13. Children with Behavior Disorders The most common form of exceptional child the educator faces in the average classroom is the one afflicted with behavioral disorders defined as a deviation from age-appropriate behavior which significantly interferes with the child's own growth and development and/or the lives of others. Many times behavior disorders are misdiagnosed as some other form of exceptionality, but as research becomes more sophisticated in this area, proper diagnosis and interventions can and will be made. Kirk (1979) wrote that a child who is extremely withdrawn and does not relate to other people, who does not seem to respond to his environment, even though he is average in intelligence, is one whose behavior is interfering with his own growth process. Such children have been termed "withdrawn," "neurotic," "autistic," or "schizophrenic." Social workers say he is "socially maladjusted." Psychiatrists and psychologists may say he is "emotionally disturbed." And if he comes in contact with the law, the judge calls him, "delinquent." Behavior disorders in children may be actions which retard social and emotional and sometimes educational growth, or they may be actions which are detrimental to other people (p. 390). Behavior disorders are of interest to many professionals. Education traditionally dealt with only with the mild behavior disorders, leaving the more severe disorders to psychiatry. The field of mental health gradually moved away from a purely medical psychoanalytical approach toward a behavioral, educational approach (Ullmann & Kassner, 1965; Glasser, 1965). Hewitt and Jenkins (1945) analyzed 500 cases of maladjusted children referred to child guidance clinics. Three patterns of maladjustment were found, each being associated with a different home situation. They defined the three types of behavior disorders as follows: 1. The unsocialized aggressive child is one who defies all authority, is hostile toward authority figures, is cruel, malicious, assaultive, and has inadequate guilt feelings. Children of this type come from broken homes where they received no love or attention in infancy. 2. The socialized aggressive child has the same characteristics or behavior problems as the unsocialized aggressive, but he is socialized within his peer group, usually gangs or companions, in misdemeanor and crime. Unlike the unsocialized aggressive child he has some security with the mother or mother figure in infancy, but is later rejected. 3. The overinhibited child is shy, timid, withdrawn, seclusive, sensitive, and submissive. He is overdependent and easily depressed. Such children in the study came from overprotective families in the higher socio-economic levels. Hewitt and Jenkins's (1945) three categories boil down to a traditional dichotomy of (a) social maladjustment including delinquency and (b) emotional disturbance. In an attempt to bring classification in line with observed behavior, Quay, Morse, and Cutler ((1966) relabeled and redefined these two categories and added a third category which better describes the behavior of one group of children. The instrument used was the Behavior Rating Checklist developed originally by Peterson (1961). The sample consisted of 80 percent boys and 20 percent girls. They found three patterns of behavior clusters as follows: 1. Conduct Disorders are sometimes referred to as unsocialized aggressive behavior. These children display behaviors such as defiance, disobedience, impertinence, uncooperativeness, irritability, boisterousness, attention seeking, bullying, temper tantrums, hyperactiveness, restlessness, and negativism. 2. Personality Problem Dimension sometimes referred to as being hypersensitive, neurotic, or overinhibited. These children were rated as being hypersensitive, shy, having feelings of inferiority, lacking self- confidence, self-conscious, easily flustered, fearful, and anxious. 3. The Inadequate Immature Dimension refers to children who were rated as inattentive, sluggish, lacking interest in school, lazy, pre-occupied, day dreamers, drowsy, and reticent. The label, delinquent, is a legal term and is reserved for those children whose behavior results in arrests and court action. Children who were elsewhere described as "socially aggressive" and "unsocialized aggressive" frequently display behavior that brings them into contact with the law and results in their being labeled "delinquent." After surveying numerous definitions of delinquency, Wirt and Briggs (1965) formulated the following definition: The delinquent is a person whose behavior is a relatively serious legal offense, which is inappropriate to his level of development, is not committed as a result of extremely low intelligent intracranial organic pathology, or severe mental or metabolic dysfunction; and is alien to the culture in which he has been reared (p. 23). Delinquent behavior soared in the 1960's and continues to do so. According to the FBI, Rakstis (1970) stated that: According to the Federal Bureau of Investigation juvenile arrests for serious crimes climbed 78 percent between 1960 and 1968, while the juvenile population rose only 25 percent. In 1968 youthful offenders accounted for 61 percent of all auto thefts, 54 percent of larcenies, 55 percent of burglaries, and 33 percent of robberies (p. 21). In a study by Morse, Cutler, and Fink (1964) characteristics of 441 children in programs for behavior disorders were listed as follows: 1. The range in age was from 5 to 15 with a mean for the boys of 9.4 and for the girls 9.8 years. 2. Of the group, 82.3 percent were boys and 16.8 percent were girls. 3. The teachers rated the majority of children as educationally retarded compared to their chronological- age educational expectancy. 4. The IQ range was 68 to above 132. The majority of children had IQ's over 100. 5. More than half of the sample were classified as neurotic, with "acting out" behavior as the dominant conduct problem. Another large group was classified as "primitive neglected" or immature. Kirk (1979) wrote that there are two approaches to the study of behavior disorders. The psychodynamic group view them as a result of intrapsychic conflicts that must be treated before the education of the child can take place. The behaviorist psychologists, and especially those dealing with operant conditioning, recognize that complex historical events determine behavior, but they felt that modification of behavior is not dependent on the reconstruction of the past or on inferences about the nature of the cognitive or affectional state of the individual. The laboratory research of Pavlov (1928) in Russia led to theories of behavior disorders as resulting from frustration. He experimented with both animals and children and found the same results. Stimulus-response theory suggested that with enough conditioning any animal or human could be predicted to act in a particular manner. However, when faced with insoluble problems, individuals exhibited behavior deviations and also lost habits they had earlier acquired (Hilgard and Marquis, 1940; Maier, 1949). These experiments suggested the hypothesis that frustrating experiences lead to aggression, regression, and/or resignation. Dollard et al (1939) postulated the well-known frustration- aggression theory. They believed that when goal-directed behavior meets interference, the individual is frustrated and his frustration leads to aggression. Barker, Dembo, and Lewin (1941) demonstrated with young children that frustration can lead to regression, defined as returning to an earlier form of behavior. Maier (1949) cited resignation as another reaction to frustration. This behavior deviation seems to be a loss of motivation and inability to respond constructively following repeated frustration. Some studies show that child-rearing methods featuring inconsistent discipline and rejection or hostility on the part of parents are positively correlated with conduct disorders. These same factors are thought to be related to many forms of personality problems. Bandura and Walters (1959) found that certain child-training factors and family interrelationships differentiated a group of aggressive boys who had come into conflict with school authorities or county probation authorities from a group of high school boys not in such conflict. They found that parent attitudes rejecting dependence, encouraging aggressiveness outside the home, and placing fewer demands for obedience, responsibility, and school achievement were significant. There was also less affection shown between father and mother and between parents and the boy. The proponents of behavior modification view all behavior, maladaptive as well as adaptive, as learned. Unlike the psychodynamic workers who see behavior disorders as symptoms of intrapsychic conflict that must be uncovered, analyzed, and treated, the behaviorist views the manifest behavior as the problem that must be dealt with. While the behaviorists admit that complex historical events determine behavior, they do not believe the reconstruction of the past is a necessary and sufficient condition to successfully effect a change in behavior. Wolpe, Salter, and Renya (1965) described the different kinds of therapies that have been used by applying the principles of respondent and operant conditioning. According to Bijou (1961) respondents are those responses which are learned by stimuli that precede them. Operants function through controlling the stimuli that follow the responses. Programmed learning materials and teaching machines utilize operant conditioning techniques. These rely heavily on positive reinforcement through knowledge of results. The main responsibility of the teacher as a behavior modifier is (1) to delineate specifically the behavior or behaviors that are considered maladaptive, (2) to determine the situations or environmental events that are sustaining or reinforcing this maladaptive behavior, and (3) to restructure the environment of the child to modify, change, or alter the maladaptive behavior. Hewett (1968) was one of the principal advocates of the developmental strategy for the education of children with behavior disorders. He established an educational program which was primarily a behavior modification procedure, with a developmental sequence of seven educational goals. These are: (1) attention, (2) response, (3) order, (4) exploratory, (5) social, (6) mastery, and (7) achievement. To assist the teacher to move the child up the hierarchy, Hewett (1967) organized what he considered to be the three essential ingredients for effective teaching: (1) selection of a suitable task; (2) selection of a meaningful reward; (3) maintenance of a degree of structure under the control of the teacher. At each level of the sequence is (1) the child's problem, (2) the educative task, (3) the reinforcement (reward), and (4) the teachers's structure. In Hewett's model, the child continues to be reinforced even if he has a bad day and regresses somewhat. The child is not penalized for maladaptive behavior on one level if he can stabilize his behavior or another. For this reason, assignments are quickly changed at the first sign of maladaptive behavior on any assigned task. Kirk (1979) described the learning disability strategy as one which intervenes directly into the remediation of the specific disability: language, reading, writing, spelling, thinking, perceiving, etc. Effective remediation tends to decrease the conduct and personality problems by assisting the child in decreasing the discrepancy between his capacity to perform and the requirements of society. The psychoeducational strategy is an eclectic approach and is concerned with what the child does and why he does it. It is concerned with the learning disability strategy since many of the emotionally disturbed are retarded educationally. In this model the psychiatric and educational emphases are equally balanced, and joint planning is accomplished among workers. Morse et al (1964) in their survey of classes for emotionally handicapped found that about one quarter of the children in the classes and/or their mothers had conjunctive therapy; that is, they were receiving psychotherapy as a planned part of their educational program by personnel other than the teachers. The goal of this type of intervention is to interrupt the behavioral cycle. Some of the factors which need to be examined in an attempt to reach this goal would include: (1) the nature of the demands and pressures placed on the child; (2) the ability of the child to meet these demands; (3) peer group relations; (4) pupil-teacher relations; (5) the youngster's motivation for the behavior; and (6) his self-concept. Long and Newsman (1965) described four alternatives to behavior that may be used by the teacher. The first is called preventative planning and suggests a hygienic environment which will allow the child to bring his behavior under control. The second is called permitting and suggests that certain types of behavior should be sanctioned by the teacher at times such as running and shouting on the playground. The third is called tolerating and suggests that the teacher should tolerate the behavior, because it is temporarily beyond the child's ability to control. Fourth, the teacher may interfere or interrupt a behavior sequence for the protection of others in the class, or for the protection of ongoing classroom activities. Kirk (1979) summarized the advantage of the psychoeducational model over the psychodynamic model as being organized and implemented within the scope of the school's responsibility making the teacher an integral part of the team with significant decision-making responsibility (p. 410). Proponents of the ecological strategy believed that a total redefinition of the nature of social pathology is required. Rhodes (1967) stated: In this alternative view of disturbance, it is suggested that the nucleus of the problem lies in the content of the behavioral prohibitions and sanctions in the culture. Any behavior which departs significantly from this lore upsets those who have carefully patterned their behavior according to cultural expectations. The subsequent agitated exchange between culture violator and culture bearer creates a disturbance in the environment. It is this reciprocal product which engages attention and leads to subsequent action. The ecological model proposes that human problems result from an agitated transaction between the excitor (the child) and the responder (the environment--family, siblings, teachers, children, etc.). The behavior disorder is a point of misfit between the child and his environment (p. 449). Hobbs et al (1969) implemented the ecological strategy with programs for emotionally disturbed children which they called Re- Ed (a project for the reeducation of emotionally disturbed children. The general program of reeducation followed these principles: 1. Life is to be lived now. This was accomplished by occupying children every hour of the day in purposeful activity, and in activities in which they could succeed. 2. Time is an ally. Some children improve with the passage of time. But a child should not remain in a residential setting for long periods since this length of time may estrange him from his family. Six months in a residential center was the goal of Re-Ed. 3. Truth is essential. Trust, according to Hobbs, is not learned in college courses, but some of those working with emotionally disturbed children "know without knowing they know, the way to inspire trust in children" (p. 302). 4. Competence makes a difference. The arrangement of the environment and learning tasks must be so structured that the child is able to obtain confidence and self- respect from his successes. 5. Symptoms can and should be controlled. The treatment of symptoms instead of attempting to use the medical model of treating causes is emphasized. 6. Cognitive control can be taught. This is accomplished by immediate experience, by the moment to moment know- how, and by day-to-day relationship between the teacher and child. 7. Feelings should be nurtured. Situations are arranged with animals and people to allow the child to show affection or other feelings. 8. The group is important to the child. Children in Re-Ed are organized in groups of eight with two counselor- teachers. Discussion of difficulties or sharing experiences develop the kind of human relations to which these children are unaccustomed. 9. Ceremony and ritual give order, stability, and confidence. Rituals and ceremonies, like a nightly backrub or being the member of a club, or a Christmas pageant, serve a major purpose. 10. The body is the armature of the self. This is accomplished through the physical activities of swimming, climbing, clay modeling, etc. 11. Communities are important. Activities to give the child a sense of responsibility to the community such as trips to fire departments, etc., are provided by Re- Ed. A liaison teacher prepares the family, school, and community for the return of the child to the community. 12. Finally, a child should know joy. In Re-Ed the counselor-teacher arranges for each child to recognize joy each day and to anticipate joy the next day. An initial follow-up survey conducted by Hobbs et al (1969) six months after 93 children completed the first Re-Ed program, it was found that 80 percent of the graduates were doing well. Recent comparisons of subgroups of adolescent, academic underachievers (i.e. general low achievers versus the learning disabled), Deshler, Schumaker, Alley, Warner, and Clark (1982) have found that "LD adolescents are more like other achievers than they are unlike them" (p. 3). Support for this find has also been reported for elementary age students (Taylor, Satz, and Frieb, 1979: Ysseldyke, Algozzive, Shinn, and McGue, 1979; Algozzine and Ysseldyke, 1983). These types of findings have led Deshler et al. (1982) to conclude: Settings in which LD and BD adolescents and young adults are expected to function place heavy demands on their cognitive and academic skills, the very area in which deficit performances by LD and BD adolescents have been identified. Thus, when placed in a setting that necessitates performance of skills in which they are deficient, LD and BD adolescents not surprisingly perform more poorly than their peers. In spite of this, LD and BD adolescents and young adults are not markedly different from others who are having difficulties in the same environments...LD and BD adolescents in school environments are similar to low achievers in this setting (p. 11).