Lee Kern, Anastasia Kokina Talida State Alexandra Hilt

Lee Kern, Anastasia Kokina
Talida State
Alexandra Hilt-Panahon
Lehigh University

Poor outcomes among students with
emotional and behavioral disorders
(EBD)
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
High dropout
Low achievement
Restrictive educational placement
Poor post-school outcomes
Funded by the Office of Special
Education Programs
•
Interviewed 46 State Directors of Special
Education or their designees (90%)
– State Director = 48% (n=22)
– Designee = 50% (n=23)
– State Director via email only = 2% (n=1)
• Administered structured interview
– Questioned about effective statewide initiatives and
services for students with emotional and behavioral needs
– Asked to identify barriers to service delivery
– Asked to identify specific programs, schools, or services
within each state that were exemplary or promising
•
State directors in 28 states identified 81
exemplary or promising programs
•
Conducted structured interviews with identified
programs to determine:
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Population served
Theoretical base for service delivery
Type of services delivered
Presence of effective academic curriculum
Availability of data
• Decision making
• Evaluate outcomes

Programs meeting most or all of criteria
independently evaluated by three individuals
and rank ordered

Those with highest rankings were contacted
for potential site visits

Five site visits conducted
 Abington School District in Pennsylvania
 Greenwood School District in Arkansas
 Haven Academy in Georgia
 New Beginnings in North Carolina
 Orchard Place in Iowa

Activities conducted during 2-day site visits
 Interviews with administrators, teachers,
supervisors, and mental health staff
 Observations of facility, classrooms, and activities
 Direct observation data of student engagement,
disruptive behavior, instructional arrangement
 Effective School Battery (completed by students
and teachers to measure school climate)
 Followed one student throughout daily activities
 Focus groups conducted
▪ Teachers
▪ Parents
▪ Students

Present findings from focus groups

Discuss in context of comprehensive findings
from site visits

Examine stakeholders’ perceptions of what
makes their program effective for students
with EBD.

Examine stakeholders’ perceptions of the
barriers and challenges in implementation of
effective programs for students for EBD.

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Conducted separately with parents, teacher,
and students
3-4 focus groups in each site
Duration – about 1 hour
3-15 participants
Consent obtained prior to study
All focus groups audio recorded
Held constant across the stakeholder groups:

“What makes this program different from
other programs?”

“What specific components of the program
make it effective?”

“What are your suggestions that could help
improve the program?”

Transcripts of focus groups obtained

Transcripts coded into themes by two
independent coders

Results discussed and compared to achieve
agreement on the coding

Most common themes identified
Program
philosophy
Setting
characteristics
Behavioral
interventions
& supports
Focus on
academics
Transition
planning
Collaboration
Personal
relationships
Program
outcomes

Understanding
“the whole school is built [on the
understanding] of all of the different areas
and issues associated with special
needs.”(T)

Accepting
“…our program allows kids to have that
second chance they need...” (T)
Individualized
“they teach each child like an individual.
My child has had different needs than other
kids. Crowds make him very anxious and so
he would go to school 5 minutes later and
meet with someone and they’d talk about
the day and then he’d go to school ..and
that works for him”. (P)


Training

Experience
“we have a system that has proven very
effective in teaching kids with
behavioral-emotional disorders. Then
the people who carry the things. They’re
really good at it”(T)
[we have]…seasoned staff familiar with
the model, and familiar with the type of
behaviors that our students display”(T)

Teachers’
personal
investment
in their job
“I think the kids are just a blast.
[laughter] it’s a different, it’s just a
really interesting population.
There’s obviously a few that you’d
like to be able to trade into for
somebody else [laughter] but you
know I just think the kids
themselves are really interesting
and it’s fun to see how they morph
and change and how they are from
day one till the point where they’re
discharged” (T)


Small studentteacher ratio
Setting size
“Well the student teacher ratio is so
much better than in the public schools.
You know they have at the most 8 kids in
a classroom plus 1 teacher and an
associate. How often in a public school
are you going to get a ratio of 1 to 4?” (P)
“I just think it’s the smaller settings - he
gets too overwhelmed with too many
people, or maybe he’s afraid to ask for
help cause there’s so many extra people
in the room.” (P)

Immediately
available
supports
“Supports are all under one umbrella. Because
couple other programs that I worked in, the
supports were outside of the building. So with all
the supports being in here, the psychologist,
social worker, guidance counselor, everyone is
here, that makes a big difference”. (T)
“…before having school-based mental health
available on site at the school…if he had an
emotional meltdown on Tuesday, well I had to call
up the office, drive him to the nearest
psychologist available 30 minutes away, and then
get him an appointment for next week. Well he’s
not going to remember next week what it was he
had a problem with on Tuesday…” (P)


Safety and
experiences
of success
Flexibility
“I’ve had so many parents say to me,
you’re the first teacher that’s either liked
my kid or said anything positive So [it’s
important] just to make school a safe place
to go to. Once they get a little success you
keep building on that, so the school
becomes a place where it’s not, you know,
filled with fear and anxiety” (T)
“[I say to student] you realize that
tomorrow’s a different day, process that
now, and we start over fresh” (T)

Clear
expectations
and rules
“We have following directions, accepting
feedback, and self-control [goals].Those are the
three standards for everybody “(T)
“Like at my day school I would get in trouble and
not even know, and here you can tell when you
are getting in trouble” (S)

Holding
students
accountable
“.. the black and whiteness of our programs
helps these kids to see that it doesn’t really
matter if you’ve got mental health stuff - we can
work with you, but that’s not an excuse or a
reason for you to be able to go out and hurt
somebody or be rude or disrespectful “(T)
 Consistency
across the
settings
“It’s consistent across all programs. So
… for example, the teachers at X are
going to do the same thing, same
consequences for the same behaviors.
There’s not really any fluctuation” (T).
“It’s just like a community …they just
really focus on that and all the
teachers use the same terminology
and so the kids hear the same thing
from all the teachers (T)

Students’
progress
within the
system
“When my son first came to the
school, he had no privileges
whatsoever. And he had to earn
points for any kind of privilege he
has. So he’s doing so well now that
he’s gotten so many points banked
that he can do what he wants to
with his points” (P)

Mastery of
behavioral
systems
“You leave that point sheet on the first
day on your job, and you’re going “Oh
good lord. I am never going to get this.”
And then after that it just becomes such
a part of your routine, part of the kid’s
routine, it’s not that big a deal. I wouldn’t
know what to do without it. I also talk to
my husband, you’re not following
directions right now, he’s looking at me
going…” (T)
 Individual
problem solving
“Students are using the model to figure out
what they’ve done wrong, and think about
it sort of meditatively… they contemplate
what went wrong and…find those
moments they’ve made mistakes, and
figure out ways to self-correct” (T)
“You also have to write essays.. about what
you did wrong, why you did it wrong, and
how can it be undone… how can it be
dangerous”. (S)
 Group
problem solving
“…and I think [huddles] help [students]
think, cause …the things that we do
bring attention to their behavior and
make them aware of what they’re
doing”. (T)
“The huddles are probably the glue for
this program. I think it’s something that
they’ll take on in life. They won’t be
able to call it huddle, but what we try to
help them understand is this is just a
basic tool for communicating” (T)
 Choices of
strategies
 Individualized
strategies
“we talk about using coping skills when
you’re mad and stuff like that, and we have
a whole list in our room like that has count
down, take deep breaths, talk to the
teacher, or talk to the staff, or talk to a
friend, write a letter or something“ (S)
“a lot of the teachers really take the time to
get to know the children’s likes and dislikes,
and their interests individually. So when my
son, whenever she sees signs of him
starting to get out of control, she’ll give him
math problems because she knows that
calms him down” (P)
 Using natural
opportunities

Awareness
… we’re constantly teaching social skills.
For example, two people raise their
hand, I have to call on one of them. One
of them may get upset and I have to
teach that social skill about letting other
people take turns…things that other
students in a regular setting might learn
from their peers, we’re teaching to them
here, so they can be better prepared”.
(T)
“We talk about interrupting, making
rude comments, stuff like that…makes
me think about it before I do it, usually I
didn’t think about it…but now I do” (S)
 Academic
challenges consequence
of behavior
difficulties
“A lot of them tend to be below grade
level academically speaking. A lot of
them it’s because their behaviors have
gotten in the way of their academics in
the past” (T)
 Difficult
behaviors as a
result of
inappropriate
academic
instruction
“…He kept getting his homework done
first, he would do it really quick, and sit
there and be bored, and that’s when he
would cause problems. So last year
…they moved him up. So now he’s
doing much better, and
actually…there’s been no behavior
problems” (P)


Dual focus
Individualized
instruction
“Here I see there is a dual focus for
behavior and academics, and it
seems to balance out a lot better
than I’ve seen”. (T)
“I really like the fact that they focus
on behavior without losing sight of
the academics. They teach children
on their level … it’s not a cookie
cutter where they just push the kids
on through. They help the kids do
their own very best”. (P)

Scaffolding
to facilitate
transitions
“It’s not a sink or swim situation, we sort of
give them the tools that they need to go
back” (T)
“most of the time when the kids go out to
the transition school, they’ve gotten
everything under control.. And so he’s
working more on academics. He’s getting
ready, we’re actually going to meet next
weekend and he’s going to be taking some
classes out at his home school“ (P)
•
Team work
“There is no I, there is no me, it’s all of us
•
Flexibility
and
creativity
“We have to be very flexible, and think out
of the box, and put our heads together to
come up with what’s going to work in that
situation sometimes “ (T)
•
Learning
“That’s very important and we can learn
so much from each other’s experiences
and different backgrounds (T)
together that make this happen…it’s
everybody, and we all need each other “
(T)

It’s not just students, he’s working with
parents a lot to help them learn how to work
with their child. That’s a big key. (T)

And from my personal experience, they’ve
always kept me involved. I’ve given them my
personal cell phone number, and I’ve
encouraged them to call me if there’s any
way I can assist them to help my son
learn..(P)
 Wraparound
approach
“[teachers] stay in constant contact
with the community support
individuals. And there have been times
… that the doctor, the play therapist,
the counselor, and individuals from the
school and his home school, …all got
together at a round table meeting
and…everyone got on the same page.
And so everyone stays in constant
communication so his teachers and his
doctors know the same information at
all times.” (P)
 Positive
Interactions
“when you walk in in the morning
teachers will greet you to see if you
had a bad night or something and they
will ask you if you are having a bad day
and if you are they’ll just let it go” (S)
“They try to encourage the kids …They
don’t intimidate them, they actually
try to become friends with them, no
matter how much of a nuisance he has
been, they’ll always try to encourage
them. “ (P)

Trust
“I know the kids that I get in contact with
are so used to everyone giving up on them,
you kind of have to go through a stage
with them of gaining their trust. And I’ve
had several kids tell me, well why are you
even trying? Cause everyone gives up on
me. I know that you have to really be
sincere about this job, or it will show. It will
show” (T)
“…the teachers actually know what they’re
doing ….It’s not like they’re trying to
change you, but they trying to make you
better student, so you could be better at
life (S)

Caring
adults
“…kids know when adults care whether
you do okay or not or if they’re here to
just get you through school, and I think
that’s what makes the difference” (P)
“He actually does care about us, and he
also cares about the other children’s
safety. I think he likes children and ... he
wants to ensure that the school’s
safer”(S)
“Yeah we help each other. Cause after dismissal
we’re like “Ohh, oh my gosh. Did you see?!” And we
just scream, we counsel each other… We’re all in the
same boat, and we’re all dealing with the same
behaviors… it’s like there’s a built-in support. It’s
that camaraderie that you have, by just knowing
that you’ve all been through the same job” (T)

Positive
supportive
peer culture
“Maybe these kids have got to be in a
culture of kids that support each other,
so it’s getting them to think about being
proud of each other and helping each
other out”(T)
“As I started to go along I met more and
more people and after some of them
left, people were a little bit nicer to me I
guess, I don’t know why. But I started
kind of like a club here. At first I didn’t
even want to be here” (S)
 Improved
“for the first time ever he was able to bring
home a good report card. I would have
been happy if he passed class and then he
brought home two A’s and B and that’s
amazing that he was motivated to do that.
“ (P)
 Improved
“I think that my behaviors already changed
a little bit, ‘cause the only thing that was
really wrong with me was my attitude and
really the words that were coming out of
my mouth, it wasn’t coming out as right as
it was supposed to be. But now as I got
older, I started noticing that oh that wasn’t
necessary. It’s time to be mature ‘cause I’m
getting older, and these teachers, they
really got to me about that”. (S)
academic
performance
behavior
 Improved
self-esteem
and
confidence
“I think this is their place to shine. I
think they build their self-esteem
up…they boost them up from what
they’ve been put through… and
when you feel good about
something, you’re going to be better
at it. And if that’s your homework, or
your relationships, or whatever, if
you’re made to feel like you can do
something, than you can do it.” (P)
Students’
challenging
backgrounds
Transition
issues
Limited social
opportunities
Collaboration
and
communication
Lack of
resources
•
Challenging,
unsupportive
family
environments
•
“…most of our kids, they’ve been
told they’re stupid, and worthless,
and ugly, and won’t ever amount
to anything. They’re dealing with
all that. There’s no telling what
they’ve been through in the
morning before they get to us.
And then what they deal with in
the afternoon when they leave us.
It’s a totally different world for
them out there.” (T)

Stressful
family
situations

“…we forget that sometimes
these parents are
overwhelmed. I had a parent
one day, cry, and say: ‘I have 5
kids. He is the only one doing
this.’ And I knew the other 4
kids were on honor roll and
doing the right thing…she’s
working 2 jobs…she’s
overwhelmed.” (T)

History of
unsuccessful
school
experiences

“…when he was in his other school,
was too crowded and he didn’t really
get what he needed, the one-oneattention, because there were so
many other students...and he just got
lost, and his grades suffered because
of it, then he got discouraged to the
point he didn’t like school at all.” (P)

“We had major issues with our son. He
was thrown out of 3 daycares, and one
of them we pulled him out because
they were restraining him. “ (P)

History of unsuccessful
school experiences

…”when I got mad,
they would call the
office, and some other
people, and get them;
it felt like to me like
they were ganging up
on me…” (S)


“I think that these kids get kicked
down so much that by the time they
get to this point, they have no selfesteem. I can’t do this, I’m stupid. I’ll
never read anything…”(P)

“…QP has post-traumatic stress
disorder and with that comes a lot of
anxiety and all of these problems in
the classroom, she can’t function…it
also created OCD because she felt she
had to function in the classroom to
meet a certain standard and she
couldn’t so it started creating all of
these other problems.” (P)
Mental health
issues


Mental health
issues
“…There are a lot of children
who are silent sufferers.
Nobody notices they have a
problem. …they have eating
disorders…somebody
accidentally finds that they’re
in the bathroom throwing up
everyday, or they’re going
home and hurt themselves, or
they’re doing drugs. They
keep it all to themselves… (T)

Disconnect
between what is
taught in the
program vs.
public schools

“[in the public school] they’re 3
months into learning fractions
or something they weren’t
doing in here; ‘I’m stupid again
because I’m not where they’re
at’… so [transition] was awful,
absolutely awful…the first day
back to class she came home
and sat on the couch all night
watching TV and she doesn’t
watch TV…she couldn’t handle
it, she couldn’t even talk about
it.” (P)

Not receiving
instruction in all
core academic
subjects

“They do social studies, English,
and math, and they don’t do
science. And they’ll have science
class when they go back, so
they’re losing content. You
know they might be learning
about compounds and things
like that [in public school] and K
won’t have a clue and so she’ll
need to be introduced back into
that slowly…” (P)

Planning for transition

“… we’re not working at
the same level (like
public school), so they’re
not going to go back and
be right on the page with
the rest of the class….so
the teachers should work
together…to help them
keep up so they don’t
feel so overwhelmed
when they come back to
school.” (T)

Limited supports
in place in regular
schools
▪ “I’ve had regular education
teachers say they couldn’t do
what we do. But you have to
do a little bit of what we do
because you’re getting that
student back. So if you can’t do
what we do, and you’re saying,
‘oh I couldn’t deal with that’,
when that student comes
back, you’re just going to do
whatever you did in the past
and set that kid off, so they’re
going to end up coming right
back into this program.”(T)
•
Limited opportunities 
to socialize and build
friendships outside of
the program
“They have their little friends
that they connect with, and
their friends are still here…I had
to tell my son, you’re not basing
your life on somebody else’s.
They want to stay here and they
don’t want to progress…You
need to try and accomplish your
goals, don’t put yourself back
because you miss Bobby over
here…” (P)

Lack of peer
networks

“…her biggest issues are the social
issues, she had been out for awhile
so the clique had shifted, so she
complains: ‘ I don’t have any
friends anymore’…” (P)

Anxiety
surrounding the
transition

“Some of the kids… have a desire
to stay, because it is such a good
program. But the objective of the
program is to get them out, get
them the skills that they need to
get back to their regular school as
quick as possible. So I think some
of them get into trouble
purposely, I believe my son even
though he wants to be out, his
behavior says another thing.
Because he can get down to the
last week and do something
stupid.” (P)
 Increased
number of
students in need
of MH services

“… we will need more
staff…we’re seeing more
and more kids that need
their emotional needs
met…I think we’re going
to need more and more
staff trained to be like our
school-based mental
health therapist, like our
psychiatrist” (P)
•
Planning time

“Whereas a lot of teachers in
regular settings are sometimes
grading papers, or teaching
something while students are
working, that’s unheard of to me.
..because of the extremity of the
behaviors, I’m constantly, even if
I’m at my computer, I’m thinking
about what are they doing, ‘okay
is he trying that student again’, ‘is
he walking out of the classroom’,
that’s what I’m constantly
thinking about. Or at least
monitoring. “(T)


“ more funding…the H program seems to
have the oldest buildings. Really old buildings
whereas other schools are brand new
schools. “ (T)
“….before this year we had a larger support
staff, and we had all those positions cut, so
this is an adjustment year…” (T)

Well just getting here is so difficult. They ride
a bus, a long time, to their base school and
then they wait at their base school and their
base school brings them out here…this
morning for 40 minutes we had kids
straggling in…such wasted time...(P)

Receiving services
outside of the
school
•
“I wish we could get in home services
at the same time as the day
treatment… that’s been frustrating
for me because my child has
academic problems in school, but
then behavior problems at home… I
would rather have all of the services
at once and help him instead of just
here is one piece ,then one piece,
and then one piece.” (P)
•
“Because there is a therapist in here
they won’t pay for therapy outside…
K needed intensive therapy when she
tried to kill herself, but they won’t
pay for both. No insurance will.” (P)






Clear program philosophy with shared
vision
Extensive staff training
Low teacher: student ratio
Comprehensive supports
Positive school climate
Excellent student-staff relationships





Clear and explicit expectations that includes
instruction in problem solving and coping
Social skills instruction embedded
throughout school day
Focus on academics
Transition planning
Collaboration

Student histories and family issues

Academic lag

Transition

Lack of resources

Data

Administrative support

Currently preparing findings for publication
 Highlighting and specifically describing exemplary
program features
 Including analysis of quantitative data