Students with Mental Illness

The first part of this article covers the following mental illnesses that many students confront: Oppositional Defiant Disorder and Conduct Disorder; Anxiety and Depression; as well as Autism and Asperger Syndrome. Each of these mental illnesses is described in terms of symptoms, school-based strategies, theorists, teaching techniques and ramifications. The Individuals with Disabilities Education Improvement Act, or IDEA, is briefly introduced, along with Section 504 of the Rehabilitation Act of 1973 (i.e., Section 504) and Title II of the Americans with Disabilities Act (i.e., ADA). Finally, the conclusion explores theoretical reasons why some disorders have experienced unpredictable patterns throughout the decades.

Keywords: Autism Spectrum Disorders; Behavior Modification; Collaborative Problem Solving; Implosive Therapy; Individuals with Disabilities Education Improvement Act (IDEA); Mental Illness; Rational Emotive Behavioral Therapy; School Phobia; Systematic Desensitization

Overview

Externalized Behaviors

Oppositional Defiant Disorder

A child with Oppositional Defiant Disorder (ODD) demonstrates unruliness toward adults by consistently defying rules, acting in a hostile, belligerent manner, and challenging the boundaries that have been set forth by authority figures. These argumentative children have tempers that flare without provocation, and maliciously seek vengeance when they feel that they have been wronged. They are easily annoyed and proactively seek to irritate others without taking responsibility for their actions. They are obstinate, inflexible, and unwilling to cooperate with others, much less settle for a shared sense of compromise (Gomez, Burns, & Walsh, 2008; Stringaris, Maughan, & Goodman, 2010; McKinney & Renk, 2007; Nock, et al., 2007). According to the 2013 version of the Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-5), a part of the diagnostic criteria entails that they struggle in their home, school, or occupation, although they are predominantly defiant at the home among family members with whom they are most intimate.

Conduct Disorder

Although not every individual with Oppositional Defiant Disorder progresses to Conduct Disorder, most teenagers with Conduct Disorder have previously been diagnosed with ODD. Thus, the incorrigible behavior evident in ODD is amplified by those who display Conduct Disorder, and often becomes violent. Indeed, either physical acts of aggression toward people or animals as well as verbally antagonistic threats and bullying behavior are common Conduct Disorder manifestations. Fights are frequently instigated by these teenagers, who wield guns, knives, broken bottles, and other dangerous weapons in such altercations. Thievery, deceit, the purposeful defacement of public property (e.g., vandalism, fire-setting), coercing others into sexual activity against their will, and serious violation of the rules before the age of 13-such as running away from home, truancy, and staying out all night are further characteristics (Maughan, et al., 2004; Olsson, 2009; Rowe, et al., 2010).

Educational Strategies

Behavior Modification

An educational strategy that works for students with both ODD and Conduct Disorder includes behavioral modification programs, which offer highly structured and consistent techniques. Such programs are usually constrained in nature, in that they sequester problematic students from the general education environment in order to protect against unwarranted harassment and bullying (Webster-Stratton, Reid, & Hammond, 2004). This arrangement also provides the affected students with individualized care amid a setting with low teacher-student ratios (Toolan, 2008). Insubordinate kids are typically starved for rules, boundaries, and limitations, despite the fact that they might outwardly reject and constantly test the restrictions that such programs set, and do well when defiant deeds are met with fair, unswerving consequences that justly reflect the behavior at hand. Helping students identify the specific triggers that elicit upsurges of volatile responses is a preemptive and thought-provoking first step in reversing unhealthy levels of anger. This should be followed by close deliberation about their bodily responses, problem-solving skills training, definition of the problem, identification, reflection of choices, and role playing. Scenarios conducive for role plays include the following prompts, which should be followed by students' responses:

• Another child stole my Game Boy…
• My sister broke my Xbox…
• Another child stole my money…
• Another child hit me (Cook, 2005, p. 5).

Also, the use of behavioral contracts is a widely-held approach in many schools, which helps redirect the conduct of rowdy youngsters by offering a series of rewards that accompany the positive strides that they accomplish (Ruth, 1996). This is the more common methodology over the deduction of points due to bad behavior, since the philosophy of most behavioral modification approaches assert that positive feedback yields positivity and criticism breeds retaliation among disruptive students (Cook, 2005). Through behavioral contracts, desirable behavior is tracked alongside a measuring device, such as a weekly calendar in which students receive X amount of stickers for achieving their specified feats, and the designated accumulation of such accomplishments warrants an ultimate reward. Some, however, argue against behavioral contracts because they seem to 'bribe' students into acting appropriately in return for highly coveted stickers, free homework passes, or pizza socials as opposed to modifying behavior for more intrinsic reasons.

Collaborative Problem Solving

Ross Greene has penned several books including The Explosive Child (2010) and Lost at School (2009), which target children with ODD, Conduct Disorder, and other behavioral and emotional disorders. According to Dr. Greene, today's society properly identifies and manages children who have learning disabilities, such as dyslexia. Similarly, he emphasizes that children who act inappropriately should be regarded as having a behavioral disability in which they are unable to incorporate the interpersonal rules that govern specific social spheres, and should be granted the same amount of services that other children receive. Like those who suffer from dyscalculia (the inability to comprehend mathematics), behaviorally disabled children may be deficient in flexibility, problem solving skills, patience, and compliance.

Dr. Greene consequently developed a construct entitled Collaborative Problem Solving (CPS), which is a model that can be used to broach this challenging phenomenon. He alleges that there are currently three tactics that can be drawn upon in a school environment that enable children to adapt to systematic educational and behavioral guidelines. Most schools adopt Plan A, which follows a "Do as I say" philosophy whereby children are expected to blindly accept the series of policies and conventions found within each particular establishment. In Plan C, Dr. Greene describes a dynamic in which the teacher feels hopeless about a child's ability to adequately retain the regulations, and therefore simply "gives up" on the child. Plan B, however, is the route that Dr. Greene encourages through CPS, which embraces three main components, the first of which involves the teacher making observations from the child's perspective about the immediate problem. For example, the child might say that he gets bored during lessons and wants to fulfill his own particular agenda. The second component of Plan B involves that the teacher reveals his requests, which may include a safe learning environment that is conducive for each member of the class. The third component consolidates the desires of both parties together to formulate a plan that is mutually agreed upon. For example, a child who listens attentively, but when becomes restless is allowed to venture toward another part of the room and quietly read a book rather than agitate his peers (Greene, 2009; Greene, 2010).

Internalized Behaviors

Anxiety

Anxiety is a condition whereby people feel an overwhelming sense of fear, either in a generalized sense in which the exact cause cannot be pinpointed, or in response to a specific trigger. Anxiety-stricken individuals may constantly feel "wound up," both in terms of the flood of apprehension that encompasses their mind, as well as the demonstrations of physiological tension such as muscle contractions, or an inability to sleep/concentrate. There are a myriad of physiological symptoms that accompany anxiety including but not limited to: rapid heartbeat, chest pain, nausea, hot flashes, shortness of breath, and a shaky, trembling comportment. Not surprisingly, a byproduct of such internal turmoil is irritability, undue exhaustion, and an impaired ability to properly uphold daily responsibilities (Andrews, et al., 2010). There are many diagnostic categories that fall under the umbrella of anxiety disorders, such as Obsessive-Compulsive Disorder, Social Anxiety Disorder, Posttraumatic Stress Disorder and Social Phobia.

School Phobia

One of the ways a social phobia might materialize for children and adolescents is through a school phobia (Csoti, 2003). Although it is not considered a formal diagnosis, school phobia is demonstrated by persistent, irrational fears associated with any aspect of the educational arena. Children who are reticent about leaving their caregivers do not qualify for this grouping since their symptoms likely fit the criteria of another anxiety subset called Separation Anxiety. School phobias, therefore, may be prompted by unknown circumstances, or they may circulate around an event during which the student felt socially or academically shamed. It is likely that the situation couples with other personality factors as well. For example, if a student had a particularly harsh teacher during his formative years who introduced a deep, socially phobic wound, a pertinent question would probe why that student became impaired while the remainder of the class progressed with their normal scholastic experiences. This broaches the issue that other dimensions comprise the etiology of school phobia-forces such as personality, temperament, background, and environmental influences, which also must be examined. School phobics who are consistently absent often face dire consequences, as they lag behind in both their academic lessons and socialization, and run the risk of encountering problems such as the attention of truant officers or even legal quandaries.

Depression

Although Major Depressive Disorder will be discussed here, the DSM-5 lists several specific types of Mood Disorders including Dysthymic Disorder, Bipolar I and Bipolar II, Cyclothymic Disorder, and Major Depressive Disorder ("Understanding," 2009; Zimmerman, et al., 2010). Depression is marked by a profound sense of sadness and a loss of interest in everyday activities that had once been pleasurable. Depressed persons often deviate from their normal weight, with either a noticeable weight gain or loss since this debilitating condition either renders them unable to maintain a balanced sense of food intake or leaves them too desolate to tend to their dietary needs altogether. Interference in sleep patterns is also common, in that people with depression either find themselves in a deep slumber for the majority of the day or suffering from cruel, insomnia-ridden nights. Further symptoms include feelings of unworthiness and guilt, hopelessness and helplessness, an inability to concentrate on daily tasks, and suicidal ideations.

Educational Strategies

Systematic Desensitization

One potential solution to school phobia is the use of systematic desensitization (Egbochuku & Obodo, 2005; London, 2009), which would likely require the service of a non-school based counselor. Systematic desensitization operates from the principle that people with specific, illogical fears often go to great lengths to avoid the stimuli that prompts their excessive angst. For example, people who suffer from pteromerhanophobia or aviophobia (fear of flying) might be paralyzed with anxiety when confronted with the notion of sky travel. Long-distance trips are avoided and alternate routes are inconveniently mapped out, and this avoidance undoubtedly limits their lifestyle. The avoidance also fuels the phobia. The process of systematic desensitization first introduces these individuals to the idea of flying intellectually, in a relaxed environment, and then gradually increases the dosage into more tolerable realms.

For example, the therapeutic trajectory for a patient with this phobia might include the following:

• Talking about flying;
• Looking at pictures of people flying;
• Conducting interviews with pilots and flight attendants who fly for a living;
• Visiting aircraft museums and touching the planes;
• Sitting in an airplane;
• Going on a short-distance plane ride.

The philosophy is that taking a slow-to-warm-up stance helps to steadily diffuse the fear, and eventually alleviate it altogether. In the instance of school phobia, the same therapeutic principles apply to fearful students, in that they might initially talk about their fears, and then progressively increase their exposure to school-based activities. They might take a series of "field trips" to their source of trepidation; first to the neighborhood that houses the school, then to the playground and after-school events, followed by the engagement in an abbreviated school day, which will prepare them to finally immerse themselves in their regular schedule.

Implosive Therapy

A related strategy that can be applied toward school phobics is called implosive therapy, in which the therapist incites strong emotions within the student by focusing on worst possible case scenarios that they might encounter (Spiegler & Guevremont, 2009; Troester, 2006). They talk about the possibility of failing courses, being shamed by teachers, and encountering awkward social situations such as falling in the middle of the cafeteria and being ridiculed by classmates. The rationale behind this approach is that these situations do in fact occur from time to time; denying their potential existence makes the eventual mishap that much more tragic, and reinforces students to recoil into their insulated comfort zones. Furthermore, through the process of implosive therapy, the student can examine the intimidating after-effects of these situations in an innocuous environment and experience firsthand that life does, indeed, move forward despite undergoing periodic bouts of humiliation.

Additional courses of action that may be taken with a school phobic includes enlisting the student in group therapy (Bostick & Anderson, 2009), which is favored over individual sessions since it mandates cooperative participation amongst one's peer group, as well as allowing the student to take a "time out" when overwhelmed, in which case he would be permitted to leave the classroom and proceed to a trusted place where he could discuss his problems, such as the counselor's office. Finally, short-term tactics that alleviate the school phobic's immediate problems include receiving home-bound instruction and/or participation in online activities. Generally these modalities merely serve as band-aids that cover the student's initial duress without delving beneath the surface to investigate and relieve causal factors.

Cognitive-Behavior Therapy

Cognitive-Behavioral therapies are renowned for making significant improvements in the lives of depressed students (McGinn, 2000), although many of these methods would be implemented outside the realm of a school environment due to their labor-intensive involvement. One of the pioneering forces of Cognitive-Behavioral therapy was Albert Ellis, who created a brand of intervention called Rational Emotive Behavioral Therapy, or REBT. REBT relies on three foundational segments, known as the ABCs of REBT, with each letter signifying a corresponding portion of the model:

• A, or Activating event is the actual incident, such as a high school student whose boyfriend breaks up with her;
• B stands for the Beliefs she attributes toward this event, and
• C references the emotional and behavioral Consequences that ensue.

Although people tend to think that the activating event is the chief ingredient that escalates people's emotions into depressive realms, it is actually their resulting beliefs that play the most prominent role. For example, in the previous breakup example, the girl's beliefs, or interpretations can take either a healthy route in which she shrugs off the separation as a disappointing, but natural part of one's high school career or it can turn into detrimental territory, in which she internalizes the breakup as indicative that she is a defective, unworthy human being. These beliefs, not the breakup itself, dictate subsequent emotional and behavioral consequences; in the latter example, she may become depressed, isolative, or suicidal. Hence, REBT focuses on restructuring flawed, faulty cognitions, which are thought to directly contribute toward depression and other neuroses (Dryden & David, 2008).

Another leader in Cognitive Behaviorism was Aaron Beck, whose concentration centered on depression. Beck postulated that depression often revolves around the following three cognitive distortions:

• The negative cognitive triad (Ingram, et al., 2007), which is a person's distorted understanding of self (e.g., "I am undeserving"), his world (e.g., "life stinks"), and his future (e.g., "nothing good will ever happen");
• Silent assumptions, or negative conjectures that people secretly presume (e.g., "If my boyfriend is angry, it's probably because I did something wrong"); and
• Logical errors that include overgeneralizations ("since one classmate snubbed me, everyone must hate me"), and arbitrary inferences, or a person's tendency to hone in on certain details while completely ignoring others, thus, missing the overall "big picture."

In response to these factors that spur on depression, Beck's interventions included role playing, assertion training, and cognitive rehearsal, in which the depressed individual partakes in a hypothetical journey to combat the failed initiatives that he has attempted, thereby instilling strength and confidence. For example, if a student is horrified at the notion of eating in the cafeteria for fear of rejection, his cognitive rehearsal would surround just that, in which he would verbally outline a step-by-step scenario that describes him successfully dining with his peers.

School counselors can also utilize non-traditional modalities while working with depressed students, such as the usage of art (Kahn, 1999), music (Gonzalez & Hayes, 2009), and journaling, which taps into the depths of their non-verbal, emotional landscape, or even pet therapy. Pet therapy is conducive for working with younger children, and involves mild-mannered animals, usually dogs, that camp out in the main office to offer a sense of solace that may not be found in dealings with humans (Jalongo, Astorino, & Bomboy, 2004). Finally, involving the entire family in counseling is a meaningful option to combat depression that takes a holistic approach in which the depression is conceptualized systemically (Larner, 2009). The systemic interpretation of depression suggests that while only one member suffers from painful feelings of destitution and dismay, this person's symptomology is reflective of the system's (i.e., family's) dysfunction; ergo, the depressed member is simply manifesting the symptoms of the dysfunctional unit. Thus, depression is treated collectively, which can alleviate the stigma and ownership that the singular individual would have otherwise faced.

Pervasive Developmental Disorders

Autism & Asperger Syndrome

Autistic Disorder, or Autism is one of three disorders that exists within the Autism Spectrum Disorders accompanied by Asperger Syndrome and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). Autism is a pervasive developmental disorder that is categorized by debilitated social skills; people with this disorder oftentimes struggle to make and maintain intimate interactions, as relationships generally revolve around each party's ability to partake in a synergistic give-and-take quality of which these individuals find difficult. Their nonverbal communication-in terms of eye contact, carriage, and mannerisms is unrefined, as is their ability to respond to situations spontaneously. Verbal transmissions are equally awkward, evinced through delayed or immobilized language development, an inability to prolong interactive discussions, repetitious speech patterns, and a lack of extemporaneous play/behavior. Additional qualities include recurrent preoccupations or behavioral patterns (e.g., incessantly rocking back and forth), and rigid devotion toward inane ritualistic habits (Ling-ling, 2008).

Asperger Syndrome was first recognized in 1944 by Hans Asperger, although it was not clinically established within the psychological community until its inclusion in the DSM in 1994. There is a tremendous amount of overlap between Autism and Asperger Syndrome, hence they both lie on the Autism Spectrum Disorders continuum, although Asperger Syndrome resides at the milder side of the spectrum. As such, the diagnostic criteria for Asperger Syndrome and Autism are strikingly similar, with the former possessing less severe symptoms, particularly regarding cognitive development and communication skills. In the DSM that was released in 2013 the diagnosis of Asperger’s was changed and Asperger’s and PDD-NOS now fall under the umbrella term of Autism Spectrum Disorders.

What Causes Autism?

It is intriguing to look at how various disorders have significantly ebbed and flowed throughout the years. Autism is one such example that has experienced a fluctuating prevalence rate. Before 1980, Autism was considered somewhat rare, afflicting 1 in 2,000 children, by 2013, however, the CDC estimated that 1 in 50 school-aged children is identified as being on the spectrum. Reasons for such a growth spurt are unknown, although several theories have been offered to explain this mysteriously mounting epidemic. Some relate to childhood vaccinations (which has no evidence and has been widely disproven and discredited), while others theories suggest that a lack sunlight/Vitamin D, household toxins , or aging parents could be factors. Some skeptics say that the rate of Autism has not grown, but our knowledge of Autism has become more cultivated-in terms of more astute research, clinicians, and crisper diagnostic criteria. Also, it is possible that because so many educational accommodations are offered to children with ASD, parents are pursuing diagnoses more readily in order to link struggling kids with extended services; this proactive parent advocacy also elevates the pervasiveness of the condition.

Educational Strategies

Students on the Autism Spectrum Disorder (ASD) do not fare well in ambiguous situations. Unless situations are clearly delineated with specific directions, grading rubrics, and rules to guide their completion of tasks, students with ASD flounder. Therefore, teachers should take this into consideration when assigning coursework, and provide detailed instructions that outline expectations amid highly programmed schedules. Although students with ASD generally struggle to intellectualize material abstractly, some school assignments are naturally more conceptual, and for those open-ended tasks teachers should adjust their expectations accordingly. Teachers should also be cognizant of the language that they use, as students with ASD become confused with metaphorical language such as "I'm dying of heat," "she was jumping for joy," and "he is the apple of my eye." They take language quite literally and can become confused with allegories, colloquialisms, and even humor (Papp, 2006). Teachers should limit the amount of sarcasm, humor or idiom in their everyday speech patterns.

Students with ASD should be taught by an interdisciplinary team (Ervin, 2003) that consists of teachers, speech and language therapists, occupational and psychological therapists, and should have as much school-to-family communication as possible. Most professionals acknowledge that inclusion, or mainstreaming students with ASD into general education classes is the most ideal and least stigmatizing route to take (Lynch & Irvine, 2009), although there should be one adult per two children with ASD in any given classroom in order for a suitable amount of attention and accommodation to be conferred. Individualized lessons that revolve around social rules-such as conversational turn taking and maintaining appropriate proximity during various interactions-should be taught and practiced with the class. Teachers should avoid over-stimulating sensations, as students with ASD are unusually sensitive to touch (Hilton et al., 2010), sound, and an overload of visual input, such as colorful bulletin boards and worksheets, which serve to distract and overpower their equilibrium.

In terms of the pedagogy used in the classroom, it is widely believed that students with ASD thrive when utilizing visual strategies over those that are audio-based or kinesthetic, although in actuality our knowledge of these learning styles can be further categorized. For example, in a study conducted by Mongillo et al. (2008) it appears that children with ASD performed at an inferior level than their non-ASD counterparts with audiovisual tasks that utilized human faces and voices, but each group functioned equally well on tasks that involved non-human stimuli. A mixture of measures, both those in which students with ASD flourish, and those with which they struggle are both relevant in their development and should be used with equal prevalence. Additionally, although students with ASD might normally steer clear from sporting activities, which require highly refined social processes such as team work, competitiveness, dealing with winning/losing, communication, and sensory-motor development, such experiences might enhance their socialization skills, which they may transfer into other life realms (Massion, 2006).

Applications

Individuals with Disabilities Education Act (IDEA)

Schools are required to properly accommodate children with the following disabilities through the advent of the Individuals with Disabilities Education Improvement Act, or IDEA:

• Mental retardation,
• Learning disabilities,
• Emotional disturbance,
• Deafness/Hearing impairments,
• Visual impairments,
• Orthopedic impairments,
• Other health impairments,

• Autism,

• Traumatic brain injury, and
• Speech or language impairments (Etscheidt & Curran, 2010; Smith, 2005).

One of the provisions that is governed through IDEA mandates that students are educated within a least restrictive environment in which students with disabilities are educated side-by-side in classrooms with the mainstream population. Students with disabilities are also required to have an Individualized Education Program written on their behalf, which precisely demarcates the special education services they are able to receive, describes future transitional planning, and provides a list of goals, objectives, and the ways in which the disabilities affect their learning process (Gartin & Murdick, 2005).

IDEA encourages that parents are inextricably involved in their child's procedures through due-process rights that require participation, as well as due-process hearings through which they can request impartial hearings if they disagree with the IEP team's consensus. Children with uninvolved parents are also accounted for through decrees such as Child Find, which seeks out students with disabilities who have not been suitably identified by parents (Shapiro & Derrington, 2004). There are some controversial elements included in IDEA, such as the fact that students with identified disabilities who get into trouble cannot accumulate more than 10 days of suspension and/or expulsion without a meeting to determine if their disability was the causal force that spurred on their misdeeds (Ryan et al., 2007).

For example, let's examine the student who has been diagnosed with Conduct Disorder and has a pattern of instigating fights. The series of punishments associated with his dishonorable behavior will be handled quite differently from other students by strictly operating under the auspices of IDEA. Students who are not eligible for IDEA may be entitled to assistance under Section 504 of the Rehabilitation Act of 1973 (i.e., Section 504) and Title II of the Americans with Disabilities Act (i.e., ADA), since the criteria for the latter two services are significantly broader (Jordan Rea & Davis-Dorsey, 2004). Disability is defined through Section 504 and ADA as follows: the person "1. has a physical or mental impairment that substantially limits one or more of such person's major life activities, 2. has a record of such an impairment, or 3. Is regarded as having such an impairment" (Smith, 2001, p. 236).

Terms & Concepts

Collaborative Problem Solving: Collaborative Problem Solving, or CPS, is a framework that was initiated by Dr. Ross Greene in order for schools to effectively work with behaviorally disruptive students.

Implosive Therapy: Implosive therapy helps students with school phobia to overcome their fears by focusing on the worst possible case scenarios that they might encounter. Discussing these instances readies the students to face possible mishaps in a safe and therapeutic environment.

Individuals with Disabilities Education Improvement Act (IDEA): Through the IDEA, schools are required to properly accommodate children with the following disabilities: Mental retardation, Learning disabilities, Emotional disturbance, Deafness/Hearing impairments, Visual impairments, Orthopedic impairments, Other health impairments, Autism, Traumatic brain injury, and Speech or language impairments.

Rational Emotive Behavioral Therapy (REBT): Created by Albert Ellis, REBT relies on three foundational segments. These segments are known as the ABCs of REBT, with each letter signifying a corresponding portion of the model.

School Phobia: While not a formal diagnosis, school phobias are demonstrated by persistent, irrational fears associated with any aspect of the educational arena.

Systematic Desensitization: Systematic desensitization operates from the principle that people with specific, illogical fears often go to great lengths to avoid the stimuli that prompts their excessive angst. This avoidance also fuels the phobia. Through systematic desensitization the fearful person is first introduced to the idea of their fear and then gradually increases the "dosage" into more tolerable realms.

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Jalongo, M. R., Astorino, T. & Bomboy, N. (2004). Canine visitors: The influence of therapy dogs on young children's learning and well-being in classrooms and hospitals. Early Childhood Education Journal, 32, 9-16. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14270796&site=ehost-live

Jordan Rea, P. & Davis-Dorsey, J. (2004). ADA in the public school setting. Journal of Disability Policy Studies, 15, 66-69. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14241039&site=ehost-live

Jung, S., & Sainato, D. M. (2013). Teaching play skills to young children with autism. Journal Of Intellectual & Developmental Disability, 38, 74–90. Retrieved December 12, 2013 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=85430831

Kahn, B. B. (1999). Art therapy with adolescents: Making it work for school counselors. Professional School Counseling, 2, 291-298. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=1786613&site=ehost-live

Larner, G. (2009). Integrating family therapy in adolescent depression: An ethical stance. Journal of Family Therapy, 31, 213-232. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=42874358&site=ehost-live

Levy, S. E., Mandell, D. S., & Schultz, R. T. (2009). Autism. Lancet, 374(9701), 1627-1638.

Ling-Ling, T. (2008). Social, language, and play behaviors of children with autism. Behavioral Development Bulletin, 14 (Spring), 40-50. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=36541515&site=ehost-live

Lloyd-Smith, M. & Sheffield-Brotherton, B. (2008). Children's environmental health: Intergenerational equity in action-a civil society perspective. Annals of the New York Academy of Sciences, 1140, 190-200. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=34909635&site=ehost-live

London, R. (2008). Systematic desensitization in 10 steps. (The psychiatrist's toolbox). Clinical Psychiatry News, 36, 1-22.

Lynch, S. L. & Irvine A. N. (2009). Inclusive education and best practice for children with autism spectrum disorder: An integrated approach. International Journal of Inclusive Education, 13, 845-859. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=46776985&site=ehost-live

Massion, J. (2006). Sport practice in autism. Science & Sports, 21, 243-248.

Matson, J. & Horovitz, M. (2010). Stability of autism spectrum disorders over time. Journal of Developmental & Physical Disabilities, 22, 331-342.

Maughan, B., Rowe, R., Messner, J., Goodman, R., & Meltzer, H. (2004). Conduct disorder and oppositional defiant disorder in a national sample: Developmental epidemiology. Journal of Child Psychology & Psychiatry, 45, 609-621. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=12336144&site=ehost-live

McGinn, L. K. (2000). Cognitive behavioral therapy of depression: Theory, treatment, and empirical status. American Journal of Psychotherapy, 54, 257-261. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=3949262&site=ehost-live

McKinney, C. & Renk, K. (2007). Emerging research and theory in the etiology of oppositional defiant disorder: Current concerns and future directions. International Journal of Behavioral Consultation & Therapy, 3, 349-371. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=27246641&site=ehost-live

Miller, L. & Reynolds, J. (2009). Autism and vaccination-The current evidence. Journal for Specialists in Pediatric Nursing, 14, 166-172. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=43017185&site=ehost-live

Mongillo, E. A., Irwin, J. R., Whalen, D. H., Klaiman, C., Carter, A. S., & Schultz, R. T. (2008). Audiovisual processing in children with and without autism spectrum disorders. Journal of Autism & Developmental Disorders, 38, 1349-1358. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=33333209&site=ehost-live

Nicholas, J. S., Charles, J. M., Carpenter, L. A., King, L. B., Jenner, W., Spratt, E. G. (2008). Prevalence and characteristic of children with autism-spectrum disorders. Annals of Epidemiology, 18, 130-136.

Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2007). Life prevalence, correlates, and persistence of oppositional defiant disorder: Results from the National Comorbidity Survey Replication. Journal of Child Psychology & Psychiatry, 48, 703-713. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=25489296&site=ehost-live

Olsson, M. (2009). DSM diagnosis of conduct disorder (CD)-A review. Nordic Journal of Psychiatry, 63, 102-112. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=37185777&site=ehost-live

Papp, S. (2006). A relevance-theoretic account of the development and deficits of theory of mind in normally developing children and individuals with autism. Theory & Psychology, 16, 141-161.

Rice, C. (2009). Prevalence of autism spectrum disorders-autism and developmental disabilities monitoring network, United States, 2006. MMWR Surveillance Summaries, 58(SS-10), 1-24. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=47390167&site=ehost-live

Rowe, R., Maughan, B., Moran, P., Ford, T., Briskman, J., & Goodman, R. (2010). The role of callous and unemotional traits in the diagnosis of conduct disorder. Journal of Child Psychology & Psychiatry, 51, 688-695. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=50329377&site=ehost-live

Ruth, W. J. (1996). Goal setting and behavior contracting for students with emotional and behavioral difficulties. Psychology in the Schools, 33, 153-158.

Ryan, J. B., Katsiyannis, A., Peterson, R., & Chmelar, R. (2007). IDEA 2004 and disciplining students with disabilities. NASSP Bulletin, 91, 130-140.

Schnur, J. (2005). Asperger syndrome in children. Journal of the American Academy of Nurse Practitioners, 17, 302-208. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=17753801&site=ehost-live

Shapiro, B. J. & Derrington, T. M. (2004). Equity and disparity in access to services: An outcomes-based evaluation of early intervention child find in Hawai'i. Topics in Early Childhood Special Education, 24, 199-212. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=15825433&site=ehost-live

Smith, T. E. C. (2001). Section 504, the ADA, and public schools. Remedial & Special Education, 22, 335-343. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=5599360&site=ehost-live

Spiegler, M. D. & Guevremont, D. C. (2009). Contemporary Behavior Therapy. USA: Wadsworth Publishing.

Stringaris, A., Maughan, B., & Goodman, R. (2010). What's in a disruptive disorder? Temperamental antecedents of Operational Defiant Disorder: Findings from the Avon Longitudinal Study. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 474-483.

Sweeney K. D. & Sweeney, K. G. (2010). Recognising and managing Asperger's Syndrome. Practice Nurse, 39, 31-34. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=48123650&site=ehost-live

Toolan, P. (2008). Conduct disorder. Community Care, 1720, 26-26. Retrieved July 30, 2010 from EBSCO online database, Academic Research Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=32086922&site=ehost-live

Toth, K. & King, B. H. (2008). Asperger's Syndrome: Diagnosis and treatment. American Journal of Psychiatry, 165, 958-963.

Troester, J. D. (2006). Experiences with implosive therapy. Clinical Social Work Journal, 34, 349-360. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=21801266&site=ehost-live

Understanding and managing the pieces of major depressive disorder. (2009). USA: Neuroscience Education Institute.

Webster-Stratton, C., Reid, M. J., & Hammond, M. (2004). Treating children with early-onset conduct problems: Intervention outcomes for parent, child, and teacher training. Journal of Clinical Child & Adolescent Psychology, 33, 105-124. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=12290412&site=ehost-live

Zimmerman, M., Galione, J. N., Chelminski, I., McGlinchey, J. B., Young, D., Dalrymple, K., Ruggero, C. J., & Witt, C. F. (2010). A simpler definition of major depressive disorder. Psychological Medicine, 40, 451-457.

Suggested Reading

Bourne, E. J. (2005). The anxiety and phobia workbook, fourth edition. USA: New Harbinger Publications.

Eddy, M. (2006). Conduct disorders: The latest assessment and treatment strategies. USA: Jones and Bartlett Publishers.

Furmark, T. (2002). Social phobia: Overview of community surveys. Acta Psychiatrica Scandinavica, 105, 84-93. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=6444968&site=ehost-live

O'Connor, R. (2010). Undoing depression: What therapy doesn't teach you and medication can't give you. USA: Little, Brown and Company.

Q & A with Ross Greene, author of 'Lost School.' (2009). American School Board Journal, 196, 13-13. Retrieved July 30, 2010 from EBSCO online database, Academic Search Complete, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=36082137&site=ehost-live

Sears, D., & Reagin, J. (2013). Individual versus collaborative problem solving: divergent outcomes depending on task complexity. Instructional Science, 41, 1153–1172. Retrieved December 12, 2013 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=91673006

Taddei, S., & Contena, B. (2013). Brief report: Cognitive performance in autism and Asperger’s syndrome: What are the differences?. Journal Of Autism & Developmental Disorders, 43, 2977–2983. Retrieved December 12, 2013 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=91897116