accommodating students with emotional disabilities

Nicole R. Biggs, M.Ed.

Site PrincipalSiaTech

Debbie Jones Disability Program

AnalystHumanitas

Accommodating Students with

Emotional Disabilities

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OBJECTIVES

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■ Center staff will be able to:● Identify appropriate examples of accommodations and

strategies based upon a student’s manifestations of the disability (i.e. presenting symptoms and behaviors)

● Verbalize how the use of appropriate accommodations and strategies assists students with emotional disabilities in improving their educational and daily living outcomes

● Identify classroom management techniques that support improved behavioral outcomes by increasing appropriate behaviors and decreasing inappropriate behaviors

OBJECTIVES

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■ IEP serves as documentation of the disability in the Job Corps program● Classification of Emotional Disturbance (ED) in IEPs

o Definition and characteristics defined within the Individuals with Disabilities Education Act Applies to public school/charter partners Provides accommodation/modification and supports history

■ Medical Records■ Psychological and Neuro-psychological

assessments

DOCUMENTATION SOURCE EXAMPLES

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DEFINITIONS

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■ According to IDEA section 34 CFR 300.8 (c)(4), an emotional disturbance is defined as:● a condition exhibiting one or more of the following

characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance: o An inability to learn that cannot be explained by intellectual,

sensory, or health factorso An inability to build or maintain satisfactory interpersonal

relationships with peers and teachers

EMOTIONAL DISTURBANCE DEFINED

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o Inappropriate types of behavior or feelings under normal circumstances

o A general pervasive mood of unhappiness or depressiono A tendency to develop physical symptoms or fears associated

with personal or school problems

EMOTIONAL DISTURBANCE DEFINED

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DETERMINING REASONABLE

ACCOMMODATION

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DETERMINING REASONABLE ACCOMMODATION

■ How do you know what accommodations an individual with a disability might need?● Did the applicant request any accommodations?

o 6-53o Accommodation Request Formo Stated in the interactive accommodation processo Documentation of disability shows previous need/history of

use of certain supports and accommodations

■ What are the presenting symptoms/behaviors?● Functional limitations

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■ Time Management■ Organization and

Prioritization■ Social Skills■ Concentration■ Memory

■ Communication■ Stamina■ Responding to Change■ Screening Out

Environmental Stimuli ■ Managing Stress

FUNCTIONAL LIMITATIONS

Definition: The inability to perform an action or a set of actions, either physical or mental, because of physical or emotional restriction1.

1Brodwin, M., Tellez, F., Brodwin, S. (1993). Medical, Psychosocial and Vocational Aspects of Disability. Athens, GA: Elliott and Fitzpatrick, Inc.

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■ Assess your own perceptions of people with emotional disabilities?● Do you have some misperceptions,

fears, questions related to working with students with emotional disabilities?

■ Be conscientiousness and aware of how your own interaction with student can lead to exacerbating disruptive or concerning behaviors● Your personality, tone, body language● Understand how you interact and react

ASSESSING ONE’S OWN PERCEPTIONS

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IDENTIFYING BEHAVIORAL SUPPORTS

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■ Unlike the core components of the Job Corps program, our public school or charter partners also have to meet the obligations outlined within IDEA including how a BIP is developed ● A BIP is based on the results of a functional behavior assessment

which would be conducted to try and determine why the behavior was occurring and then use that information to identify intervention strategies that include positive behavior supports and services to address behavior

■ In Job Corps, the Reasonable Accommodation Committee (RAC) (inclusive of the student) identifies needed supports or the student may request needed supports. When the type of support needed is unclear, a less formal assessment approach can be used. Dependent upon the specifics of the support, it may need to be added to the student’s accommodation plan

BEHAVIOR INTERVENTION PLAN (BIP)

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■ If a student with a disability is having difficulty managing his or her behavior, then convene the Reasonable Accommodation Committee (RAC), inclusive of the student, to review and discuss● Is the conduct in question caused by or had a direct and

substantial relationship to the student’s disability?● Have previously identified and agreed upon

accommodations in the student’s Job Corps Accommodation Plan been implemented? o Are they effective?

● Did the student’s IEP mention or have attached a behavior intervention plan (BIP)?

IDENTIFYING BEHAVIORAL SUPPORTS

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■ Identify the specific behavior(s) in question■ Attempt to determine why the behavior is occurring

● What function does the behavior serve for the student? For example, does it allow the individual to escape the environment to avoid over-stimulation of the senses, to resolve anxiety, to escape demands, etc.

■ Does the behavior appear to be linked to a skill deficit or a performance deficit? ● Skill Deficit - A behavior or academic skill that student does not

know how to perform (Ex. A student who hasn't mastered the skill of greeting others appropriately may have a skill deficit in that area)

● Performance Deficit - A behavioral or academic skill the student does know, but does not consistently perform (Ex. A student is chronically late for a math class he or she does not enjoy)

ASSESSING THE BEHAVIOR

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“EMOTIONAL” DISORDERS

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■ An umbrella term that encompasses several distinct disorders that share the core characteristic of excessive, irrational fear and dread:● generalized anxiety disorder (GAD) ● obsessive-compulsive disorder (OCD) ● panic disorder● posttraumatic stress disorder (PTSD) ● social anxiety disorder (also called social

phobia)● other specific phobias

ANXIETY DISORDERS

http://nichcy.org/wp-content/uploads/docs/fs5.pdf

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■ PTSD is one of the anxiety disorders that develops after a terrifying ordeal that involved physical harm or the threat of physical harm. People with PTSD may:● startle easily ● become emotionally numb ● lose interest in things they used to enjoy● have trouble feeling affectionate● be irritable● become more aggressive

POST-TRAUMATIC STRESS DISORDER (PTSD)

http://www.nimh.nih.gov/health/publications/anxiety-disorders/post-traumatic-stress-disorder.shtml

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■ Eating disorders are characterized by extremes in eating behavior - either too much or too little - or feelings of extreme distress or concern about body weight or shape

■ Anorexia nervosa, bulimia nervosa, and binge-eating are common types of eating disorders ● Anorexia nervosa is characterized by self-starvation and

dramatic loss of weight ● Bulimia nervosa involves a cycle of binge eating, then self-

induced vomiting or purging ● Binge-eating is when the person loses control over his or

her eating but they do not purge afterwards

EATING DISORDERS


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■ Mood disorders refer to a category of mental health problems that include all types of depression and bipolar disorder. Mood disorders are sometimes called affective disorders

■ Symptoms may include:● persistent feelings of sadness or feeling hopeless or

helpless● having low self-esteem● difficulty with relationships● decreased energy and/or difficulty concentrating● frequent physical complaints (i.e. headache, stomach

ache, fatigue)

MOOD DISORDERS

http://medicalcenter.osu.edu/patientcare/healthcare_services/mental_health/mental_health_about/mood/Pages/index.aspx

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■ Bipolar disorder is a mood disorder, also known as manic-depressive illness, and is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Some symptoms might include:● increased distractibility● restlessness● loss of interest● feelings of jumpiness or agitation

BIPOLAR DISORDER

http://www.nimh.nih.gov/health/publications/bipolar-disorder/what-is-bipolar-disorder.shtml

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■ Personality disorders are deeply ingrained ways of thinking and behaving that are inflexible and generally lead to impaired relationships with others. Some symptoms may include:● Rigid – unable to respond to the changes and

demands of life or inflexible as stated above● Difficulty with or extreme anxiety in social interactions● Difficulty making decisions or in completing tasks

PERSONALITY DISORDERS

http://www.nmha.org/go/information/get-info/personality-disorders

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■ Conduct disorder refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. This may include some of the following behaviors:● aggression to people and animals● destruction of property● deceitfulness, lying, or stealing● truancy or other serious violations of rules

CONDUCT DISORDER


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■ “Psychotic disorders” is another umbrella term used to refer to mental disorders that cause abnormal thinking and perceptions. Two of the main symptoms are delusions and hallucinations ● Delusions are false beliefs, such as thinking that

someone is plotting against you ● Hallucinations are false perceptions, such as hearing,

seeing, or feeling something that is not there o Schizophrenia is one type of psychotic disorder

PSYCHOTIC DISORDERS


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ACCOMMODATIONS

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STAFF RESPONSIBILITIES

■ Each staff person must ensure:● Familiarity with a student’s accommodation plan● That the accommodations related to their specific area

are discussed with the student● That the accommodations are implemented● That the accommodations are monitored for

effectiveness

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■ Individuals with the same diagnosis may and often do have needs that are unique to them; the same disability may manifest itself in different ways in different people

■ There is no list of accommodations appropriate for a particular condition. Accommodations are determined on a case-by-case basis● Functional limitations● Strengths

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■ Allow modifications to schedule to use stress relieving strategies ● Exercise

■ Provide private space to use stress relieving strategies

■ Provide special pass to see a designated staff person or go to a designated quiet space

■ Provide peer or staff mentor student can speak with if symptoms are escalating

MANAGING STRESS/ANXIETY

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■ Consider placement in work/living space● For example, a student with PTSD may need to be

seated facing doorways not in the classroom but in the dormitory and other environments

■ Provide additional time to complete certain tasks or assignments

■ Remove environmental triggers● Smells, noises, etc.● Lighting

■ Provide frequent feedback, praise, positive reinforcement, etc.

MANAGING STRESS/ANXIETY

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■ Provide organizer and assist, as appropriate● Prioritize tasks/activities/assignments

o By day, week, month, etc.

● Identify student’s patterns in activityo Example: “you do this 3 times each week”

● Emphasize due dates on calendars ● Develop a color-coded system (each color

represents a task, or event, or level of importance)

● Ensure accuracy of entries on calendar or iPhone

MAINTAINING ORGANIZATION

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■ Movement breaks■ Redesign space to

● Minimize auditory/visual distractions ● Reduce clutter

■ Visual timers or vibrating watches■ Break large assignments into smaller

segments■ Use checklists/charts■ Noise cancelling headset■ Provide written instructions and notes

when giving oral instruction■ Verify understanding

MAINTAINING ATTENTION/CONCENTRATION

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■ Provide written information or notes■ Provide pictorial or verbal cues■ Use check-lists■ Use color coding to indicate priority order■ Variety of mediums to review content independently

● Videos● Audio of content/recorder

■ Extended time

MEMORY SUPPORTS

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■ Arrange for longer/less frequent or shorter/more frequent breaks between activities

■ Help student pace their workload and social activities by using shortened task lists or a timed schedule

■ Develop substitution strategies (for times when a student cannot keep their obligation to the event or activity)

MAINTAINING STAMINA

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■ Assist student in identifying points of transition within organizer● Highlight/color code transitions in schedule

■ Provide prompts/cues and/or set up alerts via electronic or other means of transition times in schedule● Ensure enough time to process and adapt to the

change

■ Use peer mentorship to model and support individual during times of transition

MANAGING CHANGE/TRANSITIONS

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■ Environments might require different codes of conduct (i.e. classroom, career technical versus the dorm or the cafeteria or out in the community)● Provide written copy or audio version, if needed● Verify understanding

■ Use a peer, tutor, and/or mentor to reinforce appropriate social skills ● Practice appropriate social skills ● Role play

■ Provide video of expected interactions like using “social stories”

MANAGING SOCIAL INTERACTIONS

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■ Identify the “out” for those times when the student cannot demonstrate appropriate skills and build into accommodation plan● Hand gesture, word, or signal● Where to go to regain composure● Use headphones with soothing music

■ Provide information, in an accessible format, as to how the student can return/re-engage in environment

MANAGING SOCIAL INTERACTIONS

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■ Allow leaving each class a few minutes early to avoid crowded hallways

■ Sit near an exit during large meetings or assemblies■ Allow watching of assembly via electronic means live or

via videotape■ Allow to provide written response versus an oral one■ Use tri-fold boards for in-class testing■ Assign seating to the side or the back of the room■ Provide a peer mentor■ Provide information, in an accessible format, as to how

the student can return/re-engage in environment

SUPPORTING SOCIAL ANXIETY

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■ An applicant with a diagnosis of Bipolar reports being easily distracted and may have difficulty working in a large group.

■ An applicant with a personality disorder indicates that when stressed by deadlines and workload, he has a hard time managing emotions and sometimes gets into verbal conflicts with peers.

■ A student with a diagnosis of Schizophrenia reports not having energy to do academic work in the morning due to medication side effects.

■ A student with an Anxiety Disorder is having trouble learning how to do his dorm duties and feels stressed when new students arrive in the dorm.

LET’S REVIEW

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“CLASSROOM" MANAGEMENT

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■ Establish ground rules ● Rules are clear and consistent

■ Keep rules to a minimum of 5■ Clearly post rules■ Give copy of rules■ Review rules frequently■ Ensure understanding of rules■ Set limits and boundaries

SETTING EXPECTATIONS

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■ Ensure classroom instruction and assigned tasks match student’s interests and instructional level; utilizing structured, interactive, fast-paced and directive teaching styles that maximizes students' attention during whole school instruction and individual seat work

■ Provide a structured and predictable environment. This is often beneficial for students with all types of disabilities but can sometimes be essential for students with emotional disabilities

■ Establish clear short-term and long-term goals■ Use high interest materials when presenting something to

the class

CLASSROOM MANAGEMENT TECHNIQUES & STRATEGIES

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■ Praise specific behavior■ Provide opportunities for the student to use self-

control/self monitoring techniques to control behavior● Teach and/or model the techniques● Use the CMHC as a resource

o Teach self-talk to relieve stress and anxietyo Use iPhone apps that walk through calming sequence

■ Provide brief opportunities for movement and down time to participate in an activity of choice

■ Structure activities to incorporate opportunities for social interaction


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■ Allow for short breaks between assignments■ Cue student to stay on task (non-verbal)■ Change tone of voice■ Establish a quiet zone or “cool-off” area, if possible■ Praise often■ Ensure each day has some opportunity for success,

preferably at the beginning of a class, task, etc.■ Ignoring inappropriate behaviors not drastically outside

of classroom limits if not proving disruptive to others■ Post Daily/Weekly Schedule


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PREVENTION & DE-ESCALATION

■ Take preventative action to avoid behavior escalation whenever possible.● Use humor to diffuse tension ● Offer two choices as options

(if possible) ● Redirect through diversion of

attention to something else ● Again, allow time for the

individual to regroup and regain level of calmness

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Most Importantly!

Treat the student with an emotional disability as someone who is entitled to and deserves a

“normal” learning experience!

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RESOURCES

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■ Center for Effective Collaboration and Practice● http://cecp.air.org/fba/default.asp

■ United States Department of Commerce● http://www.commerce.gov/blog/2012/07/25/census-

report-nearly-1-5-people-have-disability-us-update

■ National Dissemination Center for Children with Disabilities● http://nichcy.org/disability/specific/emotionaldisturbance

■ National Institute of Mental Health● http://www.nimh.nih.gov/index.shtml

REFERENCES

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■ Laura Kuhn – Boston and Dallas Region● [email protected]

■ Nikki Jackson – Atlanta and Philadelphia Regions● [email protected]

■ Kim Jones – Chicago and San Francisco Regions● [email protected]

REGIONAL DISABILITY COORDINATORS

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■ Dave Kraft, MD, MPH - Boston● [email protected]

■ Maria Acevedo, PhD - Boston (Puerto Rico Centers)● [email protected]

■ Valerie Cherry, PhD - Philadelphia● [email protected]

■ Suzanne Martin, PsyD, MPH - Atlanta● [email protected]

■ Lydia Santiago - Dallas● [email protected]

■ Helena Mackenzie, PhD - Chicago● [email protected]

■ Vicki Boyd, PhD - San Francisco● [email protected]

REGIONAL MENTAL HEALTH SPECIALISTS

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JOB CORPS DISABILITY WEBSITEJC COMMUNITY

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JOB ACCOMMODATION NETWORKWWW.ASKJAN.ORG

accommodating students with emotional disabilities

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