In the field of special education, the topic of emotional disabilities is the most challenging to deal with. Unlike physical disabilities, developmental disorders, speech disabilities, dyslexia, attention deficit disorder, auditory processing disorders, active and passive language processing disorders, or autism, emotional disabilities are much harder to recognize, diagnose, and treat.
Until the Education for All Handicapped Children Act (EHA) was made into law in 1975, only 1 out of 5 children received special education services in the United States. Fortunately, the historical and political events of the 1960s (John F. Kennedy, Vietnam War, Civil Rights Movement) also changed the rights and special education needs for millions of children.
In 1990, EHA was renamed the Individuals with Disabilities Education Act (IDEA) in order to provide more research, technology, and support to the program. Since 1990 several amendments have been added to IDEA to further the rights of children, parents, and special educational services. In 2004, President Bush added additional laws to IDEA in order to align it with the No Child Left Behind Act of 2001. In 2009, President Obama signed the American Recovery and Reinvestment Act of 2009 and thus opened the opportunity for $12.2 billion in additional funds to IDEA.
Today, IDEA is serving 6.5 million children ages 3 to 21 and governs how states and public agencies provide early intervention, special education and related services.
What are the subcategories of special education?
Under IDEA, special education programs include any of the following 14 subcategories:
- behavioral disability
- deaf-blind impairment
- developmental disability
- emotional disabilities
- hearing impairment
- intellectual impairment
- multiple disabilities
- orthopedic or physical impairment
- other health impaired (including attention deficit disorder),
- specific learning disability
- speech and language disability
- traumatic brain injury
- visual impairment
What are emotional disabilities?
According to IDEA’s Regulations: Part 300 / A / 300.8 / c / 4 / (i), “Emotional disturbance means 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.
- (E) A tendency to develop physical symptoms or fears associated with personal or school problems.”
Unfortunately, because of many complicated factors in a school environment, many individuals are not even aware that they have an emotional disability until they are adults.
The National Dissemination Center for Children with Disabilities writes,
“The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years.”
One of the additional challenges in understanding emotional disabilities in children lies in its name. An emotional disability may be called emotional disorder, emotional distress, emotional disturbance, or mental disorder.
An emotional disability is an “umbrella term” for various mental and behavioral disorders. Emotional disabilities can include:
- Attention Deficit Disorder (ADD); Attention Deficit Hyperactivity Disorder (ADHD)
- Autism Spectrum Disorders (Pervasive Developmental Disorders)
- Bipolar Disorder (Manic-Depressive Illness)
- Borderline Personality Disorder
- Conduct (behavior) disorders
- Disruptive behavioral disorder (DBD)
- Eating Disorders(anorexia, bulimia)
- Generalized Anxiety Disorder
- Hyperactivity (short attention span, impulsiveness; this often results in symptoms similar to ADD/ADHD and can result in a misdiagnosis)
- Obsessive-Compulsive Disorder (OCD)
- Panic Disorder (panic attacks, excessive fears)
- Post-Traumatic Stress Disorder (PTSD)
- Psychotic disorders
- Schizophrenia self-injurious behavior (dermatillomania, trichotillomania, cutting)
- Social Phobia (Social Anxiety Disorder)
For special education professionals, it is often helpful to distinguish between internal disorders (for example depression) and external disorders (conduct disorder). Both disorders are, however, closely related and need to be approached simultaneously for an efficient evaluation and treatment options.
The National Institute of Mental Health reports that,
“Understanding the scope of mental health problems and treatment in the United States is central to NIMH’s mission. Much of what we understand in this area comes from research in the field of epidemiology; the scientific study of patterns of health and illness within a population. Research on psychiatric epidemiology shows that mental disorders are common throughout the United States, affecting tens of millions of people each year, and that only a fraction of those affected receive treatment.”
Only “a fraction of those affected” are adults and receive necessary treatment; even less are children.
What are the causes for emotional disabilities in children?
For special education professionals, there are two major criteria to take into consideration when evaluating someone for an emotional disability; genetics (nature) and environment (nurture).
Genetics plays a fundamental role in an emotional disability. An emotional sensitivity, a predisposition to alcoholism, a predisposition to depression, and a predisposition to internalizing or externalizing problems is passed down through generations.
A genetic predisposition to emotional sensitivities, alcoholism, or depression does not mean a child or an adult will display the symptoms of the genetic heritage. However, being aware of a family’s genetic history makes all the difference when evaluating a person.
An emotionally sensitive child or adult may appear perfectly fine until the individual experiences one of the triggers that can turn a genetically inherited emotional sensitivity into an emotional disability.
Those triggers include:
- abuse: emotional, physical, sexual, verbal
- accidental death of a family member or someone dear
- accidental death of a parent
- divorce, separation of parents
- financial problems: (resulting in suicides and murders of spouses and children after foreclosures)
- loss: of a person, a spouse, a child, a pet, a career, a dream, a purpose, a house (mortgage crisis), money, a dear object, health, (loss is one of the major triggers for suicide!)
- natural disasters: earthquakes, tornadoes, hurricanes, flooding
- near-death experiences
- parental marital problems (spousal abuse, physical or verbal abuse between parents)
- public exposure or humiliation (as seen in suicides following internet revelations of being gay, negative tabloid exposure)
- stress: emotional, academic, physical
- suicide of a parent, family member, someone dear
- violence: either personal or public (9/11, Colorado shooting, school shootings, soldiers/war)
Each child or adult reacts differently to environmental triggers. For any special education professional or mental health care professional, having the most available information about a child’s or adult’s family history is crucial for the best efficient treatment to those environmental triggers.
Children or adults that are perfectly fine throughout their life can suddenly and unexpectedly display extreme behaviors because of the combination of a genetically inherited emotional sensitivity and an environmental trigger.
What are the symptoms of emotional disabilities?
As described in IDEA’s regulations, the symptoms of an emotional disability can include
- learning difficulties
- difficulties to focus or concentrate
- an inability to build or maintain satisfactory interpersonal relationships
- inappropriate types of behavior
- a pervasive mood of unhappiness
- physical symptoms or fears associated with personal or school problems.
In contrast to the symptoms of dyslexia, attention deficit disorder, autism, active and passive language processing disorders, speech disorders, or auditory processing disorders, the symptoms of an emotional disability are much more difficult to diagnose for a special education professional.
A child with dyslexia or attention deficit disorder, for example, will display the symptoms around the age that he or she learns to read. The symptoms are most often persistent in an academic environment as well as personal environment. For educators and parents a diagnosis is much easier.
In contrast, a child with an emotional disability goes most often unrecognized because the symptoms in an academic environment might be very different than at home. While a child might have a panic attack during a test, there will be no sign of it at home. For teachers who have 30 students in a classroom, recognizing the emotional stress in one child is extremely difficult. As such, the stress an emotional child experiences in a school environment might accumulate to the point where the student fails completely, drops out of school, or turns to violence. There was no obvious warning, preparation, or defense and everyone asks, – what happened?
Besides the difference between home and school environment in regard to the symptoms of emotional disabilities is the age of a child and the length of time a child is experiencing environmental triggers.
The two important factors: age and length of time
An emotionally sensitive child who experiences stress in one or two tests in school might be able to adjust and learn to cope with the emotional experience. However, a child that consistently experiences stress in several tests will turn to whatever available resources there are. By trying to “survive” the stressful situation of test taking, a child will develop “survival skills”. Unfortunately, without support by parents, teachers, or special education professionals those coping or surviving skills can be destructive instead of constructive.
The factor of age is crucial in the diagnosis of a possible emotional disability. A 14-year-old young man who acts out in the classroom might not be behaving inappropriately because of a genetically inherited emotional sensitivity but because of hormones and trying to impress some girls.
A 7-year-old boy, in contrast, who acts out in the classroom might be inappropriately behaving because he is experiencing verbal or sexual abuse in school or at home.
For both the 14-year-old and the 7-year-old, a referral to the principal or detention would not be productive.
A referral to a special education professional, on the other hand, can provide the necessary assistance for the 7-year-old-boy and a much needed educational talk with the 14-year-old young man.
The future of special education and emotional disabilities
Because a school environment and special education teachers are limited in the information about a child and the right to interfere in a child’s personal life, the future of special education and emotional disabilities depends on the increased awareness about the disability.
The louder the voices, the clearer the message
“Tom Cruise grew up and succeeded despite poverty, frequent relocations, inadequate schooling and dyslexia. No doubt he was saved by his gifted acting ability as well as his dogged determination to overcome and thrive, come what may.” (Levinson Medical Center for Learning Disabilities)
In an interview with People Magazine published on February 11, 2005, Tom Cruise said,
“”When I was about seven, I was labeled dyslexic. I’d try to concentrate on what I was reading, and then I’d get to the end of the page and have very little memory of anything I’d read. I would go blank, feel anxious, nervous, bored, frustrated, dumb.”
By speaking about his childhood, Tom Cruise shows an excellent example of how easily a child can be misdiagnosed, if diagnosed at all. Tom’s feelings of going blank, feeling anxious, being nervous, bored, frustrated, dumb, could be interpreted as an emotional disability and a child with those feelings might have been prescribed antidepressants. No antidepressant would have helped his dyslexia.
Despite all of the information available to special education professionals, the lack of knowledge about all of the different types of learning disabilities still leads today to many incidents where a child is being misdiagnosed and receives the incorrect treatment.
Fortunately, Tom Cruise was correctly diagnosed with dyslexia and as adult became actively involved in programs supporting students with dyslexia. He is the founding board member of the H.E.L.P. — Hollywood Education and Literacy Project.
Similar to Tom Cruise, Anthony Hopkins has spoken openly about his painful childhood experience and learning disability.
“I was lousy in school: a real screw-up, a moron. I was antisocial and didn’t bother with the other kids… I didn’t know what I was doing there. That’s why I became an actor.” (Sir Anthony Hopkins Biography)
Tom Cruise and Anthony Hopkins are only two of the many voices that are already speaking about their painful childhood experiences. There are many more public voices needed. In order to increase the awareness for all disabilities, but especially emotional disabilities, more “former” childhood voices are needed for:
- the effect of genetically inherited emotional sensitivities
- the effect of a parent’s loss due to an accident (car, sports, any other) or illness
- the effect of continuous unwanted exposure to tabloids as a child (for child actors or other child public figures)
- the effect of continuous unwanted exposure to tabloids of one’s parent (if a parent is/was a public figure)
- the effect of public scrutiny, criticism, misrepresentation
- the effect on children caused by parental financial stress (bankruptcy, foreclosure)
- the effect on children caused by parental marital stress (a parent’s adultery)
- the effect of divorce on children
- the effect of a misdiagnosis or lack of diagnosis of a learning disability (dyslexia, etc.)
- the life-long effect of childhood sexual abuse
- the devastating emotional effect of childhood verbal abuse
- the effect of adult violence in a child’s life
- the devastating effect of suicide by an adult (especially a parent) in a child’s life
All of the above are major emotional triggers that can cause a child’s emotional sensitivity to turn into an emotional disability and warrant help and support for the child.
Even though there is general information about these topics available on the internet or in books, it is the specific sharing of childhood experiences provided by public figures that speak the loudest. It is those voices that have the power to make all the difference for the children of today, – the adults of tomorrow.
Mothers and Sons: A mother’s death
Princess Diana: Her childhood, legacy, love for Prince Harry, William, the world
Prince Harry’s classy mother: ‘My God, what’s happened?’
Suicide and San Diego:
San Diego earthquake: ‘My nerves are a bit shaky too’
San Diego suicide: Immadi Anil Kumar ‘thanked all his friends’
San Diego suicide prevention: Psychiatric news
San Diego suicide: Warning signs, what to do, who to call
The nature of dyslexia: Tom Cruise, Anthony Hopkins, Keira Knightley, Joe Wright
Jay Leno takes a salary reduction – shows the world a positive side of dyslexia
Michael Phelps wins more than Olympic medals; he wins the hearts of ADHD kids
Rosie O’Donnell and her childhood: ‘i am lucky to be here’ (Video)
Whitney Houston and Randy Travis: Alcohol and the lost ‘Sparkle’ of childhood (Video)