Welcome to the fall edition of The PAR Quarterly. This newsletter is designed to highlight topics of interest to you, our Customer. In this issue, we focus on the issue of emotional disturbance in children and adolescents.

Emotional disturbance: Some definitions

The Individuals with Disabilities Education Act (IDEA) defines emotional disturbance as follows:

• (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.
• (ii) Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance under paragraph (c)(4)(i) of this section.

Emotional disturbance is an umbrella term for a range of conditions including anxiety disorders, bipolar disorder, depression, eating disorders, obsessive-compulsive disorder, and psychotic disorders. The National Dissemination Center for Children with Disabilities (NICHCY) says that typical characteristics and behaviors of children with emotional disturbance can include hyperactivity, aggression or self-injurious behavior, withdrawal, immaturity, and learning difficulties.

Emotional disturbance by the numbers

A report by the Centers for Disease Control and Prevention states that during a recent school year:

• More than 8 million children ages 4-17 years had parents who talked to a health care provider or school staff about their child’s emotional or behavioral difficulties.
• Nearly 3 million children were prescribed medication for difficulties with emotions or behavior.
• Approximately 5% of children received “treatment other than medication” for emotional or behavioral difficulties.

Two recent studies funded by the National Institutes of Mental Health (NIMH) assessed the prevalence and severity of serious emotional disturbances (Archives of General Psychiatry, April 2012) in adolescents. They concluded that:

• About 8% of teens in the U.S. have a serious emotional disturbance (SED).
• Twenty percent of adolescents will be affected by a mental disorder at some point in their lifetime.

Assessment for emotional disturbance: Resources from PAR

IDEA requires that special education services be made available to every eligible child between ages 3 and 21 years with emotional disturbance. This makes accurate, reliable, and valid assessment for emotional disturbance a vital part of the job for any mental health provider who works with children and families.

PAR offers a range of assessments for emotional disturbance and related areas.

• The Emotional Disturbance Decision Tree™ (EDDT™) helps you identify children who qualify for the special education category of emotional disturbance based on federal criteria from IDEA. The EDDT includes five sections that correlate with the specific components of the federal criteria, enabling you to work through each criterion one by one. The companion parent form (EDDT™-PF) adds a parental perspective; parent booklets and forms are also available in Spanish.
• The State-Trait Anger Expression Inventory-2™ Child and Adolescent (STAXI-2™ C/A) is a self-report measure that distinguishes temporary anger states from more trait-like or enduring conditions. It also measures anger expression and control, helping you to pinpoint specific problem behaviors in children and adolescents.
• The State-Trait Anxiety Inventory for Children (STAIC) is a self-administered measure of anxiety for elementary school children in Grades 4, 5, and 6.
• The Pediatric Behavior Rating Scale™ (PBRS™) helps you identify symptoms associated with early onset bipolar disorder in children and adolescents. Parent and teacher responses provide setting-specific information; items address elements that are unique to early onset bipolar disorder, including mood swings, chronic irritability, grandiosity, explosive outbursts, and emotional meltdowns.
• The Reynolds Child Depression Scale™–2nd Edition (RCDS™-2) is designed to screen for depression in children ages 7-13 years; it is ideal for use with groups of students as part of school- or class-wide screenings.
• The Reynolds Adolescent Depression Scale, 2nd Ed. (RADS-2™) is a self-report measure for ages 11-20 years that measures the four basic dimensions of depression: dysphoric mood, anhedonia/negative affect, negative self-evaluation, and somatic complaints.
• The Clinical Assessment of Interpersonal Relationships™ (CAIR™) helps you to measure the perceptions that children and adolescents have about the quality of their relationships with the most important people in their lives—their mother, father, male and female peers, and teachers.
• The Social Emotional Assets and Resilience Scales™ (SEARS) helps you assess the social-emotional competencies of children from the perspectives of the student, the parent, and the teacher.

More resources

The American Academy of Child and Adolescent Psychiatry (AACAP) is a great source of excellent, free information to share with families who may be coping with a wide range of challenges. Their Facts for Families is a series of brief, downloadable flyers on specific conditions such as depression, attention deficit disorders, oppositional-defiant disorder, bipolar disorder, eating disorders, obsessive-compulsive disorder, and autism spectrum disorders.

Another informative resource, the NIMH’s Child and Adolescent Mental Health Web site posts the latest science news about children and adolescents. You can sign up for e-mail updates on topics of interest to you.

The Council for Exceptional Children Web site includes a wealth of information on emotional disturbance, including summaries and links to research on a wide range of special education topics. Although CEC is a membership organization, many of their materials are available to the public.