RECENT DEVELOPMENTS IN BEHAVIORAL, SOCIAL, AND CLINICAL ASSESSMENT OF CHILDREN 2015 JEROME M. SATTLER Power Point Presentation Primarily Based on Foundations of Behavioral, Social, and Clinical Assessment of Children, by Jerome M. Sattler Copyright © 2014 by Jerome M. Sattler Publisher, Inc. Presentation available at www.sattlerpublisher.com 11 ADVANTAGES OF BEING A SCHOOL PSYCHOLOGIST  Being called a psychiatrist, an MD degree bestowed upon you without ever entering medical college Can fudge your own IQ! Get to use big words like crystallized intelligence 11 ADVANTAGES OF BEING A SCHOOL PSYCHOLOGIST  Still get to play with blocks in your 40s, 50s, etc Carrying the test kits around gives you chiseled pecs, biceps and delts You can honestly refer to yourself as “psycho” 11 ADVANTAGES OF BEING A SCHOOL PSYCHOLOGIST  People don’t really know what you do (and in most cases are afraid to ask) “Clinical opinion” = “My best guess” You get to explain the normal curve to people who don’t fall under it It reduces your desire to have children You never have to actually teach those kids anything How Am I Going to Score These? Question: Before we start, what is your name and address? Answer: TMcGuire@AOL.Com Question: What is your date of birth? Answer: July fifteenth Question (follow up): What year? Answer: Every year. How Am I Going to Score These? Question: What are 12, 14, and 16? Answer: That’s easy; MTV, Fox, and Cartoon network. Question: What is celebrated on Thanksgiving Day? Answer: My cousin’s birthday. Question: What is the capital of Greece? Answer: G. How Am I Going to Score These? Question: What are the four seasons? Answer: Baseball, football, basketball, and hockey. Question: What are four other seasons? Answer: Mustard, ketchup, salt, and pepper. Question: In what way are an orange and a pear alike? Answer: Both give me hives. How Am I Going to Score These? Question: If I cut a pear in thirds, how many pieces will I have? Answer: One. Question: (Testing-of-limits) Are you sure I will have only one piece? Answer: Yes, and I will have the other two pieces. How Am I Going to Score These? Question: What does imitate mean? Answer: What does imitate mean? Question: What would you do if you were lost in the woods? Answer: I’d use my cell phone, pager, or my global positioning satellite device. How Am I Going to Score These? Question: We want to see if you are eligible for our memory training class. Repeat the following: 6Z4J5Y9A1P7W3D8G2S9T4K. Answer: Huh? Reply: You’re eligible. Question: What do you call a baby goat? Answer: Matilda would be a nice name. Psychology and Other One-liners Does the name Pavlov ring a bell? My girlfriend came from Taiwan she has a taipei personality I joined the Tourettes society today. It only took a minute to swear me in. DNA: Association of National Dyslexics When choosing a path in life, try to avoid the psychopaths Psychology and Other One-liners The road to ADHD is paved with bad attentions. I think my therapist is seeing other people. I'm great at multitasking. I can waste time, be unproductive, and procrastinate all at once. Calendar Note: One again, we did not schedule this month's Apathetics Anonymous Meeting. Psychology and Other Humor [please enter a password] ilovedogs [password must contain at least one capital] iloveparisdogs What if Google doesn't know? Psychology and Other Humor Contacting Your Phone Provider To wait a long time & get no help press 1 To wait a long time & get no help press 2 To wait a long time & get no help press 3 Redirecting Revised, New, or Additional Assessment Measures  Behavior Dimensions Scale, Second Edition: School Version and Behavior Dimensions Scale, Second Edition: Home Version, p. 347 Conners 3rd Edition, p. 351 Conners Comprehensive Behavior Rating Scales, p. 352 Social Skills Improvement System, p. 359 Revised, New, or Additional Assessment Measures  Parenting Relationship Questionnaire, p. 366 Parenting Stress Index, Fourth Edition and Parenting Stress Index, Fourth Edition– Short Form, p. 368 Koppitz Developmental Scoring System for the Bender Gestalt Test, Second Edition, p. 406 Beery VMI, p. 407 Revised, New, or Additional Assessment Measures  Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, p. 409 Multidimensional Anxiety Scale for Children, Second Edition, p. 439 Revised Children’s Manifest Anxiety Scale, Second Edition, p. 439 Children’s Depression Inventory, Second Edition, p. 442 Reynolds Child Depression Scale, Second Edition, p. 443 Revised, New, or Additional Assessment Measures  Strengths and Difficulties Questionnaire, p. 463 ADHD Questionnaire, p. 463 Attention Deficit Disorder Evaluation Scale, Fourth Edition–Home Version, p. 463 Attention Deficit Disorder Evaluation Scale, Fourth Edition–School Version, p. 463 Revised, New, or Additional Assessment Measures  BASC–2 Progress Monitor, p. 463 Comprehensive Executive Function Inventory, p. 463 See Table 17-1 for examples of standardized achievement tests Autism Diagnostic Observation Schedule, Second Edition, p. 608 Autism Observation Scale for Infants, p. 608 Autism Spectrum Rating Scale, p. 608 Revised, New, or Additional Assessment Measures  Checklist for Autism Spectrum Disorder, p. 608 Childhood Autism Rating Scale, Second Edition, p. 608 PDD Behavior Inventory, p. 608 Psychoeducational Profile–Third Edition, p. 608 Scale of Pervasive Developmental Disorder in Mentally Retarded Persons, Revised, New, or Additional Assessment Measures  Screening Tool for Autism in Toddlers and Young Children, p. 608 Social Responsiveness Scale, p. 608 SCAT3 (Sport Concussion Assessment Tool 3), p. 635 NEPSY–II, p. 665 NIH Toolbox, p. 669 Revised, New, or Additional Assessment Measures  Also see the Resource Guide for revised questionnaires, semistructured interviews, observation forms, self-monitoring forms, FBA forms, ADHD forms, SLD forms, ASD forms, Instructional handouts, miscellaneous tables, and formal and informal measures of executive functions (p. 251 and p. 258 in Resource Guide) Video Link Fetal Alcohol Spectrum Disorders Prevention PSA http://www.youtube.com/watch?v=mRf2 Kjz0hAg&feature=share&list=UU7PjTluf hDCfET974TcMWmA&index=18 10 Indicators of Child Well-Being by Ethnicity (%), 2012-2013  Abbreviations Used in the Table NA = National Average EA = European American AA = African American As = Asian American HA = Hispanic American AI = American Indian 10 Indicators of Child Well-Being by Ethnicity (%), 2012-2013  Indicator NA EA AA As HA AI Children in poverty 23 14 40 15 34 24 Teens not in school 8 and not working Children not 54 attending preschool Fourth graders not 66 proficient in reading 6 12 4 10 51 51 48 63 53 55 83 49 81 61 8 10 Indicators of Child Well-Being by Ethnicity (%), 2012-2013  Indicator NA EA AA As HA AI Eight graders not proficient in math High school students not graduating on time Low-birthweight babies 66 56 86 40 79 63 19 15 32 7 24 NA 8 7 12.8 8.2 7 NA 10 Indicators of Child Well-Being by Ethnicity (%), 2012-2013  Indicator Child and teen death per 100,000a, b Children in singleparent families Teen birth per 1,000a a Not in percent. b 2010. NA EA AA As HA AI 26 25 36 14 21 NA 35 25 67 17 42 43 29 20 44 10 46 NA 10 Indicators of Child Well-Being by Ethnicity (%), 2012-2013  Source: Annie E. Casey Foundation. (2014). 2014 data book: State trends in child well-being (25th Ed.). Retrieved from http://www.aecf.org/m/resourcedoc/aecf2014kidscountdatabook-2014.pdf Exposure to Selected Categories of Violence  N = 4,503 Year = 2011 Sample = All youth in survey ages 1 month to 17 years Subsample = Youth ages 14 to 17 years Exposure to Selected Categories of Violence  All Youth Past Year Life time Ages 14 to 17 Years Past Year Life time Any Physical 41.2% 54.5% 39.5% 69.7% Assault Physical 13.7% 24.6% 13.6% 32.6% intimidation (bullying) Exposure to Selected Categories of Violence  Any Physical Assault (Cont.) Relational aggression (bullying) Dating violence (ages 12 and older) All Youth Past Year Life time Ages 14 to 17 Years Past Year Life time 36.5% 51.8% 39.6% 72.3% 3.2% 3.4% 4.2% 6.3% Exposure to Selected Categories of Violence  Any Physical Assault (Cont.) Internet/cell phone harassment (age 5 and older) All Youth Past Year Life time 6.0% 8.5% Ages 14 to 17 Years Past Year Life time 13.9% 20.3% Exposure to Selected Categories of Violence  All Youth Past Year Life time Any Sexual 5.6% Victimization 9.5% Ages 14 to 17 Years Past Year Life time 16.4% 27.4% Exposure to Selected Categories of Violence  All Youth Past Year Life time Ages 14 to 17 Years Past Year Life time Any Child 13.8% 25.6% 20.6% 41.2% Maltreatment Physical abuse 3.7% 9.6% 5.5% 18.2% Exposure to Selected Categories of Violence  Any Child Maltreatment (Cont.) Emotional abuse (age 2 and older) Neglect All Youth Past Year Life time Ages 14 to 17 Years Past Year Life time 8.0% 14.9% 13.9% 25.7% 6.5% 14.6% 8.6% 22.3% Exposure to Selected Categories of Violence  All Youth Past Year Life time Ages 14 to 17 Years Past Year Life time Any Property 24.1% 40.2% 28.5% 56.6% Victimization Exposure to Selected Categories of Violence  All Youth Past Year Life time Ages 14 to 17 Years Past Year Life time Witnessing Violence 22.4% 39.2% 42.6% 71.5% Witnessing partner assault 6.1% 17.3% 7.6% 28.3% Exposure to Selected Categories of Violence  Witnessing Violence (Cont.) All Youth Past Year Witnessing 8.2% family assault Witnessing community assault Life time Ages 14 to 17 Years Past Year Life time 20.8% 10.2% 34.5% 16.9% 27.5% 36.4% 58.9% Exposure to Selected Categories of Violence  All Youth Past Year Indirect Exposure to Violence 3.4% Life time Ages 14 to 17 Years Past Year 10.1% 6.4% Life time 21.8% Exposure to Selected Categories of Violence  Source: Finkelhor, D., Turner, H., Shattuck, A., Hamby, S., & Kracke, K. (2015). Children’s exposure to violence, crime, and abuse: An update. Retrieved from http://www.ojjdp.gov/pubs/248547.pdf Paternal Age at Childbearing  Sample All individuals born in Sweden in 1973– 2001 (N = 2,615,081) Results Offspring of fathers 45 years and older, compared with offspring born to fathers 20–24 years old, were at heightened risk of ADHD (13.13 times greater) Autism (3.45 times greater) Paternal Age at Childbearing  Results (Cont.) Bipolar disorder (24.70 times greater) Psychosis (2.07 times greater) Suicide attempts (2.72 times greater) Substance use problems (2.44 times greater) Failing a grade (1.59 times greater) Low educational attainment (1.70 times greater) Paternal Age at Childbearing  Conclusions Advancing paternal age is associated with increased risk of psychiatric and academic morbidity in children In older fathers Sperm may not develop fully Sperm may have some form of genetic mutation Paternal Age at Childbearing  Conclusions (Cont.) Older fathers also may have been exposed to Environmental toxins longer than younger fathers and Long exposure to toxins may affect the DNA in the father’s sperm Paternal Age at Childbearing  Source D’Onofrio, B. M., Rickert, M. E., Frans, E., Kuja-Halkola, R., Almqvist, C., Sjölander, A., Larsson, H., & Lichtenstein, P. (2014). Paternal age at childbearing and offspring psychiatric and academic morbidity. JAMA Psychiatry. Advanced online publication. doi:10.1001/jamapsychiatry.2013.4525 Adverse Childhood Experiences (ACEs) California Study  Year: 2008 to 2013 Representative sample of 27,745 adults Aim of study: Effects of childhood trauma on later health problems Childhood trauma defined as experiencing Physical abuse (19.9%; N = 5,521) Sexual abuse (11.4%; N = 3,163) Emotional abuse (34.9%; N = 9,683) Adverse Childhood Experiences (ACEs) California Study  Physical or emotional neglect (9.3%; N = 2,303) Household dysfunction Mental illness (15.0%; N = 4,161) Incarcerated relatives (6.6%; N = 1,831) Mother treated violently (17.5%; N = 4,855) Substance abuse (26.1%; N = 7,241) Divorce (26.7%; N = 7,408) Findings of ACE Study  38.3% experienced 0 ACE (N = 10,626) 21.7% experienced one ACE (N = 6,020) 23.3% experienced two to three ACEs (N = 6,464) 16.7% experienced four or more ACEs (referred to as polyvictimization) (N = 4,633) Overall, at least 61.7% experienced one or more ACEs (N = 17,119) Findings of ACE Study  Adults who suffered 4 or more ACEs (compared to those who did not) were 5.13 times likely to suffer from depression 2.42 times more likely to have chronic obstructive pulmonary disease (COPD) 2.93 times more likely to smoke 3.23 times more likely to binge drink 7.4 times more likely to be alcoholic 12.2 times more likely to attempt suicide Findings of ACE Study  Adults who suffered 4 or more ACEs (compared to those who did not) were (Cont.) 10.3 times more likely to inject drugs 2.4 times more likely to have a stroke 1.9 times more likely to have cancer 1.6 times more likely to have diabetes 21% more likely to be below Federal Poverty Level Findings of ACE Study  Adults who suffered 4 or more ACEs (compared to those who did not) were (Cont.) 27% more likely to have less than a college degree 39% more likely to be unemployed Findings of ACE Study  Source: https://acestoohigh.files.wordpress.com/20 14/11/hiddencrisis_report_1014.pdf Development of Hispanic American Toddlers  Participants Children born in 2001 N = 950 Hispanic American (HA) children N = 3,600 native born European American (EA) children Development of Hispanic American Toddlers  Methods Bayley Interviews with mothers at 9 months and 24 months of age A variety of mother-infant interactions tasks Case history information and other scales used to gather data Development of Hispanic American Toddlers  Findings Cognitive rate of growth lower among most HA than EA toddlers 4/5 of HA toddlers fell below the cognitive proficiency of EA toddlers Gap significantly wider for HA toddlers of foreign-born mothers than of native-born mothers Development of Hispanic American Toddlers  Findings (Cont.) Children in families falling below the poverty line display significantly weaker cognitive growth Children showed more robust cognitive development when their mothers Had completed some college Engaged their children in daily reading and storytelling Development of Hispanic American Toddlers  Findings (Cont.) These activities may serve as proxies for the mother’s Steady interaction with the toddler Own language skills Caring and closeness that plausibly boost the child’s cognitive growth EA mothers displayed praise and encouragement more frequently than HA mothers Development of Hispanic American Toddlers  Source Fuller, B., Bein, E., Kim, Y., & RabeHesketh, S. (2015). Differing cognitive trajectories of Mexican American toddlers: The role of class, nativity, and maternal practices. Hispanic Journal of Behavioral Sciences. Advanced online publication. doi: 10.1177/0739986315571113 Life Expectancy Tied To Education  Life expectancy is 82 for individuals with more than 12 years of education Life expectancy is 75 for individuals with 12 or fewer years of education Life Expectancy Tied To Education  Possible Reasons Those with less education: Are likely to have more smoking-related diseases, such as lung cancer and emphysema—35% of Americans with an 9th to 11th grade education smoke, while only 7% with a graduate degree smoke Are likely to have lower incomes Life Expectancy Tied To Education  Possible Reasons (Continued) Are likely to live in areas that have their own health threats, either through crime or poor housing conditions Are likely to have limited health insurance and limited access to health services Are more likely to agree with the statement: “It doesn't matter if I wear a seat belt, because if it’s my time to die, I'll die.” Life Expectancy Tied To Education  Summary and Recommendations The less affluent and less educated are also, invariably, less healthy Disparities in health are a major challenge in the United States Health is not a product of health care per se, but of one's life course and opportunities Life Expectancy Tied To Education  Summary and Recommendations (Cont.) The less educated must learn the following: “It does matter. Life is uncertain, but that's no reason to surrender to fate” Fighting poverty and improving education are keys to increasing life expectancy among less-advantaged Americans Life Expectancy Tied To Education  Summary and Recommendations (Cont.) Source: Meara, E. R., Richards, S., & Cutler, D. M. (2008). The gap gets bigger: Changes in mortality and life expectancy, by education, 1981–2000. Health Affairs, 27, 350–360. Equity and Educational Opportunities In US Schools  Office for Civil Rights, Civil Rights Data Collection Sample Statistics Year of study: 2009–2010 Representative sample Covering approximately 85% of nation’s students Equity and Educational Opportunities US Schools  Key Findings African-American students represent 18% of students in sample and 35% of students suspended once 46% of students suspended more than once 39% of students expelled Equity and Educational Opportunities In US Schools  Key Findings (Cont.) Hispanic-American students represent 24% of students in sample and 25% of students suspended once 25% of students suspended more than once 24% of students expelled Equity and Educational Opportunities In US Schools  Key Findings (Cont.) Asian-American students represent 6% of students in sample and 3% of students suspended once 1% of students suspended more than once 2% of students expelled Equity and Educational Opportunities In US Schools  Key Findings (Cont.) American-Indian-American students represent 1% of students in sample and 1% of students suspended once 1% of students suspended more than once 1% of students expelled Equity and Educational Opportunities In US Schools  Key Findings (Cont.) European-American students represent 51% of students in sample and 36% of students suspended once 29% of students suspended more than once 33% of students expelled Equity and Educational Opportunities In US Schools  Key Findings (Cont.) Referred to Law Enforcement 25% of European American students (51% in sample) 42% of African American students (18% in sample) 29% of Hispanic American students (24% in sample) Equity and Educational Opportunities In US Schools  Key Findings (Cont.) School Related Arrests 21% of European American students (51% in sample) 37% of African American students (18% in sample) 35% of Hispanic American students (24% in sample) Equity and Educational Opportunities In US Schools  Key Findings (Cont.) Sex of Students Expelled Males 74% (about 50% of sample) Females 26% (about 50% of sample) Equity and Educational Opportunities In US Schools  Key Findings (Cont.) Disability Status of Students Suspended 13% of students with disabilities covered by IDEA were suspended 6% of Non-IDEA students were suspended Equity and Educational Opportunities In US Schools  Key Findings (Cont.) Disability Status of Students (Cont.) Referred to Law Enforcement Students with disabilities covered by IDEA 25% (but 12% of student population) Non-IDEA students 75% (but 88% of student population) Equity and Educational Opportunities In US Schools  Key Findings (Cont.) English Language Learners Suspended 7% (but 10% of student population) Equity and Educational Opportunities In US Schools  Sources: http://www2.ed.gov/about/offices/list/ocr/d ocs/crdc-2012-data-summary.pdf http://www2.ed.gov/about/offices/list/ocr/d ocs/crdc-disciplinesnapshot.pdf?utm_source=JFSF+Newslett er&utm_campaign=0f6e101c7eNewsletter_July_2013&utm_medium=ema il&utm_term=0_2ce9971b29-0f6e101c7e195307941 Reducing Suspensions and Expulsions  Education Development Center May 2011 Recommendations Schools and mental health, juvenile justice, and law enforcement agencies Must collaborate to improve outcomes for youth, especially those at risk for suspension or expulsion Reducing Suspensions and Expulsions  Recommendations (Cont.) Schools and mental health, juvenile justice, and law enforcement agencies (Cont.) Must employ improved informationsharing and data collection systems to identify, serve, and communicate about at-risk students Reducing Suspensions and Expulsions  Recommendations (Cont.) State standards are needed to guide schools’ practices related to Promoting students’ mental health Identifying students who need mental health services Assisting students to access services Reducing Suspensions and Expulsions  Recommendations (Cont.) School districts should Focus on implementing, adapting, and evaluating evidence-based interventions Have policies that require programs and services for at-risk youth Consistently apply suspension and expulsion policies so that existing racial and ethnic disparities are not perpetuated Reducing Suspensions and Expulsions  Recommendations (Cont.) School districts should (Cont.) Identify effective strategies to engage and collaborate with parents Provide support to enable expelled students to rejoin the school community (and community partners) Reducing Suspensions and Expulsions  Source: http://www.promoteprevent.org/sites/www. promoteprevent.org/files/resources/Califor nia_Action_Steps_May_2011.pdf Outcomes in Serious Youthful Offenders  Why do some serious adolescent offenders stop offending while others continue to commit crimes? Investigators interviewed 1,354 young offenders in the US Mean age = 16.2 years Years of offense: 2000 to 2003 Year of data collection: 2010 Outcomes in Serious Youthful Offenders  FINDINGS Other than those with substance abuse problems, those with behavioral health problems were at no greater risk than those without behavioral health problems for Rearrest or Engaging in antisocial activities Outcomes in Serious Youthful Offenders  FINDINGS (Cont.) More frequent aftercare services (e.g., frequent supervision and involvement in community activities) significantly reduced the odds of An arrest or Return to an institution during the 6month aftercare period Outcomes in Serious Youthful Offenders  FINDINGS (Cont.) Those with substance use disorders, in comparison with those without substance abuse, disorders had more negative outcomes Outcomes in Serious Youthful Offenders  Source Schubert, C. A. & Mulvey, E. P. (2014). Behavioral health problems, treatment, and outcomes in serious youthful offenders. Retrieved from http://ojjdp.gov/pubs/242440.pdf Assessing Problem Behavior Through Interviews  See Chapters 5, 6, and 7 in main text See Table B-1 (p. 20 in RG) Examples of questions to ask a student (See pp. 417–418 in main text) Example of questions to ask a teacher (See p. 418 in main text) Assessing Problem Behavior Through Interviews  See Table B-15 (p. 67 in RG) to interview teacher See questionnaires in Tables A-1, A-2, and A-3 (pp. 1–17 in RG) for parent, child, and teacher to complete See Table B-9 (p. 40 in RG) to interview parent Forensic Interviewing  What Determines Whether, When, and How Children Disclose Abuse? Individual child characteristics No two children will relate their experiences in the same way Or with the same level of detail and clarity Interviewer behavior Forensic Interviewing  What Determines Whether, When, and How Children Disclose Abuse? (Cont.) Family relationships Community influences Cultural and societal attitudes Forensic Interviewing  Specific Interview Considerations Dangers of repeated questioning Dangers of duplicative interviews Encouraging children to give detailed responses early in the interview Using open-ended questions Allowing for silence or hesitation Forensic Interviewing  Specific Interview Considerations (Cont.) Not moving too rapidly to more focused questions Eliciting potentially erroneous responses if child feels compelled to reach beyond his or her stored memory Asking important question: Because children might experience multiple incidents of abuse, ask if event happened “one time or more than one time” Forensic Interviewing  Interview Tips Consider child’s age, developmental ability, and culture Conduct interview as soon as possible after initial disclosure Record interview electronically Hold interview in a safe, child-friendly environment Forensic Interviewing  Interview Tips (Cont.) Use open-ended questions throughout the interview Delay use of more focused questions for as long as possible Forensic Interviewing  Rapport Building Build rapport with child Engage child in brief conversation about his or her interests or activities Provide an opportunity for child to describe a recent nonabuse-related experience in detail Describe interview ground rules Discuss the importance of telling the truth Forensic Interviewing  Conducting the Interview Transition to the topic of the suspected abuse carefully Always take into account the characteristics of the child and the case Ask child to describe his or her experience in detail Do not interrupt child during this initial narrative account, if possible Forensic Interviewing  Conducting the Interview (Cont.) Once initial account is fully explored, begin to ask more focused questions Ask focused questions if you need to Gather additional details Get clarification Fill in missing information Mirror the child’s wording when you ask follow up questions Forensic Interviewing  Conducting the Interview (Cont.) Use focused queries judiciously and avoid suggestive questions You don’t want to compel child to respond inaccurately Consult with those observing interview To determine whether to raise additional questions To resolve any ambiguities or contradictions Forensic Interviewing  Ending the Interview Ask child if there is something else the interviewer needs to know Ask child if there is something he or she wants to tell or ask the interviewer If needed, discuss safety plans and provide educational materials Thank child for his or her effort rather than for specific content discussed Forensic Interviewing  Source: Newlin, C., Steele, L. C., Chamberlin, A., Anderson, J., Kenniston, J., Russell, A., Heather, S., & VaughanEden, V. (2015). Child forensic interviewing: Best practices. Retrieved from http://www.ojjdp.gov/pubs/248749.pdf Assessing Problem Behavior Through Observations See Chapters 8 and 9 in main text See Tables C-1 and C-2 (pp. 78–80 in RG) Functional Behavioral Assessment (FBA; Chapter 13) Functional Behavioral Assessment  A comprehensive, multimethod, and multisource approach designed to help you Arrive at an understanding of the relationship between the problem behavior and the specific environmental events Develop a behavioral intervention plan (BIP) Functional Behavioral Assessment  Need to consider Type of problem behavior Conditions under which the problem behavior occurs Functional Behavioral Assessment  Need to consider (Cont.) Probable reasons for the problem behavior Biological Social Cognitive Affective Environmental Functions served by problem behavior Guidelines for Conducting FBA  1. Define the problem behavior See Tables F-1, F-2, and F-3 (pp. 113– 118 in RG) for FBA forms Guidelines for Conducting FBA  2. Perform the assessment. Review Prior psychological or psychoeducational evaluations Teachers’ comments on report cards Disciplinary records Anecdotal home notes Medical reports Prior interventions and results Guidelines for Conducting FBA  2. Perform the assessment. (Cont.) Conduct systematic behavioral observations (see Chapters 8 and 9) Interview student, teacher, parents, and others as needed (see Chapters 5, 6, and 7) Conduct other formal and informal assessments as needed Guidelines for Conducting FBA  3. Evaluate assessment results and also consider the questions on p. 416 in main text Guidelines for Conducting FBA  4. 5. 6. 7. Develop hypotheses to help explain relationship between problem behavior and situations in which problem behavior occurs Formulate a behavioral intervention plan Start the behavioral intervention as soon as possible Evaluate the effectiveness of the behavioral intervention Formulating Hypotheses About Problem Behavior See guidelines on pp. 419–420 in main text for formulating hypotheses Monitoring the Behavioral Intervention Plan (BIP) See p. 423 in main text for a list of questions to aid in monitoring the BIP Executive Functions (EF; Appendix M, pp. 246–262 in RG) Executive Functions  Cognitive abilities responsible for Complex goal-directed behavior Adaptation to environmental changes and demands Development of social and cognitive competence Development of self-regulation of behavior Executive Functions  EF enable individuals to modulate, control, organize, and direct Cognitive activities Emotional activities Behavioral activities Executive Functions  EF help individuals Make personal and social decisions Distinguish relevant from irrelevant material Follow general rules Make use of existing knowledge in new situations Executive Functions  EF important for Daily living Academic performance Work-related activities Social relationships Primary Executive Functions (RG, p. 247) 1. 2. 3. 4. Planning and goal setting: ability to plan and reason conceptually, monitor one’s actions, and set goals Organizing: ability to organize ideas and information Prioritizing: ability to focus on relevant themes and details Working memory: ability to temporarily hold and manipulate information in memory Primary Executive Functions (RG, p. 247)  5. 6. 7. Shifting: ability to alternate between different thoughts and actions, to devise alternative problem-solving strategies, and to be cognitively flexible Inhibition: ability to inhibit thoughts and actions that are inappropriate for a situation Self-regulation: ability to regulate one’s behavior and monitor one’s thoughts and actions Developmental Aspects of Executive Functions  EF most closely associated with the frontal lobes of the brain Maturational changes in brain structure and function and in social experiences govern the development of EF (see Table M-1 on p. 249 in RG) Developmental Aspects of Executive Functions  Begin to develop as early as 2 months of age Self-exploration Emerging understanding of volitional actions At 1 year of age Working memory Ability to detect another’s attentional and intentional states Developmental Aspects of Executive Functions  EF improves throughout development; gains noted in Working memory Strategic thinking and fluency Goal-directed behavior Monitoring of behavior Flexibility Developmental Aspects of Executive Functions  EF improve throughout development gains in (Cont.) Understanding of emotions, intentions, beliefs, and desires Deciphering of metaphors and understanding of faux pas Processing speed Problem solving Developmental Aspects of Executive Functions  Overall EF has elements Of uniformity—common evolution across EF Of individuality and variation—unique evolution across EF Intelligence and EF  Tests of intelligence correlate moderately— about .40 to .60—with tests of EF Working memory more closely related to fluid and crystallized intelligence Inhibition and flexibility less closely related to fluid and crystallized intelligence Intelligence and EF  Correlations moderate because IQ tests do not require Shifting between different tasks Shifting between competing demands Using self-regulation strategies to maximize long-term objectives Inhibiting less favorable responses Achievement and EF  Writing Essays Planning and defining the first step Rephrasing and paraphrasing one’s own work and the work of others (cognitive flexibility) Organizing and prioritizing Using accurate syntax Achievement and EF  Reading Comprehension Planning what to read first and which sections to focus on most Organizing the material mentally by its most important points Monitoring one’s comprehension by summarizing material Achievement and EF  Independent Studying, Completing Homework, and Long-Term Projects Planning ahead (time management) Acquiring materials and information (information processing) Setting long-term goals (completing tasks) Self-regulation (balancing needs) Achievement and EF  Independent Studying, Completing Homework, and Long-Term Projects (Cont.) Self-monitoring (remembering to submit completed assignments by a specific time) Cognitive flexibility (ability to modify how one goes about doing projects) Achievement and EF  Test-Taking Prioritizing and focusing on relevant themes Managing time to study and answer questions How EF Are Compromised? By Mental disorder Brain injury Learning disability Attention difficulties Fatigue Anxiety Stress Depression Motivational deficits Examples of Disabilities Where EF are Compromised Planning: ASD, TBI, SLD Goal setting: ASD, TBI, SLD Inhibition: ASD, ADHD, TBI Self-regulation: ASD, ADHD, TBI, SLD Shifting: ADHD, TBI, SLD Prioritizing: SLD Working memory: TBI Organizing: ADHD, SLD Assessment of EF  Neuropsychological tests (see Table M-2 on pp. 251–257 in RG) Psychological tests (see Table M-2 on pp. 251–257 in RG) Assessment of EF  Interviews with Child (see Table M-3 on pp. 258–259 in RG) Parents (see Tables M-3 on pp. 258– 259 in RG and B-9 on pp. 40–43 in RG) Teachers (see Table B-15 on pp. 67–70 in RG) Assessment of EF  General Assessment Considerations Measures of information processing and academic skills are indirect measures of EF Amount and nature of EF involved in each task varies No single measure provides an accurate estimate of all types of EF Assessment of EF  Observing child at school, home, and during the assessment (see Table M-3 on pp. 258–259 in RG) Analyzing samples of the child’s schoolwork and written homework assignments (see Table H-8 on p. 137 in RG) See Table L-18 (p. 242 in RG) for a checklist for rating EF Assessment of EF  Conclusion A multifaceted, comprehensive assessment is required for the assessment of EF Improving Deficits in EF See pp. 259 and 260 in RG See Handout K-1 (for parents, begins on p. 162) and Handout K-3 (for teachers, begins on p. 185) in RG Bullying and Cyberbullying (Appendix N in RG) Court Strikes Down Cyberbullying Law  Decision On July 1, 2014, New York Court of Appeals (5 to 2) struck down an Albany, NY law that made cyberbullying a crime Court said that the law violates the First Amendment of the US Constitution Law made it a crime to engage in cyberbullying against any minor or person Court Strikes Down Cyberbullying Law  Cyberbullying defined in the law as: Any act of communicating by mechanical or electronic means, including Posting statements on the internet or through a computer or email network Disseminating embarrassing or sexually explicit photographs Disseminating private, personal, false or sexual information Court Strikes Down Cyberbullying Law  Cyberbullying defined in the law as: Or sending hate mail with no legitimate private, personal, or public purpose With the intent to Harass Annoy Threaten Abuse Taunt Court Strikes Down Cyberbullying Law  Cyberbullying defined in the law as: With the intent to (Cont.) Intimidate Torment Humiliate Or otherwise inflict significant emotional harm on another person Court Strikes Down Cyberbullying Law  Case Marquan W. Mackey-Meggs, a 15-year-old student, was the first to be charged under the Albany law He posted photos on Facebook of other teenagers with captions that included graphic and sexual comments Majority of the court ruled that the law was not drafted properly Court Strikes Down Cyberbullying Law  Source: People v. Marguan M., NY Slip OP 04881 (NY. Ct. App. 2014) Are Anti-Bullying Laws Unconstitutional or Unneeded? MLA Jansen, a Calgary Associate Minister, says bullying laws do not necessarily address the complexities of the issue “It’s much more effective to teach people resilience so they can stand up to bullying and encourage others to stand up too.” Are Anti-Bullying Laws Unconstitutional or Unneeded?  Source: http://www.thestar.com/opinion/commentar y/2014/02/10/more_antibullying_laws_not_ the_answer_in_alberta_steward.html Examples of Bullying  See Table N-1 (p. 264 in RG) for examples of types of bullying Effects of Bullying  Physical and mental health Of victim Of victim’s peers, family, schools, community, and society Short- and long-term psychological, academic, and physical consequences for Victim Perpetrator Bystanders Effects of Bullying  Short-Term Effects Physical effects Behavioral effects Emotional effects See Table N-4 on p. 269 in RG for signs of distress displayed by victims of bullying Effects of Bullying  Long-Term Effects: Research Study Sample: British children (N = 7,771) Bullied at ages 7–11 years Followed up at ages 23–50 years Effects of Bullying  Long-Term Effects: Research Study (Cont.) Results: At age 23 years and at age 50 years, victims, in comparison to their nonvictimized peers, had higher rates of Depression Anxiety disorders Suicidality Effects of Bullying  Long-Term Effects: Research Study (Cont.) Results (Cont.): At age 50 years, victims also had poor Social relationships Economic hardship Quality of life Effects of Bullying  Long-Term Effects: Research Study (Cont.) Conclusion: Children who are bullied at a young age are at risk for a wide range of social, health, and economic problems nearly four decades after victimization Effects of Bullying  Long-Term Effects: Research Study (Cont.) Source: Takizawa, R., Maughan, B., & Arseneault, L. (2014). Adult health outcomes of childhood bullying victimization: Evidence from a five-decade longitudinal British birth cohort. American Journal of Psychiatry, 171(7), 777–784. doi: 10.1176/appi.ajp.2014.13101401 Bullying and Depression  5-Year Longitudinal Study N = 6,719 participants in UK Participants were peer victimized at 13 years of age Followed-up at 18 years of age Findings 3,898 (58%) had depression on follow-up Bullying and Depression  Conclusion Victimization by peers in adolescence is associated with an increase in the risk of developing depression as a young adult Bullying and Depression  Source: Bowes, L., Joinson, C., Wolke, D., & Lewis, G. (2015). Peer victimisation during adolescence and its impact on depression in early adulthood: prospective cohort study in the United Kingdom. BMJ. Advanced online publication. doi:10.1136/bmj.h2469 Dear Colleague Letter Aug. 20, 2013  US Dept of Education Office of Special Education and Rehabilitative Services Melody Musgrove, Ed. D., Director, Office of Special Education Programs Michael K. Yudin, Acting Assistant Secretary Dear Colleague Letter Aug. 20, 2013  Students with disabilities are disproportionately affected by bullying Bullying may prevent students from receiving free and appropriate education under IDEA IEP Team needs to determine whether students’ needs have changed as a result of bullying Dear Colleague Letter Aug. 20, 2013  If so, what extent additional or different special education or related services are needed If students with a disability engaged in the bullying, IEP Team needs to address the inappropriate behavior IEP Team needs to study environment where bullying occurred to see if changes are warranted Rate of Victimization Students with Disabilities  Rate for all students between 15% to 28% Rate for students with disabilities 25% to 34% Elementary school 25% Middle school 34% High school 27% Rate is 1 to 1½ times higher than for all students Rate of Victimization Students with Disabilities  Highest rates for students with Emotional disturbance 39% to 52% Other health impaired 29% to 40% Highest rates for repeated victimization Autism spectrum disorder (in elementary and middle school) Orthopedic impairments (in high school) Rate of Victimization Students with Disabilities  Source: Blake, J. J., Lund, E. M., Zhou, Q., Kwok, O., & Benz, M. R. (2012). National prevalence rates of bully victimization among students with disabilities in the United States. School Psychology Quarterly, 27(4), 210–222. doi:10.1037/spq0000008 Various Roles in Bullying Bully who takes the initiative Follower who joins in Reinforcer who encourages the bully or who laughs at the victim Intervener who tries to stop the bullying Bystander who looks on but does not participate Victim who is the object of the bullying Characteristics of Bullies  Attempt to Control Dominate Subjugate others Through the use of power Bullies aim to disempower their victims by undermining their worth and status Characteristics of Bullies  Two key components of bullying Repeated harmful acts An imbalance of power Characteristics of Bullies  Their families Less cohesive (low parent-child involvement, warmth, and affection) More conflictual (angry, hostile parentchild interactions) Less organized More disadvantaged Characteristics of Victims  Displays vulnerability or insecurity Dresses differently and doesn’t conform to the norm Has learning, speech, or other physical or mental disabilities Has low self-esteem Characteristics of Victims  Has physical attributes that differ from the norm Overweight Underweight Very short Very tall Has poor communication skills Has poor social skills Characteristics of Victims  Is a member of an ethnic or religious group viewed as different Is bright, talented, or gifted Is clumsy or immature Characteristics of Victims  Is or is perceived to be Lesbian Gay Bisexual Transgendered Is new to the school Is nonasssertive and refuses to fight Is physically weak Characteristics of Victims  Is annoying, provocative, or aggressive Is richer or poorer than the majority of classmates Is shy, reserved, timid, or submissive Is the smallest or youngest child in school Children with Special Needs  May also act as bullies if they: Want to protect themselves from further victimization Feel extremely anxious and have limited frustration tolerance Cannot size up a situation realistically and distinguish good-natured kidding from bullying Bullying and Children with Disabilities  Students with disabilities are disproportionately affected by bullying Bullying may prevent students from receiving free and appropriate education under Individuals with Disability Education Act (IDEA) Individualized Education Program (IEP) Team needs to determine whether students’ needs have changed as a result of bullying Bullying and Children with Disabilities  If needs have changed, what extent additional or different special education or related services are needed? If students with a disability engaged in the bullying, IEP Team needs to address the inappropriate behavior IEP Team needs to study environment where bullying occurred to see if changes are warranted Children with Disabilities  May also act as bullies if they: Want to protect themselves from further victimization Feel extremely anxious and have limited frustration tolerance Cannot size up a situation realistically and distinguish good-natured kidding from bullying Children with Disabilities  May also act as bullies if they: (Cont.) Feel they are being pushed too far or feel that their resources are exhausted Fail to realize that their “playful” behavior can hurt others Children with Disabilities  Bullying may have harmful effects on children with disabilities: Limit motivation to achieve and lower their grades Interfere with their compliance with treatment regimens and use of assistive technology Increase frequency and strength of their symptoms “Welcome to My Life” by Simple Plan Lyrics (Partial) Do you ever feel like breaking down? Do you ever feel out of place, Like somehow you just don't belong And no one understands you? Do you ever wanna run away? Do you lock yourself in your room With the radio on turned up so loud That no one hears you're screaming? “Welcome to My Life” by Simple Plan No, you don’t know what it’s like When nothing feels all right You don’t know what it’s like To be like me “Welcome to My Life” by Simple Plan  To be hurt To feel lost To be left out in the dark To be kicked when you’re down To feel like you’ve been pushed around To be on the edge of breaking down And no one’s there to save you No, you don’t know what it’s like Welcome to my life Bullying and Morality  Bullying has been described as an immoral action because it humiliates and oppresses innocent victims (Gini, Pozzoli, & Hauser, 2011) Bullies have adequate moral competence– that is, they have knowledge of right and wrong and an understanding of moral norms Bullying and Morality  But paradoxically they do not have moral compassion–that is, emotional awareness and sensitivity about their moral infractions In fact, bullies may disregard the harmful effects of their actions and blame the victim for causing the bullying behavior Bullying and Morality  Source: Gini, G., Pozzoli, T., & Hauser, M. (2011). Bullies have enhanced moral competence to judge relative to victims, but lack moral compassion. Personality and Individual Differences, 50(5), 603– 608. doi:10.1016/j.paid.2010.12.002 Factors That May Lead to Bullying See Table N-2 on p. 265 in RG Differences Between Bullying and Cyberbulling  Bullying Victim can hide from bully when at home Event is discrete and audience limited Bully is present, not anonymous, and can see suffering of victim Bully has opportunities for empathy and remorse Differences Between Bullying and Cyberbulling  Bullying (Cont.) Bystanders can intervene Bully may gain status by showing abusive power Differences Between Bullying and Cyberbulling  Cyberbullying Victim cannot hide from bully when at home Event can be continuous and audience potentially large Bully is invisible, may be anonymous, and cannot see suffering of victim Bully has few opportunities for empathy and remorse Differences Between Bullying and Cyberbulling  Cyberbullying (Cont.) Bystanders have little opportunity to intervene Bully lacks opportunity to show his or her abusive power immediately Cyberbullies But… Cyberbullies are not a new class of bullies—they also may engage in overt aggressive and social bullying Incidence of Bullying  Sound statistics difficult to obtain Victims may be reluctant to report Fearing retaliation Feeling shame at not being able to stand up for themselves Fearing they would not be believed Not wanting to worry their parents Incidence of Bullying  Victims may be reluctant to report (Cont.) Having no confidence that anything would change as a result Thinking their parents’ or teacher’s advice would make the problem worse Fearing their teacher would tell the bully who told on him or her Thinking it would be worse to be thought of as a snitch USA Cyberbullying Surveys In 2010 11% of children ages 10–17 years harassed online Majority (69%) being female 1999–2000 6% of online users were harassed Over a 10-year period, online harassment increased by about 83% Jamey Rodemeyer  On Sept. 8, 2011 Jamey Rodemeyer, a 14 year old, wrote on his website: “No one in my school cares about preventing suicide, while you're the ones calling me [gay slur] and tearing me down.” A day later he wrote: “I always say how bullied I am, but no one listens. What do I have to do so people will listen to me?" Jamey Rodemeyer  Then he posted the lyrics to a song by the Hollywood Undead: “I just wanna say good bye, disappear with no one knowing I don't wanna live this lie, smiling to the world unknowing I don’t want you to try, you've done enough to keep me going I'll be fine, I'll be fine, I'll be fine for the very last time” Jamey Rodemeyer  Jamey Rodemeyer  About 10 days later, on Sept. 18, 2011 Jamey Rodemeyer committed suicide. Why are Bystanders Reluctant to Report Bullying?  They know that bullying is wrong but . . . Don’t want to raise the bully’s wrath and become the next target Don’t want to be thought of as a snitch and be rejected by their peers May wrongly believe that they are not responsible for stopping the bullying May think that bullying is acceptable Why are Bystanders Reluctant to Report Bullying?  May assume that school personnel don’t care enough to stop the bullying May feel guilty for not reporting the bullying May have heightened anxiety, depression, or substance abuse May become bullies themselves because they think that this is a way to become part of a group Why do Some Bystanders Intervene? Are victim’s friends Believe that their parents expect them to support victims Believe that it is the moral and proper thing to do Believe that their peer group supports their actions Quotes The bully survives on your silence. —Christine Farrell Crotty Bystanders who are helpless in the presence of another student’s victimization learn passive acceptance of injustice. —Linda R. Jeffrey, DeMond Miller, and Margaret Linn Assessment of Bullying See Tables B-17 to B-20 in RG (pp. 71– 75) for four semistructured interviews on bullying Helping Victims of Bullying  Help them develop: Problem solving skills Conflict resolution skills Emotional regulation skills, including how to handle anxiety, depression, and anger Helping Victims of Bullying  Help them develop: (Cont.) Self-adequacy skills, including assertiveness skills and ability to say “no” or “stop that” Ability to know when to go to a safe room when under severe stress Helping Bullies  Change habitual patterns of thought and action that support bullying Develop new skills Challenge old beliefs Replace impulsive with reflective decision-making Helping Bullies  Helping children who are bullies Develop anger management skills Develop empathy skills and appreciate the harm they cause their victims Recognize that they can engage in responsible and moral behavior Give up self-justifying mechanisms, egocentric reasoning, and distortions in morality Effective Strategies To Counter Bullying In Schools  Designing comprehensive intervention strategies involving students, teachers, administrators, families, and communities Building bullying prevention programs based on principles of science and supported by scientifically valid evidence of effectiveness Effective Strategies To Counter Bullying In Schools  Applying school discipline rules, policies, and sanctions fairly and consistently Implementing policies at all levels, including primary, junior, intermediate, and high school Effective Strategies To Counter Bullying In Schools  Motivating students, teachers, administrators, and parents to understand that Bullying is a serious and preventable problem Antibullying programs must be given a chance to work They themselves can make a difference Effective Strategies To Counter Bullying In Schools  Motivating students, teachers, administrators, and parents to understand that (Cont.) Having a defender means that victims may be less likely to be bullied in the future Effective Strategies To Counter Bullying In Schools  Presenting strategies that are clear, relevant, and comprehensible to both teachers and students Encouraging bystanders to report bullying Effective Strategies To Counter Bullying In Schools  Partnering with law enforcement and mental health agencies to identify and address serious cases of bullying Assessing the frequency of bullying, the effectiveness of any intervention program, and making adjustments as needed (see Delaware Attorney General, n.d.; Hamburger et al., 2011; Safe School Survey, 2003) Effective Strategies To Counter Bullying In Schools  Delaware Attorney General. (n.d.). Bully Worksheet Questionnaire. Retrieved from http://attorneygeneral.delaware.gov/school s/bullquesti.shtml Effective Strategies To Counter Bullying In Schools  Hamburger, M. E., Basile, K. C., Vivolo, A. M. (2011). Measuring bullying victimization, perpetration, and bystander experiences: A compendium of assessment tools. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved from http://www.cdc.gov/violenceprevention/pdf/ BullyCompendiumBk-a.pdf Effective Strategies To Counter Bullying In Schools  Safe School Survey. (2003). Safe School Survey sample menu. Retrieved from https://sdfs.esc18.net/Sample_Surveys/SS M.asp Meta-Analysis of School-Based Anti-Bullying Programs  Objective Meta-analysis of 13 studies (N = 19,619) published in 2005 to 2010 that examined anti-bullying programs conducted in several countries Results School-based anti-bullying programs have a small to moderate effect on victimization Meta-Analysis of School-Based Anti-Bullying Programs  Conclusion Best results were when anti-bullying programs had Training in emotional control Peer counseling Establishment of a school policy on bullying Meta-Analysis of School-Based Anti-Bullying Programs  Source: Lee, S., Kim, C. J., & Kim, D. H. (2013). A meta-analysis of the effect of schoolbased anti-bullying programs. Journal of Child Health Care. Advanced online publication. doi: 10.1177/1367493513503581 Bystander Intervention Needs to be taught in early school grades Education needs to be continued in later school grades Accompanied by programs that encourage peer support for victims of bullying 10 Tips for Parents  1. 2. 3. Talk often with your child, listen carefully, and note any changes in your child’s behavior Talk about what bullying and cyberbullying means. See such websites as www.stopbullying.gov and www.stopbullyingnow.com Remind your child that real people with real feelings are behind screen names and profiles 10 Tips for Parents  Tell your child: 4. To tell you when he or she is being bullied and discourage your child from bullying others 5. To tell a member of the school staff if he or she sees a child being bullied 6. To refuse to join in if he or she sees another child being bullied 10 Tips for Parents  Tell your child: (Cont.) 7. To learn about the school’s rules and sanctions about bullying and cyberbullying 8. To post only information that he or she is comfortable with others seeing, and never to share passwords with anyone except you and another close family member 10 Tips for Parents  Tell your child: (Cont.) 9. To take Internet harassment seriously because it is harmful and unacceptable 10. That you may review his or her online communications if you think there is reason for concern about his or her safety 10 Tips for Teachers  1. 2. 3. Explain to students the difference between playfulness and bullying or cruelty Let students know that bullying is unacceptable and against school rules Tell students, whether they are victims or bystanders, to report bullying or cyberbullying immediately to a member of the school staff 10 Tips for Teachers  4. 5. 6. Emphasize the difference between tattling and telling on someone who is bullying another student Identify and intervene upon undesirable attitudes and behaviors that could be “gateway behaviors” to bullying and cyberbullying Watch for signs of bullying and cyberbullying and stop either one immediately 10 Tips for Teachers  7. 8. 9. Listen receptively to parents who report bullying or cyberbullying Report all incidents of bullying and cyberbullying to the school administration Always respond to requests of help from victims of bullying and make sure that they know that being bullied is not their fault 10 Tips for Teachers  10. Closely monitor students’ use of computers at school and become familiar with cyberbullying and its dangers Resources Strategies for Preventing and Dealing with Bullying, Cyberbullying, and Other Internet Issues in RG Handout K-2 for parents (pp. 177–184) Handout K-4 for teachers (pp. 210–217) Bullying Preventions Programs and Other Resources Exhibit N-2 (pp. 274–275) Concluding Comment John Palfrey (2010), a professor of law at Harvard Law School, pointed out that “No one federal law will prevent tragedies from happening. Most of the time, we have the laws on the books that we need. It’s a commitment to teaching and mentoring, to being supportive and to being tough where we have to be, that can help.” Video Links President Obama speaking at White House conference on bullying: http://youtu.be/kM0WDkevgrY Jamey Rodemeyer http://youtu.be/-Pb1CaGMdWk StopBullying.gov Webisode 11: Power in Numbers http://youtu.be/WwD0Zgk8jGA IDEA 2004—Sec. 614. EVALUATIONS PROCEDURES (Chapter 1) Assessment Considerations Information about Functional Developmental Academic functioning No single measure as the sole criterion for determination of a disability Use of technically sound instruments IDEA 2004—Sec. 614. EVALUATIONS PROCEDURES (Chapter 1) Assessment Considerations (Cont.) Selected and administered so as not to be discriminatory on a racial or cultural basis Administered in the language and form most likely to yield accurate information Child is assessed in all areas of suspected disability IDEA 2004—Sec. 614. EVALUATIONS PROCEDURES (Chapter 1) Assessment Considerations (Cont.) Consider information obtained from Parents Current classroom-based, local, or state assessments Classroom-based observations Present levels of academic achievement Developmental needs of child IDEA 2004 and Specific Learning Disabilities (SLD; Chapter 16) SEC. 602. DEFINITIONS (30) SPECIFIC LEARNING DISABILITY— (A) IN GENERAL—The term “specific learning disability” means a disorder in 1 or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations. IDEA 2004 and SLD (Chapter 16) SEC. 602. DEFINITIONS (Cont.) (B) DISORDERS INCLUDED—Such term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. IDEA 2004 and SLD (Chapter 16) SEC. 602. DEFINITIONS (Cont.) (C) DISORDERS NOT INCLUDED—Such term does not include a learning problem that is primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage. Some Facts About SLD  In 2010, almost 5 million U.S. children ages 3–17 years had a SLD (8%). About 2.4 million students diagnosed with SLD receive special education services each year, representing 41% of all students receiving special education Approximately 80% of children with a SLD have a reading disorder Some Facts About SLD  Approximately 7% of children with a SLD have an arithmetic disorder Approximately 6% to 15% of children with a SLD have a disorder of written expression The prevalence rate of SLD is higher for boys than for girls by a ratio of about 1.5 to 1 (9% vs. 6%) Some Facts About SLD  Ethnic composition African American children (10%) European American children (8%) Asian American children (4%) In families with incomes of $35,000 or less, the percentage of children with a SLD (12%) is twice that in families with incomes of $100,000 or more (6%) Some Facts About SLD  Close to half of secondary students with SLD perform at more than three grade levels below their enrolled grade in essential academic skills (45% in reading, 44% in math) Some Facts About SLD  Children in single-mother families are about twice as likely to have SLD as children in two-parent families (12% vs. 6%) Children with poor health are almost five times more likely to have SLD than children in excellent or very good health (28% vs. 6%) DSM-5 The affected academic skills are substantially and quantifiably below those expected for the individual’s chronological age Cause significant interference with academic or occupational performance, or with activities of daily living Confirmed by individually administered standardized achievement measures and comprehensive clinical assessment Reasons for Poor Performance of Children with Readings Disorders [p. 483-1] Problem areas Attention and concentration Phonological awareness Orthographic awareness Word awareness Semantic or syntactic awareness Rapid decoding Possible Reasons for Poor Performance With Children with Readings Disorders [p. 483-2] Problem areas (Cont.) Rapid naming Verbal comprehension Pragmatic awareness Overall Comment on SLD  Academic underachievement is a key characteristic usually shared by children with SLD Language-based dysfunctions underlie many children with SLD Reading disability most frequent disability Overall Comment on SLD  Examine patterns of cognitive and linguistic functioning Don’t rely on somewhat arbitrary cutoff scores Don’t depend exclusively on RTI Use the child’s unique pattern of abilities and other assessment results to serve as the foundation for developing interventions Overall Comment on SLD  Important to evaluate Cognitive-academic deficits Information-processing and executive functioning deficits Perceptual deficits Social-behavioral deficits See Table 16-1, p. 481 in main text for list of deficits in each of above areas SLD and English Language Learners (ELL)  Assessment Considerations Experiential background. Consider their: Length of residence in their new country Quality of instruction in school School attendance record Health history Family history SLD and ELL  Assessment Considerations (Cont.) Language ability of peers. Compare their language abilities with peers with similar Linguistic/cultural backgrounds Exposure to second language instruction SLD and ELL  Assessment Considerations (Cont.) Language ability of siblings. Compare their language abilities with those of their siblings when they were of the same age Typical difficulties in learning a second language. Compare their learning difficulties with those of other English language learners SLD and ELL  Assessment Considerations (Cont.) Linguistic proficiency. Compare their linguistic proficiency in their primary language and in English Appropriate assessment battery Standardized tests Checklists Language samples Interviews SLD and ELL  Assessment Considerations (Cont.) Appropriate assessment battery (Cont.) Questionnaires Observations Portfolios Journals Work samples Curriculum-based measures Language-reduced measures Reasons for Poor School Performance of ELL Experiential differences Family expectations Limited English proficiency Stress associated with acculturation and discrimination Cognitive styles and learning strategies that differ from those of the majority group Children with Reading Disorder Children with reading disorder may have difficulties in cognitive, perceptual, and linguistic areas See p. 483 in main text for a listing of these difficulties Nonverbal Learning Disability  Definition: A subtype of learning disability associated with a dysfunction in the right cerebral hemisphere Nonverbal Learning Disability  Strengths Auditory perceptual ability Receptive language Vocabulary Verbal expression Rote verbal memory Attention to small details Nonverbal Learning Disability  Weaknesses Reading comprehension Interpreting messages literally Math ability Abstract reasoning ability Coordination and psychomotor skills Ability to interact with others Nonverbal Learning Disability  Weaknesses (Cont.) Ability to correctly perceive gestures, facial expressions, and other nonverbal social cues Ability to adapt to changes and new situations Common sense Self-esteem IDEA 2004 and SLD  Assessment Process A local educational agency shall not be required to take into consideration whether a child has a Severe discrepancy between achievement and intellectual ability in various academic areas But it may use a process that determines if the child responds to scientific, researchbase intervention as a part of the evaluation procedures IDEA 2004 and SLD  Limitations of IDEA Guidelines IDEA does not define how a severe discrepancy between achievement and intellectual ability should be determined. IDEA does not provide any guidance as to how the response to intervention process should be conducted. Identifying SLD: RTI  Problem-Solving Approach The teacher uses achievement test scores to identify children who are at risk The teacher consults with others about needed instructional modifications If the interventions are not successful, the school support team considers possible causes and selects, implements, and evaluates interventions Identifying SLD: RTI  Problem-Solving Approach (Cont.) If additional interventions not successful a comprehensive assessment will be needed Identifying SLD: RTI  Standard Protocol Approach Involves intensive tutoring using a standard method of teaching All children who have similar difficulties are given the same intensive instruction Identifying SLD: RTI  RTI and Needed Implementation Decisions Timing of the assessment (e.g., pre- and post-treatment, weekly, daily) Method for measuring responsiveness Norms (national norms, local norms, or norms for children who are at risk) Method for training teachers or tutors Identifying SLD: RTI  RTI and Needed Implementation Decisions (Cont.) Intensity of interventions Procedures to use with culturally and linguistically diverse children Need for a comprehensive evaluation for the identification of SLD Identifying SLD: RTI  Comment on RTI How does RTI help in distinguishing underachieving students from those with neurologically based SLD? Is RTI working effectively in diagnosing SLD? See discussion of RTI on pp. 494–496 in main text Identifying SLD: Discrepancy Model Simple difference method Regression method See pp. 496–497 in main text Identifying SLD: Patterns of Strengths and Weaknesses (PSW) Models  Discrepancy-Consistency Model Aptitude-Achievement Consistency Model Cognitive Hypothesis Testing Model See pp. 497–498 in main text Identifying SLD: Patterns of Strengths and Weaknesses (PSW) Models  PSW models assume that in children with SLD: There are strengths and weakness in academic areas and psychological processing areas There is a relationship between areas of weakness in psychological processing and academic deficits Identifying SLD: Patterns of Strengths and Weaknesses (PSW) Models  Determining Weaknesses Below Average Academic Performance (Below 10th or 15th percentile rank) Classroom tests National standardized achievement tests State standardized tests Significant intraindividual differences on cognitive ability subtests that relate to the academic deficits Identifying SLD: Patterns of Strengths and Weaknesses (PSW) Models  Determining Weaknesses (Cont.) Below Average Psychological Processing (Below 10th or 15th percentile rank) Measures of phonological processing Measures of working memory Measures of processing speed Measures of rapid automatic naming. Examples of Standardized Achievement Tests  Phonological Awareness and Phonological Memory Tests Rapid Naming and Retrieval Fluency Tests Orthographic Processing Tests Print Awareness, Word Recognition, and Decoding Tests Reading Fluency Tests Examples of Standardized Achievement Tests  Reading Comprehension Tests Reading Inventories Written Expression Tests Oral Language Tests Mathematics Tests See Table 17-1 on pp. 500–501 in main text for a list of tests Interviewing for SLD: Written Expression See p. 504 in main text for interview questions Interventions for SLD Table 17-6 (p. 508 in main text) for young children with reading disorders Table 17-7 (p. 508 in main text) for children with SLD Table 17-8 (p. 509 in main text) for examples of metacognitive strategies for children with reading disorders Older Adolescents and Young Adults with SLD  Help with (by using role-playing and supervised job training): Filling out applications for college Finding job training Reading want ads Filling out job applications Interviewing Older Adolescents and Young Adults with SLD  Help with (by using role-playing and supervised job training): (Cont.) Following directions on the job Learning job skills Taking criticism Finishing work on time Paying attention on the job Working carefully Older Adolescents and Young Adults with SLD  Help with (by using role-playing and supervised job training): (Cont.) Learning about their legal rights on the job Learning how to advocate for necessary job accommodations Older Adolescents and Young Adults with SLD  Adjustment and Employment Success Consider: Abilities required in a particular career Ability to set reasonable goals Access to appropriate guidance Attitude toward life challenges Available support systems Older Adolescents and Young Adults with SLD  Adjustment and Employment Success (Cont.) Consider: Awareness of limitations and strengths Coping skills Cognitive ability Family’s, peers’, and teachers’ attitudes toward them Older Adolescents and Young Adults with SLD  Adjustment and Employment Success (Cont.) Consider: Motivation and perseverance Presence of comorbid disorders Self-concept Views from the Teacher’s Desk (Notes from Parents to Teachers)  Please excuse ray friday from school. He has very loose vowels. Views from the Teacher’s Desk (Notes from Parents to Teachers)  Please excuse my daughter’s absence. She had her periodicals. Views from the Teacher’s Desk (Notes from Parents to Teachers)  Please excuse mary for being absent yesterday. She was in bed with gramps. Views from the Teacher’s Desk (Notes from Parents to Teachers)  Dear school: please ecsc's john being absent on jan. 28, 29, 30, 31, 32 and also 33. Views from the Teacher’s Desk (Notes from Parents to Teachers)  Please exkuce lisa for being absent she was sick and i had her shot. Autism Spectrum Disorder (ASD; Chapter 22) Video Link Bringing the Early Signs of Autism Spectrum Disorders Into Focus http://youtu.be/YtvP5A5OHpU DSM-5 Definition A neurodevelopmental disorder characterized by persistent deficits in social communications and social interactions and by repetitive or restricted behaviors, interests, and activities Prevalence Rates of ASD in Four Countries  Research Study Western Australia, Denmark, Finland, and Sweden Compared rates of ASD in 2000 and 2011 in children aged 10 years Prevalence Rates of ASD in Four Countries  Found increases in ASD diagnoses 96% in Finland 121% in Western Australia 175% in Denmark 354% in Sweden Source: See next slide Prevalence Rates of ASD in Four Countries  Atladottir, H. O., Gyllenberg, D., Langridge, A., Sandin, S., Hansen, S. N., Leonard, H., Gissler, M., Reichenberg, A., Schendel, D. E., Bourke, J., Hultman, C. M., Grice, D. E., Buxbaum, J. D., & Parner, E. T. (2014). The increasing prevalence of reported diagnoses of childhood psychiatric disorders: a descriptive multinational comparison. European Child and Adolescent Psychiatry. Advanced online publication. doi: 10.1007/s00787-014-0553-8 Some Facts about ASD  In 2011–2012, about 1 in 50 children in the United States had a diagnosis of ASD, with a prevalence rate of about 2% for children ages 6–17 years ASD occurs in all ethnic and socioeconomic groups Parents of children ages 6–17 years with ASD reported that 58.3% of cases were mild, 34.8% were moderate, and 6.9% were severe Some Facts about ASD  ASD is almost five times more common among boys (3.23%) than among girls (.70%) Approximately 40% of children with ASD do not speak Approximately 25% to 30% of children with ASD begin speaking at 12 to 18 months of age but then stop speaking Some Facts about ASD  Before child’s first birthday, parents may have concerns about child’s Social, communication, and fine-motor skills Vision and hearing Some Facts about ASD  Children with higher IQs Tend to show fewer symptoms Usually are identified as having an ASD at a later age Some Facts about ASD  Children with other developmental disorders, such as Language disorder or Intellectual disability may also exhibit behaviors that suggest a possible ASD (see Table 22-1 on p. 601 in main text) Lifetime Costs of ASD in USA and UK  Research Study Aim of study: Conduct a literature review on the cost of ASD for individuals and families. Year: 2013 Countries: United States and United Kingdom Lifetime Costs of ASD in USA and UK  Findings Costs associated with ASD: Special education services Loss of parental productivity Residential care as adults Supportive living services as adults Individual productivity costs Medical costs Lifetime Costs of ASD in USA and UK  Results Individuals with ASD and with intellectual disability: $2.4 million in United States $2.2 million in United Kingdom Individuals with ASD and without intellectual disability: $1.4 million in United States $1.4 million in United Kingdom Lifetime Costs of ASD in USA and UK  Comment What are the most effective interventions that make the best use of scarce societal resources? How can we best coordinate services across many different service systems? How can we best deal with the enormous effect of ASD on children, their families, their schools, and society? Lifetime Costs of ASD in USA and UK  Source Buescher, A. V. S., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatrics. Advanced online publication. doi:10.1001/jamapediatrics.2014.210 Why Are More Children Diagnosed with ASD? Greater public awareness More clearly defined public policies Availability of more extensive social services and education Availability of better and more sensitive diagnostic tools Etiology of ASD  Genetic Causes Identical twins are more likely to have ASD than nonidentical twins Increased rates of ASD among siblings and first-degree relatives ASD tends to occur about 10% of the time in children who have genetic or chromosomal disorders Etiology of ASD  Genetic Causes (Cont.) Genetic mechanisms may produce an excessive number of brain cells in the prefrontal cortex Older fathers may pass on significantly more random genetic mutations to their offspring than younger fathers Older mothers are at a 30% higher risk of having a child with ASD than younger mothers Etiology of ASD  Autism Occurrence by MMR Vaccine Findings N = 95,727. Years of study = 2001-2012 Results showed that children receiving the MMR vaccine did not have an increased risk of ASD regardless of whether older siblings had ASD Etiology of ASD  Reference Jain, A., marshall, J., Buikema, A., Bancroft, T., Kelly, J. P., & Newschaffer, C. J. (2015). Autism occurrence by MMRVaccine status among U.S. children with older siblings with and without autism. Journal of the American Medical Association, 313(15), 1534–1540. doi: 10.1001/jama.2015.3077 Etiology of ASD  Environmental Factors Some children with ASD have spontaneous DNA mutations Adverse fetal environment may place the fetus at increased risk for developing ASD Antibodies in the mother’s blood during pregnancy may interfere with fetal brain development by attacking healthy tissue Etiology of ASD  Environmental Factors (Cont.) Toxic chemicals in the environment Lead and mercury can interfere with normal brain development in the fetus Etiology of ASD  Environmental Factors (Cont.) Variations in brain structure and function are thought to play a role in ASD Rate of growth of the amygdala (an almond-shaped mass of nuclei located deep within the temporal lobe of the brain) may be abnormal and disproportionate to total brain growth in very young children with ASD Etiology of ASD  Environmental Factors (Cont.) Research Study on ASD and Prenatal Pesticides Sample: 970 children (developmental delay, normal development, and ASD) studied during 1997–2008 Etiology of ASD  Environmental Factors (Cont.) Results: Residential proximity to organophosphate pestisides at some point during gestation was found to be associated With a 60% increased risk for ASD Highest during the 3rd trimester Etiology of ASD  Environmental Factors (Cont.) Organophosate pestisides are variety of organic compounds that contain phosphorus and often have intense neurotoxic activity Conclusion: Results strengthen evidence linking neurodevelopmental disorders with gestational pesticide exposure, particularly, organophosphates Etiology of ASD  Environmental Factors (Cont.) Source: Shelton, J. F., Geraghty, E. M., Tancredi, D. J., Delwiche, L. D., Schmidt, R. J., Ritz, B., Hansen, R. L., & HertzPicciotto, I. (2014). Neurodevelopmental disorders and prenatal residential proximity to agricultural pesticides: The CHARGE study. Environmental Health Perspectives. Advanced online publication. doi:10.1289/ehp.1307044 Etiology of ASD  Environmental Factors (Cont.) Research Study on ASD and Prenatal Exposure to Selective Serotonin Reuptake Inhibitors (SSRIs) Sample: 968 mother-child pairs Results: Prenatal exposure to SSRIs (antidepressants like Prozac and Zoloft) in boys may increase their susceptibility to ASD (effect stronger in boys than girls) Etiology of ASD  Environmental Factors (Cont.) Conclusion: Research findings, however, remain inconsistent about the relationship between SSRIs and ASD Etiology of ASD  Environmental Factors (Cont.) Source: Harrington, R. A. Lee, L-C., Crum, R. M., Zimmerman, A. W., & HertzPicciotto, I. (2014). Prenatal SSRI use and offspring with autism spectrum disorder or developmental delay. Pediatrics, 133(5), e1241–e1248. doi: 10.1542/peds.20133406 DSM-5 Diagnostic Criteria for ASD  A. Persistent deficits in social communication and social interaction across multiple contexts 1. Deficits in social-emotional reciprocity 2. Deficits in nonverbal communicative behaviors used for social interaction 3. Deficits in developing, maintaining, and understanding relationships DSM-5 Diagnostic Criteria for ASD  B. Restricted, repetitive patterns of behavior, interests, or activities 1. Stereotyped or repetitive motor movements, use of objects, or speech 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior DSM-5 Diagnostic Criteria for ASD  B. Restricted, repetitive patterns of behavior, interests, or activities (Cont.) 3. Highly restricted, fixated interests that are abnormal in intensity or focus 4. Hyperreactivity or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment Features Associated with ASD  Regression in development Difficulties in eating or sleeping Aggressive behavior (toward themselves like self-injurious behavior or toward other people) Features Associated with ASD  Savant skills Ability to calculate extremely difficult mathematical equations without a calculator but not calculate the correct change when purchasing items Ability to draw highly accurate and detailed perspective drawings Ability to sing with perfect pitch Features Associated with ASD  Savant skills (Cont.) Ability to state the day of the week for a date far in the past or future Ability to play a piano concerto after hearing it once Early Identification Instrument Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) Robins, Fein, & Barton, 2009 A 2-stage parent-report screening tool to assess risk of ASD Available for free download for clinical, research, and educational purposes http://mchatscreen.com/Official_MCHAT_Website_files/M-CHAT-R_F_1.pdf Research on Signs of ASD Related to Age  Early Identification (Around ages 2–5 years) Impairments in Nonverbal communication Pretend play Inflexible routines Repetitive motor behaviors Research on Signs of ASD Related to Age  Later Identification (Around ages 5–8 years) Impairments in Peer relations Conversational ability Idiosyncratic speech Research on Signs of ASD Related to Age  Authors concluded that the number of diagnostic behaviors are inversely associated with the age of identification of children with ASD Research on Signs of ASD Related to Age  Source: Maenner, M. J., Schieve, L. A., Rice, C. E., Cunniff, C., Giarelli, E., Kirby, R. S., Lee, L.-C., Nicholas, J. S., Wingate, M. S., & Durkin, M. S. (2013). Frequency and pattern of documented diagnostic features and the age of autism identification. Journal of the American Academy of Child & Adolescent Psychiatry, 52(4), 401–413. doi:10.1016/j.jaac.2013.01.014 Disorders Comorbid with ASD  Medical Asthma Skin allergies Food allergies Ear infections Frequent severe headaches Sleep disorders Sensory processing problems Feeding disorders Disorders Comorbid with ASD  Psychiatric Disorder Social anxiety disorder ADHD Oppositional defiant disorder Anxiety disorder Language disorder Depressive disorder Disorders Comorbid with ASD  Neurological disorders Chromosomal Genetic disorders Intellectual Functioning of Children with ASD  About 50% to 62% have IQs of 70 or above “Low functioning” used to describe those with IQs of 69 or below “High functioning” used to describe those with IQs of 70 or above IQs tend to be stable No specific cognitive profile Intellectual Functioning of Children with ASD  No cognitive profile can reliably distinguish children with ASD from children with other disorders But children with ASD have relative strengths on some Wechsler subtests Block Design Matrix Reasoning Picture Concept Intellectual Functioning of Children with ASD  And have relative weaknesses on other Wechsler subtests Comprehension Vocabulary Symbol Search Coding IQs may improve as a result of intensive early interventions Intellectual Functioning of Children with ASD  Children with ASD have higher IQs when they have Adequate conversational speech or Social relationships Intellectual Functioning of Children with ASD  Poorly developed language skills in children with ASD include Imitation Sequencing Organization Seeing relations between pieces of information Intellectual Functioning of Children with ASD  Poorly developed language skills in children with ASD include (Cont.) Identifying central patterns or themes Distinguishing relevant from irrelevant information Deriving meaning from the bigger picture Intellectual Functioning of Children with ASD  Relatively well-developed skills in children with ASD include Perceptual discrimination Retrieval of visual knowledge Visual reasoning Attention to visual detail Rote memory Intellectual Functioning of Children with ASD  Children with ASD and savant abilities tend to have low IQs Children with ASD usually have Selective memory deficits rather than widespread and all-encompassing ones Observing Children with ASD [pp. 606–607; 1] Areas to Observe Use of Eye contact Facial expressions Gestures Vocalizations Interactions with others Interactions with examiner Observing Children with ASD [pp. 606–607; 2] Areas to Observe (Cont.) Transitions Use of language Play Motor behavior Attention and activity level Awareness of social cues and expectations Tips for Testing Children with ASD  Adapt the environment Select a room in a quiet area Have comfortable lighting Wear little or no perfume or cologne Change room if sensory stimuli are distracting (e.g., child is screaming, avoiding, or covering ears) Use tangible rewards (e.g., food reinforcers with permission or games) Tips for Testing Children with ASD  Use frequent breaks Make sure you have the child’s attention when you speak Talk slowly Use short and simple phrases Be concrete Avoid complex grammatical forms Repeat or rephrase sentences Tips for Testing Children with ASD  Avoid reliance on purely auditory cues Use visual cues when possible to help children understand language Use simple written to-do lists Use a picture schedule of activities Learn about Child’s Communication Skills Ask parents and teachers for advice on how to best work with the child Observe the child in his or her classroom See list of questions on p. 607 in main text Under no condition should you use facilitated communication to interview a child with ASD (see pp. 607–608 in main text) Assessment Measures for ASD See p. 608 in main text Useful ASD Forms  Table J-1. Observation Form for Recording Behaviors That May Reflect Autism Spectrum Disorder and Positive Behaviors (p. 155 in RG) Table J-2. Modified Checklist for Autism Disorder in Toddlers (M-CHAT) (p. 157 in RG) Table J-3. Autism Spectrum Disorder Questionnaire for Parents (p. 158 in RG) Useful ASD Forms  Table J-4. Checklist of Possible Signs of an Autism Spectrum Disorder (p. 160 in RG) Table J-5. DSM-5 Checklist for Autism Spectrum Disorder (p. 161 in RG) Evaluating Assessment Information See questions in Table 22-3 for evaluating assessment information in cases of ASD (pp. 609–610 in main text) Interventions for Children with ASD  See pp. 609–614 in main text for a discussion of interventions for ASD See Handouts K-1 to K-4 (pp. 162–217 in RG) for parents and teachers Interventions are designed to improve Communication skills Executive functions skills Problem-solving skills Organizational skills Interventions for Children with ASD  Interventions are designed to improve (Cont.) Interpersonal and social skills Learning readiness skills Academic skills Motor skills Interventions for Children with ASD  And to reduce Restricted behaviors Repetitive behaviors Intense behaviors and interests that interfere with functioning or cause harm to the individual or to others Alternative ASD Therapies  The Following ASD Therapies Are Not Supported By Research Auditory integration training (listening through headphones to electronically modified music, voices, or sounds) Chelation (heavy metal removal) Gluten- and casein-free diets (gluten is a protein found in wheat and other grains, and casein is a protein found in milk and milk products) Alternative ASD Therapies  The Following ASD Therapies Are Not Supported By Research (Cont.) Herbal remedies (e.g., St. John’s wart, ma huang, kava kava) Hyperbaric oxygen chamber treatment (use of a pressure chamber to administer oxygen at higher pressure than in the atmosphere) Alternative ASD Therapies  The Following ASD Therapies Are Not Supported By Research (Cont.) Intravenous immunoglobulin (injection of pooled antibodies separated from the plasma of multiple donors) Manipulation or craniosacral massage (physical manipulation of the skull and cervical spine) Alternative ASD Therapies  The Following ASD Therapies Are Not Supported By Research (Cont.) Melatonin treatment (a nutritional supplement used to promote sleep) Vitamins A, B6, and C, megavitamins, and magnesium treatment (designed to address supposed metabolic abnormalities in children with ASD) Prognosis for Children with ASD  Many behaviors associated with ASD may change, diminish, or completely fade over time However, communication and social deficits may continue in some form throughout life Prognosis for Children with ASD  More favorable prognosis is for children with ASD who have Early and intensive intervention Some communicative speech before 5 years of age IQs above 70 Prognosis for Children with ASD  Prospect for employment is not encouraging In 2009 about 53% worked for pay outside the home since leaving high school Traumatic Brain Injury (TBI; Chapter 23) TBI  Approximately 1 million children in the US each year sustain head injuries from Falls Physical abuse Recreational accidents Motor vehicle accidents Approximately 75% of TBIs are mild Still, TBI account for 30.5% of all injuryrelated deaths among children TBI  TBI in infants under the age of 1 year associated with Physical abuse Shaken baby syndrome Thrown infant syndrome TBI in toddlers and preschoolers associated with Falls Physical abuse TBI  TBI in children over the age of 5 years associated with Bicycle injuries Motor vehicle injuries Sports-related accidents and injuries TBI  Children under 20 years who are treated in emergency departments for TBI sustain their injuries from Sports and recreation activities 30% Motor vehicle collisions 20% Observable Effects of TBI in Children  TBI may produce physical, cognitive, and behavioral symptoms (see Table 23-2 on p. 632 in main text) Contact health care provider if a child shows any of these symptoms after sustaining a head injury Changes in play Changes in school performance Changes in sleep patterns Observable Effects of TBI in Children  Contact health care provider if any of these symptoms show after a child sustains a head injury (Cont.) Convulsions or seizures Persistent headaches Inability to recognize people or places Irritability, crankiness, or crying more than usual Observable Effects of TBI in Children  Contact health care provider if any of these symptoms show after a child sustains a head injury (Cont.) Lack of interest in favorite toys or activities Loss of balance or unsteady walking Loss of consciousness Loss of newly acquired skills Observable Effects of TBI in Children  Contact health care provider if any of these symptoms show after a child sustains a head injury (Cont.) Poor attention Refusal to eat or nurse Slurred speech Tiredness or listlessness Vomiting Weakness, numbness, or decreased coordination Effects of TBI Related to Several Factors Location, extent, and type of brain injury Child’s age Child’s preinjury Temperament Personality Cognitive and psychosocial functioning Type, promptness, and quality of treatment School Problems in Children After Concussions  Study Sample N = 349 students and parents sampled 4 weeks post injury Ages 5 to 18 Sample divided Continuing to experience problems following head injuries Fully recovered School Problems in Children After Concussions  Results Severity of the concussion symptoms directly related to the degree of academic problems among all grade levels 88% not fully recovered still had problems with Concentration Headaches Fatigue School Problems in Children After Concussions  Results (Cont.) 77% of those same children had problems Taking notes Doing homework (needing more time) Studying for exams School Problems in Children After Concussions  Summary and Recommendations School professionals need to monitor children with symptoms of concussion because children’s school work is compromised School systems and medical professionals need to work together to support students in the recovery phase School Problems in Children After Concussions  Summary and Recommendations (Cont.) High school students have more learning problems than middle or elementary school children Supports are particularly necessary for older students because they face greater academic demands than their younger peers School Problems in Children After Concussions  Source Ransom, D. M., Vaughan, C. G., Pratson, L., Sady, M. D., McGill, C. A., & Gioia, G. A. (2015). Academic effects of concussion in children and adolescents. Pediatrics, 135(6), 1043–1050. doi:10.1542/peds.2014-3434 Sports-Related Concussions  About 40 to 50 million children in US participate in organized sports Sports-Related Concussions  Incidence of mild TBI in children who participate in sports is high—about 1,275,000 annually Football (22.6%) Bicycling (11.6%) Basketball (9.2%) Soccer (7.7%) Snow skiing (6.4%) Sports-Related Concussions  Rates of Concussion Highest in full-contact sports (e.g., football, boy’s lacrosse, ice hockey, rugby) Moderate in moderate-contact sports (e.g., basketball, soccer) Lowest in minimal contact sports (e.g., volleyball, baseball, softball) Sports-Related Concussions  Consider the cumulative effects of sportsrelated concussions Possibility of long-term permanent damage in the form of chronic traumatic encephalopathy See Table 23-3 for list of symptoms of a possible concussion (p. 636 in main text) Sports-Related Concussions  If one or more of these symptoms are present, adults on the scene should Call 911 Contact the child’s parents immediately This is especially critical because concussions can result in an intracranial hemorrhage, which is life-threatening Chronic Traumatic Encephalopathy (CTE)  Study N = 68 cases, ages 17 to 98 years 34 professional football players 9 played college football only 6 played high school football only 19 played in other sports or were in the military Chronic Traumatic Encephalopathy (CTE) Stages I to IV Stage I Headaches Attention problems Concentration problems Stage II Depression Explosivity Short-term memory impairment Chronic Traumatic Encephalopathy (CTE) Stages I to IV (Cont.) Stage III Cognitive impairment Problem with executive functions Planning Organization Multitasking and judgment Chronic Traumatic Encephalopathy (CTE) Stages I to IV (Cont.) Stage IV Full-blown dementia Memory impairment Cognitive impairments that impact daily living Chronic Traumatic Encephalopathy (CTE) Discussion CTE appears to be a slowly progressive disease in most cases CTE does not progress at the same rate in all patients Chronic Traumatic Encephalopathy (CTE) Discussion (Cont.) But 89% of the patients demonstrated clinical symptoms involving Cognitive Behavioral Mood impairments before death Chronic Traumatic Encephalopathy (CTE) Discussion (Cont.) One-third of the CTE cases diagnosed with additional neurodegenerative disease Motor neuron disease (12%) Lewy body disease (16%) Alzheimer’s disease (11%) Frontotemporal lobar degeneration (6%) Study raises troubling questions about the safety of contact sports Chronic Traumatic Encephalopathy (CTE) Source: Mooney, B. L. (2013). New CTE study categorizes stages of degenerative brain disease in veterans, athletes. Retrieved from http://www.usmedicine.com/agencies/depa rtment-of-veterans-affairs/new-cte-studycategorizes-stages-of-degenerative-braindisease-in-veterans-athletes/ Brief Mental Status and Follow-UP Examinations Use SCAT3 (see p. 635 in main text) Or ask questions on p. 636 in main text Ask follow-up questions on p. 636 in main text Refer child to a health-care provider if coaching staff or parents report that the child shows any of the symptoms on p. 637 in main text Rehabilitation Programs in Schools  When child returns to school note the behaviors shown on p. 637 in main text Consider guidelines shown on p. 638, 640 in main text and in Exhibit 23-2 on p. 639 in main text in setting up a rehabilitation program Rehabilitation Programs in Schools  Help teachers carry out appropriate strategies for Reducing or eliminating barriers to learning Reintegrating the child into the classroom Establishing objectives Using effective instructional procedures Give teachers Handout K-3 (pp. 185–209 in RG) Protecting Children from TBI See list of suggestions on pp. 643–644 in main text Research should continue to focus on ways to reduce the severity and occurrence of sports-related injuries NIH Toolbox  A set of royalty-free neurological and behavioral tests designed to assess in children and adults between the ages 3–85 years Cognitive functions Sensory functions Motor functions Emotional functions NIH Toolbox  See Table 24-7 on pp. 670–671 in main text NIH Toolbox tests are also available in Spanish See reference—National Institutes of Health and Northwestern University (2012)— for link to tests Attention-Deficit/ Hyperactivity Disorder (ADHD; Chapter 15) Definition of ADHD A neurobehavioral syndrome marked by inattention and/or hyperactivity and impulsivity (DSM-5) Video Link How to Recognize ADHD Symptoms in Children http://youtu.be/1GIx-JYdLZs Some Facts about ADHD  In 2011 about 6.4 million children ages 4–17 years had parent-reported ADHD (about 11% of the U.S. population) 69% were taking medications (3.5 million children) A 42% rate of increase from 2003 to 2011 Boys were more than twice as likely as girls to have ADHD (12.1% vs. 5.5%) Some Facts about ADHD  Incidence in different ages Children younger than 10 years (6.8%) Children ages 11–14 years (11.4%) Children ages 15–17 years (10.2%) 33.2% fail to graduate from high school on time vs. 15.2% of children without any psychological disorder DSM-5 Diagnostic Criteria for ADHD Two main types of symptoms Inattention Hyperactivity and impulsivity Three types of ADHD Combined presentation Predominately inattentive presentation Predominately hyperactive/impulsive presentation Disorders Comorbid With ADHD  Children with ADHD represent a heterogeneous population Often display a diversity of behavior problem and have a comorbid disorder Disorders Comorbid With ADHD  Disorders Comorbid with ASD Oppositional defiant disorder (about 40% to 50%) Conduct disorder (about 25%) Disruptive mood dysregulation (majority of children) Specific learning disorder (50% or more) Anxiety disorder (about 30%) Disorders Comorbid With ADHD  Disorders Comorbid with ASD (Cont.) Depressive disorder (about 20%) Substance use disorder (minority of children) Obsessive-compulsive disorder (minority of children) Autism spectrum disorder (minority of children) ADHD and Conduct Disorder  A distinct subtype and may have a genetic basis Increased risk for Antisocial behaviors Substance abuse Peer rejection Low self-esteem Depression Personality disorders ADHD and Conduct Disorder  Increased risk for (Cont.) Difficulties in processing social information Suspension from school ADHD and Conduct Disorder  Parents and Familial Factors Parents face increased stress, frustration, and despair Families tend to be nonintact and of lowincome Mothers are unhappy Parents are uninterested in their children’s activities Children with ADHD at Adulthood Adults have Less education, including fewer college degrees Lower incomes Higher divorce rates More antisocial personality disorders More substance-related disorders Increased risk for criminal behavior Other Types of Deficits in ADHD Cognitive deficits Including deficits in executive functions; see Appendix M in RG (p. 246) Social and adaptive functioning deficits Difficulty assuming responsibility Motivational and emotional deficits Limited interest in achievement Motor, physical, and health deficits Fine and gross-motor deficits Etiology of ADHD  No single cause but likely multiple factors Genetic factors Runs in families Neurological factors Different brain structures Imbalance or deficiency in one or more neurotransmitters Etiology of ADHD  Prenatal factors Exposure of the fetus to Nicotine Alcohol Other drugs Maternal psychosocial stress during pregnancy Postnatal exposure to toxic substances Lead, methylmercury, and pesticides Etiology of ADHD  Study of Acetaminophen Use During Pregnancy Sample: Danish children (N = 64,322) whose mothers used acetaminophen during pregnancy (data from the Danish National Birth Cohort during 1996-2002) Results: Children were at higher risk for receiving a diagnosis of ADHD Etiology of ADHD  Study of Acetaminophen Use During Pregnancy (Cont.) Source: Liew, Z., Ritz, B., Rebordosa, C., Lee, P.-C., & Olsen, J. (2014). Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA Pediatrics. Advanced online publication. doi:10.1001/jamapediatrics.2013.4914 Assessment of ADHD  Comprehensive history Review of the child’s cumulative school records Attendance history Reports of behavioral problems School grades Standardized test scores Number of schools attended Assessment of ADHD  Review of relevant medical information Review of previous psychological evaluations Interviews with parents, teachers, and child Observations of child in classroom and playground Administration of rating scales to parents, teachers, and child Assessment of ADHD  Administration of psychological tests to child See Appendix G (pp. 119–126) in RG for additional assessment forms See pp. 460–465 in main text for additional information about assessment of ADHD Evaluation of ADHD Assessment Findings  Presence of inattention, hyperactivity, and impulsivity Number, type, severity, and duration of symptoms Situations in which symptoms are displayed Verbal abilities Nonverbal abilities Evaluation of ADHD Assessment Findings  Short- and long-term memory abilities Other cognitive abilities See Table L-18, p. 242 in RG for an executive functions checklist Comorbid disorders Social competence Adaptive behavior Educational and instructional needs Comment on Assessment of ADHD  Diagnosis of ADHD is not easy Restlessness, inattention, and overactive behavior are common in children Parents may find it difficult to judge child’s behavior Rating scales usually do not provide for a functional analysis of the variables that interact with children’s behaviors Comment on Assessment of ADHD  Teachers tend to assign more symptoms consistent with ADHD to younger children than to older children Symptoms of ADHD can be displayed In different ways across different settings In different relationships Comment on Assessment of ADHD  A comprehensive assessment requires a multi-method approach with Multiple informants Multiple contexts Multiple psychological tests Multiple use of rating scales See Table 25-1 in Chapter 25 (pp. 697– 701 in main text) for questions to consider in preparing a report Interventions for ADHD  Pharmacological Approximately 70% to 80% of children who exhibit hyperactive symptoms respond positively to stimulant medications Interventions for ADHD  Behavioral Positive reinforcement Verbal praise Withdrawal of reinforcement Time out A response-cost program Point system Token economy Interventions for ADHD  Behavioral (Cont.) Contracts between parents/teachers and children Stipulate desired and expected behaviors at home and/or at school Consequences for failure to perform the desired behaviors Cognitive-behavioral Self-monitoring programs Interventions for ADHD  Family Parent training programs Educational Teaching new skills Establishing routines Promoting attention Improving study skills Improving memory Interventions for ADHD  Educational (Cont.) Improving listening skills See Handout K-3 for suggestions (pp. 185–209 in RG) Interventions for ADHD  Alternative interventions that have little scientific support Dietary interventions Antimotion sickness medicines Manipulation of bones in the body Exercises to improve eye tracking Enhancing the ability to hear certain frequencies of sound Neurofeedback INTELLECTUAL DISABILITY (ID; Chapter 18) American Association on Intellectual and Developmental Disabilities (AAIDD) Definition “Intellectual disability is characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before age 18” (AAIDD, 2010, p. 5). AAIDD Definition of Intellectual Functioning “. . . an IQ score that is approximately two standard deviations below the mean, considering the standard error of measurement for the specific assessment instruments used and the instruments’ strengths and limitations” (AAIDD, 2010, p. 27) AAIDD Definition of Adaptive Behavior “. . . approximately two standard deviations below the mean of either (a) one of the following three types of adaptive behavior: conceptual, social, and practical or (b) an overall score on a standardized measure of conceptual, social, and practical skills” (AAIDD, 2010, p. 27) Age of Onset Limitations must be manifest prior to the age of 18 years ID Categories Not Used AAIDD classification system does not use categories (e.g., mild, moderate, severe, profound) to classify intellectual disability, but the World Health Organization does recommend their use (See slide later in presentation) AAIDD and Other Considerations  1. 2. Limitations in present functioning must be considered within the context of community environments typical of an individual’s age, peers, and culture Valid assessment considers cultural and linguistic diversity as well as differences in communication, sensory, motor, and behavioral factors AAIDD and Other Considerations  3. 4. 5. Limitations often coexist with strengths; individuals with intellectual disability have gifts as well as limitations An important purpose of describing limitations is to develop a profile of needed supports The life functioning of individuals with intellectual disability generally will improve with appropriate supports over a sustained period (AAIDD, 2010, p. 7, with changes in notation) DSM-5  Definition similar to AAIDD Adds two related diagnostic categories Global developmental delay for children under the age of 5 years when evaluation is not possible Unspecified intellectual disability for children over the age of 5 years when assessment is not possible DSM-5  Diagnosis of ID does not rule out the coexistence of other disorders A diagnosis of intellectual disability is inappropriate when an individual is meeting the demands of his or her environment adequately World Health Organization’s Working Group on ICD-11 Severity level of intellectual developmental disorder needs to be considered 85% in mild level 10% in moderate level 3.5% in severe level 1.5% in profound level See Tables 18-1 and 18-2 on p. 520 in main text for severity levels and adaptive behavior examples Some Facts about ID  Prevalence about 1% in general population During the 2009–2010 school year, 463,000 children between ages 3–21 years in special education programs Prevalence about 7.1% in special education population Some Facts about ID  More males than females receive diagnosis 1.6:1 for mild ID 1.2:1 for severe ID Mild ID more common in rural areas and in low-income groups Correlation between measured intelligence and adaptive behavior ranges from about .30 to .50 Etiology of ID  Genetic disorders Chromosomal anomalies Cranial malformations Perinatal disorders Postnatal disorders Unknown causes See Table 18-3 on pp. 523–528 in main text for a list of disorders and conditions associated with ID Co-Occurring Disorders with ID Attention-deficit/hyperactivity disorder Depressive and bipolar disorders Anxiety disorders Autism spectrum disorder Stereotypic movement disorder Impulse control disorders Major neurocognitive disorder Support Areas and Goals for ID See Table 18-4 on p. 532 in main text Concluding Comment on ID  Measures of intelligence and adaptive behavior are for example used to Determine eligibility for disability benefits by Social Security Administration Determine whether an individual can stand trial and whether a defendant can be sentenced to death Concluding Comment on ID  Evaluation of intellectual disability thus has extremely far-reaching consequences Additional Resources  Morgan, E., Salomon, N., Plotkin, M., & Cohen, R. (2014). The school discipline consensus report: Strategies from the field to keep students engaged in school and out of the juvenile justice system. New York, NY: The Council of State Governments Justice Center. Retrieved from http://csgjusticecenter.org/wpcontent/uploads/2014/06/The_School_Dis cipline_Consensus_Report.pdf#page=10 Additional Resources  Williams, S. T. (2008). Mental health screening and assessment tools for children: Literature review. Retrieved from http://humanservices.ucdavis.edu/academ y/pdf/final2mentalhealthlitreview.pdf Additional Resources  Willamette Education Service District. (n.d.). Student threat assessment. Retrieved from http://www.wesd.org/siis/safe/threat Synapse. (2013). Acquired brain injury: The facts (4th ed.). Retrieved from https://synapse.org.au/media/71265/acquir ed_brain_injury_-_the_facts__forth_edition__2013_.pdf Additional Resources  Also see SPsych Everything for valuable links https://sites.google.com/site/spsycheveryt hing/ (Also on www.sattlerpublisher.com) Spelling Chequer  Eye halve a spelling chequer It came with my pea sea It plainly marques four my revue Miss steaks eye kin knot sea. Eye strike a key and type a word And weight four it two say Weather eye am wrong oar write It shows me strait a weigh. Spelling Chequer  As soon as a mist ache is maid It nose bee fore two long And eye can put the error rite Its rare lea ever wrong. Eye have run this poem threw it I am shore your pleased two no Its letter perfect awl the weigh My chequer tolled me sew. Children Learn What They Live by Dorothy Law Nolte  If children live with criticism, They learn to condemn. If children live with hostility, They learn to fight. If children live with ridicule, They learn to be shy. If children live with shame, They learn to feel guilty. If children live with encouragement, They learn confidence. Children Learn What They Live by Dorothy Law Nolte  If children live with tolerance, They learn to be patient. If children live with praise, They learn to appreciate. If children live with acceptance, They learn to love. If children live with approval, They learn to like themselves.