Thursday, August 16, 2018

Marrying Mental Health and Behavior Health Interventions for Students with Emotional Disturbance

Throughout the years, I have had the privilege to work with many educators and school personnel as they strive to address difficult student behaviors, including emotional disturbance.  Students with emotional disturbance present unique challenges to the classroom.  Often, these children require a myriad of techniques and an array of staff to support them including therapeutic support staff (TSS), personal care aides, school social workers, school guidance counselors, and behavior specialists.  Those that are trained in looking at behavior objectively sometimes clash with those that study the internal well-being of students.  However, each serves an important role in changing behavior.  The two facets – behavior specialist and mental health therapist – should strive to marry their practices so that their students can derive the most benefit from their collective knowledge.

Behavior specialists are trained to look at what is reinforcing behavior.  Students can successfully find unique ways to escape work or seek attention rather than do what they have been asked to do.  Sometimes, visits to helpful staff members are a form of escape.  A kind individual that will drop what he/she is doing to listen and provide counsel to an anxious or angry child is often the same staff member who is identified to work with kids who struggle emotionally.  Indeed, many times in the classroom when students are having difficulty following through with directives or tasks, their teachers encourage them to leave and report to these individuals for support.  This may become a habit as students learn to associate the support staff room as being more reinforcing than their regular classrooms.

We know that kids are kids, whether they have emotional disturbance or not.  As such, just like their peers, they can certainly take advantage of the adults in their lives to avoid unpleasant tasks.  As an example, having an outburst and leaving the classroom at the start of math on most days reflects a pattern of behavior.  Is the student struggling with the effects of trauma at that time, or is it math?  If I take a child for a break because he frequently rips his math paper, I teach the child that he can avoid doing math by having difficult behavior.  Since this behavior worked for him, he will most certainly try it again.

School social workers and guidance counselors often feel as if behavior specialists aren’t addressing core issues, including trauma, depression, and anxiety.  Sometimes kids just need a break in order to meet the demands of a school day.  Many students are living without parents due to incarceration or addiction.  Some children are homeless and can’t even count on a stable place to live when the bus drops them off in the afternoon or even food for supper.  These very real scenarios take a backseat to academics for many children.  Their mental health issues are real, and justifiably, they can’t be expected to shelve them completely for a six-hour school day. 

Collaboration with both professions would encompass the idea that it is always easier to address behavior as an antecedent rather than as a consequence.  Can the student have a scheduled break with his counselor before beginning a challenging subject?  Is the student in need of additional supports, accommodations, or adaptations so that particular assignments are not as frustrating for him?  Would earning a reinforcer help him/her to avoid escalation and be more productive?  We may not be able to solve his family issues, but surely we could teach him coping strategies. 

Clearly, the number of students with emotional disturbance is on the rise over the last several years.  This is a telling example for our society that we may be failing today’s youth.  Educators have found themselves seeking out ways to foster better mental health for their students and to incorporate mental health strategies in their classrooms.  They need to avail themselves of those who have that expertise.  When the mental health therapists and behavior specialists can work together as a team to create doable behavior plans that teach students coping skills as well as appropriate classroom behavior, children with emotional disturbance can only benefit.   When children with special needs are working successfully alongside their peers, all children benefit.


Rebecca Moyes, M.Ed., 2018
Special Education Consultant with Grade Point Resources

Sunday, October 4, 2015

What Makes a Great Special Education Classroom?

Having visited and/or provided consultation to many special education classrooms, I can say with sincerity that there are several components that are always evident in exemplary classrooms:

#1:   a teacher who has a positive attitude about his/her program.  Educators who are not "on-board" with teaching the students in their classrooms will not be as effective as those that are. Teachers who are excited to teach = students who are excited to learn.  

#2:   a properly staffed classroom.   The number of children assigned to the room, the severity of their behaviors, whether or not they are independent in their daily routines, as well as the degree of the students' communication deficits should be the deciding factor as to how many adults should be servicing the classroom.

#3:  the presence of technology for communication and learning.  I-pads are wonderful assets to include in the classroom, but they should be used as teaching tools and not just for "games." Smart-boards, communciation devices, and other assistive technology are evident and integrated in exceptional special education classrooms.

#4:  the presence of visual supports.  Most children with disabilities require them.  At some point, they will most likely demonstrate their need for them with disruptive behaviors.

#5:  structure.  Good special education classrooms have evidence of structure in the form of predictable routines and procedures for learning, "down time", and behavior interventions.

#6:  reinforcers.  Many children with disabilities require extrinsic motivation.  Those who work with these students should be equally reinforcing and positive as well.

#7:  active participation in their school's environment.  Gone are the days when kids with special needs were housed in a basement classroom.  Special education students should be readily included in typical classrooms, activities, and other aspects of the school day.  And, they should be welcomed and supported by all staff in that building.

#8:  evidenced-based programming.  Teachers in special education classrooms should be able to present data with regards to progress on goals and make decisions about programming based on that data.  For older students, data should govern transition plans as well.

#9:   training.  Most educators will require training and/or consultation to meet the needs of the most difficult students.

#10:   supportive and involved administration.  Principals and other administrators need to understand what is happening in the classroom, be supportive of the staff and students, and help to establish trusting relationships with parents.  They should be "champions" for their inclusion in the building where they attend.

#11:  good relationships with families.  Kids with disabilities benefit immensely when school and home environments are "on the same page."

#12:  flexibility.  Teachers and staff who can react calmly in a crisis, distract and "re-group" escalated students, and develop trust with their students are worth their weight in gold!

#13:  behavioral supports.  Special education classrooms that utilize applied behavior analysis to complete functional behavior assessments and to develop positive behavior support plans will have children who are learning needed replacement skills for difficult behaviors.  

#14:  multi-sensory education.  There should be plenty of evidence of visual, tactile and kinesthetic teaching experiences.

#15:  appropriate work.  Examples:   Field trips are not just trips to "get out of the building", they are planful and supported by IEP goals.   Tasks should not be too repetitive for students who have already demonstrated mastery.  "Breaks" should be short in duration and not used to "take up time."  Lesson plans are utilized and adaptations for individual children are evident.  

Special education professionals can use the above checklist to self-evaluate their own special needs classrooms.  Doing so can only result in positive outcomes and increased learning for children with disabilities.

Wednesday, February 25, 2015

Can I Punish Kids Who Have Disabilities?

As a consultant, one of the questions I get asked the most is, "Is this behavior because of his disability, or is it just bad behavior?"

My answer is usually the same, "Does it matter?"  As a child with a disability, all problem behavior should be addressed through a positive behavior support plan.  Such a plan will include consequences for when the child exhibits appropriate behavior, as well as consequences for when the child is inappropriate.  Educators often worry about consequencing a child for "disability" behavior. They do not want to be blamed for "punishing" a behavior that is related to the child's disability.  The process of developing a behavior plan must be a team effort -- all consequences should be decided by the team.  If one consequence is not effective, others will need to be considered.

It is important to note that there are certain behaviors that should NEVER be tolerated in school by ANY child.  Even children who are very disabled can learn that we don't hit, kick, punch, bite, or spit in school.  Behavior interventionists who are trained in applied behavior analysis can and should write positive behavior plans to address these behaviors and teach  new replacement skills.

In applied behavior analysis, there are two types of consequences.  Consequences come AFTER the behavior occurs.  These two types are reinforcers and punishers.  Reinforcers, if they are truly reinforcing to the child, make the behavior of concern stay the same or increase in frequency.   There are also two types of reinforcers:   positive reinforcers (what I add to the environment after the behavior occurs that causes the frequency of that behavior to stay the same or increase) and negative reinforcers (what I take away from the environment after the behavior occurs that causes the frequency of that behavior to stay the same or increase).  As an example, let's say on-task behavior is the behavior of concern.  If I apply a sticker on the child's chart after he completes a task, and this causes him to increase his on-task behavior, this is a positive reinforcer.  Or, if I take away recess because he has not completed his work, and this causes the on-task behavior to increase, I have applied a negative reinforcer.  Any behavior that is reinforced is likely to continue, thus reinforcers are very powerful in changing behavior.  A tip for you is that you always want to reinforce the good behavior!  

There are also two types of punishers.  Punishers, if they are truly punishing for a child, make the frequency of the behavior go down.  Positive punishers are what I add to the environment after the behavior occurs that causes the frequency of that behavior to decrease.  Negative punishers are what I subtract from the environment after the behavior occurs that causes the frequency of that behavior to decrease.  Let's say the behavior of concern is a child who touches electrical sockets.  If my toddler is about to stick his fingers in an electrical socket and I yell, "Don't touch that!" and he stops, I have used a positive punisher (the addition of my loud voice command caused him to stop the behavior).  If, however, I take away his favorite toy because he touched the socket, and this causes him to stop touching the socket, then I have used a negative punisher because I removed something from the environment that caused the frequency of the behavior to go down.

In conclusion, the process of finding reinforcers and consequences that work may be trial and error. As educators, you may feel that a child should receive a certain consequence for problem behavior, but the point is, if the behavior decreases with another type of consequence in place, you have achieved the same outcome!   And, there will be some children where reinforcing only appropriate behavior will serve to be so effective that a punishing-type consequence will not be needed.  Be flexible; try to get past the idea that all children should receive the same reinforcers and punishers. If you hang on to that belief, you will always have difficulty with kids who don't 'fit the mold.'  Kids with special needs are just like kids who are typical -- what works for some does not work for others. Allowing for individualization when dealing with problem behavior, is crucial.

Friday, May 2, 2014

Executive Functions -- How Much Can Your Working Memory Glass Hold?

Why is working memory so important?

Working memory is considered to be a key component in learning.  The ability to hold information in the brain, study it, manipulate it, act on it.... these are all essential "must have's" in order for a child to be successful in school.  Working memory can be compared to your laptop's desktop.  These are the files that you use more than others, you refer to them often -- you may tuck them away for a while, but you are always able to retrieve them with fluidity whenever you may need them.

How can I tell if my student or child has deficient working memory?   Does he/she forget important information that has been taught and re-taught?  Does he appear to struggle when presented with tasks that have too many steps?  Are his written expression assignments 'all over the place'?   Is multi-tasking hard for him/her?  Does he/she avoid complex tasks with multiple steps and perform poorly in those kinds of tasks?

Executive function testing helps us to determine how a student's working memory is performing.  It's an important number to know.  There are accommodations that a student simply must have to be successful in the classroom if his working memory is deficient.   Comparing working memory to a water glass is helpful.   Some folks are born with water glasses that can hold much more than others.  So for the student with a smaller water glass, he will "spill over," become less efficient in his work, and possibly appear to forget what he was taught when his working memory water glass is to full.  If he has language deficits, and his teacher provides all of the information he needs via "talking teaching," he will struggle even more!

Here are some accommodations to consider in the classroom:

Chunk important instructions -- be concise with directions, provide important steps in bits
Write directions down
Follow the teaching practice of teach a little; practice a little; teach a little; practice a little
Visual schedules are important to help with transitions -- many kids can't hold all the information in their minds throughout the day
Make lists and check lists
Use technology
Use graphic organizers for writing assignments and other subjects
Create a project plan for long-term projects, write it down, and check completed steps off
Rehearse, rehearse, rehearse
Divide task into various components and create a checklist of these components

Watch for my new book "Executive Function 'Dysfunction' " published by Jessica Kingsley Publishers to be released in June.  It contains lots of strategies to cope with executive function difficulties!




Thursday, April 24, 2014

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