Don Frazier, Jr. – MA, PPSCFamily Support Coordinator

BYA Parents Association 5/27/2015

Diagnosed (ADHD, ODD, etc.):

For who’s benefit?

• Problem Behaviors Defined• Factors (self, home, community & school)• Early Warning Signs• Diagnosing & Medicating• Individual/Institutional racism & Health

Disparities • Calling Change Agents (Educational

Recommendations)• Video

Overview

• Emotional/Behavioral Disorders: 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.

Problem Behaviors Defined

• -[Code of Federal Regulations, Title 34, Section 300.7(c)(4)(i)]

• Arguing with others• Defiance• Hitting others• Lying• Nagging• Name-Calling• Being loud• Pushing others• Rough play• Stealing• Temper tantrums

EXTERNAL BEHAVIORS INTERNAL BEHAVIORS• Exhibits painful shyness• Unexplainable intense

feelings • Feeling depressed• Feelings of anxiety• Internalized false beliefs• Socially withdrawn • Tends to be suicidal• Unfounded fears or

phobias• Tends to have low self-

esteem• Has excessive worries

Problem Behaviors Defined

• Neurological wiring• Affects to medication• Unresolved psychosocialemotional wounds

(trauma)• Lack of nutrition• Fatigue• Death in the family• Separated parents• New adults• Negative interactions with adults• Learning disabilities

Factors (self)

• Traumatized parent(s)• Consistent noise• Little to no structure• Lack of clear and healthy communication• No consistency • Poverty• No access to healthy alternatives• No recreational activities

Factors (home)

• Poverty• Gangs• Violence• Drugs• No access to clinics (mental & physical)• Little to no resources• Lack of quality education• Lack of job opportunities• No transportation

Factors (community)

• Noise• Disruptions• Temperature • No structure• Little to no expectations• Length of assignments• No choices• Learning disabilities

Factors (school)

• Principles for Identifying the Early Warning Signs of Problematic Behaviors– Understand violence and aggression within a

context– Avoid stereotypes (race, academic ability,

appearance, etc.)– View warning signs within a developmental

context – Do not over react to one sole sign– Have an understanding of behaviors before the

antecedents (reactions to mild stressors)

Early warning signs

• Grades starting to slip• Starting to withdrawal• Low interest in school• Overly suspicious of others• Lack of enjoyment when with friends and

family• Big changes in energy levels• Sees or hears things that others do not

Early warning signs

• Social withdrawal• Uncontrolled anger• Low school interest and poor academic

performance• Expression of violence in writings and

drawings • Serious threats of violence • Excessive feelings of isolation, loneliness,

or rejection• History of violent and aggressive behavior • Being a victim of violence• Feelings of persecution • History of discipline problems

More extreme signs

• The TSEA centers on the Psychosocial and Emotional progress of the individual. TSEA assesses potential risk and protective factors that influence the individual’s development. The assessment is intended to provide a glimpse of the individuals current experiences.

• Reference– http://

www.search-institute.org/content/40-developmental-assets-adolescents-ages-12-18

Transitory Social Emotional Assessment

• Need to know– Many common symptoms occur for a variety of

reasons, and can reflect several different diagnosis

– Many children who display problem behaviors tend to live or come from challenging environments

– Adverse childhood events may have more or less influence on an individuals problem behaviors

– During a child's/adolescent’s developmental years, they are constantly changing

Diagnosing & Medicating

• “A recent study by Gethun and colleagues found a 70% increase in the number of ADHD diagnoses among African-American/Black children, with a 90% increase among African-American/Black girls.” – Dr. S.A. Wallace (2013).

• “AA/Blk children were 2.3 times more likely to be identified by their teacher as having mental retardation than their White counterparts.” – J. Codrington, Ph.D. & H.H. Fairchild, Ph.D. (2012)

Diagnosing & Medicating

• (Mis)diagnosing, Medicating & Miseducating:– Children who are developmentally young for their

age may receive an inaccurate diagnosis – Children that feel classes are too easy become

bored and may be (mis)diagnosed– When students are high functioning and/or fully

developed (personality) – these behaviors are often seen as disorders

– When students are not paying attention when asked

– Being highly active– Daydreaming– Anxiety and/or sadness

Diagnosing & Medicating

• Individual– Assumptions made about people that reflect

societal ‘norms’– Implicit biases that have not been consciously

unpacked and addressed – Internalized racism may manifest helplessness,

self-devaluation, and limiting ones self-expression

– Prejudice attitudes about groups can lead care providers to overlook an individual’s strengths

– Social distancing and stigmatization; verbal and non-verbal behaviors that communicate exclusion

Individual/Institutional racism & Health Disparities

• Institutional– The quality of schools, educators and

leadership– Residential segregation – Incarceration – Barriers to hospitals and health care

institutions– Barriers to nursing homes– Lack of economic access to health care– Racial disparities in medical treatment– Disparate impact of the intersection of race

and gender– Lack of language and culturally competent

care– Lack of data and standardized collection

methods

Individual/Institutional racism & Health Disparities

• What is your role?• What are your leadership qualities?• Who’s on your team?• Who’s team are you on?• Are you in the process of transformation?• Is your child/student aware of your

transformation?• What does your support system look like?• Does your child/student have a role in your

support system?

Calling Change Agents

• Schools (educators/admin)– Create caring environments– Provide solid leadership– Focus on relevance, relationships and rigor– Cultivate shared leadership– Be aware of cultural context– Display interpersonal and institutional care– Commitment to the young scholar’s education– Cultivate compassionate communication– Have confidence and acknowledge strengths– Establish and cultivate a family culture– Take responsibility for learning outcomes of young scholars– Address the chronic failure of the general school system– Incorporate culturally-relevant curriculum & pedagogy – Address the problem of oppression and ways to gain liberation– Provide healthy food alternatives for young scholars

Educational Recommendations

• Students– Must develop a strong sense of cultural identity

that is consistent with academic achievement– Negative peer pressure towards academic

success must be reversed – Begin working with one another and with

teachers in a collaborative style– Eat nutritional meals and snacks throughout

the day

Educational Recommendations

• Parents & Community– Be engaged and involved in OUR children’s education– Consider AA/Blk families strengths as cultural capitol that can

assist in the education process– Restore a balance of power between parents and the school– Establish and maintain parent-directed programs that address

the needs of family support– Open and honest communication, support for school culture,

participate in the decision-making process, emphasize learning at home, and collaborate

– Read with children/youth (all ages) and discuss your family (racial/ethnic) heritage in a way that would influence your child(ren)

– Establish and maintain a community intervention/prevention program (church-based)

– Provide healthy food alternatives for children/youth/students

Educational Recommendations

• Dr. Umar Johnson – War on Black Boys– Presenting on the “Psycho-Academic War on

Black Boys” which entails the war waged by the public education system against children of African ancestry in the United States. In the presentation Dr. Umar Johnson explains the IQ Test, Learning Disabilities, ADHD, and how Black children are often misdiagnosed into Special Education.

– https://www.youtube.com/watch?v=Z4WTkw-EGt4

– Begin video at 31:08 – 33:07 end

Video

DrugFacts: Stimulant ADHD Medications: Methylphenidate and Amphetimines• http://

www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medications-methylphenidate-amphetamines

DSM-5: Diagnosing for Status and Money: Summary critique of the DSM-5• http://www.zurinstitute.com/dsmcritique.htmlADHD by the Numbers: Facts, Statistics, and You• http://www.healthline.com/health/adhd/facts-statistics-infographicTHE CULTURALLY-SENSITIVE DIAGNOSTIC INTERVIEW RESEARCH PROJECT: A STUDY ON THE PSYCHIATRIC MISDIAGNOSIS OF AFRICAN AMERICAN PATIENTS:• http://www.rcgd.isr.umich.edu/prba/perspectives/fall2002/whaley.pdfSpecial Education and the Mis-education of African American Children: A Call to Action:• http://www.abpsi.org/pdf/specialedpositionpaper021312.pdfBlack Males And The Rise of ADHD• http://www.blackradionetwork.com/black_males_and_the_rise_of_a_d_h_d_The Most Common Misdiagnoses in Children: When symptoms have multiple causes, mistakes are made • http://www.childmind.org/en/posts/articles/2013-4-9-most-common-misdiagnoses-children70 percent increase in ADHD among Black children, study findsdc• http://thegrio.com/2013/02/15/70-percent-increase-in-adhd-among-black-children-study-finds /Trauma and ADHD: Think “And," Not “Or”: How real adverse events can contribute to real attention problems• https://www.psychologytoday.com/blog/abcs-child-psychiatry/201407/trauma-and-adhd-think-a

nd-not-or

Bibliography

Mistaken for ADHD• http://psychcentral.com/lib/mistaken-for-adhd/0007993African American Male Discipline Patterns and School District Responses Resulting Impact on Academic Achievement: Implications for Urban Educators and Policy Makers:• http://

journalofafricanamericanmales.com/wp-content/uploads/downloads/2010/03/African-American-Male-Discipline-Patterns1.pdf

Emotional or Behavioral Disorders Defined:• http://www.education.com/reference/article/emotional-behavioral-disorders-defined/Emotional/Behavioral Disorders• http://www.gallaudet.edu/clerc_center/information_and_resources/info_to_go/educate_childr

en_%283_to_21%29/students_with_disabilities/emotionalbehavioral_disorders.html

Early Warning Signs An excerpt from “The First ‘R’: Reflective Capacities”* Jonathan Cohen, Ph.D• http://www.schoolclimate.org/parents/documents/EarlyWarningSigns.pdfSafe Communities ~ Safe Schools FACT SHEET• http://www.colorado.edu/cspv/publications/factsheets/safeschools/FS-SC06.pdfSchools and the Challenge of LD and ADHD Misdiagnoses*• http://smhp.psych.ucla.edu/pdfdocs/ldmisdiagnoses.pdf“Racism in Healthcare: Its Relationship to Shared Decision-Making and Health Disparities: a response to Bradby”• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3244674/Institutional Racism in the US Health Care System• http://academic.udayton.edu/health/07humanrights/wcar02.htm

Bibliography