Sunday, 10 June 2012

Behavioural Disorders---What are they???


                 Children and youth with behavioural disorders exhibit a spectrum of behaviours ranging from disruptive and contancerous outbursts to severe withdrawal from social interaction.  Dozens of different characteristics have been attributed to these children and youth.  There is no such thing as a typical child with a behaviour disorder; the only commonality is that the excesses are chronic and extend far beyond the norm.  Given the varied behaviours and uniqueness of every affected individual, definitions, terminology and classifications are very confused. 
               All behavioural disorders are abnormal in the sense that the word means "away from the norm", and behavioural disorders are deviations from average or standard behaviour.  It is hard to draw the line between serious behavioural disorders and problematic behaviour that is fairly common in childhood.  All children exhibit varying behaviours, and deviant and unusual behaviours may exist in the repertoires of those
who are developing normally.  Children who have behavioural challenges sometimes behave quite normally.  Distinctions between normal and disturbed behaviour are generally in the amount and/or degree rather than kind.  Children with behavioural disorders perform certain behaviours too often or intensely, or not often or intensely enough, but specifing this amount and degree is difficult.
              The field of behavioural disabilities has seen evolving terminology over the years.  At the onset, a variety of descriptors, largely arising from a psychiatric base, were used:  neurotic, psychotic, obsessive, and emotionally distrubed.  Current educators prefer to dispense with psychiatric terms, but still disagree over what constitutes a severe behaviour disorder, whether the use of term is even justifiable, and whether to call these children emotionally disturbed, behaviourally disordered, socially maladjusted, deviant, psychologically impaired, educationally handicapped, character disordered, children in conflict, delinquent, or some other descriptor.  Given the varied terminology, it is not surprising that numerous ways to define behavioural disorders have emerged over the years, but a universally accepted definition remains extremely problematic.
               To make diagnosis even more challenging, there is no single symptom that is common to all pupils who are behaviourally disordered or even to a subgroup of these children, because there is no such thing as a typical student who is behaviourally disordered.  Some (but not all) children are versitile in their antisocial behaviour, and likely to display a wide variety of inappropriate behaviours or more than one type of problem or disorder.  A child with a conduct disorder may also be depressed, and that child's behaviour may vacillate to such a degree as to show both internalizing and externalizing problems.  Some children who show versatile antisocial behaviour are, generally likely to have the more severe problems, and their prognosis is usually poorer compared to those who exhibit only one type of antisocial behaviour.
               Behavioural disorders cannot be measured quatitively.  We have no instruments analogous to the I.Q. test to determine a mental health quotient.   Behavioural problems also change as children get older.  A child who frequently disobeyed  their parents, might, as a teenager, engage in vandalism and delinquency.  Identification can also occur at any age and is usually made by parents or teachers whose expectations and tolerance levels differ by the individual doing the identifying.  Teachers place different demands on students depending upon their own behavioural standards and the degree to which they are accepting of specific maladaptive behaviours.
              
Once diagnosed, most children with behavioural disabilities are considered to struggle with one or more of the following:
- conduct disorders
-anxiety and withdrawal
-socialized aggression
-ADHD
-childhood psychosis

The two most common are aggressive behaviour (acting out) and social withdrawal.  It is important to remember that no child is the same.
 


Prevelance

                  Based on media reports, it would seem that the incidence of behavioural disorders has increased dramatically during the last few decades.  Teachers, on the other hand, found behaviour was neither increasing or decreasing.  Although mounting numbers are being identified as behaviourally disordered, accurate figures are not available chiefly because of the lack of a clear and precise definitional construct. 
                  In Canada, a national study by the Canadian Institute of Child Health (2000) reported that the rates of behaviioural and emotional problems for children aged 4 to 11 is "disturbingly high", with 1 in 10 children exhibiting behaviour consistent with hyperactivity problems, conduct disorder, or an emotional disorder.  Boys (6-16%) do get diagnosed for behavioural disorders more often than girls (2-9%).  One has to wonder if
this has anything to do with the expectations of students behaviour in school settings.  Considering that boys often function differently than girls and at different rates, could some of their diagnosis' be due to their different learning styles?  Certainly, too, different behavioural problems are more prevelant in boys (such as aggression), while others are more prevalent in girls (anxiety).  All the same, all behavioural disabilities can effect
both genders.  As well, the prevalence of behavioural disorders are consistantly low in the beginning grades, peak in middle school and tend to fall off in highschool.  This does not mean that the issues will go away with time.  Intervention, as early as possible, is essential in helping these children manage their behaviour and not lose their social, emotional and psychological skills.  In order to grow into strong, confident adults, they will need these skills for a strong self-esteem and self-image.
                Behavioural disorders often are bi-products of other learning disorders too.  A child suffering from physical, social, emotional or learning challenges is often frustrated or anxious, thus, reflecting poor behavioural symptoms.  Behavioural problems can be the result of trama or stresses at home or with peers, coming out only in highly stressful situations like the classroom or anywhere the child lacks confidence.  Because there are so many different origins and causes and so many types of diagnosis, behavioural disabilities are challenging to identify and treat. Yet it is still very important to address these issues because of how many children are affected and the impact it can have on their success.  


Etiology
  
                   Despite the vast amount of research, nobody fully understands the causes of any type of psychopathy and there is no evidence linking any behavioural disorders to any specific cause.  Behavioural disorders occur among the rich, poor, gifted, intellectually disabled, and members of all racial and ethnic groups.  Because social and cultural expectations differ, there are varying reactions to certain behaviours.  Deviance is
defined by social groups that recognize some behaviours as infractions of the rules and label as deviant persons who do not conform to these socially defined rules.  This explains, at least in part why a disapropriate number of students from culturally and linguistically different groups are labelled as behaviourally disordered. 

Here are some possible causes for behavioural disorders:






Definitions

The most widely used classification system was formed by Quay and his collegues; they came up with 5 major types of behavioural disorders:

1) Conduct Disorder
2) Anxiety & Withdrawal
3) Socialized Aggression
4) Attention Disorders & Motor Excess (ADHD)
5) Psychotic Behaviour

Conduct Disorder

-most common
-overt, aggressive, disruptive behaviour or covert antisocial acts that are breaking the social rules and as a result violate social norms and the rights of others
-volatile, unpredictable, hyperactive and disputive behaviour
-engage in attention-getting, limit-testing defiance, challenges, disrespectful, verbally abusive, blatant rule violations, threats and intimidation
-non-compliance, failing to follow ADULT rules and because they have failed to develop reliable internal controls, they often seem to not know right from wrong
-characterized behaviours are not age-appropriate

Subcatagories are Aggressive Behaviour and ODD (Oppositional Defiant Disorders).

Aggressive Behaviour  involves verbal, non-verbal and physical behaviour that injure others directly or indirectly and/or results in extraneous gains
for the aggressor (Zirpoli and Mellory, 1997, pg 339)

ODD is characterized by consistantly negavitistic, hostile and defiant behaviour, particularly towards adults.  These children frequently argue, show resentment, are touchy, spiteful, angry and vindictive and throw many temper-tantrums.   This form of conduct disorder often develops into a worse condition later.

Anxiety and Withdrawal

Currently there are 14 catagories of anxiety disorders, the most common being obsessive compulsive disorder, separation anxiety disorder, post-tramatic stress disorder, generalized anxiety disorder and social phobia.
Anxiety is a fear of future reference, characterized by worry, tension, uneasiness, and fears of what could happen, esspecially around new situations and people.  It is abnormal when it occurs in situations that most people can handle with little difficulty.
"Generalized Anxiety" is present all the time and may include phobias (fears of specific things).  These children suffer from nausea, abdominal pain and often express their fears by crying, sadness and depression.  This disorder is more common in girls than boys, but school phobia.
-affects 2% from age 5-15years equally.
Obsessive-compulsive disorders are recurrent obsessions and /or compulsions that interfere with daily life and cause distress.  Obsessions are persistant ideas that are experienced as intrusive or inappropriate.  Compulsions are repeated behaviours or acts to reduce stress and anxiety, but not for pleasure or gratification.  Disorders can result in disgust, discomfort and guilt.  These children are often withdrawn, secretive,
apathetic, day-dream and fanatsize instead of socializing.  They may experience depression, lose interest in activities, feel worthless and guilty, and have difficulty thinking, concentrating and making decisions.


Socialized Aggression

Children and youth with discipline problems at school, seem to have the same issues outside of school.
These issues are more social, than emotional or behavioural.  Children socializing in delinquent peer groups who reinforce poor behaviour in a positive way, are encouraged to fall into the pattern of repeated offences.  Violence, non-compliance, bullying, intimidation, gang vandalism, stealing, fighting, truancy and sexual assault are encouraged in these social groups.  Often this behaviour gets worse and more serious over time.
 

Attention Disorders

-a persistent pattern of inattention and/or hyperactivity/impulsivity that is more frequent and severe than is typically the norm
-inattention, impulsivity, hyperactivity
-difficulty concentrating, tuning in and actively participating
-bounce from one activity to the next, active, easily distracted by visual and auditory stimuli
-difficulty taking turns, interupts and cannot sit still
-high intelligence or at least average
-ADHD is the most common form of attention disorder.

Psychological Disorders

Austism, Aspergers, childhood disintegrative disorders, Retts, childhood psychosis, schizophenia, developmental disorders and combinations of these are psychologic disorders.  They are physiological conditions that can cause unusual behaviour as a result.  
  

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It remains important, in fact imperative that as educators, we remember the child in all of this.  No matter what the origin or prognosis of their behavioural disability is, this is a child who is suffering and needs our help.  The more positive environment we can create for them, the greater the chance to giving that child the opportunity they deserve to succeed in life.  

Test Yourself...

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