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Parent Information and Resources

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Links updated, November 2021
This information in Spanish

The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years. ( 1)

We refer to mental disorders using different "umbrella" terms such as emotional disturbance, behavioral disorders, or mental illness. Beneath these umbrella terms, there is actually a wide range of specific conditions that differ from one another in their characteristics and treatment. These include (but are not limited to):

anxiety disorders;

bipolar disorder (sometimes called manic-depression);

conduct disorders;

eating disorders;

obsessive-compulsive disorder (OCD); and

psychotic disorders.

You may be reading this fact sheet with one of these specific disorders in mind, or you may be looking for information about emotional disturbances in general. In either case, keep reading to find out what different emotional distubances have in common, how they are defined in federal law, and where to find more detailed information on specific disorders.
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Definition
IDEA defines emotional disturbance as follows:
We've chosen to use the term "emotional disturbance" in this fact sheet because that is the term used in the nation's special education law, the Individuals with Disabilities Education Act (IDEA).

"...a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems." ( 2)

As defined by IDEA, emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance. ( 3)

Characteristics

As is evident in IDEA's definition, emotional disturbances can affect an individual in areas beyond the emotional. Depending on the specific mental disorder involved, a person's physical, social, or cognitive skills may also be affected. The National Alliance on Mental Illness of Southern Arizona puts this very well:

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. ( 4)

Some of the characteristics and behaviors seen in children who have an emotional disturbance include:

Hyperactivity (short attention span, impulsiveness);

Aggression or self-injurious behavior (acting out, fighting);

Withdrawal (not interacting socially with others, excessive fear or anxiety);

Immaturity (inappropriate crying, temper tantrums, poor coping skills); and

Learning difficulties (academically performing below grade level).

Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings.

Many children who do not have emotional disturbance may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior signals that they are not coping with their environment or peers.

Causes

No one knows the actual cause or causes of emotional disturbance, although several factors-heredity, brain disorder, diet, stress, and family functioning-have been suggested and vigorously researched. A great deal of research goes on every day, but to date, researchers have not found that any of these factors are the direct cause of behavioral or emotional problems.

According to NAMI, mental illnesses can affect persons of any age, race, religion, or income. Further:

Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan. ( 5)

Frequency

Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a psychiatric disorder. ( 6) Half of all psychiatric illness occurs before the age of 14, and 75% by the age of 24. The most common psychiatric disorders in childhood are anxiety disorders, AD/HD and disruptive behavior, depression and bipolar disorders, and eating disorders. ( 7)

Help for School-Aged Children

IDEA requires that special education and related services be made available free of charge to every eligible child with a disability, including preschoolers (ages 3-21). These services are specially designed to address the child's individual needs associated with the disability-in this case, emotional disturbance, as defined by IDEA (and further specified by states). In the 2016 school year, more than 349,000 children and youth with emotional disturbance received these services to address their individual needs related to emotional disturbance. ( 8)

Determining a child's eligibility for special education and related services begins with a full and individual evaluation of the child. Under IDEA, this evaluation is provided free of charge in public schools.
10 Basic Steps in Special Education Questions Often Asked by Parents about Special Education Services Evaluating Children for Disability Developing Your Child's IEP
There is a lot to know about the special education process, much of which you can learn here on the CPIR site. We invite you to read the wide range of publications we offer on the topic, especially:

A Look at Specific Emotional Disturbances

As we mentioned, emotional disturbance is a commonly used umbrella term for a number of different mental disorders. Let's take a brief look at some of the most common of these.

We all experience anxiety from time to time, but for many people, including children, anxiety can be excessive, persistent, seemingly uncontrollable, and overwhelming. An irrational fear of everyday situations may be involved. This high level of anxiety is a definite warning sign that a person may have an anxiety disorder.

The term "anxiety disorder" is a broad term covering several different disabilities that share the core symptom of irrational fear. These include such different disorders as generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder (also called social phobia), and specific phobias. ( 9)

According to the Anxiety Disorders Association of America, anxiety disorders are the most common psychiatric illnesses affecting children and adults. ( 10) They are also highly treatable. Unfortunately, only about 36.9% of those affected receive treatment. ( 11)

Also known as manic-depressive illness, bipolar disorder is a serious medical condition that causes dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. ( 12)

For most people with bipolar disorder, these mood swings and related symptoms can be stabilized over time using an approach that combines medication and psychosocial treatment. ( 13)

Conduct Disorder

Conduct disorder refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. ( 14) This may include some of the following behaviors:

aggression to people and animals;

destruction of property;

deceitfulness, lying, or stealing; or

truancy or other serious violations of rules. (15)

Treatment will depend on the child's symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

helping the child learn how to better solve problems, communicate, and handle stress, as well as how to control impulses and anger (what's known as cognitive-behavioral therapy);

family therapy;

peer group therapy (to help better social and interpersonal skills); and

medications (although these are not typically used to treat conduct disorder). (16)

Eating disorders are characterized by extremes in eating behavior-either too much or too little-or feelings of extreme distress or concern about body weight or shape. Females are much more likely than males to develop an eating disorder. ( 17)

Anorexia nervosa and bulimia nervosa are the two most common types of eating disorders. Anorexia nervosa is characterized by self-starvation and dramatic loss of weight. Bulimia nervosa involves a cycle of binge eating, then self-induced vomiting or purging. Both of these disorders are potentially life-threatening. ( 18)

Binge eating is also considered an eating disorder. It's characterized by eating excessive amounts of food, while feeling unable to control how much or what is eaten. Unlike with bulimia, people who binge eat usually do not purge afterward by vomiting or using laxatives. ( 19)

According to the National Eating Disorders Association:

Treating an eating disorder generally involves a combination of psychological and nutritional counseling, along with medical and psychiatric monitoring. Treatment must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder... Many people utilize a treatment team to treat the multi-faceted aspects of an eating disorder. ( 20)

Obsessive-Compulsive Disorder

Often referred to as OCD, obsessive-compulsive disorder is actually considered an anxiety disorder (which was discussed earlier in this fact sheet). OCD is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors (handwashing, counting, checking, or cleaning) are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety. ( 21)

A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain. ( 22) Treatment for most people with OCD should include one or more of the following:

therapist trained in behavior therapy;

Cognitive Behavior Therapy (CBT);

medication (usually an antidepressant). (23)

"Psychotic disorders" is another umbrella term used to refer to severe mental disorders that cause abnormal thinking and perceptions. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. Schizophrenia is one type of psychotic disorder. ( 24) There are others as well.

Treatment for psychotic disorders will differ from person to person, depending on the specific disorder involved. Most are treated with a combination of medications and psychotherapy (a type of counseling). ( 25)

More about School

As mentioned, emotional disturbance is one of the categories of disability specified in IDEA. This means that a child with an emotional disturbance may be eligible for special education and related services in public school. These services can be of tremendous help to students who have an emotional disturbance.

Typically, educational programs for children with an emotional disturbance need to include attention to providing emotional and behavioral support as well as helping them to master academics, develop social skills, and increase self-awareness, self-control, and self-esteem. A large body of research exists regarding methods of providing students with positive behavioral support (PBS) in the school environment, so that problem behaviors are minimized and positive, appropriate behaviors are fostered. (See the resource section at the end of this fact sheet for more information on PBS.) It is also important to know that, within the school setting:

For a child whose behavior impedes learning (including the learning of others), the team developing the child's Individualized Education Program (IEP) needs to consider, if appropriate, strategies to address that behavior, including positive behavioral interventions, strategies, and supports.

Students eligible for special education services under the category of emotional disturbance may have IEPs that include psychological or counseling services. These are important related services available under IDEA and are to be provided by a qualified social worker, psychologist, guidance counselor, or other qualified personnel.

Recognizing and Addressing the Impact of COVID-19 | As young people return to in-person schooling in the 2021-2022 school year, they may bring with them the impact of the pandemic's trauma. This makes it essential that schools consider the possibility that many students will need to be re-evaluated to determine if they need additional services, especially behavioral support and mental health services, than they needed prior to COVID-19. Two resources of great relevance to reopening schools and returning students are the following:

Other Considerations

Children and adolescents with an emotional disturbance should receive services based on their individual needs, and everyone involved in their education or care needs to be well-informed about the care that they are receiving. It's important to coordinate services between home, school, and community, keeping the communication channels open between all parties involved.

The Importance of Support

Families often need help in understanding their child's disability and how to address the needs that arise from the disability. Help is available from psychiatrists, psychologists, and other mental health professionals that work in the public or private sector. There is also a network of mental health support operating in every state as well as locally.

To locate systems of support in your community or state, visit the organizations we've listed below. They can connect you with local resources, including support groups that provide connection and understanding, information, referral, and advocacy for those living with emotional disturbance.

There are also support groups available from organizations that address specific mental disorders under the umbrella term of emotional disturbance. See the resources at the end of this fact sheet to identify some of these groups.

Resources of More Information

AACAP | American Academy of Child and Adolescent Psychiatry | AACAP offers Facts for Families, a series in English, Spanish, and several other languages that includes many briefs on specific mental disorders, including the ones mentioned in this publication.

AACAP also operates different Resource Centers, which offer consumer-friendly definitions, answers to frequently asked questions, clinical resources, expert videos, Facts for Families, and much more. Visit the Resource Center home page if you are concerned with one of the following:

Anxiety Disorders

Autism

Bipolar Disorder

Conduct Disorder

Depression

Oppositional Defiant Disorder

NIMH | National Institute of Mental Health | NIMH is clearly a source of authoritative information on specific mental disorders. Phone: 1.866.615.6464. TTY: 1.866.415.8051

NAMI | National Alliance on Mental Illness | NAMI is an excellent source of information and connection on mental illness, including the individual disorders mentioned in this fact sheet. NAMI's website and toll-free helpline are available in English and Spanish.

SAMHSA is the Substance Abuse & Mental Health Services Administration. It offers many resources to consumers, including:.

Detailed information on specific emotional disturbances, or related issues such as positive behavior supports, is also available from these sources:

Anxiety Disorders Association of America | https://adaa.org/

Center on Positive Behavioral Interventions and Supports | The PBIS Center provides research-based information on how to provide behavioral supports to children who need them. | https://www.pbis.org

Conduct Disorders | A soft place to land for battle-weary parents
https://www.conductdisorders.com/community/

Encyclopedia of Mental Disorders | http://www.minddisorders.com/index.html

National Eating Disorders Association
1.800.931.2237 | www.nationaleatingdisorders.org

Something Fishy | (eating disorders)
https://www.something-fishy.org

**Highly Rated Resource! This resource was reviewed by 3-member panels of Parent Center staff working independently from one another to rate the quality, relevance, and usefulness of CPIR resources. This resource was found to be of "High Quality, High Relevance, High Usefulness" to Parent Centers.
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References

2 | Code of Federal Regulations, Title 34, §300.8(c)(4)(i)

3 | Code of Federal Regulations, Title 34, §300.8(c)(4)(ii)

5 | Ibid.

7 | Ibid.

11 | Ibid.

13 | Ibid.

14 | American Academy of Adolescent and Child Psychiatry. (2013, August). Conduct disorder: Facts for families. Washington, DC: Author. Available online at:
http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Conduct_Disorder_33.aspx

15 | Ibid.

16 | Johns Hopkins Medicine Health Library. (n.d.). Conduct disorder in children. Baltimore, MD: Author. Online at:
https://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/conduct_disorder_90,P02560

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Links updated, November 2021 This information in Spanish The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years.

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Mental Health: Emotional or Behavioral Disorders

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Having a mental health challenge or a behavioral disorder is more common than most people imagine. In fact, children are diagnosed with mental health disorders at a rate of 6.8% and at an even higher rate in adolescence. It is likely that each of us has known someone with a mental health or behavioral challenge or had one ourselves. Mental health disorders don't discriminate based on age, race, gender, ethnicity, occupation, religion, economic class, or ethnic background. Misconceptions about mental health can contribute to the lack of funding and public support for effective treatment and supports for children and young adults.

Check Your Knowledge

1. True or False: A youth who has biological parents with a mental illness will also develop a mental illness.

Check Answer

False. Research has found that having a biological relative such as a parent, grandparent, or sibling with a mental illness is a risk factor; it does not determine whether someone will develop a mental illness. Other risk factors associated with developing a mental illness include having a chronic medical condition, experiencing abuse as a child, experiencing traumatic life situations, exposure to toxins such as alcohol during pregnancy, or misuse of substances including alcohol or drugs. Research demonstrates that protective factors can help to counteract these risk factors. Examples of protective factors include a good social support system, adequate food, safe shelter, financial security, good problem-solving skills, and access to positive recreational activities.

2. True or False: Children and teens can have a mental illness.

Check Answer

True. Childhood mental health disorder is a term used to explain all mental disorders that can be diagnosed and begin in childhood. Many adults who have a diagnosed psychiatric disorder experienced the onset of their symptoms in adolescence or childhood. Embarrassment, fear, peer pressure, lack of community support, and stigma can prevent or delay a person from getting help. Early intervention is important to managing and recovering from mental health challenges.

To learn more about children's mental health:

3. True or False: Children or youth with mental health challenges never get better.

Check Answer

False. With the right kind of medical care, many children and youth who experience mental health challenges can and do lead healthy, productive, and satisfying daily lives. While the illness may not go away, the symptoms or challenges can be managed with appropriate treatment and support. Many individuals benefit from supports and interventions that are evidence-based and guided by principles of self-determination, recovery, and cultural competency.

To learn more about leading healthy, productive, and satisfying daily lives:

4. True or False: All youth who misuse drugs or alcohol are choosing not to get their act together.

Check Answer

5. True or False: Schools have a responsibility to help children with mental health challenges.

Check Answer

True. Children are required to attend school. Public schools are required to provide education for all students, including those with disabilities. There are options for a child with mental health challenges who is having difficulty with school, including both informal and formal supports. An informal support could be attending a "friendship group" or having a "check-in" person. A formal support might include having a 504 Plan, or doing an evaluation for Special Education services. Some schools have school-wide initiatives to promote the mental health and wellness of all students. These might include positive behavior interventions and supports (PBIS), social-emotional learning (SEL) , school-linked mental health services, bullying prevention initiatives, trauma-informed care, and youth mental health crisis response services.

To learn more about supports in schools:

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Children's Mental Health and Emotional or Behavioral Disorders Project - Inspiring Opportunities

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Families of children with mental health, emotional and behavioral needs often navigate multiple systems to access necessary supports and services. Families may also face additional challenges due to stigma about mental health. PACER's Inspiring Opportunities Project will bring together parents, youth and professionals to help families receive the resources and support their children need.

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Test Anxiety in Elementary Students

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Dealing with Anxiety Everyday

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Sometimes anxiety is easy to identify - like when a child is feeling nervous before a test at school. Other times anxiety in the classroom can look like something else entirely - an upset stomach, disruptive or angry behavior, ADHD, or even a learning disorder.

There are many different kinds of anxiety, which is one of the reasons it can be hard to detect in the classroom. What they all have in common, says neurologist and former teacher Ken Schuster, PsyD, is that anxiety "tends to lock up the brain," making school hard for anxious kids.

Children can struggle with:

Separation anxiety: When children are worried about being separated from caregivers. These kids can have a hard time at school drop-offs and throughout the day.

Social anxiety: When children are excessively self-conscious, making it difficult for them to participate in class and socialize with peers.

Selective mutism: When children have a hard time speaking in some settings, like at school around the teacher.

Generalized anxiety: When children worry about a wide variety of everyday things. Kids with generalized anxiety often worry particularly about school performance and can struggle with perfectionism.

Obsessive-compulsive disorder: When children's minds are filled with unwanted and stressful thoughts. Kids with OCD try to alleviate their anxiety by performing compulsive rituals like counting or washing their hands.

Specific phobias: When children have an excessive and irrational fear of particular things, like being afraid of animals or storms.

Here are some tips for recognizing anxiety in kids at school, and what might be causing it.

Inattention and restlessness

When a child is squirming in his seat and not paying attention, we tend to think of ADHD, but anxiety could also be the cause. When kids are anxious in the classroom, they might have a hard time focusing on the lesson and ignoring the worried thoughts overtaking their brains. "Some kids might appear really 'on' at one point but then they can suddenly drift away, depending on what they're feeling anxious about," says Dr. Schuster. "That looks like inattention, and it is, but it's triggered by anxiety."

Attendance problems and clingy kids

It might look like truancy, but for kids for whom school is a big source of anxiety, refusing to go to school is also pretty common. School refusal rates tend to be higher after vacations or sick days, because kids have a harder time coming back after a few days away.

Going to school can also be a problem for kids who have trouble separating from their parents. Some amount of separation anxiety is normal, but when kids don't adjust to separation over time and their anxiety makes going to school difficult or even impossible, it becomes a real problem. Kids with separation anxiety may also feel compelled to use their phones throughout the day to check in with their parents.

Disruptive behavior

Acting out is another thing we might not associate with anxiety. But when a student is compulsively kicking the chair of the kid in front of him, or throws a tantrum whenever the schedule is ignored or a classmate isn't following the rules, anxiety may well be the cause. Similarly, kids who are feeling anxious might ask a lot of questions, including repetitive ones, because they are feeling worried and want reassurance.

Anxiety can also make kids aggressive. When children are feeling upset or threatened and don't know how to handle their feelings, their fight or flight response to protect themselves can kick in - and some kids are more likely to fight. They might attack another child or a teacher, throw things, or push over a desk because they're feeling out of control.

Trouble answering questions in class

Sometimes kids will do perfectly well on tests and homework, but when they're called on in class teachers hit a wall. There are several different reasons why this might happen.

"Back when I was teaching, I would notice that when I had to call on someone, or had to figure out who's turn it was to speak, it was like the anxious kid always tended to disappear," says Dr. Schuster. "The eager child is making eye contact, they're giving you some kind of physical presence in the room like 'Call on me, call on me!' " But when kids are anxious about answering questions in class, "they're going to break eye contact, they might look down, they might start writing something even though they're not really writing something. They're trying to break the connection with the teacher in order to avoid what's making them feel anxious."

If they do get called on, sometimes kids get so anxious that they freeze. They might have been paying attention to the lesson and they might even know the answer, but when they're called on their anxiety level becomes so heightened that they can't respond.

Frequent trips to the nurse

Anxiety can manifest in physical complaints, too. If a student is having unexplained headaches, nausea, stomachaches, or even vomiting, those could be symptoms of anxiety. So can a racing heart, sweaty palms, tense muscles, and being out of breath.

Problems in certain subjects

When a child starts doubting her abilities in a subject, anxiety can become a factor that gets in the way of her learning or showing what she knows. Sometimes this can be mistaken for a learning disorder when it's really just anxiety.

However anxiety can also go hand in hand with learning disorders. When kids start noticing that something is harder for them than the other kids, and that they are falling behind, they can understandably get anxious. The period before a learning disorder is diagnosed can be particularly stressful for kids.

Not turning in homework

When a student doesn't turn in her homework, it could be because she didn't do it, but it could also be because she is worried that it isn't good enough. Likewise, anxiety can lead to second guessing - an anxious child might erase his work over and over until there's a hole in the paper - and spending so much time on something that it never gets finished. We tend to think of perfectionism as a good thing, but when children are overly self-critical it can sabotage even the things they are trying their hardest at, like school work.

You might also notice that some anxious kids will start worrying about tests much earlier than their classmates and may begin dreading certain assignments, subjects, or even school itself.

Avoiding socializing or group work

Some kids will avoid or even refuse to participate in the things that make them anxious. This includes obvious anxiety triggers like giving presentations, but also things like gym class, eating in the cafeteria, and doing group work.

When kids start skipping things it might look to their teachers and peers like they are uninterested or underachieving, but the opposite might be true. Sometimes kids avoid things because they are afraid of making a mistake or being judged.

Dr. Schuster notes that when kids get anxious in social situations, sometimes they have a much easier time showing what they know when teachers engage them one-to-one, away from the group.

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How Does Anxiety Affect Kids in School? - Child Mind Institute

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Sometimes school anxiety is easy to identify - like when a child is feeling nervous before a test at school. Other times anxiety in the classroom can look like something else entirely - an upset stomach, disruptive or angry behavior, ADHD, or even a learning disorder.

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National Eating Disorders Association

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Healthy Teen Eating Project

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List of Resources on Eating Disorders: Organizations for Local, National, Parents & Professional; Websites; Books for Parents and Families & Professionals

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Texas First Project-Protections and Resources available to students

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en Español * Share *

Texas Education Agency and Statewide Leadership Projects related to Behavior & Emotional or Mental Health Issues:

Texas Behavior Support Network (Region 4 ESC) - The goal of the Texas Behavior Support (TBS) Network is to create a system of Positive Behavioral Interventions and Support (PBIS) for students with disabilities and all students attending Texas public schools. Here you can find PBIS resources and training materials (including good information on Functional Behavior Assessments) and information about their annual Texas Behavior Support Conference.

Texas Behavior Support Initiative (Region 4 ESC) - The Texas Behavior Support Initiative (TBSI) is a state-level training mandated by Senate Bill 1196 and the Texas Administrative Code §89.1053. The TBSI training is designed to provide foundational knowledge for the use of positive behavior interventions and supports for all students, including those with disabilities. This web page links to online training and handouts on interventions, restraints and time-out.

TBIS and Mental Health (Region 4 ESC) - Advancing Education Effectiveness: Interconnecting School Mental Health and School-Wide Positive Behavior Support (pdf)

Texas Statewide Leadership for Autism Training (Region 13 ESC) - This website has free online training related to Emotional and Behavioral Evaluations, as well as fact sheets in the TARGET Manual related to Functional Behavior Assessment and Positive Behavior Supports.

Texas Education Agency School Health - Students with Special Health Needs - In accordance with HB 1322 passed by the 81st Legislative Session in 2009, TEA added fact sheets to its website on specific disabilities. Fact sheets (in pdf format) offer an overview of the disorder, symptoms or behaviors associated with the disorder, educational implications, and instructional strategies and classrooms accommodations that might be provided.

The Legal Framework for the Child Centered Special Education Process (Region 18 ESC) - Emotional Disturbance

Texas Collaborative for Emotional Development in Schools (Region 4 ESC) - TXCEDS was created to develop guiding policy that promotes the well-being and mental health of children in Texas schools through the development of integrated and comprehensive support programs and services. The site offers video and a toolkit with a step by step process to develop a successful model of delivery of social, emotional and behavioral interventions and supports.

TEA - Guidance on Restraint and Time-Out

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Association for Positive Behavior Support - Links to Positive Behavior Support resources for families, including examples of PBS plans, PBS Practices fact sheets, research-based case study summaries, and articles about parenting and behavior.

Behavior Analyst Certification Board - Find out what is involved in becoming a board certified behavior analyst (BCBA) and locate a certified provider.

Center for Parent Information and Resources - See Behavior Assessments, Plans and Positive Supports and Behavior at School.

Center for Social and Emotional Foundations for Early Learning - This website is focused on promoting the social emotional development and school readiness of young children birth to age 5. There are FREE training modules for parents, tip sheets, scripted stories for social situations, videos and tools for developing behavior support plans. They also have short training packages based on the What Works Briefs topics that include PowerPoints, notes pages, activities and handouts.

Collaborative for Academic and Social Emotional Learning - CASEL was founded in 1994 by Daniel Goleman, the author of Emotional Intelligence, to advance the science and evidence-based practice of social and emotional learning.

Depression and Bipolar Support Alliance - DBSA offers information about mood disorders, support groups and their various chapters. The site also offers advocacy advice and confidential screenings as well as a way to join the DBSA e-mail list. Also available in Spanish.

Disability Rights Texas - Has a resource titled " Your Rights, Your Voice: A Guide to Mental Health Concerns Transitioning to Adulthood " to help transition age youth learn about their rights and provide tools to help them transition successfully to adult life. Also one of their priority areas focuses on ensuring students with disabilities are not wrongly disciplined, and that students in alternate settings receive a free appropriate public education.

Florida Mental Health Institute - Recognized as Florida's premier research and training center for behavioral health services and a recognized national leader dedicated to improve the lives of people with mental, addictive, and developmental disorders through research, training, and education.

Gentle Teaching - This site discusses the "Gentle Teaching" instructional strategy - "a non-violent approach for helping people with special needs and sometimes challenging behaviors..." It includes a web link to the Gentle Teaching International home page.

IDEAS That Work! - Families: Social, Emotional, and Behavioral Skills

Supporting Student Behavior

Partnering with Schools

Secondary Transition

LEAPS - FREE downloadableFamily Talk Activities designed to help families talk about important social and emotional behaviors.

Mental Health America - This website includes mental health information, news releases, advocacy information, free publications and more. Many articles are also available in Spanish.

Mental Health Texas - Texas Health & Human Services website promoting mental health awareness in Texas.

National Alliance on Mental Illness (NAMI) - This grassroots mental health organization is dedicated to improving the lives of persons living with serious mental illness and their families. Their site includes advocacy information, support groups, mental health information and resources.

National Association of School Psychologists - The website of the National Association of School Psychologists. It includes their position papers on a number of educational, behavioral, and assessment issues.

National Institute of Mental Health - Look under Health & Education for topics and resources related to Child and Adolescent Mental Health.

OSEP Technical Assistance Center on Positive Behavioral Intervention and Support (PBIS) - This is the home page for the OSEP Technical Assistance Center on Positive Behavioral Intervention and Support (PBIS). The purpose of PBIS is to give schools information and technical assistance to identify, adapt, and sustain positive behavioral interventions and supports school-wide. Resources include:

Pacer Center Resources - My Child's Social or Emotional Needs at School

Substance Abuse and Mental Health Services Administration (SAMHSA) - This National Mental Health Information Center site includes resources such as mental health FAQs, a mental health dictionary, free booklets on children's mental health and anxiety management, grant projects, and a Behavioral Health Treatment Facility Locator. Also available in Spanish.

School Mental Health.org - This site offers school mental health resources not only for clinicians, but also for educators, administrators, parents/caregivers, families, and students.

Search Institute - Website offers research based information on what kids need to succeed. Their listing of Developmental Assets offers the basic building blocks of positive development to help children grow up to become caring, responsible adults.

Technical Assistance Center on Social Emotional Intervention of Young Children - TACSEI takes the research that shows which practices improve the social-emotional outcomes for young children with, or at risk for, delays or disabilities and creates FREE products and resources to help decision-makers, caregivers, and service providers apply these best practices in the work they do every day.

Texas Appleseed - Finding Help When You're in Trouble with the Law:A Handbook for persons with Mental Illness and their Families / Encontrando Ayuda Cuando Usted Está En Problemas Con La Ley: Un Manual para Personas Con Enfermedades Mentales y Sus Familias

Texas Health & Human Services - Information on where to get Mental Health and Substance Abuse services in Texas. See also:

UCLA - Center for Mental Health in Schools - Offers online training and presentation resources for mental health in schools. Click on the "First Time" link and scroll down.

Wrightslaw - When Schools Have Children Arrested for School-Related Behavior Problems by Pete Wright, Esq.
Please submit any Links you feel would be appropriate using the SHARE YOUR SITES link.

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en Español * Share * Texas Education Agency and Statewide Leadership Projects related to Behavior & Emotional or Mental Health Issues: Texas Behavior Support Network (Region 4 ESC) - The goal of the Texas Behavior Support (TBS) Network is to create a system of Positive Behavioral Interventions and Support (PBIS) for students with disabilities and all students attending Texas public schools.

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Advent Health-Local Resource for Treatment

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Compassionate Behavioral Health Care Now

Hope for Tomorrow

Broken bones and flu symptoms are easy to see and diagnose. But mental and emotional pain doesn't show up on X-rays or in lab tests. Yet, these often hurt more and also require special care. If you're experiencing any lingering uncertainty, anxiety, or sadness, come to us. At AdventHealth, formerly Metroplex Health System, we offer compassionate, individualized behavioral health services. We offer treatments for depression, mood disorders, anxiety, addiction, trauma, and a range of other conditions with in-patient and outpatient options to suit your needs and find you healing. We're here with open arms and listening ears, ready to help empower and guide you back to feeling hopeful and secure.

We're here to help you find the right physician or a location that's convenient for you.

In your journey to a healthier, more fulfilling life, the road map is not always clear. We're here to help you find your path. Our multidisciplinary team helps you find the right medical support, community resources, and spiritual care you need to find - and take - the next step. Let us help guide you, support you, and cheer you on as you reclaim your whole health.

In the journey to better behavioral health, the path is not always clear. We're here to help you take the next step in your care. Our multidisciplinary team helps you find the right medical support, local resources, and spiritual care you need to feel more confident and more in control. Let us help guide and support you as you enjoy a better quality of life, more-compassionate support, and a higher level of expert care.

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Find hope and healing with behavioral health services from AdventHealth, formerly Metroplex Health System

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Find hope for healing. Learn how the compassionate inpatient and outpatient behavioral health care at AdventHealth, formerly Metroplex Health System, can help children, adolescents, and adults reclaim their joy. We offer treatments for depression, mood disorders, anxiety, addiction, trauma, and a range of other behavioral health conditions.

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Local Resource for Inpatient Care

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Cedar Crest, A Behavioral Healthcare System

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Learn about what makes our inpatient program for children unique

At Cedar Crest Hospital & Residential Treatment Center, located in Belton, Texas, our inpatient children's treatment program has been specifically designed to meet the needs of children ages 5 to 12. We understand that childhood is a time of much transition, growth, and sometimes, turmoil. Children today face a number of challenges and pressures and even young children may feel emotions that may overwhelm and cripple their emotional growth. Cedar Crest offers free, confidential assessments performed by a licensed clinician 24 hours a day, 7 days a week. If you believe your child is struggling with a mental health disorder and could benefit from our treatment program, please give us a call.

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Inpatient Program for Children | Belton, TX | Cedar Crest Hospital

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At Cedar Crest Hospital & Residential Treatment Center, located in Belton, Texas, our inpatient children's treatment program has been specifically designed to meet the needs of children ages 5 to 12. We understand that childhood is a time of much transition, growth, and sometimes, turmoil.

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Strategies for Educators

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School Counselors and Disruptive Behavior Disorders

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Interventions

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Disruptive Behavior Disorders

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Having ADHD along with a coexisting disruptive behavior disorder (ODD/CD) can complicate diagnosis and treatment and also worsen the prognosis. Even though many children with ADHD ultimately adjust, some (especially those with an associated conduct or oppositional defiant disorder) are more likely to drop out of school, have fewer years of overall education, have less job satisfaction and fare less well as adults. Early diagnosis and treatment of these conditions is by far the best defense against these poorer outcomes.

What are the types of disruptive behavior disorders?

Disruptive behavior disorders include two similar disorders: oppositional defiant disorder (ODD) and conduct disorder (CD). Common symptoms occurring in children with these disorders include: defiance of authority figures, angry outbursts, and other antisocial behaviors such as lying and stealing. It is felt that the difference between oppositional defiant disorder and conduct disorder is in the severity of symptoms and that they may lie on a continuum often with a developmental progression from ODD to CD with increasing age.

Oppositional defiant disorder (ODD) refers to a recurrent pattern of negative, defiant, disobedient and hostile behavior toward authority figures lasting at least six months. To be diagnosed with ODD four (or more) of the following symptoms must be present:

often loses temper

often argues with adults

often actively defies or refuses to comply with adults' requests or rules

often deliberately annoys people

often blames others for his or her mistakes or misbehavior

is often touchy or easily annoyed by others

is often angry and resentful

is often spiteful or vindictive.

These behaviors must be exhibited more frequently than in other children of the same age and must cause significant impairment in social, academic or occupational functioning to warrant the diagnosis.

Conduct disorder (CD) involves more serious behaviors including aggression toward people or animals, destruction of property, lying, stealing and skipping school. The behaviors associated with CD are often described as delinquency. Children exhibiting these behaviors should receive a comprehensive evaluation.

Children and adolescents with ADHD and CD often have more difficult lives and poorer outcomes than children with ADHD alone.
Incidence of ADHD and ODD or CD
Approximately one-third to one-half of all children with ADHD may have coexisting oppositional defiant disorder (ODD). These children are often disobedient and have outbursts of temper. The rate of children meeting full diagnostic criteria for ODD is similar across all ages. Males have a greater incidence of ADHD and ODD, as do children of divorced parents and mothers with low socioeconomic status. Children with the ADHD combined subtype seem to be more likely to have ODD.

In some cases, children with ADHD may eventually develop conduct disorder (CD), a more serious pattern of antisocial behaviors. Conduct disorder may occur in 25 percent of children and 45 percent of adolescents with ADHD. CD is more commonly seen in boys than girls, and increases in prevalence with age. Children with ADHD who also meet diagnostic criteria for CD are twice as likely to have difficulty reading, and are at greater risk for social and emotional problems. Non-aggressive conduct problems increase with age, while aggressive symptoms become less common.

Given the high co-occurrence of ADHD with disruptive behavior disorders, all children with ADHD symptoms and disruptive behaviors need to be assessed for the possibility that ODD or CD may be present in addition to ADHD.
Risks of having ADHD and a disruptive behavior disorder
Children with ADHD and CD are often at higher risk for contact with the police and the court system than children with ADHD alone. These children frequently lie or steal and tend to disregard the welfare of others. In addition, they risk getting into serious trouble at school or with the police. The risk for legal troubles may be mostly attributable to the symptoms of CD rather than ADHD.

Disruptive behavior disorders and untreated ADHD have been found to lead to an increased risk of substance use disorders. In addition, adolescents with disruptive behaviors disorders and ADHD are more likely to be aggressive and hostile in their interactions with others, and to be arrested. It has also been suggested that the greater impulsivity associated with the ADHD may cause greater antisocial behavior and its consequences. Thus, early recognition and treatment of both the ADHD and disruptive behaviors in children is essential.
Treatment of ADHD and Disruptive Behavior Disorders
All children with symptoms of ADHD and ODD/CD need to be assessed so that both types of problem behaviors can be treated. These children are difficult to live with and parents need to understand that they do not need to deal with their ADHD and ODD/CD child alone. Interventions such as parent training at home and behavioral support in the school can make a difference and parents should not hesitate to ask for assistance.

Home Interventions

Parent Training (PT): Parent training has been shown to be effective for treating oppositional and defiant behaviors. Standardized parent training programs are short-term interventions that teach parents specialized strategies including positive attending, ignoring, the effective use of rewards and punishments, token economies, and time out to address clinically significant behavior problems. Such training programs may include periodic booster sessions.

Severe cases of CD may require multisystemic therapy, an intensive family- and community-based treatment that addresses the multiple causes of serious antisocial behavior in youth. This approach is very comprehensive and demanding. The therapist using such an approach must possess access to developmental and clinical expertise. These intervention services are delivered in a variety of settings, such as home, school and peer groups. Academic and school-based problems are included and some therapists work directly with an entire peer group to influence change.

Parent-child interaction therapy is a treatment that teaches parents to strengthen the relationship with their child and to learn behavior management techniques. It has been found to be effective in the long term for young children with ODD and ADHD. Three to six years after treatment, the mothers of children with these disorders reported that the changes in their children's behavior and their own feelings of control had lasted. Mothers' reports of disruptive behavior decreased with time after treatment.

Collaborative Problem Solving (CPS): Another technique that seems to be promising for children with ADHD and ODD is collaborative problem-solving (CPS). CPS is a treatment that teaches difficult children and adolescents how to handle frustration and learn to be more flexible and adaptable. Parents and children learn to brainstorm for possible solutions, negotiate, make decisions, and implement solutions that are acceptable to both. They learn to resolve disagreements with less conflict.

Family Therapy: Often a child's behavior can have an effect on the whole family. Parents of children with ADHD often report marital difficulties. Mothers may be more depressed and siblings may also develop behavior problems. Family therapy is critical to helping a family address these issues and cope with the realities of having a child with ADHD and disruptive behaviors. Seeking out a counselor or family therapist in your neighborhood can help the entire family address these issues.

School Interventions

School-wide Positive Behavioral Supports: In addition to the environment at home, the school can have a significant impact on a child's behavior patterns. Many school systems now have programs in place to provide school-wide positive behavioral supports. The aim of these programs is to foster both successful social behavior and academic gains for all students. These programs consist of: (1) clear, consistent consequences for inappropriate behaviors; (2) positive contingencies for appropriate behaviors; and (3) team-based services for those students with the more extreme behavioral needs.

Tutoring: Children's ADHD symptoms, as well as oppositional symptoms, have been found to be significantly lower in one-on-one tutoring sessions than in the classroom.

Classroom Management: Providing appropriate instructional supports in the classroom can also lessen disruptive behavior. These include: creating an accepting and supportive classroom climate, promoting social and emotional skills, establishing clear rules and procedures, monitoring child behavior, utilizing rewards effectively, responding to mild problem behaviors consistently and effectively managing anger or aggressive behavior.
Medication
Overall results from several clinical studies indicate that medications used for the treatment of ADHD (stimulants as well as non-stimulants) remain an important component in the treatment of ADHD and coexisting ODD/CD. Children with these disorders treated with these medications were not only more attentive, but less antisocial and aggressive. ADHD medications are often effective treatments for aggressive or antisocial behavior in patients with ADHD and certainly play a role in any treatment program. See Managing Medication for Children with ADHD for more information.

In addition to using stimulant medications alone, medication combinations to reduce behavioral and conduct symptoms associated with attention-deficit/hyperactivity disorder appear to be very effective. In several studies, this treatment combination was reported to be well tolerated and unwanted effects were transient.

What can a parent do?

To increase the chance for a successful future and to discourage delinquent behaviors in children with ADHD, diagnosis and intervention is extremely important. It is essential for parents to provide structure and reinforce appropriate behavior. In addition, a positive behavior management plan to lessen anti-social behavior is important. Parents should discuss their child's behavioral symptoms with the pediatrician or family practitioner and seek a referral to a mental health professional who can suggest effective parenting strategies.

In addition, parents should contact their child's school counselor or school psychologist to discuss possible interventions to improve behaviors at school. Having the counselor or psychologist support the teacher in handling classroom behaviors often results in significant behavioral changes and decreases the incidence of expulsion. Consistent behavior management at home, school and elsewhere needs to be enforced.
For more information and further reading
Barkley, Russell. (1998). Your defiant child: 8 steps to better behavior . New York, NY: Guilford Press. This book is divided into two parts, "Getting to Know Your Defiant Child" and "Getting Along with Your Defiant Child." Part two contains an eight-step parenting program built on consistency.

Clark, Lynn. (1996) SOS! Help for parents . Berkeley, CA: Parents Press. This book helps parents learn methods for helping children to improve their behavior and techniques for aiding a variety of child personalities, from the stubborn and willful child to time-out basics. It focuses on the basic skills of time-out and how parents can use these techniques to further a child's behavior modification.

Forgatch, Marion S. and Gerald R. Patterson. (2005) Parents and adolescents living together: Family problem solving. Champaign, IL: Research Press. This book shows parents how to improve their communication and problem-solving skills, hold family meetings and get the whole family involved in solving problems. It explains how parents can teach their teenaged children to be responsible about schoolwork, sexual behavior and drugs and alcohol.

Goldstein, Sam; Robert Brooks and Sharon K. Weiss. (2004) Angry children, worried parents: Seven steps to help families manage anger . Plantation, FL: Specialty Press. This book helps parents cope with anger in their children. It presents the following seven steps to help children learn to manage anger: (1) understand why children become angry; (2) determine when your child needs help; (3) help the child become an active participant in the process; (4) use strategies to manage and express anger; (5) develop and implement a daily management plan; (6) assess and solve problems; and (7) instill a resilient mindset in the child.

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ADHD and Disruptive Behavior Disorders - CHADD

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Having ADHD along with a coexisting disruptive behavior disorder (ODD/CD) can complicate diagnosis and treatment and also worsen the prognosis. Even though many children with ADHD ultimately adjust, some (especially those with an associated conduct or oppositional defiant disorder) are more likely to drop out of school, have fewer years of overall education, have less...

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American Academy of Child and Adolescent Psychiatry

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The mission of AACAP is to promote the healthy development of children, adolescents, and families through advocacy, education, and research, and to meet the professional needs of child and adolescent psychiatrists throughout their careers.

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International OCD Foundation

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From training and educational opportunities to networking, the IOCDF has much to offer the mental health professional community. Our professional and institutional members form a strong community of knowledgeable providers and researchers who are working to improve the lives of those affected by OCD across the US, and around the world.

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Parent Resource

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School Counselor and OCD

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Teachers Guide to OCD

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For Educators Mental Health

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Educators are often the first to notice mental health problems in children and young adults. Here are some ways you can help your students and their families.

What Educators Should Know

You should know:

What Educators Should Look for in Student Behavior

Consult with a school counselor, nurse, or administrator and the student's parents if you observe one or more of the following behaviors:

Feeling very sad or withdrawn for more than two weeks

Seriously trying to harm oneself, or making plans to do so

Sudden overwhelming fear for no reason, sometimes with a racing heart or fast breathing

Involvement in many fights or desire to badly hurt others

Severe out-of-control behavior that can hurt oneself or others

Not eating, throwing up, or using laxatives to make oneself lose weight

Intense worries or fears that get in the way of daily activities

Extreme difficulty concentrating or staying still that puts the student in physical danger or causes problems in the classroom

Repeated use of drugs or alcohol

Severe mood swings that cause problems in relationships

Drastic changes in the student's behavior or personality

What Educators Can Do in Classrooms and Schools

You can support the mental health of all students in your classroom and school, not just individual students who may exhibit behavioral issues. Consider the following actions:

Learn more about mental health by taking a mental health awareness training

Promote social and emotional competency and build resilience

Help ensure a positive, safe school environment

Teach and reinforce positive behaviors and decision-making

Encourage helping others

Encourage good physical health

Help ensure access to school-based mental health supports

Developing Effective School Mental Health Programs

Efforts to care for the emotional well-being of children and youth can extend beyond the classroom and into the entire school. School-based mental health programs can focus on promoting mental wellness, preventing mental health problems, and providing treatment.

Effective programs:

Promote the healthy social and emotional development of all children and youth

Recognize when young people are at risk for, or are experiencing, mental health problems

Identify how to intervene early and appropriately when there are problems

Learn More about Ways to Support Your Students and Their Families

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Educators are often the first to notice mental health problems in children and young adults. Here are some ways you can help your students and their families.

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Mental Health Efforts

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Teen Mental Health

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S chizophrenia is a psychotic disorder that often begins in late adolescence or early adulthood. It is an illness of the brain that affects how a person perceives the world, thinks, and behaves. Many people confuse psychosis with violence but they are not the same thing. In fact, people with psychotic disorders like Schizophrenia are much more likely to be the victim of a crime than to commit one. Psychosis means "to break from reality," and that's exactly what Schizophrenia is - a mental disorder that causes the individual to have difficulty distinguishing what is real from what is not. Although Schizophrenia is a psychotic illness, psychosis can also occur in other mental disorders, such as: Bipolar Disorder, Depression, or as a result of drug ingestion or Substance Use Disorder.

Individuals with Schizophrenia experience these two categories of symptoms, plus many others. These categories are symptoms based on problems with cognition (delusions) and problems with perceptions (hallucinations):

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S chizophrenia is a psychotic disorder that often begins in late adolescence or early adulthood. It is an illness of the brain that affects how a person perceives the world, thinks, and behaves. Many people confuse psychosis with violence but they are not the same thing.

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Code of Ethics and Referrals

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School Counselors and Referrals

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Texas Education Agency

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School Guidance and Counseling, which is an interactive component of Coordinated School Health (outside source), is implemented by professional school counselors to reduce dropout rates, improve academic performance, and increase participation in postsecondary education.

Texas School Counselor Certificate

The certification requirements to be a school counselor are described in the Texas Education Code and the Texas Administrative Code (outside source).

You can view general information on Texas teacher and counselor certification requirements.

The Texas Model for Comprehensive School Counseling Programs (5th Edition)

The Texas Model for Comprehensive School Counseling Programs is a revision and expansion of the 2004 Pre-K-12th Grade Development Guide: A Model Comprehensive, Developmental Guidance and Counseling Program for Texas Public Schools. The revision was completed by the Texas Counseling Association (TCA) in collaboration with the Texas Education Agency (TEA). As in the 2004 guide, the Texas Model is based on the statutory description of Texas school counseling programs and school counselor responsibilities (Texas Education Code [TEC] §§33.005-33.007). The Texas Model is further expanded to address changes to statute related to school counseling since 2004.

The Texas Model for Comprehensive School Counseling Programs (5th Edition) (PDF, 9035KB)

Resources

The following resources provide additional information about school guidance and counseling:
Counseling Resources Frequently Asked Questions

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School Guidance and Counseling, which is an interactive component of Coordinated School Health (outside source), is implemented by professional school counselors to reduce dropout rates, improve academic performance, and increase participation in postsecondary education. The certification requirements to be a school counselor are described in the Texas Education Code and the Texas Administrative Code (outside source).

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Safe Schools

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School Counselors

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Comprehensive Counseling Program

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Graphic of Emotional and Behavioral Disorder

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Implications for Professional School Counselors

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Collaboration with Stakeholders

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Coping with Student Anxiety

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"My heart is pounding. I feel like I can't breathe. My stomachs hurts. I don't want to be here at school. I know I shouldn't be worried about it, but I

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Mindfulness Techniques

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Helping Students Understand and Manage Anxiety through a School C

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Role of the School Counselor

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Educator Toolkit

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Cause for Concern

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Students with Depression

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Bipolar Disorder

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School Counselors and Strategies for ADHD

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Strategies for ADHD: How Counselors Help Today's Students Succeed

More than 6 million children between the ages of 4 and 17 had been diagnosed with attention deficit hyperactivity disorder (ADHD) as of 2011, according to the Centers for Disease Control and Prevention External link . It's a complicated disorder with a long history. In order to cope with the symptoms, children with ADHD need continuous support from parents, teachers, and school counselors. School counselors are especially poised to serve as a key intermediary between parents and teachers and can be essential in helping students with ADHD thrive.
The Difference Between ADD and ADHD

The term "attention deficit disorder" was first coined in 1980 when the Diagnostic and Statistical Manual (DSM) - the industry standard publication for psychiatric diagnoses - published its third edition. Since then, "ADD" and "ADHD" have become relatively ubiquitous in American vocabularies, yet they do not exist simultaneously. In fact, they are mutually exclusive terms.

As research poured in in the 1980s and 1990s, the DSM adjusted the nomenclature to reflect new findings. Specifically, "attention deficit hyperactivity disorder" was introduced in the 1987 edition and appeared again in 1994, this time with three subtypes: predominantly inattentive subtype, predominantly hyperactive/impulsive subtype, and combined subtype. With the DSM 5, these have been re-termed as "presentations" (i.e., predominantly inattentive presentation, predominantly hyperactive/impulsive presentation, and combined presentation) owing to the research suggesting that children can have different presentations over time. The Attention Deficit Disorder Association External link has a helpful fact sheet with more details on the evolution of ADHD's nomenclature and its subtypes on its website.

Ultimately, while many use the terms "ADD" and "ADHD" interchangeably, the latter is technically the correct, up-to-date term External link .

Symptoms of ADHD

According to the Mayo Clinic External link , symptoms of ADHD often appear in early childhood, with diagnoses typically occurring before age 12. Typical symptoms of ADHD include fidgeting, excessive daydreaming, continual forgetfulness or losing things, taking needless risks, talking too much, limited self-control, misreading social cues and struggles with social interactions such as taking turns or getting along with others

Some may think, "Don't most children experience these 'symptoms' at one point or another during childhood?" - and they'd be right. The difference for children with ADHD is that these behaviors never subside and often worsen over time, and must result in impairment in key domains of functioning (e.g., social, familial, and academic), and often co-occur in two or more settings. Ultimately, ADHD is chronic for many affected children, impeding their social and academic lives well beyond their childhood and adolescence. According to the nonprofit Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) External link , "more than 75% of children with ADHD continue to experience significant symptoms in adulthood." As such, school counselors and educators have an opportunity to support children and teens with ADHD to develop effective techniques to manage their symptoms in school, and maintain them into adulthood.

More than 75% of children with ADHD continue to experience significant symptoms in adulthood.

Helping Students with ADHD

Children with ADHD can have a particularly hard time managing their symptoms in school environments. For example, experiencing difficulty sitting still during class, having trouble waiting for a turn during an activity or conversation, or being unable to play quietly and independently are not only disruptive behaviors, they also interfere with a student's social, emotional, and academic development and functioning.

With up to roughly 11 percent of children External link ages 4 to 17 diagnosed with ADHD, school counselors serve as an important support system for children with ADHD and their families, as well as an essential resource for teachers and other professionals who work with students in and outside of the classroom. Because ADHD manifests itself in many different ways (most children are diagnosed with a combined form of ADHD External link ), counselors should be equipped with several strategies to address the many ways symptoms may occur in students.

With up to roughly 11 percent of children External link ages 4 to 17 diagnosed with ADHD, school counselors serve as an important support system

Before jumping into strategies and suggestions, it's critical to understand what skills, specifically, students coping with ADHD need help developing. "Children need to learn to develop impulse control and time management skills, as well as the ability to focus or concentrate on an undesired task," said Rebecca Newman, an early childhood mental health consultant for the Child Center of NY External link . If the development of these skills is ignored, "they may experience continual frustration, fatigue, poor self-esteem, or embarrassment," she said.

A big part of successfully managing ADHD symptoms is providing structure. The National Institute for Mental Health says External link that keeping the same routine every day and addressing any changes (such as school assemblies or field trips) as far in advance as possible is imperative. Helping students stay organized is another way to provide structure while keeping them on track with demands and expectations from homework, clubs, and sports.

Strategies for School Counselors

Evidence-based interventions (EBIs) are a primary way school counselors can provide support to students coping with ADHD. EBIs are an important part of managing ADHD symptoms, and usually occur outside of where a change in behavior is needed, such as a classroom.

Anil Chacko External link , a professor for Counseling@NYU's online master's in school counseling program, said there are specific strategies that school counselors can implement when working with students who have ADHD.

"School counselors should utilize methods that support students' time management, planning, and organization," Chacko said, citing the work of Joshua Langberg External link at VCU and Howard Abikoff External link at NYU's School of Medicine - both leaders in ADHD research for children and adolescents. "I would also encourage school counselors to work directly with parents to create a school-home note system to support cross-setting changes."

Research as recent as 2016 found that with early intervention for behavioral therapy External link , children who received behavioral therapy first before other interventions (such as medication) received "four fewer rules violations an hour at school than the medication-first group." This is not to say medical treatments should be dismissed, as they have proven benefits for helping children as well, but rather demonstrates the importance of a school counselor's role in encouraging behavior modification. This form of therapy is also cost-effective, as the reports found behavior-first therapy cost roughly $700 less per year compared to medication-first treatment. The CDC agrees both behavioral therapy and medication External link are important for treatment moving forward.

These intervention techniques can be implemented at any point in a student's academic career; it's equally applicable for elementary students as it is for high schoolers. What's more, social and emotional learning is increasingly appearing External link in schoolwide curricula, which can further support a student coping with ADHD in a formal classroom setting, as well.

Strategies for Teachers

In addition to EBIs, school counselors can train teachers to support children coping with ADHD in the classroom. It can be as simple as suggesting that teachers implement point- or token-based systems in class to reward good behavior, or as robust as dedicating a day of in-service training to identify symptoms and provide additional intervention strategies.

As for some immediate tips, for students who are easily distracted (predominantly inattentive), the National Resource Center (NRC) on ADHD External link suggests:

Seating the student near the teacher's desk or away from distractions like windows or the corridor.

Splitting longer assignments into smaller segments, and providing more breaks during class time.

For students who squirm and fidget often (predominantly hyperactive/impulsive), the NRC recommends:

Seating students in an area where there will be the least disruption, such as along the side of the classroom.

Creating opportunities for movement throughout the day, such as completing assignments sitting on the floor or helping with class activities (e.g., handing out activity sheets).

Newman adds that using "first/then" statements - such as "First push your chair in, then come sit for story time" - with children, and directing them to assist during class time will help them both refocus their energy and also feel valuable. A general best practice is for school counselors, teachers, and parents to offer praise and reward when children coping with ADHD exhibit good behavior.

The NRC has additional resources for teachers on supporting students with ADHD for reading External link , writing External link , and math External link accommodations, and general classroom instruction External link .

Strategies for Parents

ADHD is a relatively well-known mental disorder and is subsequently stigmatized - discussions of ADHD as a "fake" disorder on mainstream news sites External link don't help, either. As such, ADHD is oversimplified or even appropriated with things like "AD/HD" T-shirts and an endless meme stream across the internet. Beyond the web, stigmas of ADHD are found in television. Season 2 of Netflix's wildly successful Unbreakable Kimmy Schmidt references an ADHD medication, Dyziplen, that transforms rambunctious kids into slow-moving, deadpan pseudo-robots.

A big part of empowering children to manage their ADHD is providing them with interventions, therapies, medications, and lots of support from adults in all aspects of their life. But when it comes to stigma, speaking up in defense of your child is a great way to fight it, just as this parent did External link in reaction to the Kimmy Schmidt episode last year.

When it comes to stigma, speaking up in defense of your child is a great way to fight it.

While misconceptions of ADHD are seemingly omnipresent, there are many strategies parents can use for helping their child with ADHD at home:

Additionally, Chacko encourages parents to learn more about available behavior parent training programs - arguably the most well-studied and effective "therapy" for children with ADHD and related oppositional problems.

"It's important to remember that many students with ADHD also have a learning disability or learning issues," Chacko said. "School counselors, teachers and parents should appreciate that the challenges these children face may be more than just 'ADHD.' "

As with many misunderstood mental disorders, the best way to change the conversation is through an amplified voice. In terms of supporting parents, school counselors can educate them on support groups External link , online forums External link , and through websites like CHADD External link .
Republished with permission: Counseling@NYU, the online masters in school counseling program from NYU Steinhardt.

Fine Print

ADD and ADHD are used interchangeably for Attention-Deficit/Hyperactivity Disorder.

Any information or suggestions in this article are solely the opinion of the author(s) and should not replace the advice of appropriate medical, legal, therapeutic, financial or other professionals. We do not test or endorse any product, link, author, individual or service listed within.

© 2006 - 2017, by The ADD Resource Center. All Rights Reserved.

To view HUNDREDS of articles and videos on ADD/ADHD, go to addrc.org

Posted on Category:Tagged with:
Categories School Issues
Tags ADD, ADHD, counseling, Education, school, Students

More than 6 million children between the ages of 4 and 17 had been diagnosed with attention deficit hyperactivity disorder (ADHD) as of 2011, according to the Centers for Disease Control and Prevention External link . It's a complicated disorder with a long history. In order to cope with the symptoms, children with ADHD need continuous support from parents, teachers, and school counselors. School counselors are especially poised to serve as a key intermediary between parents and teachers and can be essential in helping students with ADHD thrive.
More than 75% of children with ADHD continue to experience significant symptoms in adulthood.

With up to roughly 11 percent of children External link ages 4 to 17 diagnosed with ADHD, school counselors serve as an important support system

Seating the student near the teacher's desk or away from distractions like windows or the corridor.

Splitting longer assignments into smaller segments, and providing more breaks during class time.

Seating students in an area where there will be the least disruption, such as along the side of the classroom.

Creating opportunities for movement throughout the day, such as completing assignments sitting on the floor or helping with class activities (e.g., handing out activity sheets).

When it comes to stigma, speaking up in defense of your child is a great way to fight it.

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Strategies for ADHD: How Counselors Help Today's Students Succeed

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Strategies for ADHD: How Counselors Help Today's Students Succeed More than 6 million children between the ages of 4 and 17 had been diagnosed with attention deficit hyperactivity disorder (ADHD) as of 2011, according to the Centers for Disease Control and Prevention External link . It's a complicated disorder with a long history.

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Middle and High School Students