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INTERNALIZING DISORDERSEDSP 306December 1, 2007Today’s AgendaClass Business8:00 to 8:15Virtual Class # 28:15 to 8:30Case Study Review8:30 to 9:30Break9:30 to 9:45Mood Disorders9:45 to 11:30Lunch11:30 to 12:00Mood Disorders / Anxiety Disorders12:00 to 1:30Break1:30 to 1:45Anxiety Disorders1:45 to 3:30Next Steps3:30 to 4:00What school data are you interested in reviewing for the last class?•Service Delivery?•Total enrollment•% of students on IEPs, 504s, ESTs•FTE of special educators•Behavioral Data?•Incident reports•Suspension / expulsion123Virtual Class•Need for interpreters•Conflict b/w FAPE, LRE and family culture•Separation of church and stateUnanswered questions•How does No Child Left Behind assist schools in addressing the issue of providing multicultural assessment when testing is standardized to accommodate an American curriculum? What about the ESL student?Unanswered questions•What kinds of training is available for practitioners to become more effective with multicultural families in the state of Vermont?456Unanswered questions•According the article, when practitioners and parents accept each other's traditional beliefs, intervention approaches can occur with a combination of belief systems. What examples can you provide of when a child's cultural beliefs conflicted with classroom management and how was this handled with respect to the families belief system?Unanswered questions•The article discussed how “parent beliefs about the nature of disability are related to parent beliefs about and participation in treatment and intervention”. Have you ever experienced this in a way that you felt limited or benefited the child? Please give examples.Unanswered questions•The article urged special educators to be “guides who respectfully offer services that families may or may not choose to embrace”. Have you experienced times when families chose not to accept special education services? How have you handled this as a professional?789What about Maria?•What are her strengths?•What are your concerns for her?•What potential disorders?•Hypotheses on functions?•Meet criteria for special education?•What else did you want to ask or know more about?Maria’s EBD Assessment•Interviews•Observations•Social Skills Rating System (SSRS)•Children’s Depression Inventory (CDI)•Relevant Syndrome Scales of Achenbach SystemBell Shaped Curve101112Maria’s Achenbach’sAnxious / DepressedWithdrawn/DepressedSomatic ComplaintsSocial ProblemsThought ProblemsAttention ProblemsRule-Breaking BehaviorsAggressive BehaviorMs. CortezMrs. PleasantMs. GabbyMariaBorderlineClinicalNormalClinicalNormalClinicalNormalClinicalBorderlineBorderlineBorderlineClinicalNormalClinicalNormalClinicalClinicalClinicalClinicalClinicalNormalClinicalNormalBorderlineClinicalClinicalBorderlineClinicalNormalBorderlineNormalBorderlineMaria’s Conners’ ScalesOppositionalCognitive ProblemsHyperactivityADHD IndexMs. CortezMrs. PleasantMs. GabbyClinicalClinicalBorderlineBorderlineClinicalClinicalBorderlineClinicalClinicalClinicalClinicalClinicalSocial Skills Rating System•Social skills: cooperation, assertion, responsibility, empathy, self-control•Problem Behaviors: externalizing, internalizing•What did you think of the SSRS?•What did it tell you about Maria?•How could this be helpful in your work?131415Maria’s SSRSSocial SkillCooperationSocial SkillAssertionSocial Skill Resp.Social SkillSelf-ControlProb. Beh.Ext.Prob. Beh.Int.Academic CompetenceMs. CortezMs. GabbyFewerFewerFewerFewerMoreMore-FewerFewer-FewerMoreMoreBelow•Most widely used child self-report for depression•5 subscales: negative mood, interpersonal problems, ineffectiveness, anhedonia, negative self-esteem•Long (27 items) & short (10 items)•Ages 7 to 17 yrs (3rd grade reading)•Takes 15 min. to administer (can read items to child)•Refers to last 2 weeksChild Depression InventoryMaria’s CDIScaleScoreTotal84Negative Mood64Interpersonal Problems84Ineffectiveness74Anhedonia74Negative Self-Esteem83161718The unfinished scale•Maria’s evaluator chose to discontinue administration of the Piers-Harris 2 Children’s Self-Concept Scale•A well-established measure of children’s perceptions about themselves•Standardized for children 7-18 years•Brief self-report measure with yes / no responsesPiers-Harris 2•Provides a measure of child’s self-concept with a total score (most reliable) and six domain scales:•Physical Appearance and Attributes•Intellectual and School Status•Happiness and Satisfaction•Freedom From Anxiety•Behavioral Adjustment•PopularityMood Disorders“I find nothing more depressing than optimism.”- Paul Fussell192021Depression Concepts•Depressed Mood - focus on symptom or emotional state (normative approach)•Depression as Syndrome - empirically derived cluster of behaviors & emotions (Achenbach approach)•Depression as Disorder - Combination of conceptually related symptoms show presence of a disorder (DSM-IV approach)•It was believed that depression did not exist in children in a form comparable to that in adults•Now believed that children do experience depression, and that depression in children is not masked, but rather may be overlooked because it frequently co-occurs with other more visible disordersHistory of DepressionMood Disorders•A mood disorder (also called affective disorder) describes a disturbance in mood•children with mood disorders suffer from extreme, persistent, or poorly regulated emotional states222324Depression in Young People•Depression is one of the most disabling childhood disorders•Prevalence in young people is increasing and age of onset is decreasing•The way in which depression is experienced and expressed changes with age•Depression in children under age 7 tends to be diffuse and less easily identifiedMajor Depressive Disorder•DSM-IV clinical diagnosis requires presence of a major depressive episode, which is suggested by:!•depressed mood/sadness most of the day, most days (in children and adolescents, may be irritable mood)•diminished interest or pleasure in activities•changes in appetite or weight•sleep disturbances•psychomotor retardation or agitation•fatigue or loss of energy•feelings of worthlessness or inappropriate guilt•difficulty thinking or concentrating•thoughts of death or suicidal ideationMDD Prevalence/Comorbidity•Prevalence:•point prevalence 2-8% of children ages


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UVM EDSP 306 - INTERNALIZING DISORDERS

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