Are you a teacher or a therapist?
Understanding and managing emotional
problems in the classroom
9th Annual Western Regional Student Assistant
Conference
Ogden, Utah
Douglas Goldsmith, Ph.D.
Executive Director
The Children’s Center
Unmet Mental Health Needs
• While as many as 13.7 million of the nation's
children have a diagnosable mental illness, only
about one-third of these children receive mental
health services. Even though advances have
been made in treatment development for some
childhood disorders, the prevalence of child and
adolescent mental illnesses, the usage rates of
mental health services, and the gap between
them have remained essentially the same for
almost 15 years.
Whitehouse Conference on Mental Health (1999)
Unmet Mental Health Needs
• In the United States, one in ten children
and adolescents suffer from mental illness
severe enough to cause some level of
impairment (Burns, et al., 1995; Shaffer, et
al., 1996). Yet, in any given year, it is
estimated that about one in five of such
children receive specialty mental health
services (Burns, et al., 1995).
Whitehouse Conference on Mental Health (1999)
The road to detention
• There is broad evidence that the nation
lacks a unified infrastructure to help these
children, many of whom are falling through
the cracks. Too often, children who are not
identified as having mental health
problems and who do not receive services
end up in jail.
Whitehouse Conference on Mental Health (1999)
Who is responsible?
• Responsibility for mental healthcare is
dispersed across multiple settings:
schools, primary care, the juvenile justice
system, and child welfare. But the first
system is the family
Consequences of Behavior
Problems
• In the United States, children's (ages 1-19)
emotional and behavioral problems and
associated impairments are most likely to lower
their quality of life and reduce their life chances.
No other set of conditions is close in the
magnitude of its deleterious effects on children
and youth in this age group. Children with these
disorders are at a much greater risk for dropping
out of school and of not being fully functional
members of society in adulthood.
Surgeon General’s Report on Mental Health (1999)
Outcomes of ED
• Learning disabilities and speech and language
handicaps account for the majority of the 11% of
school age children in special education. Fewer
than 1% of children are found eligible in the
school category of emotional disturbance.
Compared to children in the two largest
categories of special education (LD and SL) who
are mostly mainstreamed (over 80%), fewer than
half the children under the ED category are
mainstreamed.
Surgeon General’s Report on Mental Health (1999)
From recognition to treatment
• Before these children got into special education:
• Parents reported recognizing a problem at a mean age
of 3.5.
• Outside agency records (e.g., discipline referral,
prescription medication) indicated problems at a mean
age of 5 (i.e., kindergarten)
• The first documented intervention involving some sort of
pre-intervention was at age 6.5.
• The first eligibility for special education was at about 7.8
years (i.e., toward the end of second grade)
• In more than 50% of the cases, these children were
placed in the category of LD, not in the category of ED.
• These children finally got the right services at age 10.
Utah Statistics
• Every month in Utah:
– 12 youth 1-19 die as a result of injury
– 14 teens attempt suicide
– 77 teens 15-17 give birth
– 1048 children are abused or neglected
– 487 domestic violence cases appear in court
– 80,892 children live below the poverty level
Utah Children 2005
Abuse & Neglect
• Abuse and neglect cases under 18
– 2004 - 12, 582
• Juvenile violent crime
– 2003 -
13, 787
• Substance abuse offences
– 2003 -
12, 324
• Domestic violence
– 2003 -
5, 846
Utah Children 2005
Sexual Activity
• Chlamydia Cases
– 1997
– 2003
691
1,207
Utah Children 2005
What is the average child thinking
about in class?
•
•
•
•
•
•
•
•
Divorce issues
Witnessing domestic violence
Physical/Sexual abuse
After-school issues
Parental unavailability
Peer issues – bullying
Drug abuse
Etc., etc. etc.
Prevalence of Mental Health
Issues
• ADHD
– 7-8% of children
– 3:1 males to females
• Co-morbid disorders
–
–
–
–
–
Oppositional Defiant Disorder
Conduct Disorder
Anxiety Disorder
Major Depression
Bipolar Disorder
40-70%
20-56%
18-30%
10-40%
6-10%
Barkley 2005
Psychiatric Disorders in the
Classroom
•
•
•
•
•
•
•
ADHD
Anxiety - Masked Anxiety
Depression
Obsessive Compulsive Disorder
Bipolar Disorder
Post Traumatic Stress Disorder
Autism Spectrum Disorder
A brief introduction to
attachment theory
The Attachment Relationship
• “Almost every infant will develop an
affective tie with a caregiver, and will
endeavor to use that caregiver as a source
of comfort and reassurance in the face of
challenges or threats from the
environment”
Weinfield, Sroufe, Egeland & Carlson, 1999
Almost every child will develop
an affective tie with a teacher,
and will endeavor to use that
teacher as a source of comfort
and reassurance in the face of
challenges or threats from the
classroom
Development of Attachment
• Biological process
• Recognition of the caregiver
• Utilization of the caregiver as
a “haven of safety” and a
“secure base” in order to
explore the environment
Secure Base
• The infant returns to the secure base for
protection and comfort in the light of any
threatening or distressing event
Secure Attachment
• The caregiver is
perceived as a
reliable source of
protection and
comfort
February
2005
Teacher’s Pests
• Helicopter Parents – the hovering parent
gets in the way of self-reliance
• Monster Parents – the lurking parent who
is always looking for reasons to disagree
• Dry-Cleaner Parents – drop off their kids
and want them cleaned up by the end of
the day
Attachment Concepts
•
•
•
•
Always be bigger, wiser, and kind
Set and maintain limits
Nurture, nurture, nurture
See emotional outbursts as need for
emotional repair
• Help children learn to regulate their
emotions
• Let them know that they are important to
you
We must always keep our demands
and expectations in balance with
the capacity of the individual child