{{Short description|Educational term used primarily in the US}} '''Emotional and behavioral disorders''' ('''EBD'''; also known as '''behavioral and emotional disorders''')<ref name="ICD-10-web-EN">{{cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/F90|title=International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10): Behavioural and emotional disorders with onset usually occurring in childhood and adolescence (F90–F98)|author=World Health Organization|date=2016|access-date=2 November 2018|author-link=World Health Organization}}</ref><ref name="ICD-10-Clinical">{{cite book|url=https://icd.who.int/browse10/2016/en|title=The ICD-10 Classification of Mental and Behavioural Disorders. Clinical descriptions and diagnostic guidelines|author=World Health Organization|place=[[Geneva]]|page=40|author-link=World Health Organization}}</ref> is a term used primarily in the United States that refers to a disability classification used in educational settings that allows educational institutions to provide [[special education]] and related services to students who have displayed poor social and/or academic progress.<ref>{{Cite web|url=https://www.cherokeek12.net/userfiles/wp-uploads/2016/07/Emotional-and-Behavioral-Disability-Eligibility.pdf|title=EMOTIONAL AND BEHAVIORAL DISORDER (EBD)|website=Cherokee County School District|access-date=2019-05-09|archive-date=2019-05-02|archive-url=https://web.archive.org/web/20190502051329/https://www.cherokeek12.net/userfiles/wp-uploads/2016/07/Emotional-and-Behavioral-Disability-Eligibility.pdf|url-status=dead}}</ref>
The classification is often given to students after conducting a Functional Behavior Analysis. These students need individualized [[Classroom management|behavior supports]] such as a Behavior Intervention Plan, to receive a [[free and appropriate public education]].<ref name=":5" /> Students with EBD may be eligible for an [[Individualized education plan|Individualized Education Plan]] (IEP) and/or accommodations in the classroom through a [[504 Plan]].<ref name=":5">{{Cite web|url=https://classroom.synonym.com/students-ebd-given-iep-plan-17195.html|title=Are Students with EBD Given an IEP Plan? {{!}} Synonym|website=classroom.synonym.com|language=en|access-date=2019-05-06}}</ref>
== History ==
=== Early history === Before any studies were done on the subject, [[mental illness]]es were often thought to be a form of demonic possession or witchcraft. Since much was unknown, there was little to no distinction between the different types of mental illness and developmental disorders that we refer to today. Most often, they were dealt with by performing an [[exorcism]] on the person exhibiting signs of any mental illness.{{Citation needed|date=March 2026}} In the early to mid-1800s, asylums were introduced to America and Europe. There, patients were treated cruelly and often referred to as lunatics by doctors in the professional fields.<ref>{{Cite web|url=http://study.com/academy/lesson/the-history-of-asylums-in-the-1800s.html|title=The History of Asylums in the 1800s - Video & Lesson Transcript|website=Study.com|language=en|access-date=2019-05-07}}</ref> The main focus of asylums were to shun people with mental illnesses from the public. In 1963, the [[Community Mental Health Act|Community Mental Health Centers Construction Act (Public Law 88–164)]], was passed by Congress and signed by John F. Kennedy, which provided federal funding to community mental health centers. This legislation changed the way that mental health services were handled and also led to the closure of many large asylums. Many laws soon followed assisting more and more people with EBDs. 1978 came with the passing of [[Education for All Handicapped Children Act|Public Law 94- 142]] which required free and public education to all disabled children including those with EBDs. An extension of PL 94–142, [[Public Law 99-457|PL 99-457]], was put into act which would provide services to all disabled children from the ages of 3-5 by the 1990–91 school year.<ref>{{Cite journal|last=Fong|first=Yvonne|title=The History of Emotional and Behavioral Disorders|url=https://www.academia.edu/17559495|website=Academia |language=en}}</ref> PL 94-142 has since been renamed to the [[Individuals with Disabilities Education Act|Individuals with Disabilities Education Act (IDEA)]].
=== Use and development of the term === Various terms have been used to describe irregular emotional and behavioral disorders. Many of the terms such as mental illness and [[psychopathology]] were used to describe adults with such conditions.<ref name=":1">{{Cite web|url=http://www.proedinc.com/Downloads/12762Ch01.pdf|title=Overview of Emotional and Behavioral Disorders|website=Pro Ed Inc.}}</ref> Mental illness was a label for most people with any type of disorder and it was common for people with emotional and behavioral disorders to be labeled with a mental illness.<ref>{{Cite web|url=http://ebdforeveryone.weebly.com/history-of-emotional-behavioral-disorders.html|title=History of Emotional Behavioral Disorders|website=Emotional Behavioral Disorders|access-date=2019-05-07}}</ref> However, those terms were avoided when describing children as it seemed too stigmatizing. In the late 1900s the term "behaviorally disordered" appeared. Some professionals in the field of special education accepted the term while others felt it ignored emotional issues.<ref name=":1" /> In order to make a more uniformed terminology, the National Mental Health and Special Education Coalition, which consists of over thirty professional and advocacy groups, coined the term "emotional and behavioral disorders" in 1988.
==Criteria== {{Further|Expectancy challenge}} According to the Individuals with Disabilities Education Act an EBD classification is required if one or more of the following characteristics is excessively observed in a student over a significant amount of time:<ref>{{Cite web|url=https://www.parentcenterhub.org/emotionaldisturbance/|title=Emotional Disturbance {{!}}| website = Center for Parent Information and Resources| date = 2010-06-16 | archive-url = https://web.archive.org/web/20170728020020/https://www.parentcenterhub.org/emotionaldisturbance/ | archive-date = 2017-07-28 |access-date=2019-05-06}}</ref>
* Learning challenges that cannot be explained by intellectual, sensory, or health factors. * Trouble keeping up or building satisfactory relationships with peers and teachers. * Inappropriate behavior (against self or others) or emotions (shares the need to harm others or self, low self-worth) in normal conditions. * An overall attitude of unhappiness or depression. * A tendency to develop physical symptoms or fears related with individual or school issues.
The term "EBD" includes students diagnosed with [[schizophrenia]]. However, it does not have any significant bearing on students who are socially maladjusted unless they also meet the above criteria.
===Criticisms=== Providing or failing to provide an EBD classification to a student may be controversial, as the [[Individuals with Disabilities Education Act|IDEA]] does not clarify which children would be considered "socially maladjusted". Students with a psychiatric diagnosis of [[conduct disorder]] are not guaranteed to receive additional educational services under an EBD classification.<ref name="cecp.air.org2">{{cite web|url=http://cecp.air.org/resources/20th/eligchar.asp/|title=Students with Emotional Disturbance: Eligibility and Characteristics| date = 2001|department = The Center for Effective Collaboration and Practice | website =American Institutes for Research |archive-url=https://web.archive.org/web/20151018115029/http://cecp.air.org/resources/20th/eligchar.asp|archive-date=18 October 2015|url-status=dead|access-date=22 October 2015}}</ref> Students with an EBD classification who meet the diagnostic criteria for various [[disruptive behavior disorder]]s, including [[attention-deficit hyperactivity disorder]] (ADHD), [[oppositional defiant disorder]] (ODD), or [[conduct disorder]] (CD) do not have an automatic eligibility to receive an IEP or 504 Plan.<ref name="cecp.air.org2" /> Students considered "socially maladjusted", but ineligible for an EBD classification (i.e., students diagnosed with [[conduct disorder]]), often receive better educational services in special education classrooms or alternative schools with high structure, clear rules, and consistent consequences.<ref>{{cite web|url=http://www.behavior-consultant.com/social.htm|title=Social Maladjustment|work= Reinforcement Unlimited |location = Georgia | archive-url = https://web.archive.org/web/20010502221502/http://www.behavior-consultant.com/social.htm | archive-date = 2 May 2001 |access-date=22 October 2015}}</ref>
==Student characteristics== Students with EBD are a diverse population with a wide range of intellectual and academic abilities. Males, African-Americans, and economically disadvantaged students are over-represented in the EBD population, and students with EBD are more likely to live in single-parent homes, foster homes, or other non-traditional living situations.<ref name=":3"/> These students also tend to have low rates of positive social interactions with peers in educational contexts.<ref>{{cite journal|last1=Wehby|first1=Joseph|last2=Symons|first2=F.|last3=Shores|first3=R. E.|date=1995|title=A descriptive analysis of aggressive behavior in classrooms for children with emotional and behavioral disorders|journal=Behavioral Disorders|volume=20|issue=2|pages=87–105|doi=10.1177/019874299502000207|s2cid=151985694}}</ref> Students with EBD are often categorized as "internalizers" (e.g., have poor [[self-esteem]], or are diagnosed with an [[anxiety disorder]] or [[mood disorder]]) or "externalizers" (e.g., disrupt classroom instruction, or are diagnosed with [[disruptive behavior disorders]] such as oppositional defiant disorder and conduct disorder). Male students may be over-represented in the EBD population because they appear to be more likely to exhibit disruptive externalizing behavior that interferes with classroom instruction. Females may be more likely to exhibit internalizing behavior that does not interfere with classroom instruction, though to what extent this perception is due to social expectations of differences in male and female behavior is unclear. Both internalizing and externalizing behaviour can and do occur in either sex;<ref name=":3">{{Cite journal|last1=Danielson|first1=Melissa L.|last2=Bitsko|first2=Rebecca H.|last3=Ghandour|first3=Reem M.|last4=Holbrook|first4=Joseph R.|last5=Kogan|first5=Michael D.|last6=Blumberg|first6=Stephen J.|date=2018-03-04|title=Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016|journal=Journal of Clinical Child & Adolescent Psychology|volume=47|issue=2|pages=199–212|doi=10.1080/15374416.2017.1417860|issn=1537-4416|pmc=5834391|pmid=29363986}}</ref> Students with EBD are also at an increased risk for learning disabilities, school dropout, substance abuse, and juvenile delinquency.<ref name=":3" />
==Internalizing and externalizing behavior== A person with EBD with [[Internalizing disorder|"internalizing" behavior]] may have poor self-esteem, have depression, experience loss of interest in social, academic, and other life activities, and may exhibit [[non-suicidal self-injury]] or [[substance abuse]]. Students with internalizing behavior may also have a diagnosis of [[separation anxiety]] or another anxiety disorder, [[post-traumatic stress disorder]] (PTSD), [[Specific phobia|specific]] or [[social phobia]], obsessive–compulsive disorder (OCD), [[panic disorder]], and/or an [[eating disorder]]. Teachers are more likely to write referrals for students that are overly disruptive. Screening tools used to detect students with high levels of "internalizing" behavior are not sensitive and are rarely used in practice.<ref name=":4">{{Cite journal|last1=Wells|first1=Erica L.|last2=Day|first2=Taylor N.|last3=Harmon|first3=Sherelle L.|last4=Groves|first4=Nicole B.|last5=Kofler|first5=Michael J.|date=2018-11-26|title=Are emotion recognition abilities intact in pediatric ADHD?|journal=Emotion|language=en|doi=10.1037/emo0000520|pmid=30475028|issn=1931-1516|pmc=6535378|volume=19|issue=7|pages=1192–1205}}</ref> Students with EBD with "[[Externalizing Disorders|externalizing]]" behavior may be aggressive, non-compliant, extroverted, or disruptive.
Students with EBD that show externalizing behavior are often diagnosed with [[attention deficit hyperactivity disorder]] (ADHD), [[oppositional defiant disorder]] (ODD), [[conduct disorder]], [[autism spectrum disorder]] and/or [[bipolar disorder]]; however, this population can also include typically developing children that have [[Operant conditioning|learned]] to exhibit externalizing behavior for various reasons (e.g., [[Reinforcement#Positive and negative|escape from academic demands]] or [[Reinforcement#Positive and negative|access to attention]]). These students often have difficulty inhibiting emotional responses resulting from anger, frustration, and disappointment. Students who "externalize" exhibit behaviors such as insulting, provoking, threatening, bullying, cursing, and fighting, along with other forms of aggression. Male students with EBD exhibit externalizing behavior more often than their female counterparts.<ref name=":4" />
Children and adolescents with ADD or ADHD may display different types of externalizing behavior and should be either medicated or going through behavioral treatment for their diagnosis.<ref name=":3"/> Adolescents with severe ADHD would likely benefit most from both medication and behavioral treatment. Younger children should go through behavioral treatment before being treated with medication. Another recommended form of treatment for children and adolescents diagnosed with ADHD would be counseling from a mental health professional. Treatment options will improve performance of children and adolescents on emotion recognition tasks, specifically response time as there is no difficulty recognizing human emotions.<ref name=":4"/> The degree of required treatments vary depending on the degree of ADD or ADHD the individual has.
Treatment for these types of behaviors should include the parents as it is evident that their parenting skills impact on how their child deals with their symptoms, especially when at a younger age. Parents going through a parenting skills training program were reported a decrease in internalizing and externalizing behavior in their children post-training program.<ref>{{cite journal |doi=10.1111/j.1744-6171.2005.00014.x |title=Parenting Skills Training: An Effective Intervention for Internalizing Symptoms in Younger Children? | issn =1744-6171 |publisher = Wiley |journal=Journal of Child and Adolescent Psychiatric Nursing |volume=18 |issue=2 |pages=45–52 |year=2005 |last1=Cartwright-Hatton |first1=Sam |last2=McNally |first2=Deborah |last3=White |first3=Caroline |last4=Verduyn |first4=Chrissie |pmid=15966947 }}</ref> The program included learning how to give positive attention, increase good behavior with small frequent rewards and specific praise as well as learning how to decrease attention when the child behaved poorly.
==Effect in cognition== In recent years, many researchers have been interested in exploring the relationship between emotional disorders and cognition. Evidence has revealed that there is a relationship between the two. Strauman (1989) investigated how emotional disorders shape a person's cognitive structure, that is, the mental processes people utilize to make sense of the world around them.<ref>Garner, B. K. (2007). Getting to “got it!”. Alexandria, VA: Association for Supervision and Curriculum Development.</ref> He recruited three groups of individuals: those with social phobias, those with depression, and controls with no emotional disorder diagnosis. He wanted to determine whether these groups had a cognitive structure showing an actual/ideal (AI) discrepancy (referring to an individual not believing that they have achieved their personal desires) or actual/own/other (AOO) discrepancy (referring to an individual's actions not living up to what their significant other believes that they need to be). He found that depressed individuals had the highest AI discrepancy and social phobics had the greatest AOO discrepancy, while the controls were lower or in between the two for both discrepancies.<ref>{{cite journal | author = Strauman T. J. | year = 1989 | title = Self-discrepancies in clinical depression and social phobia: Cognitive structures that underlie emotional disorders? | journal = Journal of Abnormal Psychology |issn = 0021-843X | eissn = 1939-1846| oclc= 818916111| publisher = APA |volume = 98 | issue = 1| pages = 14–22 | doi=10.1037/0021-843x.98.1.14 | pmid = 2708634}}</ref>
Specific cognitive processes (e.g., attention) may be different in those with emotional disorders. MacLeod, Mathews, and Tata (1986) tested the reaction times of 32 participants, some of whom were diagnosed with Generalized Anxiety disorder, when presented with threatening words. They found that when threatening words were presented, people with greater anxiety tended to have increased selective attention, meaning that they reacted quicker to a stimulus in an area where a threatening word was just presented (32-59ms faster). When in the control group, subjects reacted slower when there was a threatening word proceeding the stimulus (16-32ms slower).<ref>{{cite journal |doi=10.1037/0021-843x.95.1.15 |title=Attentional bias in emotional disorders |journal=Journal of Abnormal Psychology |volume=95 |pages=15–20 |year=1986 |last1=MacLeod |first1=Colin |last2=Mathews |first2=Andrew |last3=Tata |first3=Philip |issn = 0021-843X | eissn = 1939-1846| oclc= 818916111| publisher = APA |issue=1 |pmid=3700842 }}</ref>
Emotional disorders can also alter the way people regulate their emotions. Joormann and Gotlib (2010) conducted a study with depressed, or previously depressed, individuals to test this. They found that, when compared to individuals who have never had a depressive episode, previously and currently depressed individuals tended to use maladaptive emotion regulation strategies (such as rumination or brooding) more. They also found that when depressed individuals displayed cognitive inhibition (slowing of response to a variable that had been previously ignored) when asked to describe a negative word (ignored variable was a positive word), they were less likely to ruminate or brood. When they displayed cognitive inhibition when asked to describe a positive word (ignored variable was a negative word), they were more likely to reflect.<ref>{{cite journal |doi=10.1080/02699930903407948 |pmid=20300538 |pmc=2839199 |title=Emotion regulation in depression: Relation to cognitive inhibition |journal=Cognition & Emotion |volume=24 |issue=2 |pages=281–298 |issn = 0269-9931 | eissn = 1464-0600 | lccn =00238845 |oclc=1039330776 | publisher = Routledge |year = 2010 |last1 =Joormann |first1=Jutta |last2=Gotlib |first2=Ian H. }}</ref>
==References== {{reflist}}
== External links == {{Commons}} * {{cite web |title=What is an emotional or behavioral disorder? |url=https://www.pacer.org/parent/php/PHP-c81.pdf |website=Children's mental health and emotional or behavioral disorders project |publisher=Minnesota Parent Training and Information Center |access-date=29 June 2022 |archive-url=https://web.archive.org/web/20061002154325/https://www.pacer.org/parent/php/PHP-c81.pdf |archive-date=2 October 2006 |location=PACER}} * [http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=357 Behaviour Management (EBD) Review Group: Published reviews]
{{Medical resources | ICD10 = {{ICD10|F|90||f|90}}–{{ICD10|F|98||f|90}} | ICD9 = {{ICD9|312}} | ICDO = | OMIM = | DiseasesDB = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = }}
{{Mental and behavioural disorders|selected = childhood}} {{Emotional and behavioral disorders}}
{{DEFAULTSORT:Emotional And Behavioral Disorders}} [[Category:School and classroom behaviour]] [[Category:Disability by type]] [[Category:Mental disorders diagnosed in childhood]] [[Category:Emotional issues]]