SEBD Flashcards

1
Q

prevalence of SEBD

A

Sutton et al. (2004):
15 % of 5 year olds show behaviour that is oppositional and defiant
4 –10 % of children show persistent and pervasive behaviour problems
7.4% of boys between 5 and 15 were conduct disordered
3.2% of girls between 5 and 15 were conduct disordered
In disadvantaged neighbourhoods estimates as high as 20%

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2
Q

general charavcteristics of SEBD

A

Difficulty in forming friendships
Often preoccupied or find it difficult to get involved in activities
Difficulty keeping on task
Difficulty taking part in group activities and discussion
Low self-esteem and often become victims of bullies
Aggressive and disruptive
Difficult conforming to classroom rules and routines
Excessively attention-seeking through negative behaviour / clinginess

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3
Q

perception of SEBD

A

Warnock Report (1978):
Emotional and behavioural difficulties viewed as special educational needs
Difficulties viewed as an interaction between the child and his/her environment
Armstrong (2013):
Teachers often ill-equipped to deal with children with SEBD
Problematic behaviour by students is a source of teacher burnout, distress and attrition
Need for change in educational practice with children with SEBD, particularly in enacting inclusion

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4
Q

dev psy basis of SEBD

A

Family conversations that centre on emotional experiences can help toddlers achieve a better understanding of their own and others feelings

Denham et al. (2003): emotional competence (assessed at age 3-4) has implications for children’s emerging social abilities and patterns of social adjustment

Attachment theory (Ainsworth Strange Situation) – identified both secure and insecure attachment types.
Caregiving hypothesis (Ainsworth) - aspects thought to promote secure attachments: sensitivity, attitudes, synchrony, mutuality, support and stimulation
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5
Q

risk factors (caregivers) for SEBD

A

Clinically depressed caregivers: ignore babies’ social signs, fail to establish relationship
Caregivers who were unloved, neglected, abused as children: sometimes withdraw affection, neglect or abuse, particularly if difficult babies
Unplanned pregnancies/unwanted babies: children more frequently hospitalised, have lower grades, less stable family and more irritable
Families with health related/legal/financial problems: incidence of insecure attachments is highest in poverty stricken families
Caregivers with a poor relationship with spouse: less favourable attitudes towards infants, less secure ties

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6
Q

attachment and later dev

A

Waters (1979):
Children with insecure attachment at 15 months.
At age 3.5 yrs - more likely to be hostile and aggressive and be socially and emotionally withdrawn.
This pattern emerged also when seen at age 11-12 and age 15-16

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7
Q

conduct disorder (DSM V Criteria)

A

A pattern of repetitive behaviour where the rights of others or the social norms are violated, as manifested by the presence of three (or more) of the following 15 criteria in the past 12 months, with at least one criterion present in the past 6 months:
Aggression to people and animals (7 criteria): e.g. often bullies, threatens, or intimidates others
Destruction of property (2 criteria): e.g. has deliberately engaged in fire setting with the intention of causing serious damage
Deceitfulness or theft (3 criteria): e.g. has broken into someone else’s house, building, or car
Serious violations of rules (3 criteria): e.g. often stays out at night despite parental prohibitions, beginning before age 13 years
Behaviour causes significant impairment in social or academic functioning

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8
Q

conduct disorder (DSM V subtypes)

A

Onset:
Childhood-onset: at least one symptom prior to age 10
Adolescent-onset: no symptoms prior to age 10
Unspecified onset: criteria met, but not enough information to determine whether onset before 10 years
Severity:
Mild: few criteria, relatively minor harm to others (e.g. lying, truancy)
Moderate: intermediate number / effect of criteria (e.g. stealing without confrontation, vandalism)
Severe: high number or considerable harm to others (e.g. forced sex, physical cruelty, use of weapon, breaking / entering, stealing with confrontation)

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9
Q

DSM V specifiers of Conduct Disorder

A
CD with limited prosocial emotions - at least 2 of the following in multiple settings: 
Lack of remorse / guilt
Callous – lack of empathy
Unconcerned about performance
Shallow / deficient affect
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10
Q

features, causes and prevalence of conduct disorder

A
Associated features:
learning problems
depressed mood
hyperactivity
addiction
dramatic or erratic or antisocial personality
Cause: 
poor parenting 
child abuse
poverty
children brought up in chaotic environments 
Prevalence: 
6 to 16% of boys 
2 to 9% of girls
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11
Q

DSM V criteria for ODD

A

A pattern of angry / irritable mood, argumentative / defiant behaviour, or vindictiveness lasting at least 6 months, with at least four symptoms from any of the following categories, exhibited with at least one non-sibling individual (most days if under 5; at least weekly for 5+):
Angry / irritable mood: often loses temper; often touchy / annoyed; often angry / resentful
Argumentative / defiant behaviour: argues with authority figures / adults; defies / refuses to comply with requests; deliberately annoys others; blames others for mistakes / misbehaviours
Vindictiveness: spiteful / vindictive at least twice in last 6 months
Behaviour associated with distress in the individual / others, or impacts negatively on social / educational functioning
Not caused by substance use / psychotic / depressive / bipolar disorder

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12
Q

ODD severity

A

Severity:
Mild: symptoms confined to one setting (home / school / with peers)
Moderate: some symptoms present in at least two settings
Severe: Some symptoms present in three or more settings
Pervasiveness better predictor of functional impairment than number of symptoms
Virtually all with symptoms have them at least at home
Symptoms just at home demonstrated to be enough for clinical impairment

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13
Q

ODD features and causes

A

Associated features:
Learning problems
Depressed mood
Hyperactivity
Addiction
Dramatic or erratic or antisocial personality
Cause:
No systematic research into the causes of ODD
Genetic and environmental factors are probably combined
Children with oppositional defiant disorder are more likely to have family history of disruptive behaviour disorders, substance-use disorders, or mood disorders

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14
Q

intermittent explosive disorder

A

Recurrent outbursts demonstrating inability to control impulses: verbal / physical aggression twice weekly for three months or injury / destruction three times within a year
Must be disproportionate to stressors, not premeditated, cause distress / impaired functioning / legal / financial consequences, not explained by other mental / medical disorder / substance use
Cannot be diagnosed below age 6
Very small amount of research (~160 articles in past 30 years)

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15
Q

signs of depression in children

A

Frequent vague, non-specific physical complaints, such as headaches, muscle aches, stomach aches or tiredness
Frequent absences from school or poor performance in school
Talk of or efforts to run away from home
Outbursts of shouting, complaining, unexplained irritability, or crying
Being bored
Increased irritability, anger, or hostility
Reckless behaviour
Difficulty with relationships

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16
Q

major depressive disorder (DSM V criteria

A

Five or more of the following (must include 1 or 2), during a 2-week period, most of the time; change from previous functioning:
Depressed mood
Markedly diminished interest or pleasure in activities
Significant weight loss / gain or decrease / increase in appetite
Insomnia / hypersomnia
Psychomotor agitation / retardation
Fatigue / loss of energy
Feelings of worthlessness / excessive / inappropriate guilt
Diminished ability to think / concentrate / indecisiveness
Recurrent thoughts of death / suicidal ideation / suicide attempt / plan for committing suicide
Symptoms cause significant distress / impairment in functioning
Not attributable to substance use / medical condition / psychotic disorders

17
Q

Seperation Anxiety Disorder

A

Excessive, age-inappropriate, fear about being apart from family members, especially parents; children fear being lost to their families or are sure something bad will happen to family members if they are separated from them
Prevalence: approximately 4% of children age 6-12 (no gender difference)
Symptoms:
Physical symptoms, such as headaches or stomach aches, particularly when they occur persistently in anticipation of separation from parents
Not wanting parents to be out of sight: following them around the house, requests to sleep in the parents’ bed at night
Nightmares about parents being gone or leaving
Causes and risk factors
A scary event that the child experiences personally (such as an earthquake) or hears about (e.g. a child abduction)
A serious separation (e.g. a parent’s service in the military)
Stress in the family or a significant change

18
Q

Generalised Anxiety Disorder

A

Excessive, uncontrollable anxiety / worry about many events / activities most days
Symptoms: irritability, difficulty concentrating, lack of energy, difficulty falling asleep, restless sleep; may show physical symptoms (muscle tension, headaches, nausea)
May worry that things seen on TV will happen to them, expect worst possible outcome, underestimate ability to cope
Prevalence: approx. 2%; equally common in boys and girls, but slightly higher for older adolescent females
Average onset in early adolescence; symptoms increase with age; persistent over time

19
Q

medical model of SEBD

A

Research over the past 15 years has demonstrated a steady increase in the use of psychopharmacology (medication) to treat children and adolescents with EBD
The medical model suggests that psychopharmacological interventions needed to be added to existing behavioral or psychosocial treatment for management of children with EBD, rather than treated as a distinct, separate alternative
There have been overall increases in the prescription of psychopharmacological medicines with as many as 2-4% of children in general education, 15-20% of children in special education and 40-60% of children in residential facilities receiving medication

20
Q

educational model of SEBD

A

Social inclusion: Pupil support guidance (Charles Clarke, Secretary of State for Education, 1999):
“Even in the most difficult areas, schools can and do make a difference to the behaviour and attitudes of their pupils, especially when they are effectively supported by other agencies”
Estelle Morris, Minister of State for Schools, 1999:
“Good teaching, sound behaviour management, effective anti bullying policies, clear rewards, consistently applied sanctions and imaginative use of the curriculum all make a difference, and reinforce the message that all young people can achieve their potential”

21
Q

child related factors explaning behaviour

A
Personality
Cognitive ability
Social skills
Specific difficulties, e.g. dyslexia, ADHD, ASD
Self-image
22
Q

home, family and community factors explaining behaviour

A
Family finances
Parental expectations
Parental experiences
Lifestyle
Peer pressure
Parenting styles
Out of school activities
23
Q

teacher and classroom factors explaining behaviour

A
Classroom management
Curriculum
Communication
Rules and routines
Rewards and consequences
24
Q

whole school factors explaining behaviour

A
Behaviour policy
Curriculum planning 
Quality of teaching and learning
Pastoral, SEN and academic departments
Teaching groups
Extra curricular activities
25
Q

procedure and general assessment of SEBD

A

Consultation / structured discussions with parents / carers, key staff
Observation: structured / unstructured; ABC analysis
Rating scales: e.g. Strengths and Difficulties Questionnaire (SDQ), Connors Comprehensive Behaviour Rating Scales (Conners CBRS)

26
Q

ABC analysis of behaviour

A

Antecedents: things that come before the behaviour (triggers)
Behaviours: behaviours displayed by the child
Consequences: positive or negative consequences of the behaviour

27
Q

Specific assessments for SEBD

A

Strengths and Difficulties Questionnaire (SDQ): 3-16; emotional symptoms, conduct problems, hyperactivity / inattention, peer relationship problems, prosocial behaviour
Conners’ CBRS: 6-18; parent / teacher / self-report (8+); includes emotional distress, academic difficulties, separation fears / anxiety, violence potential, defiant / aggressive behaviours, physical symptoms, GAD, CD, ODD, MDD and more
Reynolds Depression Scale: 7-13; self-report; maps depressive disorders in DSM-V
Beck Youth Inventories: 7-18; self-report; 5 inventories:
Beck Depression Inventory
Beck Anxiety Inventory
Beck Anger Inventory
Beck Disruptive Behaviour Inventory
Beck Self-concept Inventory

28
Q

whole school level interventions for SEBD

A

Prioritising work on social emotional development, not just behaviour, e.g. SEAL programme
Work on underlying causes
Promote staff competence and well being
Implement whole school programmes

29
Q

class/teacher level interventions for SEBD

A

Class environment / practice
Teacher strategies and skills
-Use of encouragement and rewards (e.g. Token system)
-Providing firm boundaries, limits and structure
-Reminders about consequences
-Consistent use of sanctions when necessary
Curriculum planning
Working with parents/carers
Working with other agencies

30
Q

individual/group level interventions for SEBD

A
Social skills training
Mentoring
Stress management, therapeutic and counselling programmes
Learning Support Units
Circle of friends
31
Q

SEBD interventions: support strategies

A

Ensure a consistent approach to the child’s behavioural difficulties
Encourage the provision of a positive classroom environment
Have group and class discussions (circle time) to focus on problems
Set up small social skills groups for children who have difficulties
Develop social interaction through games and problem-solving activities
Give short, clearly-defined tasks
Provide activities that encourage the building of self-esteem
Give the child opportunities to express their feelings

32
Q

early intervention for SEBD

A
Start really early
Promote attachment
Parent training 
Strong school ethos and school programmes 
Family therapy
Involvement in community