Some Old-News Updates on Best Practices

Two articles you may have missed in The New York Times reiterate some important points about how to help children with two very different but very common difficulties – anxiety and disruptive behavior. 

The first article, an opinion piece written by Dr. Perri Klass, whose work and writing have been featured in a number of our blog posts (check out her other informative pieces in The Times here), reports on a meta-analysis that investigated the effectiveness of different therapies and drugs used to treat a variety of anxiety disorders in children. To read the meta-analysis on your own, see the reference at the bottom of this post. A meta-analysis is a large research undertaking that combines the results of many smaller studies to get a better idea of the big picture. This meta-analysis looked at a combined total of 7,719 patients between the ages of five and sixteen. As expected, the researchers found that exposure-based cognitive behavioral therapy (CBT) is a preferred treatment. With this type of therapy, children as young as five years old are exposed to what makes them anxious so that they can practice dealing with the triggers with support, while they simultaneously work on changing how they think about the things that make them feel bad. The researchers also found that the newer types of anti-depressants can be helpful, but they are best when used in combination with therapy (and they were found to be not as effective when used alone, as compared to the exposure-based CBT).

For those of us working in the field, this meta-analysis didn’t really tell us anything groundbreaking. It does, however, get the message out that there is an evidence-based way to help children who are suffering from the kind of anxiety that interferes with their ability to function at home and school. It also reiterates, for parents and caregivers who are seeking help, the importance of finding a therapist who focuses on this type of therapy in her or his work with anxious children.

The second Times article, from October, is another opinion piece, published in the Fixes column, and written by Suzanne Bouffard. In her column, Bouffard describes the process of Collaborative Problem Solving, a technique developed by Ross Greene, who wrote a book we love to recommend at The Yellin Center - The Explosive Child. Bouffard begins by describing the typical disciplinary methods used at many schools, even preschools, across the country. Children are typically removed from the educational environment as a disciplinary measure - they may be put in time out, forced to complete useless assignments as punishment, or even suspended from kindergarten. The main point that Bouffard makes here, and that is at the foundation of my field - school psychology - is that these exclusionary tactics may temporarily stifle unwanted behaviors, but they are also often psychologically harmful and, even more importantly, do not teach our youngest students what they should be doing instead. There’s an unfortunate persistent idea that kids behave well when they want to, but the truth is that kids behave well when they can. Taking a child who struggles with regulating her behavior and excluding her from the classroom and putting her in isolation, for example, does absolutely nothing to help her practice the skills she needs to do better next time.

Collaborative problem solving was described in one of my previous posts on this blog. Bouffard’s piece takes the philosophy behind it and puts it in a very real context, with real examples of families who have seen what a difference it can make. I highly recommend reading the article and thinking deeply about the kind of discipline your child experiences at home and at school. It offers us the opportunity to ask ourselves some potentially difficult questions about whether we’re really using what the field of psychology likes to call best practices when helping our children and our students grow into well-adjusted citizens.



Wang, Z., Whiteside, S. P., Sim, L., Farah, W., Morrow, A. S., Alsawas, M., ... & Daraz, L. (2017). Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety Disorders: A Systematic Review and Meta-analysis. Jama Pediatrics, 171(11), 1049-1056.



Photo by Michał Parzuchowski on Unsplash

Suspension, Disability, and Race

A new report, Opportunities Suspended: The Disparate Impact of Disciplinary Exclusion from School, provides a disturbing perspective on the impact of school suspensions on students with disabilities and on African-American students (and on those students who fit into both categories).

The report, written by Daniel J. Losen and Jonathan Gillespie, is from the Civil Rights Project at UCLA and analyzes data released in March 2012 by the U.S. Department of Education. 

The report notes the enormous number of school days lost to suspension -- more than three million per year -- and the fact that districts that suspend more students do not show that removing so many disruptive students from their classrooms results in any benefit (in the form of increased test scores) to the other students in their system. 

Among the most compelling findings are:

• the higher rate of suspensions for students with disabilities: 13%, or twice the rate of their nondisabled classmates,
• higher rates of suspension for all African-American students: 17%, which is far higher than any other racial group, and
• very high suspension rates for students who are both African American and disabled: 25%.

As we have noted before in this blog, there are special procedures in the Individuals with Disabilities Education Act that require an examination of the reasons a student with an IEP is being suspended and the relationship of that student's actions to his or her disability. This would be expected to result in fewer, not more, suspensions of students who have or are suspected of having a disability, not the greatly increased numbers revealed in the data contained in the report.

  

This is a well written and accessible report, worth reading for its analysis and suggestions for finding alternative approaches to discipline that do not result in excluding from school those students who often most need to be there.

Photo: Kevin Krejci / Creative Commons

School Law Institute

Yesterday's annual School Law Institute, sponsored by the Practicing Law Institute, covered a number of topics of interest to the attorneys, advocates, and school employees in attendence -- and should be of interest to parents as well. Not covered by the program, but very much a feature of the day, was the new format in which the conference was conducted, with each participant having an iPad at their seat, set up to provide the course materials, PowerPoint presentations, and course evaluations at the touch of a button. This is the kind of experience some of our children have in their iPad powered classrooms, and it was fascinating to see how this group of professionals, who ranged from their twenties through grey-haired seniors, handled this technology.

One topic covered at length was manifestation determination, the process by which a school is required to look at a student facing long term suspension (10 days or more, or a combination of shorter suspensions which add up to ten days or more) to determine if the student's conduct is connected to a disability. For example, if a student who has been classified as having an emotional disturbance and has an IEP in place is facing a suspension for fighting, the school is required to convene a meeting to determine whether the student's behavior was a manifestation of his disabilty. If so, his IEP team needs to immediately put in place appropriate measures to address this problem behavior and set up a behavioral intervention plan (or modify the one he may already have), so that the issues that triggered the fighting are included. This does not mean that students with IEPs cannot get suspended from school. Just that before that happens, the school needs to take a look at the student's disability and determine whether his IEP is doing a sufficient job of helping the student to deal with his areas of difficulty. These rules apply to public, charter, and state approved non-public schools, but not to other private schools.

Another presentation, by former Executive Director of Advocates for Children of New York, Elisa Hyman, Esq. focused on the disparities in how affluent families and those without means fare when dealing with the Individuals with Disabilities Education Act. It is more difficult for families who do not speak English, who do not know how to go about finding legal representation, or who cannot lay out tuition for a private school to avail themselves of the benefits of the IDEA. Ms. Hyman and her colleagues are working to use the attorney fee provisions of the IDEA to obtain services and an appropriate education for students who might not otherwise receive the free, appropriate, publicly funded education contemplated by the law.

Photo: Steven Depolo/Flickr Creative Commons