The information in this article applies to public schools in the United States. If your child attends school in a different type of setting, talk to your child’s school to see what they recommend for children with behavioral and/or social-emotional needs.
What is Emotional Disturbance?
Emotional Disturbance (ED) is considered one of the 14 disabilities under the Individuals with Disabilities Education Act (IDEA) that entitles students to an individualized education program (IEP). “IDEA is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.”
Emotional Disturbance is specifically defined as 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; or
E. A tendency to develop physical symptoms or fears associated with personal or school problems.
The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance (ED). Read more about social maladjustment vs. emotional disturbance.
Suggested Material: Eligibility Criteria Checklist for a Classification of an Emotional Disturbance
If you suspect your child or student is manifesting characteristics of emotional disturbance, you can request a psycho-educational evaluation, which will be carried out by a school psychologist. A school psychologist can evaluate the student to determine if they meet criteria for emotional disturbance and if they are in need of an individualized education program (IEP).
The evaluation will likely consist of an IQ test; achievement test; behavioral rating scales (behavioral questionnaires) administered to parents, teachers, and possibly the student; observations of the student in the school setting; interviews with parents, teachers, and the student; and a review of the student’s educational records. The evaluation may also consist of a functional behavior assessment, which will assist in determining the reason for the child’s challenging behaviors in order to come up with a plan (positive behavior support plan) to improve the child’s behavior.
If a student is found to have an emotional disturbance which is negatively and significantly impacting their academics, behavior or social skills in the school setting, they will be eligible for an IEP. An IEP is used to meet the needs of students with disabilities in the school setting. The IEP provides students with accommodations and/or modifications as a way to level the playing field with students who do not have a disability. This assists the child with a disability in meeting their full potential. Examples of accommodations/modifications for students with emotional disturbance may include, but are not limited to:
- providing breaks during the school day to engage in preferred activities, rest periods, or periods of movement
- chunking work into smaller steps
- incorporating choice into learning
- allowing the student to earn privileges for desired behaviors
- allowing the student extended time to complete assignments or tests
- providing specific positive feedback for displaying appropriate behaviors
- being able to go to a preferred area or quiet location to calm down or regain composure
- having the option to talk to the guidance counselor when needed
The IEP will also allow the student to work on specific behavioral or social goals such as building coping skills or improving social skills. These goals may be implemented by a school staff member such as a school psychologist, social worker or counselor, or special education teacher. The staff member may work with the student one on one or in a group or class setting.
If needed, the IEP would also include academic goals in reading, writing, or math and these goals would generally be implemented by a special education teacher. Depending on the level of the student’s academic, behavioral, and/or social-emotional needs, they may spend the school day in the general education classroom with consistent or as-needed support from a special education teacher or other designated staff member; or they may be placed in a classroom specifically designed for students with severe emotional/behavioral needs (e.g., self-contained classroom/emotional support classroom), with a teacher trained in working with special education students. Some students may spend part time in the general education classroom and part time in an emotional support type of classroom.
In some instances, students with emotional disturbance also have a crisis intervention plan and/or safety plan which outlines what to do if the student threatens or attempts to harm him/herself or someone else, or run out of class or the school building. The IEP team works together to outline the steps of the crisis intervention plan or safety plan.
You may be unsure as to whether a student should be referred for an evaluation for emotional disturbance. Below are some characteristics of students with emotional disturbance, but these characteristics can sometimes be found in children with other disabilities.
If you have observed some or all of the characteristics below to a significant degree over a period of time (e.g., 6 months), a request for a psycho-educational evaluation by a school psychologist is likely warranted. Once a student is referred for an evaluation, the school team (which includes the parent) may agree to try some behavioral interventions with the student at school (e.g., social skills group, coping skills group, meetings with school counselor, positive reinforcement for desired behaviors) before moving to an evaluation; but in some cases, interventions may have already been tried or behaviors may be severe enough to start the evaluation process while implementing interventions at the same time.
Characteristics to Look Out for When Considering an Evaluation for Emotional Disturbance
1. The student is not acquiring academic skills at the same rate as their peers. They may be failing classes or significantly behind on assessments of reading, writing, or math skills.
With emotional disturbance these academic deficits are generally due to factors such as:
- lack of motivation or desire to succeed in school
- an unwillingness or inability to focus on topics that are not of interest or choice
- difficulty focusing on academic tasks due to severe emotional turmoil/mental illness (e.g., depression, anger, anxiety; hallucinations or delusions associated with a psychotic disorder such as schizophrenia)
Learning disabilities can occur in someone with emotional disturbance, but emotional disturbance (ED) itself is not a learning disability, even though ED can interfere with academic progress
2. The student has mood swings or their mood is negatively impacted to a significant degree:
- they may laugh, cry or become very angry without apparent cause
- they may look depressed or nervous all the time; or complain of feeling depressed or anxious for a significant period of time, possibly with no significant cause
3. The student behaves in a way that is considered inappropriate or extreme:
- sits and stares blankly or daydreams regardless of what is going on around them
- shows extreme interest in morbid, obscure or gruesome events or themes such as murder, suicide, etc.
- is in constant motion, compulsively playing with objects and moving all around the room
- shows poor judgement/acts impulsively without considering circumstances or consequences (e.g., steals, runs away from school, hits staff/students)
- makes neurotic complaints (i.e., a person making neurotic complaints may appear overly anxious, stressed or hypersensitive, frequently worrying about little things, questioning situations, being indecisive, seeking reassurance, etc.)
- is excessively fearful of typical situations such as going to school, going out into the community, etc.
- exhibits paranoia (e.g., the student seems overly jealous or suspicious to such a degree that it interferes with functioning at school)
- constantly complains of pain, tiredness, or illness with no know medical cause
- engages in repetitive behaviors to an excessive degree, such as rocking, nail biting, peeling skin on fingers, (these behaviors can also be seen in children with ADHD or autism, who may not meet criteria for emotional disturbance; as well as in children without disabilities)
4. The student has trouble relating to others:
- has trouble making and maintaining friendships
- has difficulty building positive relationships with adults (teachers, coaches, etc.)
- has trouble working or playing cooperatively with others
- gets in repeated altercations (e.g., fights, arguments, misunderstanding)
- withdraws/isolates oneself
5. The student does not seem to care for or believe in him/herself, or is too critical of self:
- lacks interest or desire to keep self well groomed, maintain hygiene
- has very low self-esteem/no confidence (e.g., says “I hate myself” “my life is not worth living” “I am no good at anything” “I am a loser”)
- is unwilling to try new or difficult tasks due to fear or low confidence
- has extreme negative reactions to minor failures (e.g., crying all day or hitting oneself over a low test grade or a missed point in a basketball game)
6. The student has trouble with communication:
- uses jargon, says things that make no sense, uses incessant profanity or other speech inappropriate to context
- talks about inappropriate topics and does not take interest in the questions or responses from others
- talks without permission or regard for what is going on around them; interrupts conversations
- struggles to communicate with others due to a lack of awareness of the real word, a disconnect from reality
- has trouble regulating speech (may talk unusually fast or slow; may talk too loud, soft, high, or low; may make makes errors in speech; stutter)-these difficulties may be related to a speech/language delay or impairment as well, but in some instances they are related to an emotional disturbance/mental illness. If speech is a concern, a speech-language evaluation should be requested in the school setting as well.
Some Things to Keep in Mind about Emotional Disturbance
- The behavior is not an isolated incident but rather occurs repetitively for a long period of time (e.g., 6 months or more).
- The behavior is intense and appears clearly inappropriate for the time and place in which it occurs.
- The behavior occurs so frequently that it is expected to happen under normal circumstances within a specific amount of time. For example, if you were to observe the student for an hour, it would be hard to miss the behavioral concerns because they occur so often.
When a school psychologist evaluates students for emotional disturbance, some of these students already have a diagnosis from a professional outside of school, such as a child psychologist or psychiatrist, while other students have not been diagnosed with anything prior to the in school evaluation.
Common outside diagnoses for students being evaluated for emotional disturbance include (but are not limited to):
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Obsessive Compulsive Disorder
Intermittent Explosive Disorder
If you are concerned that your child or student has emotional disturbance and is in need of an IEP, meet with your school team (e.g., counselor, principal, psychologist, teacher) to discuss the possible need for an evaluation and immediate intervention. If you think your child would benefit from counseling or other support services outside of school (e.g., behavior specialist, outpatient therapy, medication) take them to see a professional (e.g., psychologist/psychiatrist) in your community. Check your insurance or do a search in your community for a recommendation. An evaluation in school will not lead to support out in the community. It will only be used to develop the IEP and related supports, which are implemented in school.
Remember to always keep in mind the strengths, the positives attributes, and the things you enjoy about your child/student. Even the most challenging students have personal strengths which can be built upon. For example, a student with emotional disturbance may love to help others, create art, talk about their feelings, or play an instrument. Let’s think about how we can use these attributes to build them up. Tie their strengths and interests into their IEP and into their school day!
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