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Step VII
Understand and Implement Classroom Management Strategies for Students With Specific Psychological Disorders
Child and Adolescent Mental Health and Schools
Mental health is how people think, feel, and act. It affects how they handle stress, relate to each other, and make decisions. It influences how they look at themselves, their lives, and others. Good mental health allows children to think clearly, develop socially, and learn new skills. Mental health in children and adolescents is the achievement of expected milestones (cognitive, social, and emotional) and effective coping skills and secure social relationships.
Doctors’ offices and schools are important settings in which children’s mental health issues can be recognized and addressed. Schools may function as the de facto mental health system for many children and adolescents.
Students with a mental health diagnosis do not automatically qualify for special education under the Individuals with Disabilities Education Act (IDEA). Keep in mind that individualized education program (IEP) teams cannot make DSM-IV diagnoses and physicians cannot identify a child as having special education needs under IDEA. Schools may serve these students in their regular education programs by using a 504 Plan under the Americans with Disabilities Act.
Risk Factors
Usually a combination of risk factors is at work. They can be biological and/or psychosocial.
Biological
• Genes that carry a predisposition or risk for an illness
• Environmental (prenatal damage, poverty, deprivation, abuse and neglect, trauma, and poor nutrition)
• Problems caused by injury, illness, exposure to toxins
Adverse Psychosocial Development
• Stressful life events leading to a negative change in the child’s circumstances (dysfunctional family life, severe discord, parent psychopathology or criminality, inconsistent discipline, lack of loving relationship with at least one parent, maladaptive influence of peers and siblings)
• Economic hardship
• Exposure to violence
• Poor caregiving
How common are mental health problems in children? Consider the following data from the Surgeon General’s Report and the President’s New Freedom Commission:
• Among children ages 9–17, almost 21 percent have a diagnosable mental or addictive disorder; of those, 11 percent have a significant impairment, and 5 percent have an extreme functional impairment.
• Only one in five children or adolescents gets mental health services in any given year.
• Children of depressed parents are more than three times as likely to experience depression.
• Parental depression increases a child’s risk of anxiety disorders, conduct disorders, and alcoholism.
• Of 21-year-olds with mental health disorders, 74 percent had prior problems.
Mental Disorders With Onset in Children and Adolescents
• Anxiety disorders (e.g., obsessive-compulsive disorder (OCD), generalized anxiety disorder, phobias, panic disorder)
• Attention deficit and disruptive behavior disorders
• Autism and other pervasive developmental disorders
• Eating disorders
• Elimination disorders
• Learning and communication disorders
• Mood disorders (e.g., depression, bipolar disorder)
• Schizophrenia
Warning Signs That a Child or Adolescent May Need Mental Health Services
Emotions
• Crying or overreaction
• Excessive concern with physical problems or appearance
• Excessive worry or anxiety
• Extreme anger most of the time
• Extreme fearfulness
• Fear of being out of control
• Feeling life is “too much”; thoughts of suicide
• Sadness or hopelessness for no reason that does not go away
• Unable to get over a loss or death
• Worthlessness or guilt
Big Changes
• Avoiding other people and isolating oneself
• Daydreaming too much and not finishing tasks
• Decline in school performance
• Hearing voices that cannot be explained
• Loss of interest in things once enjoyed
• Poor grades despite strong efforts
• Repeated refusal to go to school or take part in normal childhood/adolescent activities
• Unexplained changes in eating or sleeping habits
Experiences/Behaviors
• Behaving without regard for other people
• Bingeing and purging; abusing laxatives
• Breaking the law; abusing the rights of others
• Difficulty concentrating and/or making decisions
• Excessive dieting or exercising
• Excessive worry about doing something “bad”
• Hyperactivity or excessive fidgeting
• Life-threatening or other dangerous behavior
• Need to wash or perform certain routines hundreds of times each day
• Persistent disobedience or aggression
• Persistent nightmares
• Racing thoughts
• Setting fires
• Torturing or killing animals
• Using alcohol or other drugs
Role of the School
• What are the functions of “mental health services in the school”?
• Promoting positive mental health and social and emotional development
• Addressing mental health problems as they present barriers to learning
• Providing linkages to community agencies and resources
• Delivering mental health resources within or in association with school settings
• Providing school resources for meeting student mental health needs
• Delivering primary prevention services
Alcohol and other drug abuse (AODA) education
• Delivering early intervention
Accommodations for learning and behavior concerns
Pregnancy prevention/school-age parent programs
• Providing care for severe and chronic problems
Communication with families
Coordination with community service providers
Restoring calm, problem-solving, collecting information
Moving the student away from being a victim
Connecting the student with immediate support
Taking care of the caretakers
Providing for the aftermath
How can we differentiate between manifestations of the illness and learned behaviors?
• Learn about the symptoms of the illness in general. Talk to parents and the therapist about how the illnes...
