presented by rance l. harbor, ph.d., school psychologist hillsborough county public schools leto...

Presented by Rance L. Harbor, Ph.D., School Psychologist Hillsborough County Public Schools Leto High School Email: [email protected]

Learning Objectives How to identify and assess academic, acculturation, and emotional factors that may impact English Language Learner students. Specifically, we will discuss characteristics often present with ELL students at risk for school failure including language acquisition Acculturation school bonding and family factors.

Learning Objectives How to develop Tier 1, 2, and 3 interventions based on the students needs at each level. Assessment and outcome measurement techniques and materials will be presented for each level.

Identification and Assessment of Academic, Acculturation, and Emotional Factors

ELLs in Florida by Country of Birth United States 149,327 Mexico 10,232 Cuba 18,864 Puerto Rico 5,384 Colombia 4,556 Dominican Republic 2,945 FL DOE, 2009-2010

Latinos are the most numerous and fastest growing ethnic minority group in the United States, and approximately 15.4 million are under the age of 18 years (U.S. Department of Commerce, Bureau of the Census 2009).

Selection of Assessment Tools and Identification of Appropriate Treatment Goals

Tier 1, 2, & 3 Identification Make sure you know the Referral Question! Harbor Student Survey (Spanish & English) Support Service Intake Form Background Information- Parent Form (Spanish & English) Teacher Feedback Form (English only, but Spanish in 2011) Student Feedback Form (Spanish & English) Classroom Observations Behavior Rating Scales (CBCL or BASC)

Tier 1, 2, & 3 Identification Cella Testing IPT Testing FAIR Testing Math Formative FCAT Writing, Reading, Math Algebra 1 Grades Intensive Reading Grades Discipline Reports Attendance Reports

Student Survey Behavior Not at All SomeVery Much 1. How motivated are you to stay in school? 123 2. Do you believe you will be able to graduate? 123 3. Do you think you can pass Algebra? 123 4. Do you think you will pass the FCAT Math? 123 5. Do you think you will pass the FCAT Reading? 123 6. Do you think you think you will pass the ACT or SAT? 123 7. How well do you understand your teachers when they are teaching? 123 8. How well do you understand what you read in your text books? 123 9. Do you think you can make all A, B, or C grades? 123 10. How much do things at home interfere with you being successful at school? 123 11. How much do things in your neighborhood interfere with you being successful at school? 123 12. How safe do you feel at school?123 Please rate how much the following questions apply to you by circling the appropriate number.

Student Survey AlwaysSomeNever 13. How often do you feel sad/ depressed?1 2 3 14. How often do you sleep in class?1 2 3 15. How often do you feel anxious or nervous?1 2 3 16. How often do you get angry at your teachers?1 2 3 17. How often do you get angry at other students?1 2 3 18. How often do you get angry at your parents?1 2 3 19. How often do you get in trouble at school?1 2 3 20. How often are you late for your classes?1 2 3 21. How often are you absent from school?1 2 3

Who do you feel comfortable going to for help if another student, or an adult at school, was harassing or bullying you? (Check all that apply and write a specific name of the person if you want.) Teacher(s) _________________ Administrator _________________ School Resource Officer School Psychologist School Social Worker Guidance Counselor School Nurse A Friend Parent (s) ______________ Nobody Student Survey What things about school worry you the most? ___________________ _________________________________________________________ What things could we do to help you do better in school? ____________ _________________________________________________________

Teacher Survey Please rate this students behavior by circling the appropriate number. Current Grade (estimate): A B C D F Academic Concerns, if any: __________________________________________ Behavior Concerns, if any: __________________________________________ Behavior Very PoorPoorFairGoodExcellent 1. Attendance 12345 2. Arrives to class on time 12345 3. Participation in class 12345 4. Completion of class assignments 12345 5. Completion of homework 12345 6. Remains alert in class 12345 7. Sits still, stays focused12345 8. Interaction/ Social Skills with peers12345 9. Interaction/ Social Skills with teacher12345 10. General attitude 12345 Always Often SometimesSeldomNever 11. Does this student appear sad/ depressed?123 45 12. Does this student sleep in class?123 45 13. Does this student appear anxious/ nervous?123 45 14. Does this student get angry?123 45 15. Is this student a discipline problem?123 45

Academic Needs.

What about ELL? For those students who: have not passed FCAT Reading Benchmark Who took the FAIR Assessment Examine by Grade ELL Status x Success Zone AP2 Compare: Developmental Score 2008-09 for FCAT Reading FSP Score AP1 FSP Score AP2

Academic Interventions Going to develop a FUSE model to coteach regular education classes with ELL Paraprofessionals. This will allow LYCs who are stuggling to also have additional ELL resources as well as allow small group pullout/Tier 2 instruction for LYAs and LYBs Newcomer Academy will consist of core language acquisition classes (English, Spanish, Dev LA) with splintering off for Math and Science based on placement test results. Core classes will also allow for delivery of Tier 2 transitional services from psych, guidance, and social work (similar to work already being done in acculturation group) since students are already grouped together.

Academic Interventions For all Level 1 FCAT students, an intensive reading program is required. Developmental LA course counts for LYAs + LYBs. Academy of Reading is not recommended as it is not at an appropriate reading level for them. Suggested Math + Science placement tests for newcomers. Math department has Algebra materials in Spanish to create a "screener". Note: Geometry is too language intensive for Lys.

Acculturation Mental Health

The Importance to Address Culture What is culture? Worldview that a group has which allows members of that group to interpret the world. Culture cannot be interpreted to just mean individuals from a particular ethnic group. Culture and Pathology A groups values determine how a problem will be expressed. College students express problems overwhelmingly as being tired, or being burnt out; this is not common among individuals who are not currently in college.

Why do different cultural groups look at pathology different? Reason is because of their worldview. Rejection of mind-body duality. A disease of one person is, by default, a disease of the group and of the whole (Kirmayer & Young, 1998). This shared responsibility can, in many instances, relieve the stress that is normally experienced by an individual living in a Western society.

Introduction to Depression Depression is a disorder characterized by persistent depressed (sad) mood which may last months or even years. About 2% of school-age children (i.e. children 6-12 years of age) appear to have a major depression at any one time. Puberty - the rate of depression increase to about 4% major depression overall. Overall, approximately 20% of youth will have one or more episodes of major depression by the time they become adults.

Prevalence of Depression Lifetime prevalence for Major Depressive Disorder 17% for men 21.3% for women. (Garber 2000) Prevalence Rates of depression: Adolescence: 0.4% 6.4%.

Prevalence of Depression Latina women are at a higher risk of having a depressive episode. Women seem to be affected more in general, but as many as 46% of Latina women were depressed. Opposed to men, the prevalence of depression in Latino men is 19.6% (NAMI).

Differential Issues in Diagnosis Much stigma and negative connotation associated with depression or any mental related issues in the Latino Culture. Often associated as being crazy or ataque de nervios. In order to receive help, Latinos may complain and express somatic symptoms. Seeking medical attention is a more valid and socially acceptable way to receive services and avoid embarrassment.

Differential Issues in Diagnosis Rather than seeking professional help, many rely on spiritual belief or other folk tale particular to their culture. Latinos may seek treatment from general doctors which may result in misdiagnosing or missing the root of the problem all together.

Differential Issues in Diagnosis Other factors that can play a role is the on-going stress of issues such as: Poverty Racism Social stratification Legal status Pre-existing mental health issues in native country Assimilation and Acculturation (student and parents) Acculturation - individuals are able to find value and meaning in both cultures and identify with both. Assimilation: The students home cultural values and beliefs are replaced by the new culture, leaving behind the parents culture.

Barriers One big barrier is the shortage of Latinos in the health force to adequately serve these communities. 1.7% of all school psychologists are Latino. Not knowing where to receive help can pose a barrier especially because many Latino families are of low to middle income families

Barriers Increase the awareness of Latino issues concerning depression including, cultural traditions among non-Latino groups and individuals. Realizing that although Latinos are very interdependent as a family, the sense of space to communicate feelings of depression is not easily available and can pose a great barrier if a child is experiencing such feelings.

Barriers By learning how to reach the Latino communities includes everyone that is involved in the childs life. That may be parents, brothers and sister and as a whole come up with better interventions. Making resources available for parents is of great step to help their children receive medical treatment if needed. Lack of information regarding the intensity and severity of depression. Not informing Latinos of the severity of depression as well as the treatment available can further hinder in receiving the adequate treatment.

A Tier 2 Intervention: ELL Transition Group 5 students 3 females (1 from Cuba, 2 from Dominican Republic) 2 males (both from Cuba Primarily 9 th and 10 th graders/Spanish first language Met bi-weekly for 50 mintues Referred primarily by Guidance Counselor Served as a reference point/bridge between them and the school

Adjustment Issues Barriers Transition Family support Group support as a means for navigating school Legal status A Tier 2 Intervention: ELL Transition Group

ELL Transition Group/Tier 3 Individual Students Larger issues than just transition Socio-emotional Behavioral

Anxiety Anxiety involves constant, excessive, and unrealistic worry Generalized Anxiety Disorder Obsessive Compulsive Disorder Panic Disorder Posttraumatic Stress Disorder Separation Anxiety Social Anxiety Specific Phobias

Culture & Anxiety Cultural differences in perceptions and approaches to illness have an impact in the experience of disease, interpretation of symptoms, symptom expression, and the manner in which one copes Salman et al. (1997)

Social stigma and family shame linked to psychological disorders in Latino culture Influence descriptions and interpretations of psychological symptoms Salman et al. (1997) Cultural influences in defining Anxiety

Culturally accepted terms when referring to symptoms Widely used term to communicate a wide range of symptoms is nervios Anxiety Somatic symptoms Panic attacks Misbehavior Emotional distress Schizophrenia Nervios translates to nerves

Prevalence of Anxiety Latinos meet criteria for separation anxiety disorder more often than Caucasians 6-17 years old Mainly Central American origin More reported general anxiety, social anxiety and somatic symptoms Secondary school students Females report more social anxiety and somatic symptoms Related to absences & visits to school nurse? Ginsburg & Silverman (1996), Glover et al. (1999), McLaughlin et al. (2007)

Prevalence of Anxiety Latinos report more worries than Caucasian youth Research included Mexican youth residing in Mexico and America as well as European American youth residing in the United States A later study added youth residing in the United States from Central American origins. Similar results were found. Varela et al. (2004, 2008)

Beyond developing explicatory models of psychopathology with Latino youth, our understanding of how relevant cultural and contextual variables may serve to protect or place such children at greater risk will facilitate the development of psychosocial and cognitive interventions and preventive measures for anxiety disorders with this population. Varela & Hensley-Maloney, 2009

Cognitive-Behavioral Therapy for Anxiety Balance of cultural sensitivity and evidence-based practices Flexibility necessary Be a reflective practitioner How may my own biases affect treatment? What is working/not working? Get to know the student within family and cultural context Involve the family Extended family also valuable Establish goals that are culturally valued and relevant Wood et al. (2008)

Barriers to Mental Health Therapy Language proficiency of therapists Miscommunication Misdiagnosis/treatment Cultural barrier Cultural context of information Cultural competence necessary Suzuki & Ponterotto, 2008

Transition Group 2010-2011 9 students 4 Females (2 from Cuba, 1 from Puerto Rico, 1 from Dominican Republic) 5 Males (3 from Cuba, 2 from Colombia) 9 th -12 th graders Spanish is primary language Met bi-weekly

Transition Group 2010-2011 Length of time in country 2 less than one school year 4 1-2 school years 3 four school years

Referral reasons Recent transitions from other countries Emotional distress Poor academic motivation Lack of appropriate coping skills Level of acculturation/assimilation

Student Goals Learn how to make new friends Share experiences in own countries Improve emotional states Improve social & problem-solving skills Improve grades Graduate high school

Goals for Transition group Decrease symptoms of emotional distress Increase school and community involvement Development and application of problem- solving strategies

Progress Monitoring Problem identifiedMeasureFrequency Emotional distressAchenbach CBCL Survey Pre & post School and community involvement Verbal group check-ins Biweekly Academic motivationSurvey Grades Pre & post Every 9 weeks Problem-solving skillsSurveyPre & post

Specifics on Group Counseling

Monitoring progress using the RtI model.

How and when to access additional resources. Family Need to get the family involved Medical Anxiety, Headaches, Health Concerns, etc. Pharmacological Anxiety, Depression, ADHD, etc. Tutoring Intensive Therapy Community Support Church Hispanic Council

How and when to access additional resources. 211 http://www.211atyourfingertips.org

References www.nami.org Garber J. (2000). Handbook of Developmental Psychopathology, Second Edition, edited by Arnold J. Sameroff, Michael Lewis, and Suzanne M. Miller. Kluwer Academic/Plenum Publishers, New York, 2000. Suzuki, L.A. and Ponterotto, J.G. (2008). Handbook of Multicultural Assessment. Clinical, Psychological, and Educational Applications, Third Edition, Jossey-Bass, San Francisco, 2008. Garcia Coll, C., and Garrido, M. (2000) Handbook of Developmental Psychopathology, Second Edition, edited by Arnold J. Sameroff, Michael Lewis, and Suzanne M. Miller. Kluwer Academic/Plenum Publishers, New York, 2000 www.psychinternational.com/abroad/abroad01.htm http://www.ldldproject.net/theoretical_foundation.html

References Ginsburg, G. S., & Silverman, W. K. (1996). Phobic disorders in Hispanic and European-American youth. Journal of Anxiety Disorders, 10, 517528. doi:10.1016/S0887-6185(96)00027-8. Glover, S. H., Pumariega, A. J., Holzer, C. E., Wise, B. K., & Rodriguez, M. (1999). Anxiety symptomatology in Mexican- American adolescents. Journal of Child and Family Studies, 8, 4757. doi:10.1023/A:1022994510944. McLaughlin, K. A., Hilt, L. M., & Nolen-Hoeksemsa, S. (2007). Racial/ethnic differences in internalizing and externalizing symptoms in adolescents. Journal of Abnormal Child Psychology, 35, 801816. doi:10.1007/s10802-007-9128-1. Salman, E., Diamond, K., Jusino, C., Sanchez-LaCay, A., & Liebowitz, M. R. (1997). Hispanic Americans. In S. Friedman (Ed.), Cultural issues in the treatment of anxiety (pp. 5980). New York: The Guilford Press.

References Silverman, W. K., & Nelles, W. B. (1988). The Anxiety Disorders Interview Schedule for Children. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 772778. Varela, R. E., Vernberg, E. M., Sanchez-Sosa, J. J., Riveros, A., Mitchell, M., & Mashunkashey, J. (2004). Anxiety reporting and culturally associated interpretation biases and cognitive schemas: A comparison of Mexican, Mexican American, and European American families. Journal of Clinical Child and Adolescent Psychology, 33, 237247. doi:10.1207/s15374424 jccp3302_4. Varela R, Hensley-Maloney L. The Influence of Culture on Anxiety in Latino Youth: A Review. Clinical Child and Family Psychology Review [serial online]. September 1, 2009;12(3):217-233. Available from: ERIC, Ipswich, MA. Accessed October 19, 2010. Wood, J., Chiu, A., Hwang, W., Jacobs, J., & Ifekwunigwe, M. (2008). Adapting Cognitive-Behavioral Therapy for Mexican American Students with Anxiety Disorders: Recommendations for School Psychologists. School Psychology Quarterly, 23(4), 515-532. Retrieved from ERIC database.

For more information contact: Rance L. Harbor, Ph.D. School Psychologist [email protected]

presented by rance l. harbor, ph.d., school psychologist hillsborough county public schools leto...

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