Handbook of psychology volume 7 educational psychology

School-Related Behavior Disorders

HILL M. WALKER AND FRANK M. GRESHAM

511

CRITICAL ISSUES AFFECTING THE FIELD

OF BEHAVIOR DISORDERS

513

The Current Landscape of Behavior Disorders

as a Field

513

What Is Right With Behavior Disorders?

514

What Is Wrong With Behavior Disorders?

518

ADOPTION AND DELIVERY OF

EVIDENCE-BASED INTERVENTIONS

522

THE CONTENT OF SCHOOL INTERVENTIONS FOR

STUDENTS WITH BEHAVIOR DISORDERS

523

Social Skills Instruction for Students with

Behavior Disorders

524

Objectives of Social Skills Instruction

524

Promoting Skills Acquisition

525

Enhancing Skills Performance

526

Removing or Eliminating Competing

Problem Behaviors

526

Facilitating Generalization and Maintenance

526

CONCLUSION

527

REFERENCES

527

The focus of this chapter is on the behavior disorders of chil-

dren and youth, which are increasingly manifested within the

context of schooling. Children by the thousands now appear

at the schoolhouse door showing the damaging effects of

prior exposure to family-based and societal risks (abuse, ne-

glect, chaotic family conditions, media violence, etc.) during

the first 5 years of life. Our society has begun to reap a bitter

harvest of destructive outcomes among our vulnerable chil-

dren and youth resulting from such risk exposure and from

our seemingly diminished capacity to rear, socialize, and care

for them effectively. It is now not uncommon for as many as

half of the newborns in any given state to suffer one or more

risk factors for later destructive outcomes and poor health

(Kitzhaber, 2001).

The characteristics, needs, and demands of these children

and youth have overwhelmed the capacity of schools to ac-

commodate them effectively. Ironically, our school systems

have been relatively slow to recognize the true dimensions of

the challenges that these students pose to themselves, to the

social agents in their lives, and to the larger society. Recent

estimates by experts of the number of today’s youth with

significant mental health problems reflect the destructive

changes that have occurred in the social and economic condi-

tions of our society over the past 30 years. Angold (2000)

estimated that approximately 20% of today’s school-age chil-

dren and youth could qualify for a psychiatric diagnosis using

criteria from the Diagnostic and Statistical Manual of Mental

Disorders–Fourth Edition (DSM-IV; American Psychologi-

cal Association, 1994). Hoagwood and Erwin (1997) argued

that about 22% of children and youth enrolled in school set-

tings have mental health problems that warrant serious atten-

tion and treatment. Slightly less than 1% of the school-age

population is served as emotionally disturbed under provi-

sions of the Individuals with Disabilities Act (IDEA, 1997),

which illustrates the enormous gap that currently exists be-

tween need and available supports and services for these stu-

dents in the school setting. 

In a recent Washington Post investigative report on the

changed landscape of problem behavior and its impact on

schooling, Perlstein (2001) provided elaborate documentation

of the increasingly outrageous forms of behavior displayed

by younger and younger children and concluded that our

schools are “awash in bad behavior” (p. B1). She described

elementary school students who defied their teachers and

called them obscene names, who threatened them with physi-

cal violence, who attacked their peers for no apparent reason,

who brought drugs and weapons to school, who destroyed

classroom furnishings when disciplined, and whose parents

denied their child’s culpability in these incidents and refused

to take ownership or responsibility for dealing with them. In

addition, Perlstein provided compelling evidence of national

trends involving the rising use of school suspensions and ex-

pulsions of very young children, the creation of school-based

detention centers, and investment in alternative educational

512

School-Related Behavior Disorders

programs and personnel—all increasing dramatically at the

elementary school level. Educators perceive the costs of these

accommodations as taking dollars away from needed school

reform efforts designed to increase educational accountability

and achievement levels.

The larger society has finally begun to express concern

about our troubled children and youth and to assemble experts

from multiple disciplines to create policy, develop legislative

initiatives, and construct action plans that will address this

growing national problem. For example, in September 2000,

the U.S. Surgeon General convened a national conference

on children’s mental heath, involving a collaboration between

the U.S. Departments of Health and Human Services, Educa-

tion, and Justice, to develop a national action agenda that

balances health promotion, disease prevention, early detec-

tion, and universal access to care. This conference produced

an influential report titled Report of the Surgeon General’s

Conference on Children’s Mental Health: A National Action

Agenda, which provides a blueprint for action on this critically

important topic.

In a more reactive vein, the widely publicized school-

shooting tragedies of the 1990s have shocked us into action

and cast a national spotlight on the problems that young peo-

ple daily experience with bullying, emotional abuse, and ha-

rassment at the hands of their peers. It is estimated in media

reports that approximately 160,000 U.S. students miss school

each day because of bullying. When mixed with mental health

problems (severe stress and anxiety, depression, paranoia) and

the desensitizing effects of pervasive exposure to violence in

the media, the toxic consequences of bullying can pose a real

risk of tragic outcomes in the context of an abused student

seeking revenge—a recurring pattern that we have seen in

school shootings. Kip Kinkle, who went on a school-shooting

rampage at Thurston High School in Springfield, Oregon, in

1998 after murdering his parents, was an exemplar of this

combination of destructive attributes. The Thurston shooting

prompted a collaborative effort between the U.S. Departments

of Education and Justice (in which the senior author was a

participant) that created a national panel of experts who pro-

duced two resource guides sent to every school in the country:

Early Warning/ Timely Response: A Guide to Safe Schools and

Safeguarding Our Children: An Action Guide. Implementing

Early Warning, Timely Response. The first document focused

on warning signs and early detection; the second provided

guidelines for implementing the Early Warning/Timely Re-

sponse guide.

Schools have now realized that these complex problems

cannot be dealt with through a business-as-usual approach.

School administrators are searching for and considering an

array of strategies that will help make schools safer and more

effective; they are now open to prevention approaches in

ways that have not heretofore been in evidence. The spate of

tragic school shootings over the past decade prompted a

strong investment in school security technology by educators

and created pressures for the profiling of potentially danger-

ous, troubled students. Neither approach has been demon-

strated as particularly effective in making schools safer or

free of the potential for violence. Profiling has very serious

downside risks for student victimization through damage to

reputations (Kingery & Walker, 2002).

School administrators have been generally open to, but less

enthusiastic about, investing in comprehensive, positive, be-

havioral-support approaches that (a) create orderly, disci-

plined school environs; (b) establish positive school cultures;

and (c) address the needs of all students who populate the

school. Perhaps this is the case because these programs require

up to 2 years for full school implementation. Two of the best

known and most cost-effective approaches of this type are the

Effective Behavioral Support (EBS) and Project Achieve in-

tervention programs developed respectively by Horner, Sugai,

and their associates at the University of Oregon and Knoff

and his associates at the University of South Florida. Both of

these proven model programs are profiled in Safeguarding

Our Children: An Action Guide. Implementing Early Warning,

Timely Response (see Dwyer & Osher, 2000).

The development of comprehensive interagency collabo-

rations that address primary, secondary, and tertiary forms

of prevention is an investment that schools have yet to make

to any significant degree. However, to reduce and actually

reverse the harm caused by the broad-based risk exposure

experienced by today’s children and youth, it will be neces-

sary to scale up and mount such collaborative initiatives with

good integrity (Eddy, Reid, & Curry, 2002).

Behaviorally at-risk children and youth provide a funnel

through which the toxic social conditions of our society spill

over into the school setting and destructively impact the

capacity of our schools and educators to provide for these

vulnerable students the normalizing and protective influences

of schooling. This growing student population increasingly

stresses and disrupts the teaching-learning process for every-

one connected with schooling. The peer cultures of schools

grow ever more corrosive, and there are more incidents of

challenges to school authority and operational routines by

angry, out-of-control students. School personnel, perhaps un-

derstandably, regard members of this student population with

suspicion because of the large number of school-shooting

tragedies that have occurred over the past decade. At the

other end of the spectrum, significant numbers of today’s

students experience severe anxiety and depressive disorders

primarily of an internalizing nature.

Critical Issues Affecting the Field of Behavior Disorders

513

This chapter focuses on the topic of behavior disorders

(BD) in the context of schooling and is written from the

perspective of the school-based professionals (school psy-

chologists, special educators, school counselors, early inter-

ventionists, behavioral specialists) who are specialists in

addressing the needs and problems of this behaviorally

at-risk student population. Herein, we address three major

topics as follows: (a) the critical issues that have shaped and

continue to influence the field of behavior disorders; (b) the

adoption and delivery of proven, evidence-based strategies

that have the potential to divert at-risk students from a de-

structive path and that contribute positively to school

engagement and academic success; and (c) the content of in-

terventions for addressing the adjustment problems of BD

students within the school setting. The chapter concludes

with some brief reflections on the future of the BD field and

directions it should consider for its future development. 

CRITICAL ISSUES AFFECTING THE FIELD OF

BEHAVIOR DISORDERS

BD professionals working in higher education and school

and agency settings are uniquely positioned, and qualified, to

have a positive impact on the needs, challenges, and prob-

lems presented by the behaviorally at-risk student popula-

tion. They have intimate knowledge of schools and their

cultures; they know instructional processes and routines; and

they are experts in behavior change procedures. No other

professional combines these types of skills and knowledge.

As a rule, BD professionals are strongly dedicated to improv-

ing the lives of these children and youth through the direct

application of the strategies and techniques that they have

been taught for changing behavior in applied contexts. How-

ever, as our society’s problems have worsened, the results of

their intervention efforts look less and less impressive in the

face of schools that have been transformed into fortress-like

structures and student populations that continue to be out of

control.

The BD field has developed some seminal contributions to

our understanding of school-related behavior disorders along

with methods for addressing them, but this knowledge base

and these proven practices are often not in evidence in the

daily operation of schools. The gap between what is known

and proven and what is practiced is no where greater than in

the field of school-related behavior disorders. This section is

divided into two major topics that focus, respectively, on

“What is Right with Behavior Disorders?” and “What is

Wrong with Behavior Disorders?” We believe that the critical

issues affecting the BD field can be effectively illustrated

using this dichotomy. Before dealing with this set of issues,

however, we would like to put the BD field in context relative

to its role as a resource to schools in dealing with behav-

iorally at-risk students and its status as a subspeciality of the

larger field of special education. 

The Current Landscape of Behavior Disorders as a Field

The field of behavior disorders, as a disciplinary subspecialty

of general special education, is a relatively new field dating

from the early 1960s. Frank Wood (1999) recently profiled

the history and development of the Council for Children with

Behavior Disorders (CCBD) in this regard. 

Although encompassing diverse philosophical and theo-

retical approaches, the field has generally maintained a

consistent focus on empirical research and has provided im-

portant journal and monograph outlets for the contributions

of its researchers and scholars. The Journal of Behavioral

Disorders, the CCBD Monograph Series, the Journal of Emo-

tional and Behavioral Disorders, and Education and Treat-

ment of Children are excellent examples of peer-reviewed

publications that publish high-quality research and commen-

tary in the BD field. These outlets and their respective editors

have advanced the field’s development and have contributed

enormously to the cohesive knowledge base that we see

today relating to the social, emotional, and behavioral status

of at-risk children and youth in the contexts of school and

community.

The field of behavior disorders can trace its roots to the use

of behavior change procedures with mentally ill children and

youth within highly restrictive settings (mental institutions,

residential programs) and to the delivery of mental health

services for the emotional problems of vulnerable children

and youth within school and community settings. Over the

past three decades the number and severity of the problems

manifested by children and youth, who are referred to as

having emotional disorders (ED) or behavior disorders, have

changed substantially (Walker, Zeller, Close, Webber, &

Gresham, 1999). Early in our field’s development the children

and youth referred and served as having emotional disorders

had primarily mental and emotional problems (depression,

social isolation, self-stimulatory forms of behavior, etc.).

Problems representing critical behavioral events, sometimes

involving a danger to self and others, such as severe aggres-

sion, antisocial behavior, vandalism, cruelty to animals,

and interpersonal violence, were rarely dealt with by BD

professionals.

It is clear that thousands of young children in our society

are being socialized within chaotic, abusive family and com-

munity contexts in which they are exposed to a host of risk

514

School-Related Behavior Disorders

factors that provide a fertile breeding ground for the develop-

ment of highly maladaptive attitudes, beliefs, and behavioral

forms. These risk factors can operate multiply on an individ-

ual across family, community, school, and cultural contexts.

They are registered in unfortunate life paths that are often

tragic and involve huge social and economic costs. We now

see comorbid mixtures of syndromes (conduct disorder

and attention-deficit/hyperactivity disorder, or ADHD) in

school-age children that are efficient predictors of adult

psychopathology (see Gresham, Lane, & Lambros, 2000;

Lynam, 1996).

Professionals in the field of behavior disorders are charged

with effectively accommodating this changed population of

children and youth within the context of schooling. The pres-

ence, risk status, and intense needs of these students place

powerful stressors on the ability of schools to serve them;

they present a continuing and significant challenge to BD

professionals and to the field. Increasingly, educators are

having to forge partnership arrangements with mental health

and other social service systems in order to meet the needs of

these individuals, their families, and their caregivers. 

In our view, the field of behavior disorders possesses the

knowledge and skills necessary to accommodate the majority

of behaviorally at-risk children who must be served by

schools. However, for those children who enter the school-

house door having severe tertiary-level involvements, schools

will find it necessary to continue forging effective partnership

arrangements with nonschool service systems such as mental

health. We see this development as a positive one that should

be promoted and enhanced. The advent of family resource

centers, attached to school districts, provides an excellent ve-

hicle for the coordination and delivery of such approaches.

Today, BD professionals at all levels are challenged as

they have never been before. Continuing to serve students

having mental health needs primarily under the aegis of the

ED category of special education is no longer viable. The in-

tensity of need and the sheer numbers of affected individuals

are simply too great, and the consequences of not serving this

growing student population are both tragic and ominous.

Schools, in collaboration with community agencies, must

find new ways of responding to this service need that contin-

ues to grow and expand. The BD professional can play a

powerful role in building a new service delivery infrastruc-

ture for meeting this critical need and making sure that

schools are key players in developing viable solutions to this

societal problem that we all own collectively. 

What Is Right With Behavior Disorders?

Because of the quality of the BD field’s cadre of profession-

als, its consistently empirical focus, strong commitment to

best and preferred practices, and the diversity and rigor of its

methodological tools and approaches, the field has a well-

developed capacity to contribute innovations that can lead

(a) to important outcomes in the lives of youth with emo-

tional disorders and (b) to the enhancement of the skills and

effectiveness of online BD professionals (Walker, Sprague,

Close, & Starlin, 2000). Many of these contributions can be

documented as they operate currently within general educa-

tion contexts. Some examples include the following:

• The roots of many standards-based school reforms and

performance-based assessment systems can be traced to

behavioral psychology and applied behavior analysis.

• The current emphasis on teaching social skills as part of

the regular school curriculum to reduce conflicts and pre-

vent violence results from initiatives by BD and related

services professionals.

• The development of behavior management approaches for

managing student behavior in specific school settings re-

sults from prototype models developed by the BD field.

In recent years the BD field has contributed some advances

that (a) increased our understanding of how behaviorally at-

risk children and youth come to engage in and sustain their

destructive, maladaptive behavior patterns over time; (b) doc-

umented how some of our interactions with students with

emotional disorders in teaching-learning situations control

both teacher and student behavior in negative ways; (c) pro-

vided for the universal screening and early identification of

school-related behavior patterns that facilitate effective early

intervention; (d) documented the relationship between lan-

guage deficits and conduct disorder among at-risk children

and youth; (e) investigated the metric of disciplinary referrals

and contacts with the school’s front office as a sensitive mea-

sure of the following school climate, the global effects of

schoolwide interventions, and the behavioral status of indi-

vidual students; (f) developed effective, low-cost models of

school-based intervention that allow access to needed ser-

vices and supports for all students in a school; (g) contributed

schoolwide, disciplinary and positive behavioral support sys-

tems that improve outcomes for the whole school; (h) re-

ported longitudinal, comprehensive profiles of the affective,

social-behavioral status of certified, referred, and nonreferred

students; and (i) developed the concept of resistance to inter-

vention for use in school-based eligibility determination and

treatment selection decisions (Walker et al., 2000). Ulti-

mately, these advances will improve the BD field’s capacity to

meet the challenges and pressures of a changed population

with emotional disorders and to address proactively the vul-

nerability of schools in preventing and responding to the

violent acts of very disturbed youth such as Kip Kinkle