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David Gotthelf, Ph.D., NCSP

With credit to Jessica Minihan, John D’Auria, Paul Ashand the Barium Springs Home for Children

About 10% of the U.S. school population(9-13 million children) struggle withmental health problems Students with Social/Emotional Disorders:

◦ Only 20% ages 14-21 receive a highschool diploma

◦ 48% drop out of grades 9-12◦ 30% are employed◦ 58% have been arrested

We can help our students, but first we haveto help ourselves.

Collaboration Education (Capacity Building) Leadership

And

Trust (The encompassing factor)

Collaboration

LeadershipEducation

None of us are as smart as all of us. Teamwork is central to collaboration and

effective reform. Continually develop teams and individuals. Collaboration is dependent on team skills

more than personality. Expect excellence in both individual

performance and teamwork.

Learning is continuous: It never ends. Learning involves continuous feedback. Learning involves sharing external research. Value and utilize our areas of expertise. Value self-reflection. Insure quality supervision and evaluation. Link professional development to student

needs.

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Leadership is at all levels, not top/down. Leadership involves sharing one’s vision of

helping students. Inclusive work culture and core values. Supporting the hearts and minds of everyone. Creating collaborative culture and structures. Balancing advocacy with inquiry.

Supportive leaders & honoring groupnorms. Being able to engage in difficult

conversations. Communicating openly and honestly. Embracing a culture supporting the

learning and social/emotional needsof both students and educators.

The Personalities of our students. The Environment(s) in which we place them,

either in school or on field trips. The Activities we ask them to do.

and The Relationships students form with us and

with each other. The first three concepts areall influenced by the relationships weestablish.

ThePerson

TheActivity

TheEnvironment

Most students have an innate drive to exploretheir environment and demonstrate masterywithin it.

Competence is reached when a student is ableto perform skills that meet his or her ownpersonal needs.

Our students need to be able to use theresources (personal, social, material) withintheir environment.

Our job is to use the relationships we developwith them to help them achieve these goals.

Each of us is made up of a series of intrinsicfactors that involve different levels of skills,abilities, and styles◦ Cognitive Abilities◦ Executive Functioning◦ Social Pragmatics Skills◦ Social/Emotional Profile◦ Physiological Abilities◦ Temperament

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Participation is always influenced by the extrinsiccharacteristics of the environment in which itoccurs.

Experience in one environment can significantlyaffect experience in another.

Environmental factors to think about and plan for:◦ Constructed◦ Natural◦ Cultural◦ Social interactions

A key aspect of any program is thedevelopment and implementation of activitiesthat students can do and want to do.

Activities should follow a sequential patternof complexity.

Students should have some understanding ofthe relevance of the activity.

We need to be mindful of how the activity willaffect our students.

Affects the three previous constructs in that itcan manage the interaction of personalfactors (intrinsic), the environment (extrinsic),and the chosen activity or activities.

Having a strong and constructive interactiverelationship with a student can lead tostronger performance and greaterparticipation.

Anxiety: Looking at one behavioralhealth issue, how it manifests inschool, and what we can do inresponse.

A student may be excessively fearful,distressed, and uneasy in situations whereothers would not.

Reduces productivity and quality of life. May lead to poor school attendance, deficient

interpersonal skills, and adjustment skills. Can range from relatively simple Adjustment

Disorder to more serious disorders, such asPanic Disorder and Post Traumatic StressDisorder.

Often overlooked or misjudged, despite beingeffectively treatable.

Many are ashamed and refuse to seektreatment.

There is evidence that adult anxiety disordersare often the result of anxiety disorders firstmanifested in childhood, and that childhooddisorders left untreated will result in adultversions of AD.

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Researchers suggest watching for anxiety inchildren between 6 and 8 years of age.◦ At this age, children become less afraid of the dark

and imaginary creatures, and more concernedabout school performance and social relationships.

◦ High levels of anxiety in a child ages 6 through 8may be a warning sign that the child may developan anxiety disorder later on.

◦ A child’s fears may change as the child ages, whichcomplicates research

Many students with ASD have high risk forsignificant anxiety.

Anxiety may be closely related to sensoryintegration or social difficulties.◦ Think about the noisy cafeteria. Multiply that noise

level by a factor of 10. That is what kids with ASDmay (but not always) be experiencing.

◦ Think about that group of kids teasing each otherand horsing around. What if you always thought thatwas bullying and you were the target?

According to a study of children with ASDand anxiety, the impact of anxiety wasmore substantial, from their parents’perspective, than the impact of ASD onthe child’s life.

Parent and child perspectives on the nature of anxiety in children and young people with autism spectrum disorders: a focus group studyAnn Ozsivadjian, Fiona Knott, Illiana MagiatiAutism March 2012 vol. 16 no. 2 107-121

SELF-REGULATIONThought stopping/thinking traps Social skillsExecutive Functioning Flexible thinking

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Establish check-ins on arrival to facilitatetransition into school.

Accommodate late arrivals due to difficultieswith transitions.

Address reluctance to go to school:◦ Determine the cause of the child’s avoidance and

initiate a plan to get him or her in school ASAP.◦ It may ease anxiety if the school day is shortened

temporarily.◦ If the child will not leave the house, having the

teacher or counselor go to the house has oftenbeen successful as part of the transition process.

Understanding the Behavior: ABC◦ Antecedent◦ Behavior that results◦ Consequences resulting from that behavior

Effective Interventions◦ Effective means empowering, not enabling

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Misbehavior is a symptom of an underlyingcause:◦ Is it: “She can’t” or “She won’t”?

Behavior is communication. Behavior has a function. Behavior occurs in patterns. Behavior can be changed.

Tanya wrote two beautiful paragraphsyesterday…

Today she hasn’t finished onesentence….

Easily frustrated Has somatic complaints

such as stomach achesand headaches, troublebreathing

Fears Hyper-vigilant Excessive worrying

/perfectionism Crying

Difficulty completing work Being irritable Being angry Not following school rules Inconsistent patterns in

antecedents Ritualistic/repetitive

behavior Inflexible out of the blue or

over reactive

Activity Following AdultDirections

Using SchoolLanguage

Using a SafeBody

MorningMeeting

1 2 3 1 2 3 1 2 3

Math 1 2 3 1 2 3 1 2 3Reading/Writing 1 2 3 1 2 3 1 2 3Science 1 2 3 1 2 3 1 2 3Lunch 1 2 3 1 2 3 1 2 3Recess 1 2 3 1 2 3 1 2 3

Adequate anxiety management

Teaching the skills needed to behave

She can’tvs.

She won’t

Functional hypothesis and antecedent analysis

Accommodations development

Interaction Strategies

Response Strategies

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nsor

Mark Durand

•Better than no attention•Why some students seek negativeattention:

•Efficient•Predictable•Obvious•Dramatic and Intense

Alternate Lunch Alternate Recess

Reduce language Reduce social demands Reduce distractions

Mood regulation interventions◦ Regular class exercise◦ Mindfulness activities such as yoga

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Feeling Strate gi esAngry

Ta ke a bre ak; deep bre aths

F rus t rated

Get a d ri nk ; use m y c alm ingbox

E xc i te d

T ake de ep bre aths

Anxi ous

Use m y c alm ing box

SadUse m y w ords ; u se m y

c alming box

Cont e nt

Use m y w ords

Happy

Use my w ords ; Sm ile or

laugh.

Adapted from: Kenneth W. Merrell, Helping Students Overcome Depression and Anxiety: A Practical Guide(New York: Guilford Press, 2008).

This can be used for almost any kind ofbehavior.

Most effective for young children andstudents who cannot express the level oftheir feelings easily (or at all.)

Very helpful for kids with ASD. Kids can help you draw up a scale and it

could be posted

Tell It Like It Is:5: I need to leave.4: I need some space.3: Please don’t talk.2: I am a little nervous1: I can handle this!

Monitoring My Anxiety Level:5: Forget it. My self-control is zero. I need an

advocate4: It is pretty hard for me to control myself. I’ll

need somebody safe with me or a way out in ahurry.

3: I’m OK. But I would like somebody nearby to supportme.

2: I’m cool.1: No problem. I’m in complete control for at

least___minutes. I’ll even be able to help someoneelse.

Helpful for younger children and less verbalchildren, but kids of all ages like iterations ofthis.

Possible calming sensory items may include:◦ Weighted blanket◦ Putty◦ Headphones◦ Yoga cards◦ Stuffed animal◦ Portable study carrel

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Sosh Lite At Ease Calm Counter Stress Tracker DBT iCouch CBT emWave Personal Zen Happify

Writing can be stressful due to it’s relativelack of structure and specificity relative toother subjects and skills

Ideas to consider include visualization of thetask, (graphic organizers), but also of theideas as well as ways for students to sharetheir feelings in a constructive manner.◦ Thinking Maps◦ Empower

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1.Stopping the activity

2.Making the cognitiveshift to next activity

3.Starting the nextactivity

4.The inherent lack ofstructure duringtransitions

1.Find a stopping point

2.Use visual schedules,photographs

3.Count down typewarnings...5 moreminutes...

4.Try to structure thedowntime.

◦ Neutral, calm tone◦ Avoid yes or no questions◦ Use choices when possible◦ Declarative, not authoritative,language

◦ Indirect◦ Deliver and move away◦ Extended time to comply◦ Yes/No question - alternative

Be mindful of the “Jekyll & Hyde” student whoholds it together in school but whose parentssay is problematic at home. This could be theresult of stress experienced at school.

Be pro-active in helping students and familiesget support. Area parents and teachers canuse Project Interface Referral Service:

(617) 332-3666 x1411 Helping kids get better involves teamwork by

teachers, parents, and providers.Don’t give up! Things can improve!

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Ash, Paul and D’Auria, John (2013) SchoolSystems That Learn, Corwin, Thousand Oaks, CA

Attwood, Tony (2007) The Complete Guide toAsperger’s Syndrome, Jessica KingsleyPublishers, Philadelphia, PA

Buron, Kari & Curtis, Mitzi (2012) The Incredible5-Point Scale, AAPC Publishing, Shawnee Missin,KA

Minihan, Jessica and Rappaport, Nancy (2012)The Behavior Code, Harvard Education Press,Cambridge, MA