1. Building Classroom Discipline Chapter 3 How Do I Recognize and Deal with Atypical Behavior That is Neurological-Based?

2. Neurological-Based Behavior Behavior that results from cerebral processes that do not occur in a “normal” manner. Common diagnoses within NBB include ADHD Learning disabilities Sensory integration dysfunction Bipolar disorder oppositional defiant disorder autism spectrum disorder Fetal alcohol spectrum disorder Brain injuries

3.  Students who behave erratically or inconsistently may do so because they have difficulty processing information correctly due to compromised cerebral functioning caused by Chemical imbalances Congenital brain differences Brain injuries Brain diseases

4. Students with this diagnosis show high degrees of Inattention Hyperactivity Impulsivity Excess emotionality Anxiety Inconsistent emotion responses Unpredictable intense mood swings Withdrawal Episodes of rage (Scenario 1)

5.  The various diagnosis associated with neurological-based behavior (NBB) are considered to be mental health conditions  Some of the mental health conditions are due to biological factors such as Genetics Chemical imbalances  Some are due to environmental factors such as Violence Extreme stress Significant losses of person or home

6. Diagnoses within NBB that appear prominently in the literature and affect students adversely  Attention-deficit hyperactivity disorder Restlessness and short attention span  Affective disorder Affect mood or feeling  Bipolar disorder Cycle between mania and depression  Anxiety disorders Involve fear and extreme uneasiness  Post-traumatic stress disorder From witnessing or hearing about traumatic events  Conduct disorder Breach society’s moral constraints  Oppositional defiant disorder Oppose and defy teachers and others  Autism spectrum disorder Fail to develop normal speech patterns or personal relationships  Fetal alcohol spectrum disorder Show poor impulse control, poor judgment, lack of common sense, and learning difficulties

7. Brain Injuries  Traumatic brain injuries result from blows to the head incurred during events such as accidents, sporting events, or assaults  Nontraumatic injuries result from disrupted blood flow to the brain, or tumors, infections, drug overdoses, and certain medical conditions  Mild injuries may go unrecognized even if they have a significant effect on behavior

8. Indicators of NBB  Behavior difficulties  Language difficulties Problems in understanding, processing and expressing information verbally  Academic difficulties Memory often compromised Difficulties with fine and gross motor skills, comprehension, and language and mathematics skills

9. Sensory Integration Dysfunction (SID)  Also called sensory processing disorder  Sensory integrations refers to the process of organizing, interpreting, and responding to information taken in through the senses  This is the major cause of hyperactivity, inattention, fidgety movements, inability to calm down, impulsivity, lack of self-control, disorganization, language difficulties, and learning difficulties

10. Some students’ sensory processing systems seem to be easily overwhelmed by excess visual and auditory stimulation.  Teacher can help by Keeping classroom neat and tidy Removing sources of unpredictable loud noise Enlarging printed question or directions Standing in front of a solid white overhead screen when giving instructions and directing lessons Give directions slowly and distinctly Check to ensure students have understood correctly Maintain a sense of calm (Scenario 2)

11. Attention-Deficit Hyperactivity Disorder (ADHD)  Characterized by Short attention span Weak impulse control Hyperactivity  Can begin in infancy and extend into adulthood  Males more likely to have it than females Males typically have ADHD Females typically have ADD

12. Oppositional Defiant Disorder (ODD)  Symptoms Frequent temper tantrums Excessive arguing with adults Active defiance and refusal to comply with adult requests and rules Belligerent and sarcastic remarks, made when directly praised Deliberate attempts to annoy or upset people Blaming others for one’s own mistakes or misbehavior Being touchy or easily annoyed by others Speaking hatefully when upset Seeking revenge

13. 5-15% of ALL school-age children have ODD.  Consider using positive reinforcement when the student shows flexibility or cooperation.  Indirect or earshot praise sometimes works well.  Reduce the number of words used when speaking to a student with ODD.  Say and show what you mean just once. Student will ask for help if they need it.  Consider a personal time-out if you feel your responses are about to make the conflict worse.

14. Bipolar Disorder  Characterized by severe mood swings which could happen several times a day  Cause unknown  Can begin very early in life  Often diagnosed as ADHD, depression, ODD, OCD, or separation anxiety  Misdiagnosis may be treated with stimulants or antidepressants which make it worse

15.  Indicators Hysterical laughing and infectious happiness for no evident reason Belligerence and argumentation, followed by self-recrimination Jumping from topic to topic in rapid succession when speaking Blatant disregard of rules because they think they do not pertain to them Arrogant belief that they are exceptionally intelligent Belief they can do superhuman deeds without getting seriously hurt  Interferes with quality of sleep Often wake up tired Show irritability and nebulous thinking during mornings at school Able to function better in the afternoon

16. Learning Disabilities  Affects students of average to above-average intelligence  Difficult to receive and process information  Some common learning disabilities Dyslexia  Difficulty in processing language Dyscalculia  Difficulty with basic mathematics Dysgraphia  Difficulty with handwriting and spelling Dyspraxia  Difficulty with fine motor skills

17.  Indicators Inability to discriminate between/among letters, numerals, or sounds Difficulty sounding out words; reluctance to read aloud; avoidance of reading and /or writing tasks Poor grasp of abstract concepts; poor memory; difficulty telling time Confusion between right and left Distractibility, restlessness, impulsiveness; trouble following directions Saying one thing but meaning another; responding inappropriately Slow work pace; short attention span; difficulty listening and remembering Eye-hand coordination problems; poor organizational skills

18. Dyslexia  Difficulties in word recognition, spelling, word decoding, and occasionally with the phonological component of language.  Due to a signal-scrambling disturbance involving the inner ear and the cerebellum  Degree of dyslexia is dependent on The number of inner-ear circuits that are not working properly The degree of signal scrambling The ability of normal cerebral processors to descramble or otherwise compensate for scrambled signals. (Scenario 3)

19. Autism Spectrum Disorder (ASD)  Affects 4 times as many males as females  Includes various diagnoses of abnormal development in verbal and nonverbal communication, along with impaired social development and restricted, repetitive, and stereotyped behaviors and interests Pervasive developmental disorder  Delays in socialization and communications skills Asperger syndrome  Normal intelligence and language development  Exhibit autistic-like behaviors and marked deficiencies in social and communications skills  May show extreme hyperactivity or extreme passivity in relating to people around them

20.  Indicators Self-stimulating, spinning, rocking, and hand flapping Obsessive compulsive behaviors such as lining objects up evenly Repetitive odd play for extended periods of time Insistence on routine and sameness Difficulty dealing with interruption of routine schedule and change Monotone voice and difficulty carrying on social conversations Inflexibility of thought and language  Avoid sensory overload (Scenario 4)

21. Fetal Alcohol Spectrum Disorder (FASD)  Results from the fetus being exposed to alcohol from the mother’s blood  Even small amounts of alcohol puts the mother at risk of having a child with FASD  Leading cause of mental retardation in the Western world  Most individuals with FAS and other diagnoses on the FASD continuum have normal intelligence  Many have compromised adaptive and social skills including Poor impulse control Poor judgment tendency to miss social cues Lack of common sense Learning difficulties Difficulty with the task of daily living (Scenario 5)

22. The Rage Cycle  Not a neurological disorder but rather an extreme kind of behavior exhibited by students with NBB.  Manifested as an explosion of temper that occurs suddenly, with no real warning, and may turn violent  Not goal-oriented, but rather a release of built-up tension or frustration  Once started, little can be done to stop it  Could last for minutes or hours

23. Rage Cycle  Phase 1. Pre-Rage Phase 1. Pre-Rage  Phase 2. Triggering Phase 2. Triggering  Phase 3. Escalation Phase 3. Escalation  Phase 4. Rage or Meltdown Phase 4. Rage or Meltdown  Phase 5. Post-Rage or Post-Meltdown Phase 5. Post-Rage or Post-Meltdown

24. Phase 1. Pre-Rage  This is the time just before something triggers the rage event and sets it in motion.

25. Phase 2. Triggering EEvents that provoke episodes of rage AAssociated frequently with Work transitions Sensory overload Being told “no” Fatigue Frustration Confusion Hunger Central nervous system executive disorder Anxiety Mood swings IIn triggering phase, students may appear Angry Confused Frustrated Dazed Tense Flushed TThey may Swear Use other rude language

26. How can you help during this phase?  Recognize that a rage episode may be forthcoming and you may not be able to prevent it.  Understand that this is a neurological event. The student's flight/fight/freeze responses are strongly activated.  Understand that the rage is not intentional or personal toward you.  Stay calm. Use a quiet tone of voice. Do not become adversarial.  Use short, direct phrases and non-emotional language.  Do not question, scold, or become verbose.  Use nonthreatening body language. Stand on an angle off- center to the student, at least a long stride away. Make sure the student can see your hands.  Use empathetic verbal support. (It sounds like you are upset.)  Deflect control elsewhere. (The clock says it’s time to clean up.)  Calmly, quietly, and succinctly use logical persuasion of provide the student an alternative behavior.

27. Phase 3. Escalation  Mild escalations Begins to get angry Call names Swear Exhibit startled verbal or physical responses Talk rapidly Increase the volume and cadence of speech Show tension in arms, hand, and body  Rapid escalations Violent temper Hostility Aggressive comments Profanity Flushed face Clammy body  May show fists or throw objects or furniture

28. How can you help during this phase?  Stay calm.  Ensure the safety of others by clearing them from the room or supporting them to ignore the escalation.  If the student threatens you, walk away.  Calmly direct the student to a safe place to allow the energy to dissipate.  When speaking to the student, use short, direct phrases and non-emotional language.  Use body language that is nonthreatening or nonconfrontational.  Use supportive empathy to acknowledge the student’s feelings.  Calmly, quietly, and succinctly use logical persuasion to provide the student an alternative.  Praise the student as soon as he or she begins to respond to your direction.  Do not address the student’s inappropriate language, threats, or other behavior at this time. The student cannot process the information and may only become further inflamed.

29. Phase 4. Rage or Meltdown  The student is caught up in the rage.

30. How can you help during this phase?  Allow the student space to go through the physical manifestations.  Do not restrain the student unless there is an immediate threat to physical safety.  Do not question, make sarcastic comments, or try to talk the student out of the rage.  Do not try to make the student understand instructions.  While the student is going through the cycle of reactions, support others in the room and help ensure that their interpretations of the rage event are correct.

31. Phase 5. Post-Rage or Post Meltdown  Student may or may not remember the behavior or the triggering causes.  This is a low point Expended energy Confused Embarrassed  Now tired, passive, headachy, and sometimes remorseful and apologetic  May need sleep or may be able to continue the day

32. How can you help during this phase?  Reassure the student that her or she is all right now.  When the student is ready, help him or her put language to the event.  Help him or her plan what to do the next time a rage occurs – such as finding a sensory-friendly refuge, using words to get what they need, and remaining in a safe place until able to calm down.  After the rage event and when the student is calm, take care of yourself. Relax, drink water, and remind yourself that it was not personal and that you did the best you could. Document your observations Hold debriefing conversations with a colleague Listen to reflections made by anyone involved Note any evident triggers, sensory influences, or other environmental characteristics (Scenario 6-cleanly)

33. Most childhood mental health problems are treatable with medication. But, since this issue is controversial, the decision to medicate is made by parents.