is left up to the discretion of the presenter how much of this information to share during the presentations. This supplemental information may also be useful for presenters if members of the audience ask questions about information on the slides. Certain information contained in the notes sections of the slides should always be used when presenting. This content is always preceded with “SAY:” and can be rephrased at the discretion of the presenter. Other information in the slide notes is presented in plain text and is meant to instruct and guide the actual delivery of the presentation. For example, on certain slides, bulleted text is shown gradually and a mouse/remote/pointer “click” is needed to display the subsequent bullet or piece of information. The notes for these 79 slides contain reminders for presenters that a “click” is needed to continue displaying slide content. Also, on each of the slides containing vignette activities, notes are provided for the presenter to help structure each activity. Handouts should be provided for all attendees. Copies of the PowerPoint slides (6 per page) should be distributed to participants, as well as the supplemental handouts that can be found in the appendices of this project. Appendix C contains a two-page handout about bibliotherapy, which should be provided for those attending the Pre-Kindergarten-Kindergarten, Grades 1 – 2, and Grades 3 – 5 presentations. Appendix D contains a three-page handout with specific strategies and approaches for working with particular populations of students. This handout should be included at all presentations. Lastly, Appendix E contains a sample referral form that can be used by teachers and other school staff when they feel a student may need outside help from a school psychologist. This handout is optional and the presenter can choose to include this for any of the presentations. To encourage audience participation throughout the presentations, there are several informal audience participation opportunities in addition to the vignettes. One example is asking audience members to raise hands to indicate whether they had encounter problems behaviors that were presented. This should be done after reviewing the slide content. Each presentation is designed to last approximately 75 minutes. A recommended timeline for an individual training follows, using the Grades 3-5 as an example: Slides Topic #1-9 Introduction and Outline #10-12 What is Social Competency? #13-23 Typical Development/ Signs of Dysfunction #25-37 What Can I do to Help? #38-41 Vignettes & Practice #42-55 When to Refer/ Conclusions Duration 5 minutes 5 minutes 15 minutes 20 minutes 15 minutes 15 minutes 80 About the Authors Catherine Teller and Danielle Harrington are school psychologist interns who both hold Master’s degrees from California State University, Sacramento in School Psychology and Bachelor of Arts degrees in Psychology from University of California, Santa Barbara. This workshop was completed to satisfy part of the requirements of their Specialist in Education (Ed.S) degrees. 81 APPENDIX C BIBLIOTHERAPY HANDOUT 82 Targeted Intervention: Bibliotherapy What is it? Bibliotherapy has been described as “the process of growing toward emotional good health through the medium of literature” (Kramer & Smith, 1998). Essentially, bibliotherapy involves using carefully selected books to normalize experiences, start discussions, and indirectly model pro-social behaviors for children. How is it done? 1) Prepare: Read the book on your own to make sure the content is appropriate for your needs. 2) Plan Discussion Questions: These will probably come to mind when you first read the book. Develop a list of open-ended questions. Having options to choose from in the moment can enhance its efficacy. Also, some questions will work better than others, so having several to choose from is helpful, but do not expect to get to all of them. General Question Example: a. What are the characters feeling? b. How do you feel about what just happened in the story/to the characters? c. What would you do? 3) Read the Story: You can choose to read the book uninterrupted or questions can be interspersed during the reading. If the story is read uninterrupted, questions can be asked at the end. 4) Follow-Up: A variety of activities can be used to enhance the bibliotherapy process. These academic can include art activities, creative writing, and role playing. Creative writing activities could include re-writing the story from a specific character’s perspective or writing a letter to a character in the book. Art activity ideas could include drawing a picture of a favorite part of the story or a favorite character. Role plays could be done to re-enact parts of the story or to show different ways that problems in the story could have been solved. Books by Topic: Age/Grade ranges are meant to be a general guide, books may still be good selections for groups outside the ages/grades listed. Read the book yourself to help decide whether it may be a good match for the children you work with. Friendship Join In and Play, by: Cheri J. Meiners (Ages 4-7) How to be a Friend, by: Laurie Kransy Brown & Marc Brown (Ages 4-8) 83 The Sandwich Swap, by: Her Majesty Queen Rania Al Abdullah (Ages 4-7) Perro Grande…Perro Pequeno/Big Dog…Little Dog, by: PD Eastman (Ages 4-8) Rosie and Michael, by: Judith Viorst (Ages 6 & up) How to Lose All Your Friends, by: Nancy Carlson (Ages 4 & up) Shy Charles, by: Rosemary Wells (Ages 5 & up) Social Skills Share and Take Turns, by: Cheri Meiners (Ages 5-8) We Can Get Along: A Child’s Book of Choices, by: Lauren Murphy Payne (Ages 4-8) Eric Learns to Share, by: Chris Dear & Molly Corbett (Ages 4-7) My Mouth is a Volcano, by: Julia Cook (Ages 4-8) A Bad Case of Tattle Tongue, by: Julia Cook (Ages 4-7) Personal Space Camp, by: Julia Cook (Ages 4-7) Howard B. Wigglebottom Learns to Listen, by: Howard Binkow (Ages 4-8) Talk and Work it out, by: Cheri Meiners (Ages 4-8) Winners Never Quit, by: Mia Hamm (Ages 5 & up) Feelings When Sophie Gets Angry-Really, Really Angry, by Molly Bang (Ages 4-8) How Are You Peeling? Foods with Moods, by: Saxton Freyman & Joost Elffers (Ages 4-7) Sometimes I Feel Awful, by: Joan Singleton Prestine (Ages 5-8) Alexander and the Terrible, Horrible, No Good, Very Bad Day, by: Judith Viorst (Ages 4-8) Wemberly Worried, by: Kevin Henkes (Ages 5 & up) Lizzy’s Ups and Down, by: Jessica Harper (Ages 3-9) Bullying/Teasing One, by: Kathryn Otoshi (Ages 4 & up) Big Bad Bruce, by: Bill Peet (Ages 4-8) Chester’s Way, by: Kevin Henkes (Ages 5-7) Hooway for Wodney Wat!, by Helen Lester (Ages 5 & up) Chrysanthemum, by: Kevin Henkes (Ages 4 & up) Super Emma, by Sally Warner (Grades 2-4) Dog Sense, by Sneed B. Collard (Grades 5-8) The Revealers, by Doug Wilhelm (Grades 5-8) 84 APPENDIX D SUPPORTING STUDENT SOCIAL COMPETENCY: SPECIAL POPULATIONS 85 Supporting Student Social Competency: Special Populations Attention Deficit Hyperactivity Disorder (ADHD): ● Structure and routine: Students with ADHD respond well to structure and routine. Establish consistent expectations and predictable routines to prevent problem behavior, and periodically review both for all students (e.g., what to do when entering/exiting the room, appropriate behavior outside the classroom, organization of supplies, and where homework assignments are written down). ● Problem-solving: Students with ADHD struggle with planning, organization, and self-regulation. Younger students may need explicit instruction of problem-solving and behavior regulation strategies. Guided practice and cueing to reinforce behavior may also be needed. In secondary years, students may continue to need cueing and they should be encouraged to personalize the strategies that have been are most effective for them. ● Reinforcement: Positive reinforcement of using prosocial problem-solving strategies is an essential part of the student recognizing and internalizing appropriate behavior. A behavior chart can help track progress (if needed). Reinforcement examples include: o Approving nonverbal cues (e.g, smile, thumbs-up, nod) or physical cue (e.g., high-five) o Verbal praise naming the behavior (e.g., “I like how you suggested taking turns. That was a good decision because it’s safe and respectful.”) o Classroom job (e.g., messenger, passing out papers, erasing board) o Positive mark on behavior chart (e.g., sticker, star, circling “excellent”) o Access to preferred activities (e.g., reading a book, playing with a toy, using the computer) o Earn rewards at home (agreed upon in advance with parents) ● Hyperactivity: Transtions can be difficult for students who have difficulty staying still. Consider providing the student with ideas for appropriate activities to do during “waiting” time in order to prevent behavior problems (e.g., playing “20 questions” in the lunch line or drawing a picture during transitions in class). Oppositional Defiance Disorder & Conduct Disorder Due the severe behaviors associated with these disorders, students with these diagnoses will likely need more intensive support, provided by behavior or mental health professionals. Consult with these specialists for individualized recommendations. Autism Spectrum Disorders: ● Clear expectations: Talk to the entire class about rules and behavioral expectations. Use concrete examples of what expected behaviors “look like” and “sound like,” providing them with sample phrasing. Classrooms rules and expectations should be visible at all times. Because students with autism respond well to visual cues, using pictures/icons illustrating rule are recommended. ● Triggers: Avoid possible behavior problems by becoming familiar with the student’s sensory needs and “triggers” for outbursts. When possible, adapt the 86 classroom environment to accommodate sensory needs. Consider creating a “safe space” for the student to go to when stressed. It is important that this space not be associated with punishment. ● Ask about sharing information: Ask students on the autism spectrum whether they would like to share information with other students about their diagnosis, and, if so, how they would want to go about sharing this information. ● Social comfort level: Find out the student’s preferences for group activities or social interaction (e.g., favorite and least favorite activities, number of students they are comfortable working with on an activity). ● Incorporate structured socialization: Establish routines for socialization to provide structured opportunities for students to practice social skills (e.g., taking a moment for students to greet each other in the morning). ● Encourage sharing: Many students with autism spectrum disorders have particular interests that they enjoy talking about. Encourage students to share their knowledge with each other, tutor others, or join clubs related to their interests. You may also want to develop activities or academic assignments relating to these interests. ● Be aware of possible anxiety: It is common for students with autism spectrum disorders to experience anxiety, especially in secondary years. Recommendations below under Anxiety Disorders may also be appropriate for these students. Anxiety Disorders ● Signs of anxiety: Try to recognize when the student is experiencing anxiety. Signs may include: avoiding classroom participation, tests, or coming to school; poor memory (i.e.,“freezing up”) especially on tests, and reports of physical symptoms (e.g., headaches, nausea). Remember: students with anxiety often try very hard to appear as though they are “holding it together,” but in reality they may be experiencing extreme internal distress. ● Safe environment: Establish a nonjudgmental and accepting classroom environment. Model and talk about positive ways you handle stress (e.g., exercise, humor). ● Triggers: Try to find out what “triggers” your student’s anxiety or emotional distress. This may involve asking the parents, counselor, or previous teacher (if possible), or check the student’s cumulative file. If triggers are unknown, note what happens right before and after the student exhibits emotional distress. ● Performance anxiety: Some students with anxiety tend to be overly concerned with grades, performance on tests, etc., and/or may “shut down.” Emphasize the process of learning rather than test performance or grades. Keep in mind that the social environment of the classroom can be intimidating for these students. ● Avoidance: If students with anxiety experience (or anticipate experiencing) failure or an unpleasant situation, they may avoid the situation rather than to use problem-solving to approach it. Work with the parents, school psychologist, and the student (at the secondary level) to develop a plan for reasonable expectations and goals with small, achievable steps. 87 ● Modifications: Depending on the needs and triggers of the student, modify expectations for attendance, group work, and oral presentations. Consider creating a “safe space” at school (e.g., in counselor’s office) where the student can go temporarily if anxious. ● Response to distress: If a student appears to be experiencing lower levels of distress, support his/her attempts to problem solve independently. Use a calm voice and encourage the student to express what is going on. Validate feelings, and coach/ cue coping strategies as necessary (e.g., taking deep breaths, asking for a break, thinking of solutions). If anxiety is more severe, contact the school psychologist/counselor and parents. Depression ● Develop a relationship: Don’t be afraid to talk with depressed students, try to build a working relationship. Although it may seem otherwise, depressed students are often looking for someone who cares about them. Use positive approaches and don’t give up on the depressed student. DO NOT use punishment, sarcasm or other negative techniques, because these can reinforce feelings of incompetence. ● Remember, depression is not a choice: Depressed students want to feel better and they are not choosing to feel the way they do. Students with depression need extra caring, help and support. ● Provide opportunities for success: When possible, arrange for activities and experiences that you know the student will experience success with and can be recognized for this success. It is very important that depressed students feel a “part” of the class and feel that their teachers believe in them. ● Threats of self-harm: If a student makes threats of imminent self-harm, immediately call the school psychologist or counselor. If no mental health professionals are on site, call an administrator. 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