Helping 2e Children with Emotional and Behavioral Issues

By J. Mark Bade

May, 2015

Please note that for reasons of confidentiality the descriptions of young people in this article are composites. —Ed.

Paula Wilkes, Ph.D., a gifted education consultant with the Summit Center in California, remembers a student she taught during her 25 years as a K-8 public school teacher and, sometimes, gifted coordinator. The student, labeled as “emotionally disturbed,” or ED, asked one day to be excused from class to go to the bathroom. After 15 minutes or so he hadn’t returned, so Wilkes sent another boy to find him. Upon his return, Bathroom Boy threw open the classroom door, struck a pose in the doorway, and exclaimed, “What! A guy can’t even take a dump around here?”

Besides being emotionally disturbed, the boy was also very gifted intellectually, very artistic, and significantly dysgraphic, according to Wilkes. Like any other “e” that goes along with giftedness, the boy’s ED posed a challenge to educators, family, and fellow students.

Emotional Disturbances

What Qualifies as EBD?

As an example of what might qualify for the disability of emotional disturbance, here’s what the California Code of Regulations for Education says in Title 5, Article 3.1, Individuals with Exceptional Needs.

Emotional disturbance means 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:

(A)   An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(B)   An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C)   Inappropriate types of behavior or feelings under normal circumstances.

(D)   A general pervasive mood of unhappiness or depression.

(E)   A tendency to develop physical symptoms or fears associated with personal or school problems.

(F)   Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance under subdivision (b)(4) of this section.

—See https://goo.gl/R9LbFZ

Depending on where you’ve been geographically and when you’ve been there, the types of emotional and behavioral difficulties we’ll focus on in this article have gone by many different names. In some states it has been called “severe emotional disturbance,” or SED. In California, where the Summit Center is located, the state special education regulations used to refer to it as a “serious emotional disturbance.” In 2014, the term was changed to simply “emotional disturbance,” which follows terminology used in the Individuals with Disabilities Education Act. 

Another term is “emotional or behavior disorders,” or EBD, the term we’ll use in this article. [See related articles on EBD in the July, 2012, issue of 2e Newsletter.] The book Special Education: Making a Difference defines EBD as comprising two types of behaviors:

  • Internalizing behaviors, which include eating disorders, depression, and anxiety
  • Externalizing behaviors, which are aggressive. One example is hyperactivity, described in the book as “a high level of irritating behavior that is impulsive and distractible, and persistent aggression.” (The book states that ADHD and EBD often occur together.)

It’s worth noting that practitioners may find the use of some of these labels problematic. For example, Summit Center co-founder Dan Peters finds the term “severe emotional disturbance” to be “demeaning, disrespectful, and pathologizing,” saying, “A child who has a mental health or behavioral diagnosis has just that, not a severe emotional disturbance.” 

Wilkes often prefers to use the term “emotional dysregulation.” She says, “There are a host of reasons why kids overflow emotionally.” And, as you’ll see in this article, it’s even possible for a child to be mislabeled as EBD when his or her behavior is simply a manifestation of gifted intensity.

Gifted and EBD… or ED… or SED

As with other “e’s,” EBD in combination with giftedness can be difficult to parse in order to effectively serve the giftedness and accommodate the challenge. For example, imagine a gifted talented teen girl who has trouble communicating at school, showing a reluctance to talk or engage. This girl might perform acts of self-harm -- cutting or perhaps banging her head against a wall. In such a case, school staff members might tell the girl’s family that she needs therapy.

During the initial appointment with a client such as this, Paula Wilkes will try to ascertain what is going on in the girl’s life. Is it an emotional issue related to family dynamics? To the learning environment at school? Is the girl exhibiting select mutism, an anxiety disorder interfering with speech in certain situations?

One tool Wilkes uses is a set of gifted categories crafted by George Betts and Maureen Neihart. The categories include successful, challenging, underground, drop-out, double-labeled, and autonomous learner. Wilkes will present the categories to young clients and ask which category they think they fit into. A girl like the one we’re discussing might choose underground, a category of (usually) middle-school females who want to hide their giftedness, may be insecure and anxious, and whose parents may push them to achieve academically. Such a girl presents EBD that is internalized.

Psychologist Dan Peters says that it’s important to determine if the emotional issue is related to giftedness or is a separate issue. He’ll ask, “Does the problem go beyond the intensities of giftedness when observed in an appropriate situation?” He looks at mood, self-regulation, and behavior across a child’s various environments and daily situations.

“If the problem exists across the various situations in a young person’s life and causes significant distress to the child and others,” says Peters, “it’s probably a clinical issue. If it’s only in school, for example, it’s probably more of a situational issue.”

Wilkes adds, however, “Parents might see disturbances at home that don’t manifest in the classroom but may be precipitated by a bad learning environment.”

Peters observes that giftedness complicates a diagnosis. “For the general population of educators, psychologists, and mental health professionals,” he says, “it’s easy to misdiagnose and attribute an element of giftedness to pathology. In general, everyone over-pathologizes [gifted] kids.” On the other hand, he notes, “In ‘gifted land,’ we may be hesitant to pathologize — but [gifted kids] are also subject to all of the issues non-gifted kids have.”

For someone like Underground Girl, Summit Center might do a team approach to determine the most appropriate approach to addressing her academic issues, and then present their ideas to the school. They might offer ideas for how a 504 Plan could be modified to help. For example, her math routine could be modified so that if she understood a concept, she received no additional homework. If she did not understand, she could get help in a special period. In a case like this, Wilkes would continue to communicate with the girl’s teachers to keep track of particular academic issues. Wilkes has found that once teachers understand that a student is actually twice exceptional rather than simply a bright but lazy student, they can be willing to make appropriate accommodations.

The Thrower

Silence and self-harm are internalized emotional issues. Throwing objects at others is externalized. A school trying to deal with such an elementary-school boy might assess him, observe him, and then put him into a pull-out resource room to help him change his behavior, under the supervision of a behaviorist. But what happens if the boy is gifted as well as EBD?

In the pull-out room, that gifted boy would be likely to make very little academic progress, and his behavior might even become worse. The focus would be on behavior modification with no attention to his intellectual giftedness.

In a situation like this one, Wilkes says, she would do additional testing to look for issues such as dysgraphia, would try to find out what was going on at home, and would get the school staff to understand the extent of the child’s giftedness. 

The next step would be for Wilkes to go to school to discuss with teachers what might be done, including addressing the boy’s strengths. Wilkes is able to communicate well with educators, according to Peters, because of her extensive background in education. After her K-8 teaching career, she created and coordinated the Center for Gifted Education at Pacific University in Eugene, Oregon, for nine years. With this background, Wilkes says she’s able to empathize with teachers about issues like the lack of training most receive about gifted education.

Now, Dan Peters says, “In my experience, when districts identify EBD, they will not include anything about giftedness.” So in cases like The Thrower’s, unfortunately, it can be up to the family to find a school that will nourish the gifts and accommodate the challenges, or up to the family to find outside resources for giftedness.

The Talker

As a teacher, what would you do with an intense young girl who can’t keep quiet, who seems emotionally intense, who offers comments and connections on every idea that comes up, and whose apparent desire to share keeps pulling you, the teacher, off task? Suppose this girl has absolutely no interest in sitting in a circle and listening to classmates share about topics that are of no interest to her. A child like this could easily earn the label of EBD.

How might this young girl look to Paula Wilkes? Instead of EBD, you might discover through meetings with the parents and The Talker that the child has lots of asynchrony and intellectual intensities along with an IQ of over 150. Maybe you’d discover issues such as perfectionism and emotional intensity as well. The result: everything The Talker saw and heard sparked a connection to something she had read or previously experienced; and as a gifted extrovert, she just had to talk about those connections. So here was a young girl who was being viewed as EBD when she was actually highly gifted, and her learning environment was a poor fit for her intellectual needs.

A likely solution for a child like this could be a transition to homeschooling, where the girl could be much happier and highly engaged in her learning. If necessary, coaches and counselors from someplace like the Summit Center could help the girl and family with issues such as perfectionism and emotional intensity.

Addressing the Gifts and EBD Too

Often, Summit Center clients arrive there after unsuccessful engagements with professionals who might not understand twice-exceptionality. “We get parents coming in with thick files from previous testing, but they still don’t understand the problem,” says Summit Center co-founder Peters, who insists that a good practitioner needs to understand the child in order to come up with the right plan. He notes, “We’re always trying to understand the child through the gifted lens.”

The approach used by the Summit Center in dealing with EBD issues in gifted children leads to action items for the school, the family, and the child. One of those items might be counseling. Peters observes that therapeutic strategies need to be geared to the child’s intellect. Furthermore, he says, “we need to determine the supports and interventions that will allow the child to work to the best of his ability.”  

Also part of the Summit Center’s approach might be what Wilkes calls “cognitive coaching.” In these sessions, Wilkes spends more than 50 percent of her time with clients working in areas of strength. Then she’ll turn to areas of challenge, such as spelling, and will try to use the child’s preferred learning style for remediation.

However, the approach the Center uses can vary, depending on the situation. It might be somewhat different when it’s a purely emotional issue that prevents a child’s successful navigation of life. Then, Peters explains, it’s the emotional issue that needs to be the primary focus to help the child thrive or get through the day.

And Bathroom Boy?

As we’ve seen with Underground Girl, The Thrower, and The Talker, clinical therapy may help the gifted EBD child; so, too, might educational coaching and strategizing, either alone or in combination with therapy. But sometimes therapy or formal educational coaching aren’t required to address EBD. Sometimes it just requires insight, patience, and a willingness to look beyond problem behavior to underlying causes. That was the case with Bathroom Boy.

During the school year he spent with Wilkes, Bathroom Boy made significant progress because she, the boy, and the boy’s classmates all worked hard. For example, Wilkes had a meeting with the rest of the class about the situation, explaining that the boy’s actions and distractions were a way to gain the reward of attention. The rest of the class followed Wilkes’ request not to be distracted by or to reward the antics of Bathroom Boy. By the end of the school year, says Wilkes, she was sad to see him leave for another school because of a family relocation. She worried that his progress might not be sustained in an environment that didn’t recognize his strengths as well as his weaknesses and that wouldn’t be able to address emotional disturbance in a gifted child.   

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