Assessing severity in behavior disorders: Empirically based criteria

Abstract

School psychologists are routinely required to make judgments about the severity of behavior disorders in children. While federal law demands that a child exhibit an emotional problem "to a marked degree," school psychologists are given few clearcut guidelines for making judgments about the severity of students' adjustment problems. The purpose of this paper is to present a list of empirically based criteria for assessing the severity of behavior disorders in children. To this end, research on major behavior disorders in children of interest to school psychologists is reviewed.School psychologists are routinely required to make judgments about the severity of behavior disorders in children. As used herein, the term behavior disorders refers to both conduct disorders and emotional problems. Severity refers to the degree or harmful extent of the consequences of given disorders. Not only would a very severe condition have adverse effects on the individual and/or others, it would also be characterized by a poorer response to intervention and have an unfavorable outcome. Given the ubiquity of children's problems and the financial constraints of school districts, care must be exercised in rendering judgments about the severity of children's person and social difficulties. Federal law (e.g., PL 94-142) requires that a child manifest an emotional problem "to a marked degree"; some state laws demand differentiation between seriously emotionally disturbed and emotionally disturbed; yet psychologists are given few clearcut guidelines for making judgments about the severity of students' adjustment difficulties.Major texts on child psychopathology (Quay & Werry, 1986) and school psychology (Reynolds & Gutkin, 1982) do not provide explicit, systematic, integrative coverage of this important issue. Thus, despite the ever-present demand to evaluate the severity of pupils' behavior disorders, psychologists are given very little precise guidance in making judgments about the severity of children's adjustment problems.The purpose of this article is to develop a list of empirically based criteria by which psychologists can judge the severity of behavior disorders in children. To this end, the published research literature on the major behavior disorders in children that is of interest to school psychologists is reviewed. The focus of this review is limited, by and large, to a discussion of the nature of the child's condition as it relates to severity. Discussion of home (e.g., parental psychopathology), community (e.g., community disorganization), and classroom factors (e.g., pacing) are excluded, even though they influence severity of the child's disorder. Moreover, no attempt has been made to review systematically each criterion presented with respect to every psychopathological disorder of childhood as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM 111-R, 1987), which devotes 68 pages to disorders usually first evident in infancy, childhood, or adolescence (excluding mood disorders and schizophrenia, ...

Stability of Special Education Placements: Data-Based Policy Consultation

“…As for the amount of service, the mean number of minutes of services at the time of follow-up was 677, 1,032, and 1,541 for students with one, two, and three or more classifications respectively, F(2, 331) = 32.7, p I .001. The greater amount of time in special education for students with more than one classification is consistent with the finding that comorbidity is an indicant of severity in childhood psychopathology (Clarizio, 1990). The child's IQ was significantly related to changes in classification, F(3, 275) = 8.25, p r .001, and type of service, 2(4, 329) = 28.9, p I .001.…”

“…Over the 3-year period, pupils with a single classification experienced a decrease of more than 1 hr per week in special education services whereas those with two classifications averaged an increase of 2% hr per week in special education services. In short, comorbidity (having more than one condition) appears to be an indicant of severity in public school population as it is in clinic populations (Clarizio, 1990).…”

Three ways to consider educational performance when determining serious emotional disturbance.

“…The most troublesome aspects of the definition, such as whether the presence of social maladjustment precludes SED identification, have been tackled directly in the literature (Clarizio, 1992; Forness, 1992; Skiba & Grizzle, 1992; Skiba, Grizzle, & Minke, 1994). School psychologists’ awareness of emotional problems also has been highlighted at the same time that an apparent paradigm shift is occurring toward emotional/behavioral concerns in the school psychology literature (e.g., Adams, Wass, March, & Smith, 1994; Jones, Sheridan, & Binns, 1993; Laurent, Hadler, & Stark, 1994; Sandoval, 1996; Sandoval & Brock, 1996), in the core professional skills advocated for doctoral level school psychologists (American Psychological Association, 1994; Hughes & Conoley, 1995), and by articles describing how to identify and quantify emotional/behavioral problems using objective instruments (Clarizio, 1990; Clarizio & Klein, 1995; Mattison & Gamble, 1992; McConaughy, 1993; McConaughy, Mattison, & Peterson, 1994; McDermott, et al, 1995). School psychologists’ practice regarding preferred instruments, chronicity of symptoms, and social maladjustment exclusion likewise have been reported (Clarizio & Higgins, 1989; Wodrich & Barry, 1990).…”