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2014 Convention News
Washington, DC, February 18–21

Presenters Up Close: Identification of Emotional Disturbance in Practice

By Shanna Sadeh, Amanda L. Sullivan, & Katherine C. Cowan

This is the second installment in our “Up Close” series of Q&As with presenters scheduled for the 2014 convention in Washington, DC, February 18–24. Our goal is to provide a little more depth on some of the issues being addressed at the convention. Keep in mind, though, that these conversations represent only very small sampling of the more than 1,000 educational sessions at the convention, the vast majority of which are included with your registration. In this issue, we pose a few questions to Shanna Sadeh and Amanda Sullivan from the University of Minnesota regarding emotional disturbance. They will be presenting DS05: Distinguishing Emotional Disability and Social Maladjustment: Law Into Practice on Thursday, February 20, 10:00–11:20 a.m. Documented Sessions (DS) provide documented NASP- and APA-approved CPD. Relevant Domains of Practice (NASP Practice Model): 1, 4, 8, and 10.

In recent years, more than 374,000 U.S. students received special education because they were identified with emotional disturbance (ED; Data Accountability Center, 2013). Federal regulations define ED as follows:

(i) Emotional disturbance means 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 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; and (E) a tendency to develop physical symptoms or fears associated with personal or school problems. (ii) Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance. (34 C.F.R. § 300.8(c)(4))

Critics note the ambiguity of this definition, lack of information on the identification process, and the difficulty this presents for multidisciplinary teams involved in educational planning for students with emotional and behavioral difficulties (e.g., Maag & Howell, 1992; Olympia et al., 2004; 71 Fed. Reg. 46, 549–550, 2006). This issue is further compounded by the heterogeneity of students experiencing social–emotional difficulties that may warrant special education eligibility for ED. The controversy surrounding this disability category raises a number of questions for school psychologists involved in eligibility determinations. We address a few of these questions below.

NASP: How varied are states in how they define and identify ED?

Shanna & Amanda: There is considerable variability in how states define ED. Some eliminated the social maladjustment (SM) exclusion (Wisconsin, Iowa, Minnesota, and Indiana). Some adopted the federal law without changing it (e.g., Alabama, Arizona, Texas, Utah, North Carolina, New Mexico, Missouri, Connecticut, Delaware). Some defined SM with specificity—e.g., South Dakota defined SM as “common disciplinary problem behaviors, such as truancy, smoking, or breaking school conduct rule” (S.D. Admin. R. 24:05:24.01:16-17, 2013); Tennessee defined it as “substance abuse related behaviors, gangrelated behaviors, oppositional defiant behaviors, and/or conduct behavior problems” (Tenn. Comp. R. & Regs. 0520-01-09-.02, 2013). Some presumed that multidisciplinary evaluation teams can reliably discern discrete mental states in children. Vermont, for instance, required high-inference determinations like whether children's actions “are based on perceived self-interest even though others may consider the behavior to be self-defeating” and whether “general social conventions and behavioral standards are understood, but are not accepted” (Vt. Code R. 22-000-006, 2013). Likewise, Kentucky excluded from ED inappropriate behaviors that are the “result of willful, intentional, or wanton actions”(KRS § 157.200, 2012). At least two states, Alaska and Vermont, required schools to consult a licensed psychologist or psychiatrist before determining a student has ED. Such variability is concerning because students' access to a federal entitlement like special education should not hinge on geographic location. What's more, the inferences assumed in these definitions often go beyond valid professional judgment (Katsiyannis & Maag, 2001).

NASP: What advice would you give to school psychologists asked to testify on cases related to the identification of ED?

Shanna & Amanda: If school psychologists testify about an evaluation, the lawyer calling them to the stand should help them prepare for this experience. Practicing with the attorney (or the attorney's assistant) will help the school psychologist know what kinds of questions will be asked at trial and lets the attorney learn the strengths and weaknesses of the school psychologist's testimony.

Relative to low-incidence disabilities, ED eligibility decisions seemingly hinge more on professional judgments than discrete, objective data. Thus, the school psychologist's professional judgment probably will be scrutinized by numerous people throughout a disputed case, which can feel like a personal attack, especially if the dispute involves allegations of inappropriate evaluation practices or unlawful discrimination. Although it can be very difficult, practitioners should not take the adversarial process personally. In very contentious disputes, they should seek support from trusted colleagues that can help foster productive reflections on one's practice.

It is important to be aware that professional guidelines will generally serve as the metric against which one's professional behaviors and educational recommendations are judged. This requires staying abreast of current guidelines (i.e., standards for ethics, training, and practice), emerging research, and best practice. In all cases, school psychologists should engage in practices consistent with the ethical principles and standards of the field, best practice, and the procedural requirements of IDEA; maintain stringent documentation; and seek ongoing professional development to ensure knowledge and skills are up-to-date.

NASP: What practices should school psychologists implement so that they can be credible witnesses if they need to testify at trial?

Shanna & Amanda: Testifying school psychologists will want to substantiate their professional judgment with objective data as much as possible. To do so, the school psychologist needs to have collected and safely stored relevant and reliable data about the referral concern. For most students, the final evaluation report should include descriptions of prereferral interventions and data showing intervention fidelity and the student's treatment responsiveness. The school psychologist will want to explain to the court why the interventions implemented were appropriate (e.g., research-based, culturally relevant, likely to improve problem behaviors). Accordingly, this information should be included in the evaluation report or otherwise captured in the related documentation. Additionally, some case law suggests that judges find expert witnesses (like school psychologists) more credible if their professional judgment is based on substantial personal contact with the student as opposed to a single assessment session.

NASP: What is the most important thing a school psychologist should know about the identification of ED?

Shanna & Amanda: Students who have SM can receive special education services for ED. The SM exclusion simply means that SM, by itself, does not qualify a student for special education. The controversial problem for practitioners is how to differentiate ED from SM when the federal law provides no definition for SM. One way to approach this problem is simply to determine whether the student satisfies the conditions for ED alone.

NASP: What are some suggestions for school psychologists to improve collaboration around and advocate for improved services and practices for students with ED?

Shanna & Amanda: One possible reason society continues to scrutinize the ED category using antiquated legal standards like “willful” behavior may be because of the general stigma associated with mental illness. Better understanding of the research on the genetic and biological bases of disruptive behaviors may help reduce such stigma. School psychologists should educate themselves and other multidisciplinary evaluation team members about biopsychosocial research that rebuts the common misconception that antisocial or undesirable behaviors can be classified as simply voluntary (evidencing SM) or involuntary (evidencing ED; for discussion, see Dodge & Pettit, 2003). There are also helpful practitioner- oriented resources that address the interplay between biology and psychology and provide treatment guidelines (e.g., the Developmental Repair Model; Gearity, 2009).

Collaboration among stakeholders is necessary to meet the diverse needs of students with ED through individualized supports tailored to students' unique needs. School psychologists should promote parent and teacher involvement throughout the intervention, referral, and evaluation processes. This necessitates ongoing conversations and meetings about the student's behaviors and needs, and shifting away from the assessor/gatekeeper role. In the case of students receiving mental health services outside of school, the school psychologist can seek the input and participation of these providers at all stages of the process. To improve school-wide practices to support the needs of students with emotional and behavioral issues, school psychologists can help to identify and provide inservice training to boost teachers' skills in classroom management, behavior modification, and positive behavioral interventions and supports.

References and Resources

Data Accountability Center. (2013). Part B data and notes. Retrieved from https://www.ideadata.org/PartBData.asp

Dodge, K. A., & Pettit, G. S. (2003). A biopsychosocial model of the development of chronic conduct problems in adolescence. Developmental Psychology, 39, 349–371. doi:10.1037/0012-1649.39.2.349

Gearity, A. (2009). Developmental repair: A training manual. Minneapolis, MN: Washburn Center for Children. Available at http://washburn.org/wp-content/uploads/2012/09/Developmental-Repair1.pdf

Individuals with Disabilities Education Act of 2004. 20 U.S.C. § 1400 et seq. (Fed. Reg., 2006). Available at http://idea.ed.gov/download/statute.html

Katsiyannis, A., & Maag, J. W. (2001). Manifest determination as a golden fleece. Exceptional Children, 68, 85–96.

Maag, J. W., & Howell, K. W. (1992). Special education and the exclusion of youth with social maladjustment: A cultural-organizational perspective. Remedial and Special Education, 13, 47–59. doi:10.1177/074193259201300109

Olympia, D., Farley, M., Christiansen, E., Pettersson, H., Jenson, W., & Clark, E. (2004). Social maladjustment and students with behavioral and emotional disorders: Revisiting basic assumptions and assessment issues. Psychology in the Schools, 41, 835–847. doi:10.1002/pits.20040

Shanna Sadeh, JD, MA, is a doctoral candidate in the school psychology program at the University of Minnesota, and Amanda L. Sullivan, PhD, is an assistant professor of educational psychology and faculty member in the school psychology program at the University of Minnesota, Minneapolis. Katherine C. Cowan is NASP Director of Communications.