Socially Maladjusted vs. Emotionally Disturbed Cynthia S. Buechler Buechler & Associates, P.C. 3660 Stoneridge Road, Suite D101 Austin, TX 78704 attorneys@buechlerlaw.com

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“Socially Maladjusted” and “Emotionally Disturbed” are terms that are part of our educational vocabulary. However, what do they mean and how do they affect the way a school district handles a student who has been designated as exhibiting Socially Maladjusted behaviors or diagnosed as having an Emotional Disturbance? The following discussion will address the terms “Socially Maladjusted” and “Emotionally Disturbed” as they relate to identifying, programming, and discipline.

1. What is “Socially Maladjusted”? The term “Socially Maladjusted” is an educational term used in the exclusionary clause of the definition of Emotionally Disturbed under the Individuals With Disabilities Education Act (“IDEA”). Specifically, 34 C.F.R. §300.8(c)(4) provides the following definition for “Emotional Disturbance”:

The term means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which adversely affect educational performance: (A) An inability to learn which 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; or (E) A tendency to develop physical symptoms or fears associated with personal or school problems.

Emotional Disturbance includes schizophrenia 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. (emphasis added)   “Socially Maladjusted” has commonly been considered as encompassing the psychological diagnoses of “Conduct Disorder” and “Oppositional Defiant Disorder.”

2. What is the difference between an educational eligibility and a psychological disorder? The IDEA, which is an educational statute, specifically sets forth the educational criteria for eligibility under the law. Both the terms “Emotional Disturbance” and “Socially Maladjusted” are educational terms. Emotional Disturbance is a category of eligibility under IDEA. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), provides specific criteria to make a diagnosis of a psychological disorder. The DSM-V was released in 2013.

3. How is Oppositional Defiant Disorder defined? A.  A persistent pattern of angry and irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.

Angry/Irritable Mood 1. Often loses temper 2. Is touchy or easily annoyed 3. Is angry and resentful

Argumentative/Defiant Behavior 4. Often argues with authority figures or, for children and adolescents, with adults 5. Often actively defies or refuses to comply with requests from authority figures or with rules 6. Often deliberately annoys others 7. Often blames others for his or her mistakes or misbehavior

Vindictiveness 8. Has been spiteful or vindictive at least twice within the past six months

NOTE: The persistence and frequency of these behaviors should be used to distinguish a behavior that is within normal limits from a behavior that is symptomatic. For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months unless otherwise noted. For individuals 5 years or older, the behavior should occur at least once per week for at least 6 months, unless otherwise noted. While these frequency criteria provide guidance on a minimal level of frequency to define symptoms, other factors should also be considered, such as whether the frequency and intensity of the behaviors are outside a range that is normative for the individual’s developmental level, gender, and culture. 

3. How is Oppositional Defiant Disorder defined? (Continued) B.  The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational or other important areas of functioning.

3. How is Oppositional Defiant Disorder defined? (Continued) C.  The behaviors may not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.   Specify current severity: Mild: Symptoms are confined to only one setting (e.g., at home, at school, at work, with peers). Moderate: Some symptoms are present in at least two settings. Severe: Some symptoms are present in three or more settings.

4. How is Conduct Disorder defined? According to the DSM-V, to diagnose Conduct Disorder, at least four of the following have to be present:   Aggressive behavior toward others and animals. Frequent physical altercations with others. Use of a weapon to harm others. Deliberately physically cruel to other people. Deliberately physically cruel to animals. Involvement in confrontational economic order crime – e.g., mugging. Has perpetrated a forcible sex act on another. Property destruction by arson. Property destruction by other means. Has engaged in non-confrontational economic order crime – e.g., breaking and entering. Has engaged in non-confrontational retail theft – e.g., shoplifting. Disregarded parent’s curfew prior to age 13. Has run away from home at least two times. Has been truant before age 13.

The preceding criteria is accompanied by the following: 1. The behaviors cause significant impairment in functioning; and 2. If the individual is over age 18, the criteria for Antisocial Personality Disorder is not met.   Further qualifiers are: 1. Child, Adolescent, or Unspecified onset; 2. Limited prosocial emotions – lack of remorse or guilt, lack of empathy, callousness, unconcerned about performance, shallow or deficient affect; and 3. With mild, moderate, or severe levels of severity.

5. What is the usual period of onset for Conduct Disorder? Middle childhood to middle adolescence is the time frame where Conduct Disorder symptoms are most apparent, and come to parental/educational/clinical attention. Rejection by more prosocial peers and association with delinquent peers with reinforcement of conduct disordered behaviors might occur (American Psychiatric Association, 2013).

6. How common is Conduct Disorder? According to the DSM-V, the annual prevalence of Conduct Disorder is 2% to 10%, with a median of 4% (American Psychiatric Association, 2013).

7. What are the differences between boys and girls? It is more common in boys, or at least more apparent and more frequently diagnosed, due to boys’ tendencies to act out violently, while girls tend to act out in interpersonal relationships – e.g., social rejection of disliked peers, non-confrontation of a victim through malicious postings on a social networking site (American Psychiatric Association, 2013).

8. How do you distinguish between Socially Maladjusted and Emotionally Disturbed? There is no legal definition for Socially Maladjusted which in turn makes the behavior difficult to assess. In an effort to assist school districts in this task, the Texas Education Agency and the TDMHMR Joint Task Force on Emotional Disturbance developed guidelines several years ago to help differentiate between behaviors which are indicative solely of either emotional disturbance or social maladjustment. These guidelines are based upon the characteristics of emotional disturbance which have been set forth in the chart on page 5 of your printed materials for this paper.

Another study, conducted several years ago, differentiated Emotionally Disturbed from Socially Maladjusted. Please refer to the chart on page 8 of your printed materials for this paper to view the different patterns between Emotionally Disturbed and Socially Maladjusted.

What the research appears to show is that students who are socially maladjusted tend to typically display a persistent pattern of intentional refusal to comply to society’s standards without genuine signs of guilt or remorse. These students are not in chronic distress although they may exhibit situational anxiety, depression, or stress to isolated events. Typically, these students do not respond to the same interventions as students with emotional disturbance.

9. How should a school address a student with ODD or Conduct Disorder? Even though a child with ODD or Conduct Disorder may not qualify for special education, the child is still in need of behavior interventions. A BIP can be developed through the General Education Support Team that implements RTI.   For behavior interventions to work, the program must have certain properties: Prioritize behaviors. The behavior must be clearly defined. High degree of structure. There need to be positive reinforcers as well as consequences. The rewards and consequences need to be geared to the individual. It should be simple and straightforward so that the child easily understands it. Clear limits. Precise rules. Immediate meaningful and impartial implementation of consequences.

10. What factors should be evaluated to distinguish between Socially Maladjusted and Emotionally Disturbed? The evaluator should consider information regarding the following:   The student’s ability to tell right from wrong. Reality orientation. Adaptive behavior. Level and chronicity of affective disturbance. Presence/absence of remorse. Responsive to prior learning. Teachers and parents can provide valuable information to assist in determining eligibility.

11. Does the school district’s ED evaluation have to indicate that the student has a specific diagnosis in the report? No. There is no requirement to make a DSM-V diagnosis as part of the ED evaluation. Even if a child has been diagnosed as having a mental disorder, that does not mean that the student meets the criteria for Emotionally Disturbed. The term “Emotionally Disturbed” is an educational term under the IDEA with specific criteria that must be met as previously set forth above. First, the student must meet one of the five areas for a long period of time and to a marked degree. Second, this condition must be adversely affecting educational performance.

12. If the student demonstrates an educational need for special education services as Emotionally Disturbed, would the student need a BIP? It is imperative to remember the criteria for qualifying under the category of Emotional Disturbance. The important language is that the student has exhibited one or more of the five characteristics set forth in the ED criteria over a long period of time and to a marked degree that adversely affects educational performance. By virtue of the fact that a district determines that a student does meet the qualifications for Emotional Disturbance, the student is exhibiting aberrant behaviors at school. This does not mean, necessarily, that the student is engaging in disruptive or aggressive behaviors. The ARD committee should examine the identified behaviors that are adversely affecting the educational performance and develop a BIP to address those behaviors.

13. Can a student with Emotional Disturbance be held accountable under the student’s code of conduct? The student with ED is still subject to the student code of conduct. The student’s accountability under the code is tempered only by the BIP. The BIP is a supplement to the code, it does not replace it. If a conflict exists between the two, the BIP prevails.

14. How do the bullying laws interplay with these populations? According to state law, bullying occurs when a student or group of students engages in written or verbal expression, expression through electronic means, or physical conduct that occurs on school property, at a school-sponsored or school-related activity, or in a vehicle operated by the District and that:  1. Has the effect or will have the effect of physically of physically harming a student, damaging a student’s property, or placing a student in reasonable fear of harm to the student’s person or of damage to the student’s property; or 2. Is sufficiently severe, persistent, and pervasive enough that the action or threat creates an intimidating, threatening, or abusive educational environment for a student.

The conduct is considered bullying if it:   Exploits an imbalance of power between the student perpetrator and the student victim through written or verbal expression or physical conduct; and Interferes with a student’s education or substantially disrupts the operation of a school. Bullying of a student may include hazing, threats, taunting, teasing, confinement, assault, demands for money, destruction of property, theft of valued possessions, name calling, rumor spreading, or ostracism.

15. When the perpetrator of bullying is an Emotionally Disturbed student can he be disciplined? With respect to a student who is Emotionally Disturbed, the Texas Education Code §37.001 provides that the methods adopted to prohibit bullying must provide that a student who is enrolled in special education may not be disciplined for bullying, harassment, or making of hit lists until an ARD committee meeting has been held to review the conduct.