Characteristics of Emotional Disturbance

The detection of students with emotional and behavioral disorders in the United States education system is guided by definitions and guidelines detailed in the U.S. Individuals with Disabilities Act (Individuals with Disabilities Education Act, 2004). According to the Individuals with Disabilities Education Act (2004), emotional disturbance is defined as:

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: (1) an inability to learn that cannot be explained by intellectual, sensory, or health factors, (2) an inability to build or maintain satisfactory interpersonal relationships with peers and teachers, (3) inappropriate types of behavior or feelings under normal circumstances, (4) a general pervasive mood of unhappiness or depression, and/or (5) a tendency to develop physical symptoms or fears associated with personal or school problems.

(https://sites.ed.gov/idea/regs/b/a/300.8/c/4) Although the Individuals with Disabilities Education Act (2004) was developed to ensure students with emotional and behavioral disorders are not denied access to quality educational opportunities, educators and special needs support staff have expressed frustration over the definition of emotional disturbance, arguing the vague and subjective nature of the characteristics listed often interfere with the effective detection of at-risk students (Walker, Nishioka, Zeller, Severson, & Feil, 2000).

The ambiguity surrounding the defining characteristics of emotional disturbance is exacerbated upon consideration of cross-cultural comparisons of the practices that are used to identify students struggling with emotional and behavioral issues. For instance, in response to international calls to guarantee students’ rights to inclusive education services, many European countries have worked to refine the diagnostic criteria used to identify students with special education needs to ensure the allocation of the resources to students at considerable risk for academic difficulties (Banks & McCoy, 2011; Chakraborti-Ghosh, Mofield, & Orellana, 2010). Despite these reform efforts, most Western countries have failed to generate an agreed upon definition of emotional disturbance – also referred to as severe emotional disability (ED), emotional difficulties, or emotionally disturbed within commonly used classification schemes – and some countries have failed to recognize students with emotional disturbance as a unique subtype of students with special education needs (Chakraborti-Ghosh et al., 2010). Further complicating discussions of definitional guidelines is evidence suggesting that efforts to establish clear definitions of emotional and behavior disturbance within many non-Western countries are still in their infancy (Chakraborti-Ghosh, 2008; Chakraborti-Ghosh et al., 2010; Mazurek & Winzer, 1994).

Despite ambiguity with the operational definition provided by the U.S. Individuals with Disabilities Education Act (2004) and classification schemes used by educators within other Western and non-Western countries, researchers and practitioners have come to a general consensus that manifestations of emotional disturbance can be parsed into two qualitatively distinct categories: internalizing and externalizing (Merrell & Walker, 2004). Students with externalizing forms of emotional disturbance routinely engage in overt behavioral patterns that disrupt the classroom environment and interfere with effective instruction (i.e., aggression, noncompliance, and delinquent behaviors; Stouthamer-Loeber & Loeber, 2002; Walker, Ramsey, & Gresham, 2004), whereas students with internalizing forms of emotional disturbance typically exhibit inwardly focused cognitions and behaviors that contribute to academic deficits (i.e., major depressive disorder, generalized anxiety, obsessive compulsive tendencies, somatic complaints, eating disorders; Gresham & Kern, 2004; Morris, Shah, & Morris, 2002). Hue (Chapter 10, this volume) provides additional discussion of internalizing and externalizing behaviors. Given the clear impact that externalizing disorders have on learning environments and the relative ease of observation for external behaviors, there has historically been greater attention to this form of emotional disturbance. However, there is a growing and pressing level of research being devoted to internalizing disorders, prompted largely by the rising rates of identification of anxiety, depression, and related emotional disorders. The internalizing domain is where the bulk of our focus lies, but it is imperative to recognize that externalizing disorders frequently co-occur or point to more covert internalized emotional difficulties and should not be overlooked during the identification and intervention efforts (Bubier & Drabick, 2009; Martín, Granero, Domènech, & Ezpeleta, 2017).

The association between emotional disturbance and maladaptive outcomes is well established within literature focusing on the contribution of non-cognitive factors to academic success. Across their academic lives, students with emotional disturbance often struggle to master fundamental skills that are required for success (i.e., reading comprehension, written expression, mathematical reasoning; Reid, Gonzalez, Nordness, Trout, & Epstein, 210, 004; Wagner & Cameto, 2004; Wagner & Davis, 2006), receive lower grade point averages (Newman et al., 2011), fail courses at higher rates (Newman et al., 2011), and are more likely to withdraw from school prior to completion (Kaufman, Alt, & Chapman, 2004). Unfortunately, the experience of maladaptive outcomes among this population of learners is not confined to the school years and persists into adulthood. Results of large-scale, longitudinal examinations investigating students’ transitions to adulthood indicate learners with emotional disturbance experience more negative employment outcomes (i.e., unemployment, underemployment, and job instability; Bullis & Cheney, 1999; Carter & Wehby, 2003; Wood & Cronin, 1999), attend college at a lower rate (Wagner & Cameto, 2004), are more likely to come into contact with the criminal justice system (U.S. Department of Health and Human Services, 1999), and engage with the community at lower rates than their non-emotionally disturbed peers (Armstrong, Dedrick, & Greenbaum, 2003).

Factors Interfering with the Identification of Students with Emotional Disturbance

Given the sizable population of students at risk for persistent maladaptive outcomes associated with emotional disturbances, it is critical that educators can identify at-risk learners early enough to secure formal and informal support services (e.g., academic, social, emotional). However, research repeatedly demonstrates school personnel struggle to effectively identify and support students with emotional disturbances, as illustrated by the extremely small percentage of K–12 students (< 5%) who are currently receiving special education services (McFarland et al., 2017).

The Use of Universal Screening to Support the Identification of Students with Emotional Disturbance

Given the obvious limitations of these traditional “wait to fail” approaches, advocates have called for the adoption of universal screening methods to support the detection of emotional disorders and disturbances alongside cognitive deficiencies. Universal emotional and behavioral screening is a proactive approach that tests all students within particular educational settings (e.g., classrooms, schools, school systems) throughout critical time points (Bruhn et al., 2014; Glover & Albers, 2007). Those data are analyzed to identify the students who may need intensive and structured support or more limited supportive efforts to thrive academically (Marquez, Yeaton, & Vincent, 2014). A variety of benefits associated with the use of universal screening practices have been articulated in the literature, including greater precision in identifying need, timely response to provide support for those at risk, and the ability to more effectively observe changes over time within students.

Foremost in this list of benefits is that validated assessment measures enhance the likelihood of identifying students at risk for emotional disturbance who would benefit from additional academic, social, or emotional support. Related to this, universal screening improves the timeliness of identification. The importance of early identification cannot be overstated given the plethora of empirical evidence suggesting a large percentage of students with emotional disturbance are often identified too late for supports to meaningfully impact student outcomes (Walker et al., 2004). Finally, the collection of data at multiple points during the academic year allows educators to observe both progressive and rapid changes in level of risk that may prove critical in detecting student needs (Lane, Menzies, Oakes, & Kalberg, 2012).

The development and adoption of universal screening methodologies are generally most effective when incorporated into a “multitiered” program of academic support emphasizing the integration of identification and support strategies to assist struggling learners. Multitiered intervention frameworks are consistent with the logic of the response-to-intervention approach (Brown-Chidsey & Steege, 2010; Walker et al., 1996) which strives to support learners by implementing a continuum of evidence-based academic and behavioral interventions matched to the severity of the presenting behavior. The lowest tier of support (Tier 1) involves exposing all students in an educational setting to programming promoting core social and emotional competencies to prevent the development of problematic internalizing and externalizing behaviors (i.e., conflict resolution skills, classroom behavioral expectations, anger management strategies; Horner, Sugai, & Anderson, 2010; Seeley, Severson, & Fixsen, 2010; Walker et al., 1996). Students who demonstrate persisting deficits in functioning following exposure to Tier 1 programming are referred to receive additional support (Fletcher & Vaughn, 2009; Walker & Severson, 1992). The Tier 2 interventions are more intensive and tailored to meet the needs of clusters of at-risk students demonstrating behaviors that interfere with effective instruction and learning (e.g., social skills lessons, identification and management of emotional states; Horner et al., 2010; Walker et al., 1996). Finally, students who exhibit multiple risk factors for ED as well as learners who are not responsive to Tier 1 and 2 supports are exposed to Tier 3 interventions, which are highly structured, individualized interventions designed to reduce the intensity and frequency of severe externalizing and internalizing behaviors (Sugai & Horner, 2009). Because of their individualized nature and intensity, Tier 3 programs require coordination among a team of individuals (i.e., educators, administrators, school psychologists, counselors, behavioral specialists) to develop and implement them effectively (Horner et al., 2010; Seeley et al., 2010).

Benefits of Universal Screening Methods

Universal screening and multitiered frameworks represent a relatively new approach in the field of behavioral and emotional disabilities screening (Brown-Chidsey & Steege, 2010), but their impact on student outcomes is promising. Studies of implementations of school-wide screening practices that emphasize both preventative practices and targeted support after identification through screening practices have shown significant improvements in academic performance (i.e., improved vocabulary, course grades, standardized test scores), classroom behavior, and mental health outcomes (i.e., improved emotional perception, emotional management, reductions in internalizing behavior; Hoagwood et al., 2007; Vidair, Sauro, Blocher, Scudellari, & Hoagwood, 2014).

Unfortunately, schools in the United States and many other Westernized countries have been slow to incorporate universal screening and multitier support into their emotional and behavioral screening procedures (Bruhn et al., 2014; Volpe et al., 2018). For instance, one recent nationwide investigation of the prevalence of emotional and behavioral screening methods used in K–12 educational settings in the United States indicated the majority of surveyed school systems (87%) do not use universal screening and multitier frameworks to identify at-risk students (Bruhn et al., 2014). Common barriers to implementation cited by educational professionals include limited access to screening materials, budgetary concerns, and mere lack of awareness (Bruhn et al., 2014). Although these barriers were identified by educators in the United States, available evidence suggests educators interested in adopting multitiered support systems in European countries also cite limited access to screening tools as the primary barrier preventing the adoption of universal screening practices (Grosche, & Volpe, 2013; Volpe et al., 2018).

We see promise and advocate for broader use of universal screening and multitier intervention supports based on the value of early identification and intervention in promoting academic and emotional thriving for more students, as well as the financial benefits schools experience when adopting proactive rather than reactive policies. However, until universal screening becomes commonplace, schools must rely upon “frontline” educators to initially identify students with needs. One strategy to support this is to provide teachers and other school professionals with parsimonious and functional approaches to recognizing the signs demonstrated by students struggling to manage emotional stressors in educational settings.

Educational Psychology Perspectives on Emotional Disturbances

A variety of theoretical perspectives are relevant when examining the impact of emotional disturbances on optimal student functioning in schools (e.g., Pekrun & Loderer, Chapter 18, and Wigfield & Ponnock, Chapter 17, this volume). From a broad perspective, our work on explaining and intervening with students who present with internalized emotional difficulties is predominantly informed by social-cognitive and cognitive perspectives. This is not to minimize the clear utility of behavioral and cognitive-behavioral strategies to support learners with both internalized and externalized emotional difficulties. That literature is well established, and we recognize the utility of effective behavior management supports. However, we believe incorporating the social-cognitive and cognitive perspectives provides added value in helping educators recognize relevant factors that can support learners’ representations of academic settings and events to promote optimal functioning. Collectively, our views are explained by a model referred to as the emotional information processing framework (EIP; Cassady & Boseck, 2008). The EIP attempts to support the understanding of learners’ abilities to successfully navigate challenging events by recognizing the influences of (a) individuals’ perceptions of internal and external cues and (b) self-regulated learning and emotion regulation strategies (e.g., Crick & Dodge, 1994; Lazarus & Folkman, 1984, 1987; Pekrun, 2006; Schunk & Zimmerman, 2003). In short, the EIP model (see Figure 3.1) recognizes an iterative process for encoding and interpreting internal and external cues, developing and evaluating goals to respond to the perceived situation, and implementing solutions to meet these goals (relying on personal experiences to determine the most viable solutions for the task at hand; see Cassady & Boseck, 2008).

Emotional Information Processing Framework and Affective Disorders in Schools

Building on the brief overview of theory, this section is intended to provide a bridge between theory and practice, with an attempt to illustrate how educators may gain insight into identifying and subsequently supporting individuals with affective disorders (i.e., emotional disturbances) in academic contexts. The wide range of specific emotional and affective disruptions learners encounter in schools precludes a full detailing of all conditions. Given our own experience, we use academic anxieties to illustrate what we see as the functional potential of the EIP. However, the model is intended to function effectively in explaining a wide array of negative and positive emotional representations and behavioral outcomes that follow from those experiences.

Variations in Emotional Difficulties in Schools

A primary misconception we observe in our work with current and future educators is the belief there is uniformity in the experiences students with special needs or disabilities encounter. That is, many novice educators in particular suggest that characteristics of emotional disturbances will be universally demonstrated by all students experiencing that disorder. Obviously, this is an error of overgeneralization that is not limited to educating learners with emotional difficulties, but it is imperative to start all identification and intervention efforts with a reaffirmation that wide variability underlies individual experience. In the case of test anxiety, for instance, there is a long history of research demonstrating that there are at least two primary factors of test anxiety (i.e., cognitive/worry and affective/emotional; Cassady & Johnson, 2002; Liebert & Morris, 1967; Zeidner, 1998), with recent research suggesting a third factor emphasizing the role of socially focused concerns (i.e., fear of letting down important social others) in the experience of test anxiety (Friedman & Bendas-Jacob, 1997; Kavanagh, Harvey, & Mesagno, 2017; Lowe et al., 2008).

Another key point related to classic misperceptions of test anxiety is that the condition is not a transient experience that arises and dissipates within an evaluative session. To the contrary, test anxiety has been identified as present in three phases of the “learning–testing cycle” (Cassady, 2004; Schwarzer & Jerusalem, 1992). This recursive cycle represents the test preparation, test performance, and test reflection phases. Review of each phase has demonstrated that learners with test anxiety show differing forms of anxious responses during the three phases. During the test preparation phase, common responses include procrastination, withdrawal, or selection of relatively ineffective study strategies when preparation for the test does begin (Cassady, 2004; Kalechstein, Hocevar, Zimmer, & Kalechstein, 1989; Zeidner & Matthews, 2005). During the performance phase, the traditional representations of distracting thoughts, physiological hyperarousal, and fear of negative consequences of the test are commonly reported, hampering performance (Zeidner, 1998). Finally, during test reflection, learners with test anxiety are more likely to adopt learned helplessness perspectives and attributional stances that perpetuate negative appraisals for future testing events (Cassady, 2004, 2010).

Such variations in learners’ experiences with test anxiety led to Zeidner and Matthews’ (2005) proposed classification of six types of test anxiety: (a) study or testing skills deficits; (b) anxiety blockage or retrieval failure; (c) failure-acceptance, where anxiety promotes learned helplessness and low motivation; (d) failure-avoidance, where the learner actively withdraws from or avoids perceived stressors; (e) self-handicapping, which involves self-imposed barriers to success that ultimately provide ego-preserving explanations for eventual performance failures; and (f) perfectionism, with a predominately “maladaptive” style that involves socially prescribed and overly high expectations for performance. We believe that the development of diagnostic protocols (including assessment instruments, behavioral data, and recommendations from educators) in schools will help schools more effectively identify (a) primary sources of the anxiety; (b) immediate cognitive, behavioral, or emotional responses to those stressors; and (c) the academic, emotional, and social impacts that follow. When these diverse elements are reviewed for each individual case, there is a greater potential to identify both the causes and solutions for more effectively managing emotional difficulties in the classroom (see von der Embse, Barterian, & Segool, 2013).

Assisting Students with Academic Anxiety and Related Emotional Difficulties

The utility of the EIP can only be realized when put into operation. This section is meant to articulate exemplar strategies educators can employ to identify, explain, and help remediate students’ emotional disturbances. Collectively, we reiterate that the optimal condition to support such an effort would rest within a universal screening and tiered intervention model, but believe that, in the absence of such a formalized structure, diagnostic observation and prescriptive intervention can still be realized. Whereas the full model of the EIP addresses five primary phases or steps, for simplicity we address two broad aspects of cognitive and emotional processing: (a) attention, perception, and interpretation of external and internal cues and (b) self-regulation and emotion regulation strategies that focus on setting effective goals and monitoring progress in meeting those goals. Below, we articulate both the model perspective on the importance of these two broad domains of EIP as well as provide exemplar strategies that may support optimal outcomes for learners.

Future Research

Our brief overview of several converging lines of research demonstrates the field of educational psychology is actively pursuing solutions to support learners with emotional disturbances on a variety of applied and theoretical fronts. From our perspective, the theoretical constructs have been sufficiently articulated and supported, and it is time for applied research studies to take a lead in the discipline. We see two primary areas of promising research that are centered on applications of the theories articulated in this chapter. First, recognition of the shared characteristics of subclinical forms of anxiety in educational contexts (e.g., academic anxieties such as math or test anxiety) is critical to support learners with negative affective responses to educational settings. Broadening the attention of educators to the variety of anxiety responses that commonly arise in educational settings may provide a more focused identification of learners who struggle to perform at optimal levels owing to the deleterious effects of anxiety. As more educators begin to recognize the common forms of evaluation-related anxiety learners experience in all phases of educational activity (not just “during tests”), the potential to support treatment in large groups, small groups, or individual counseling will be improved.

The second broad area of burgeoning research in the field of anxiety in school settings is focused on identifying the efficacy of specific interventions that will promote success for individuals experiencing distinct manifestations of academic anxiety (e.g., study skills limitations, cognitive distractions, emotional reactivity; Cassady, 2004; Zeidner & Matthews, 2005). As more precise identification of the component features of school-based anxieties (and related emotional difficulties) are identified (e.g., von der Embse, Kilgus, et al., 2013), provision of precision interventions is anticipated to be more effective, overcoming prior barriers in research demonstrating success for specific strategies of test anxiety (e.g., Hembree, 1988) because the interventions were not specifically focused on the primary areas of need.

In support of this next phase of work, in our own labs we are currently exploring the utility of real-time indicators of elevated anxiety (e.g., wearable heart rate monitors on smart watches) to help learners and educators identify periods of time when their anxiety is increased. Connected to this, using data from specific assessments to identify the sources of academic stress, we are working to provide prescriptive interventions that focus on emotional control strategies (e.g., relaxation techniques, improving views of self) and SRL strategies (e.g., study skills, cognitive monitoring) to overcome those uniquely identified challenges. We see great potential in connecting these lines of inquiry, ideally using integrated technology applications that help learners diagnose, plan, monitor, and engage in positive emotional and cognitive strategies to support their success.

Conclusion

As the incidence of affective disorders such as academic anxieties continues to rise, the field is in need of systemic research and practical solutions to support learners to reach their academic potential as well general subjective well-being. Overall, our review of this condition leads to the recommendations that schools will better serve their learners with the adoption of universal screening practices that will identify students in emotional distress, as well as those who are demonstrating precursors to distress. Taken in conjunction with a tiered support system to promote adaptive and positive emotional coping strategies, we believe considerable success can be achieved in breaking the negative cyclical trends observed in learners with maladaptive emotional responses to academic stressors. Even without these formal structures, educators can support students with predispositions toward negative emotional appraisals in academic settings by reviewing supportive strategies using a model such as the EIP. Starting with a clear understanding of the interpretation of the perceived threats in the academic setting, as well as learners’ beliefs in their ability to successfully meet the challenge, will help educators better understand the social-cognitive representation that has been formed by their learners. Helping students reframe threats as challenges that can be overcome, identifying support mechanisms to achieve that task, and establishing effective coping strategies and goals are all well-validated strategies that can support students with emotional disturbances and support optimal functioning.

The functional utility of examining these primary dimensions of emotional distress and reactivity rests in the ability to identify and modify primary perceived threats as well as guide the learners toward goal structures and academic behaviors that will scaffold their progressive success. That is, the pathways on which learners reach a given academic outcome vary dramatically, and, by extension, the methods for supporting the learners should also be strategically adopted and applied. For instance, one immediate impact of academic anxiety is inefficient cognitive processing (e.g., attention, organization, retrieval) during the test preparation and test performance phases (Cassady, 2004; Eysenck et al., 2007). This outcome of test anxiety is more commonly experienced by learners whose source of negative self-appraisal rests in deficient study skills or habits (e.g., Naveh-Benjamin, 1991) or limitations in attentional control, working memory, or SRL skills (e.g., Deffenbacher, 1980; Sarason, 1986). Successful interventions for this source and manifestation of test anxiety tend to orient toward training in SRL strategies or study skills interventions (Segool et al., 2013). However, these interventions would be less prescriptive for students whose source of anxiety is rooted in “emotional reactivity” and may have the necessary cognitive skills and study strategies to be successful. For these students, it is more promising to employ emotion regulation strategies that help them reduce the misattributions of threat through behavior or cognitive-behavioral therapies focused on de-escalating the anxiety symptoms (e.g., Serrano Pintado & Escolar Llamazares, 2014). The key to ensuring that more students achieve greater success in overcoming the deleterious effects of anxiety is to provide individually specific intervention strategies to first identify the primary contributing factors that spark the development of anxiety, then provide an intervention strategy that meets their needs directly. In so doing, researchers and educators are in a stronger position to enhance the academic journey of students who would otherwise experience a problematic passage through school – and beyond.