Dear CCBD members,

First, I want to thank all of you for the opportunity to serve as President of the Council for Children with Behavioral Disorders for the past 11 months. It is an honor to represent this organization and all that we collectively stand for, advancing positive outcomes and opportunities for children and youth with emotion and/or behavioral disorders. Although I will be moving out of this role, the incoming president, Justin Cooper, will bring a calming energy and commitment to advancing the organization. I’m proud of the accomplishments this year, specifically achieving organizational stability, both financially and structurally. That being said, all of our successes are the result of the phenomenal work by the entire Executive Committee, both past and current. As I step aside, please know that I am always available and interested in helping any and all in future CCBD endeavors, including local- and state-level activities. I believe that it is the work that happens every day in schools and facilities that truly matters and I am committed to doing anything I can to support that work. Thank you again and I look forward to serving CCBD in the future and hope that you will too!

Nick 

I recently stumbled upon some video footage from my student teaching days, which I had used to collect data regarding the frequency of opportunities to respond.  Being somewhat embarrassed about things I had said, and even more about how my words appeared to impact student behavior, I concluded that it is essential to be intentional about the messages we send to students, families, and other professionals.  The words and actions we choose (or omit) can have a powerful influence on student behavior, not to mention on how our profession is perceived.  Here are a few tips for enhancing intentional teaching:

1. Utilize think-aloud strategies: Many students exhibit difficulty with conflict resolution, and by modeling this particular practice, you are making the implicit more explicit and validating the thoughts and feelings of others.
2. Offer encouragement: Making non-judgmental statements of encouragement can help students to engage in self-evaluative practices and to build intrinsic motivation.
3. Be precise and concise: Tell students exactly what you want them to do in as few words as possible.
4. Have a sense of humor: This one can be a little tricky, but is an important consideration as “teachers with a sense of humor are usually happy, relaxed, fun-loving, and reinforcing to others” (Webber, Anderson, & Otey, 1991, p. 291).  Using humor appropriately can support student engagement, foster positive teacher-student relationships, and promote an overall positive environment.
5. Opt for silence: Not every situation requires an immediate verbal response.  If you anticipate that saying something will make a situation worse, or you can’t find a way to say it without reflecting negativity, simply keep it to yourself.
6. Engage in reflective practices: One reflective practice is to record a lesson or other interactions with students, and consider how intentional you were with your words, and if they appeared to elicit desired responses.  Sometimes, it is more obvious that our words, for better or worse, had an impact on a situation.  In those situations, we might consider what to say differently in a similar situation, or how to use a successful strategy in other circumstances.
7. Speak positively about your occupation: The field of education is replete with unique challenges and obstacles.  Although perhaps somewhat relatable, when a teacher says, “Time for another day in the trenches,” or “I feel like a glorified babysitter today,” it can undermine the merits of the profession and send a negative message about students.  The work of educators is incalculably complicated, but engaging in intentional teaching practices can affect positive change for students and educators.

References

Webber, J., Anderson, T., & Otey, L. (1991). Teacher mindsets for surviving in BD classrooms. Intervention in School and Clinic, 26(5), 288-292.

Dear Miss Kitty:

I have a student in my class who is eleven years old named Mario.  Mario has ADHD and has intellectual disabilities.  He threatens me and the other students in my self-contained class frequently.  He makes comments like:  “I’m gonna blow your house up,” and “I’m gonna stab you with my knife.”  In the past, I have just ignored his comments because I don’t think he is serious.  

With the school shootings recently, I am now wondering whether I am doing the right thing.  

Please help.  I want to do the right thing.

Confused in Clarksville

Dear Confused in Clarksville:

I am glad you are seeking assistance about the right thing to do.  When students are making such statements, you may think that they are just joking or being impulsive but we have to take such threats seriously.  Some students do make statements when they are mad or they make statements to get attention but, regardless of their intellectual level,  they have to be taught that those statements can’t be tolerated within the school.

As a preventive strategy within your classroom, you should teach your children what statements are acceptable and what statements are not and let them know the consequences if they state that they will take any aggressive action. You should encourage peaceful statements and teach anger management skills so that your students know more appropriate strategies when they are mad.  Many children are easily influenced and are seeing violence on TV, in their computer games, on the streets, etc.  We need to teach them what will be tolerated within the school and what will not.  It is hard for students to understand that they may engage in such behaviors on the streets or see it on TV, but it isn’t appropriate in the school setting.

Students also have to get more attention for positive behaviors than negative threats.  Thus when Mario is engaging in kind actions with other students or with you, as the teacher, he should be praised for that.

It is also critical that you have a positive relationship with Mario so that when he is frustrated he can look to you to help him get calmed down.  If he is angry about something, you want him to be comfortable enough to talk with you rather than make threats.

Always look for warning signs that Mario may be upset about something else that is going on and talk to him when you notice changes in behavior.  Active listening is critical to find out the source of the frustration.

Now if Mario has made a statement, you have an obligation to report the statement, according to your school’s protocol.  Talk with your building principal to see what the proper procedures are for reporting a threat. 

Some schools have homicide threat committees so that when a student makes such a statement, a group of school team members come together and determine whether the threat was serious and, if so, report the statement to local law enforcement.  Such a committee would consist of the building administrator, the social worker, the school psychologist, a counselor, and the teacher.  Whenever there is doubt on the part of that committee, the safest thing to do is to report the statement to law enforcement.  Students and their parents need to know that this is the school’s procedure.  The school takes threats seriously.  Too often, statements were ignored and a student later harmed someone.  We cannot take those chances in today’s world.

At the same time, the incident needs to be documented in writing and the parent needs to be notified.  Of concern with Mario, and with any child regardless of functioning level, is whether the student has access to weapons. The parent needs to be told that any weapons in the home need to be locked up and should not be accessible to the child.  It is important to work with your social worker or school psychologist when you talk with the parent and to document in writing what you have talked about.  If you and your team believe that the student has easy access to weapons, that should be reported to a child welfare agency.  

Parents need to avail themselves of local mental health services that are available.

Your job is to teach the child acceptable behavior, know your school’s protocol for reporting threats, report the threat, connect the student to needed support services, and document the action you have taken.

I hope this provides you with some guidance on such a serious topic.

Miss Kitty

In the inaugural column, we learned from Eric Common and Kathryn Germer about Eric’s affinity for bath bombs which he used as a reinforcer delivered contingent upon completing his writing goal. Two of our great professional and recreational loves are applied behavior analysis and CrossFit, respectively. The good news is the two have much in common (not to be confused with Eric Common). In this column, we begin by describing a typical CrossFit class and then highlight the principles of applied behavior analysis at work in the functional fitness recreational activity.

Keywords: antecedent adjustments, positive reinforcement, self-monitoring, successive approximations, scaffolding, public posting, CrossFit

About three years ago, Katie Lane (age 15) developed a keen interest in CrossFit thanks to an excellent high school teacher. According to the Level 1 Training Guide, CrossFit refers to “constantly varied, high-intensity, functional movement” (p. 2).  Though some find pictures of world-class athletes intimidating, most CrossFit workouts are completed by seemingly average people ranging from kids to grandparents in group class settings. The range of athletes illustrates that just like applied behavior analysis, CrossFit is for everyone.

At the beginning of a class, the coach leads the group through a general warm-up that often includes stretching or mobility exercises. It is common for the coach to call the class over to a whiteboard to review the agenda for that day. The coach explains the movements, expectations, and scaling options (modifications, often antecedent adjustments) for all athletes across both strength or skill building components and the workout of the day (referred to as the WOD, not to be confused with a piece of gum).

Next, the class begins with a task-specific warm-up. For strength exercises, this often includes a barbell warm-up where athletes work through movement progressions with a PVC pipe or a light barbell prior to adding any weight. For gymnastics movements, the coach may break a single movement, like a pull up, down into several pieces. Athletes practice each component before stringing them together to perform a single pull up. The specific warm up typical involves scaffolded learning, where the athletes are expected to elevate their heart rate and lightly activate muscles that will be used later on in the WOD.

After a short break, athletes set up and take on the WOD which may include specific tasks to be completed as quickly as possible (“for time”) or as many times as possible in a given block of time (“as many rounds as possible, AMRAP”). At the conclusion of the WOD, coaches and athletes exchange high-fives, fist-bumps, and words of praise. Finally, everyone writes their scores on the white board (public posting of performance data). More competitive members enjoy comparing their times to friends in other classes for additional drive each day. Most athletes then go on to work or home to their families, taking pride in the fact that they have dedicated the last hour to bettering themselves.

The workout may last only a few minutes or take a full hour. A key component of CrossFit is that the stimulus must be “constantly varied.” Workouts are designed to combine different movements and varying weights in as many different combinations as one can imagine. This methodology allows athletes to become skilled across broad domains instead of specializing in a single area.

Now, back to Katie. Katie – a future special education teacher – may have embraced this recreational activity for many reasons. It may be because good CrossFit coaching is like good teaching, acknowledging all behavior is shaped by the consequences that follow. These classes feature excellent instruction including: modeling, guided practice during warm ups and skill building activities, positive practice through progression of skills to be mastered, immediate reinforcement from peers, progress monitoring of personal performance, and long-term reinforcement in the muscles built and enhanced aerobic capacity.

For Kathleen – Katie’s mom and professor of special education – her initial reinforcer was access to time with Katie by attending these CrossFit classes. From Kathleen’s view, CrossFit exemplifies tiered systems of support in action. While Katie may be on the rig flying through 21 pull ups with great ease, Kathleen is on the same rig with assistance from two (very thick!) rubber bands to complete her 21 banded pull ups. While Katie is upside down on a wall doing deficit handstand pushups, Kathleen is laying on top of box, with arms stretched out, simulating handstand pushup (with an ab-mat on the floor just in case she loses control!). The list of modifications goes on and on (and we will spare you the accommodations needed during jump rope activities - an important one for women over 50!). One might think of these adjustments as tiered supports, with Katie needing Tier 1 prevention efforts only, Kathleen needing Tier 2 supports, with others requiring even more intensive Tier 3 supports (e.g., ring rows).

Yet, regardless of the level of support needed, all athletes are included in the recreational activity, reinforced by a range of reinforcers – immediate and distal. All athletes are in the gym (or “box” if using CrossFit terminology) together regardless of limited athletic skills or injuries. Antecedent adjustments are made and desired behaviors are shaped via positive reinforcement. Thanks to the positive, productive climate and the extensive accommodations to support her access to this recreational reinforcement activity, Kathleen has gone on to solicit some of the same naturally occurring reinforcement experienced by Katie in addition to enjoying time with her talented daughter!

Our sincere thanks to Donald Baer and Greg Glassman, the fathers of applied behavior analysis and CrossFit, respectively! Now, hit gym and log your scores!

Have you ever planned what you thought was an exciting lesson, only to have trouble moving through the activities because students’ behavior “got in the way?”  Sometimes even the most talented teacher is tempted to say: “I am teaching, but the students are just not learning!” or “I cannot possibly teach until student behavior is under control.”

Instead of thinking about instruction with this divided view, another approach is to build instructional experiences specifically designed to meet students’ academic, behavioral and social needs in an integrated fashion. Many schools across the country have placed a priority on building comprehensive, integrated, three-tiered (Ci3T) models to meet students’ multiple needs. As part of a typical Ci3T plan, academic instruction at Tier 1 is accompanied by positive behavioral intervention and support (PBIS) strategies, as well as explicit instruction of social skills. By using a validated social skills curriculum, schools can help their students develop the ‘soft skills’ needed to do well academically and interpersonally.

At schools with Ci3T plans in place, teachers build lessons to simultaneously address three domains: academics, behavior, and social skills. For example, if a teacher is providing core instruction in mathematics using a validated curriculum, the lesson plan would likely follow a direct instruction approach. Specifically, the lesson would include an instructional objective linked to a district or state mathematics standard. Furthermore, the lesson would include a social-emotional objective of skills previously taught at Tier 1, such as goal setting or practicing good digital citizenship, to support their academic success. Once the academic and social objectives are set, the teacher constructs an engaging lesson by employing the following elements of direct instruction: a motivating anticipatory set, modeling, guided practice, independent practice, as well as experiences to support the generalization of new knowledge and skills to other settings. To ensure a smooth progression through these instructional phases, the teacher would remind students of the school-wide expectations. The teacher may even reteach particularly critical points within the lesson (e.g., showing respect to others with different perspectives). Finally, throughout the lesson the teachers would weave in specific strategies to increase student engagement and minimize disruption, such as behavior specific praise, instructional choice, increased opportunities to respond, active supervision, and pre-correction. Such well-constructed, integrated lesson plans set the stage for positive, productive, safe, and enjoyable instructional experiences for teachers and students alike.

We hope you will join us at the Teacher Educators for Children with Behavior Disorders (TECBD) conference in October 2018! In partnership with TECBD, Council for Children with Behavior Disorders (CCBD) will be hosting two three-hour workshops on Saturday, October 20, 2018: Supporting School Success! Feasible Strategies for Supporting Engagement (morning) and Supporting School Success! Designing Engaging Lesson Plans (afternoon). We hope you will register and join us!

The Janus Oral History Project collects the reflections of leaders in education of children with emotional and behavioral disorders (EBD). Participants are asked to reflect on events that have influenced their career, the current state and future of the field, and to share their advice for those entering the field. The Midwest Symposium for Leadership in Behavior Disorders (MSLBD) has provided ongoing support for the Janus Project. To date nearly 70 conversations have been recorded in video form and are available at the following URL: http://mslbd.org/what-we-do/janus-project/

Below are excerpts from a conversion with Kay Cessna. Kay passed away at home on May 6, 2018 surrounded by her family. She started her career as an elementary teacher and later worked for the Colorado Department of Education working with teachers around the state. She also served as the Director of Special Services for the Jefferson County Schools, a large Denver area school district. Kay was employed in that capacity when the Columbine High School shooting occurred. Her leadership following that tragedy has served as a model for others who have since faced similar situations. The following are selected excerpts of our 2008 interview with Kay.

* * * * *

Janus:            If we could look forward from today, what do you see as the future of the field?  

Kay:    I think we really need to be refocused on the purpose of school on the learning part. I wish I had this little "ah-ha" about 15 years earlier in my field. I think somewhere deep in my heart, I thought if I couldn’t love them well, I could at least teach them well. I don’t think my colleagues who work with visually impaired kids worry about that. They never expect that if they did their job well enough they could help these kids see again. They really see their job as helping them have the highest quality of life given whatever lot they’ve drawn. I think somehow there’s a major switch that I haven’t quite worked through in my mind yet. It’s not the same as acceptance, but it is a realization of the impact of the condition.  

If you have bipolar [disorder], we need to teach you to live productively with bipolar. If you’re schizophrenic and you’re ready to check out, we need to be asking several questions. Like, "What’s the correct way to do that?" or " How do you keep yourself safe when you do that?”…those kinds of things we’ve really not thought about. It’s almost like because we’re so operative, we just don’t allow that any of the neurons firing might have something to do with the conditions they deal with.

I think we need to be much more intentional in even listening to our kids. Questions like, "What happens for you when that goes on?" or " Do you know when it’s happening?” I think we’ve got to refocus on helping them live comfortably and successfully with true neurological-biological based behavior disorders.  

I think that we’ve really got to embrace a lot of the other things that are happening in the world. We need to take something like systems theory and apply it to an individual human being who’s living in that system. For example, there is incredible research that I’ve been reading about what they’re able to do to treat phobias using simulations.  

I do think there’s quite a lot that’s not in the behavior disorders literature because the behavior disorders literature is very involved in policy. Now if I scan the front page of the journal, I kind of do my own systems analysis all the time. I keep scanning the journals and see who’s writing about what. I think we’re very mired down right now, kind of into the mechanics in keeping the monster of special education alive and dealing with the mechanics - painting this room and redecorating this one. To really do a breakthrough thing about where are we going with this kid, that’s where we’ve got to get refocused. That’s a disadvantage of being a mature person in the field. When you’re all out of lessons, everything’s up for grabs. We’ve kind of lived through the adolescent, creative time of the field, but that doesn’t mean it can’t become again in a more mature way.

Janus:            That may be our mid-life crisis.

Kay:    Yeah, it allows us to say, “You know what? You don’t have to do this. We can think this over another way.” I do think there are incredibly exciting things happening. I think of getting the picture of passing through that adolescence phase of thinking that it has to be our way or truth has been thrown out the window.  I think that’s an incredibly important tool and it leads us to many wonderful things for many wonderful kids who would not have been treatable before. It’s when we insist that what we’ve been doing is the only answer and we’re not going to attend to the other things, that things turn out poorly. 

We need to know about that stuff. I don’t know where it’s going to take us.  We need to know about that stuff because the kids are different now - and some of that’s not bad at all - but kids are different today. My grandchildren, they’re on cell phones, they’re wired to the internet. My 5-year-old grandchild wakes me up by saying, “Put me into Sesame, Grandma. Oh, that’s it!” I think, I’m not even to the site yet. Seriously, it’s not a skill. His brain works differently.

* * * * *

The Janus Projects is thankful to Kay for her leadership and passion for working with children who present emotional and behavioral challenges. Kay's experience, counsel, and presence will be missed as we continue facing the challenges of providing support for students with EBD and creating positive and rehabilitative school cultures in the context of recurring crises such as those in Columbine, Sandy Hook, Parkland, and Sante Fe, Texas.

The complete conversation with Kay Cessna and her long-time friend, Steve Forness, can be viewed at https://archive.org/details/PanelDiscussionWithKayCessnaSteveForness     

or at the website for the Midwest Symposium for Leadership in Behavior Disorders (http://mslbd.org/what-we-do/janus-project/). Kay was the keynote speaker at the 2009 MSLBD annual conference. The title of her presentation was "Looking Back, Looking Forward: Renewing Our Commitment." An audio recording of her address can be found at https://archive.org/details/Cessnas2009KeynoteAddress.

Excerpts from conversations with other contemporary leaders in the field will appear in future issues of Behavior Today.

Substance abuse and addiction are epidemic problems in the United States and throughout the world (Center for Disease Control [CDC], 2016).  In this brief article we use the term substance abuse to encompass alcohol abuse, abuse of illicit drugs (e.g., cocaine, heroin), or abuse of prescription drugs (e.g., opioids, central nervous system depressants). Abuse of these substances threatens the lives of thousands of people each year. For example, according to the CDC, 91 Americans lose their lives to an overdose of opioids each day, with drug overdose being the leading cause of accidental death in the U.S. (Rudd, Seth, Scholl, & 2016).  The statistics describing substance abuse among youth in the United States are equally grim.  Researchers have suggested that more than 10% of adolescents suffer from substance abuse or dependence, with Caucasians being significantly more likely to develop abuse/dependence issues than other races (Kilpatrick et al., 2000).  A particularly disturbing trend is the growing use of opiates.  In 2015, 122,000 12 to 17-year old adolescents had an addiction to prescription pain relievers and approximately 21,000 had used heroin in the past year (Center for Behavioral Health Statistics and Quality, 2016).  Additionally, the rate of adolescents between the ages of 15 and 24 who died from a heroin overdose increased 15% from 2014 to 2015 (from 1452 to 1649; CDC, 2016). 

According to Addiction.com (2017), persons with disabilities have between substance abuse rates two to four times greater than do persons without disabilities.  Moreover, persons with disabilities are at a greater risk of substance abuse due to possible risk factors (National Rehabilitation Information Center, 2017).  Clearly, if students with disabilities have such problems, their academic and social emotional functioning will likely be negatively affected (Waldspurger & Dikel, 2015). 

In such situations, assessments for services under the IDEA or Section 504 may be required.  Unfortunately, the assessment of student needs may be affected by the substance abuse, which may make accurate evaluations difficult (Addiction.com, 2017).  Nonetheless, if a student is suspected of having a disability under the IDEA or Section 504, it is the duty of the assessment team to ensure that a full and individualized assessment is conducted. In such cases, a professional on the team conducting the assessment, such as a school psychologist or school social worker should have expertise in assessing students for possible drug abuse.  Readers should note that some states have privacy laws that cover substance abuse assessments.

Substance abuse is not a disability category under the Individuals with Disabilities Education Act (IDEA).  Thus, if a student engages in substance abuse, that in and of itself will not result in the student being identified as having a disability under the law, nor would substance abuse trigger the child find obligations of the IDEA.  If, however, there is a suspicion that a student may also have a disability that adversely affects his or her education or behavior, referral and assessment are required.  For school personnel to attempt to untie the Gordian Knot of whether a student’s educational or behavioral problems are due to a student’s disability or underlying substance abuse is an impossible task and any attempt to do so may subject the school district to legal difficulties. 

Additionally, although substance abuse disorder is not a disability category, students with disabilities served under the IDEA may have substance abuse problems.  For example, students served under the classification of an emotional disturbance (ED), may have concomitant mental illness, which could include substance abuse.  Additionally, many individuals who abuse drugs or alcohol may have underlying conditions such as anxiety and depression that may lead a student to self-medicate.  These underlying conditions may be the basis for the need to evaluate the child for an emotional disturbance under the IDEA and must be part of a thorough assessment if a student is identified as possibly having a disability, no matter what the category. 

Students with disabilities may also be eligible for services under Section 504 of the Rehabilitation Act if they have a mental or physical impairment that substantially limits a major life activity (e.g., learning, attention) and are being educated in a school that receives federal financial assistance.  This could include students who abuse drugs as long as the student is not currently engaging in the use of illegal drugs. Moreover, students who are in drug rehabilitation programs are eligible for services under Section 504 as long as they are no longer abusing drugs.

If the student who is suspected of substance abuse is in special education or being served under Section 504, a teacher, parent, counselor, or school official may request an additional evaluation be conducted.  If, however, a student who is a substance abuser is not suspected of having a disability under either law, neither the IDEA nor Section 504 require that he or she be evaluated for services, although as previously noted making such a determination could put a school district in a legally precarious situation. 

If a student is found eligible under the IDEA, because he or she is determined to be in one of the 13 disability categories and needs special education services, the IEP team is then responsible for ensuring that the student receives a free appropriate public education (FAPE) under the IDEA.  Similarly, if a student with disabilities qualifies under Section 504, a team of professionals likewise has an obligation to ensure that that student receives a FAPE under that law.  School districts may have professionals with the expertise to address substance abuse issues, and in such cases, these professionals should be part of a student’s IEP or Section 504 team.  For these students it is the responsibility of the team to provide special education services under the IDEA or 504 services that enable the student to receive a FAPE. Unfortunately, neither special education services nor services under Section 504 will ameliorate substance abuse problems.  Successful treatment of substance abuse may involve specialized treatments, and if the substance abuse program involves medical treatment, schools are not required under IDEA or Section 504, to pay for or reimburse parents for such services.  Treatment programs that do not involve medical treatment; however, could be included in a student’s IEP or 540 plan, if the team believes it is needed to provide a FAPE to a student.

References

Addiction.com. (2017). Living with disability increases risk of drug abuse.  Available at https://www.addiction.com/3007/living-disability-increases-risk-substance-abuse/

Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/

Centers for Disease Control and Prevention (2016a). National Vital Statistics System, Mortality. CDC WONDER. Atlanta, GA: US Department of Health and Human Services, Retrieved from https://wonder.cdc.gov/

Individuals with Disabilities Education Improvement Act, 20 U.S.C. § 1415 et seq. (2004).

Kilpatrick, D. G., Acierno, R., Saunders, B., Resnick, H. S., Best, C. L., & Schnurr, P. P. (2000). Risk factors for adolescent substance abuse and dependence: Data from a national sample. Journal of Consulting and Clinical Psychology, 68(1), 19. doi: http://dx.doi.org/10.1037/0022-006X.68.1.19

National Rehabilitation Information Center (2017). Substance abuse and individuals with disability.  Retrieved from  https://www.naric.com/?q=en/publications/volume-6-number-1-january-2011-substance-abuse-individuals-disabilities

Rudd, R. A. (2016). Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR. Morbidity and Mortality Weekly Report, 65, 1445-1452. doi: http://dx.doi.org/10.15585/mmwr.mm655051e1.

Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794 et seq.

Walspurger, M. & Dikel, W. (2015).  Drugs and disabilities:  Conducting special education evaluations of students who abuse drugs or alcohol.  Retrieved from http://www.williamdikel.com/drugs-and-disabilities-conducting-special-education-evaluations-of-students-who-abuse-drugs-or-alcohol.html.