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Tuesday, October 14, 2008

Is it fair that the squeaky wheel gets the grease?

According to Mental Health America, "recent studies show that, at any given time, as many as one in every 33 children may have clinical depression. The rate of depression among adolescents may be as high as one in eight." (Department of Health and Human Services). As a school psychology candidate, I've had the chance to observe crisis intervention, individual and group counseling and socio-emotional assessments of many students. From what I've seen, there has been more focus in the school setting on assessment and intervention of externalizing behaviors, such as conduct disorder. Perhaps, however, other school psychologists and candidates have seen otherwise at their schools or practicum sites.

If you read up on depression in children and adolescents, you'll find that many of the symptoms or warning signs of depression exhibited by students are difficult to observe on a day to day basis because many of them are internalized. It is especially difficult to identify in adolescents because it is normal for them to experience constant ups and downs associated with external stressors and biological changes. An adolescent may present as depressed one day and elated another. Although this is typical teen behavior, it makes identifying depression much more difficult for school psychologists, teachers and parents.

On a personal note, in my hometown there have been a number of adolescent suicides in the past year. One of the incidences involved a local student who was a friend of my youngest brother and another happened to be my best friend's younger brother. Most suicide attempts are closely associated with depression. Since the issue hits close to home for me, I take it very seriously and think it's a matter worth addressing in the field. I'd like to hear feedback from current or future school psychologists on the following: Have you seen externalized behaviors addressed more frequently in your schools than internalizing behaviors? If so, is it fair that externalized behavior gets more attention from teachers and school psychologists? Are there better ways to identify depressed students and address their needs? How do you plan to balance the focus between both types of behavior?

This blog was created by Vincent Balestrieri.


Mike C said...

There is no doubt in my mind that externalizing behaviors take precedent over internalized conditions such as depression or stress and it is only when these conditions manifest themselves to the outside world that others take notice.
Behvaviors such as physical aggression, active noncompliance or out of seat behavior can wreak havoc on a teacher's classroom but the boy who sits quietly in the back of a classroom may be a teacher's dream because he doesn't bother anyone but this student may be at the highest level of danger.
It is important that educators be aware of changing demeanors in their students. If a student is typically happy who plays with many friends and then becomes a student who looks sad and isolates himself from social situations, it is important that educators take notice. It is also important that we make sure that parents/guardians are aware of possible symptoms of depression and how to intervene so that there is work being done at home and at school to help the student and prevent such tragedies as suicide.

Katie said...

It is also true in my school that externalizing behaviors take precedent over internalizing behaviors. Like Mike said the boy who sits quietly in the back of the classroom is the teacher's dream.
Right now we are currently taking observations on a child who is demonstrating isolated behaviors. He no longer wants to take part in social situations. He is very quiet, usually only spokes when spoken to and sometimes cries during school for no reason. But the truth is that if he didn't display non compliant and aggressive behaviors in the previous year I don't think anyone would have noticed.

Teachers, school psychologists, and administrators have to consta ntly be reminded that depression can be internalized and that even though the externalized behaviors are more obvious that the students who internalize their behaviors may be in greater need of help.

Anonymous said...

This issue is yet another issue that warrants interventions way before we come into the picture. Although it may seem that I almost always advocate for early intervention or addressing the under-lying issue that contributes the behavioral outcomes… it is really the only way! One could argue that my approach may be too clinical or analytical…however in this case, violent acts of aggression and or suicide does not just result from imitation or “copy cat” episodes in schools. It begins with brain formation and early life experiences. That is, if a child’s early years are fraught with instability, violence, and fears of abandonment; this will in turn affect the way the brain develops. If a child does not receive intervention during his or her “critical period” (the time when neurobiological development of the brain results in habit forming synaptic connections) it is likely that a child that will be predisposed to a depression, violence or aggression.

From this perspective….how can we REALLY intervene and/or help a child who is not easily identifiable? The reality is that we are inundated with writing BIP’s in order to help children who are “spinning like tops” in a classroom. Yes, I do “want to help the children” but at this point it is a matter of hard wiring that will take years to “unravel”. Can we really teach old dogs new tricks in a SCHOOL setting? At what point do we, as School Psychologists, realize that we really can not be effective?

I recommend reading, “Ghosts in the nursery” . I am sure the way you look at the timing of intervention will be impacted and may even change the population that you desire to work with. As this blogger infers, the time to intervene is now! Moreover, school personnel should be taught how to identify early warning signs of childhood depression.

Happy reading!

Rosa said...

I must say that my district has made mention of the quiet, non behavioral kid in the classroom. I went to a training last semester that was on Managing Antisocial Behavior and was being given to the I&RS teams in my district. We had an example story for a newspaper article about a boy that came to his school with a gun and just opened fire. We were asked to get into groups and identify what was done right, wrong, or better to have helped the kid in the story. Intervening early couldn't have been emphasized more by the trainers and as such we were taught to notice the child who is withdrawn in the class, the child that changes his or her way of dress, who the child interacts with, if the child is being bullied, etc. The I&RS teams were told to notice these early warning signs, tell the teachers to make referrals to the guidance counselor if they noticed these changes, etc. What's interesting is, most of the I&RS team were teachers now or at some point and were able to identify these identifiers in the article, new what could have been done and what should have been done...just like we as school psychologists have learned...but when you have a kids jumping on desks, wiggling/exposing their private parts, running the halls, flipping desks, etc. chances are, we forget the kid who's quiet and withdrawn and like Mike and Katie said, they become our dream student. I observed a kid who is selectively mute in his class, not b/c I was asked to observe him, but b/c he was placed in the wrong class and the CST received a call asking how he was doing in the wrong class. The child was basically not paying attention to the teacher about 80-90% of the lesson, he was looking aimlessly around the room. Since he's quiet, actually says almost nothing, he's not the problem in the class. So he isn't learning, but since he's not a problem behaviorally, he misses more and more of what he's expected to know. Then at the end of the day when he fails the state tests, they will blame it all on his limited cognitive ability. Can our programs ever truly prepare us for the reality some of us will experience? So we can choose to ignore him too, or I can do my paperwork at home, essentially working overtime, so that I can try to help this kid or at least try to get his teacher to care. So no Judy, I don't think it's fair that this kid and kids just like him are counting on someone who is willing to devote personal time to him...and bottom line is, many people will clock out at 3pm and say not my problem. Sometimes I wish I could be that person. :(

Anonymous said...

Educating everyone on internalizing as well as externalizing behaviors is the key – parents, administrators, teachers, students. The previous blogs have said it all. Anyone who owns or works with children/teens needs to be an astute observer and watch behavior closely, and right from the start. Teachers and students need to feel safe in their environments; all to often people are afraid to open their mouths in the school setting. Teachers and parents should strive to keep the lines of communication open. Also, it would be good for districts to have a plan in place for when situations arise. Just as zero tolerance policies are in place. Which makes me think about how violence is socially acceptable, but mental health issues are not. Hmmm...

Anonymous said...

oops - i thought i selected my name - the last post is mine!