Handbook of psychology volume 7 educational psychology

Critical Issues Affecting the Field of Behavior Disorders

519

and controlling the transport of dangerous weapons across

school boundaries). Further, the BD field does not promote its

solutions to these problems with the audiences that count, in-

cluding the general public, state and local policy makers, and

the U.S. Congress. 

The article argued that the gap between what is known in

the BD field and what is applied in everyday practice is glar-

ing and likely rivals that of any other field. BD professionals

were urged to reference the outcomes of their research to

these larger issues of great societal concern and to target their

interventions in ways that impact them and their precursors.

In our view, the BD field has a long way to go in establishing

its value to the larger constituencies that it serves as the fields

of medicine, engineering, psychology, and speech-language

pathology have accomplished so successfully. However,

given the concerns of the public and educators about youth

violence, schooling effectiveness, and school safety, the

time has never been better for the BD field to demonstrate

its value and effectiveness through the promotion of many

of its seminal contributions as solutions to these societal

problems.

Behavior Disorders and the Postmodern,

Deconstructivist Perspective

Postmodernism and deconstructivist philosophies have

spread rapidly through the social sciences in the past decade

(Wilson, 1998). These philosophies reject the scientific

method and deny the possibility of common or universal

forms of knowledge. The proponents of postmodern decon-

structivism (PD) often criticize scientific understanding on

the basis that it is decontextualized and does not acknowledge

the construction of meanings. PD advocates have gained con-

siderable influence in many institutions of higher education;

their positions pose a significant threat to the BD field partly

because a behavior disorder or emotional disturbance is

known as a judgmental disorder (Walker et al., 1998). That is,

the disorder is said to exist only if certain persons agree that it

represents a departure from expected or normative patterns of

behavior. Thus, the subject matter of behavior disorders is

particularly vulnerable to postmodern constructions of real-

ity. PD suggests that we can know nothing but our own expe-

riences and that the realities of phenomena are determined

more by our perceptions of them than by their actual physical,

objective attributes.

Postmodernism, as Kauffman has noted, is receiving con-

siderable press and attention in the social sciences (Kauffman,

1999). Recently, the journal, Behavioral Disorders devoted a

special issue to postmodern perspectives and formulations

vis-à-vis behavior disorders (Hendrickson & Sasso, 1998).

Reactions from BD scholar-researchers to the lead article by

Elkind (1998) were not particularly supportive or in agree-

ment with most of the key points made.

Elkind (1998), for example, argued that our conceptions

and theories about behavior disorders are determined by the

basic social and cultural tenets prevailing in our society at

any given time. Elkind argued further that there has been a

paradigm shift in this regard as reflected in the postmodern

themes of difference, particularity, and regularity. Specifi-

cally, Elkind suggested that individual differences in behav-

ioral characteristics and expression are so vast, complex, and

unique that traditional classification systems are next to use-

less and artificial at best. Elkind recommended that we focus

our efforts exclusively on the individual and said that BD

professionals have at their disposal an array of therapeutic

techniques, from differing theoretical approaches, and that

we should apply combinations of them as the child’s individ-

ual needs warrant. How we would select such combinations

of techniques and evaluate the efficacy of our efforts remains

a mystery to the present authors. 

This case, albeit persuasively articulated by Elkind, has not

and likely will not be well received by the BD field. Calls to

focus on the unique characteristics and strengths of individual

children and youth have always had appeal for BD profes-

sionals. However, adoption of this approach by some sectors

of the BD field strikes us as the inverse of progress. In our

view, the wide spread adoption of this perspective would

result in a return to a focus on the single case, each of which is

considered a unique event, which characterized the early be-

ginnings of the field of applied behavior analysis over 30 years

ago. Treating every student as a unique individual case means

that we cannot generalize from one case to another and that

each is essentially a new experiment, the results of which

would have no meaning or relevance to those coming before

or after. At present, we do not have the financial luxury of

not treating at-risk students in group contexts within school

settings.

Further, we have learned a great deal over the past two

decades from studying problems and maladaptive conditions,

among BD as well as non-BD student populations, that share

certain commonalities of attributes and characteristics (e.g.,

ADHD, social isolation, instrumental aggression, antisocial

behavior, depression, etc.). Our ability to develop interven-

tions that produce similar outcomes, across children and

youth representing these conditions, is critical to advancing

the knowledge base in behavior disorders. It would be a mis-

take of gigantic proportions to abandon this approach in our

research and development efforts in the future. 

520

School-Related Behavior Disorders

Ultimately, the postmodern perspective will likely occupy

some space in the universe of accepted formulations about

behavior disorders that currently exist in the BD field. How-

ever, because of the BD field’s long commitment to research-

based solutions and empirical approaches, we believe that it

is doubtful that it will ever occupy a dominant or prevailing

position in this regard. 

Failure to Serve the Full K–12 Range of Students With

Behavior Disorders

Historically, school systems have substantially underserved

the K–12 student population with behavior disorders. As

noted earlier, approximately 20% of the public school popu-

lation is estimated to have serious mental health problems,

but slightly less than 1% nationally of K–12 students are de-

clared eligible annually for services under the ED category of

the IDEA. Using the IDEA definition for ED, school psy-

chologists have traditionally served as gatekeepers in deter-

mining which students referred for behavior disorders

actually qualify as emotionally disturbed and thus are able

to access the services, supports, and protections afforded

through IDEA certification. School psychologists have typi-

cally used the IDEA definition for ED to rule out rather than

rule in students referred for behavior disorders as emotion-

ally disturbed; thus, the vast majority of students with school-

related mental health problems is denied access to IDEA

services and appropriate interventions tailored to their needs.

The ED definitional criteria of IDEA require that an evalua-

tive judgment be made regarding whether the referred stu-

dent is emotionally disturbed versus socially maladjusted. If

as a result of the IDEA eligibility evaluation process the stu-

dent is considered to be maladjusted, then ED certification is

denied; otherwise, the student is certified and can access

IDEA supports, services, and protections. 

The strict gatekeeping by school psychologists around the

determination of ED eligibility is reflective of school admin-

istrators’ extreme reluctance to extend the protections of

IDEA to this student population. By so doing, it becomes

very difficult to apply disciplinary sanctions to ED-certified

students because of the protections built into IDEA. Further-

more, parents and advocates can sue school districts for not

providing a free and appropriate education for an ED-certified

student. Out-of-state residential placements for these students

can easily exceed $100,000 annually, and school districts

have to bear these costs if it is shown that they cannot provide

a free, appropriate educational experience for an ED-certified

student. Currently, the Hawaii state government is under a

costly, court-ordered decree after losing a class action suit for

denying services to ED-eligible students. Further, teachers

who refer students with behavior disorders for possible ED

certification are sometimes negatively regarded by adminis-

trators as unable to manage their classrooms effectively. In

the face of these strong barriers, it is unlikely that adequately

serving students with behavior disorders will ever be accom-

plished under the aegis of the IDEA. 

The ED eligibility definition and its application to the

population referred for behavior disorders has been the sub-

ject of considerable debate over the past several decades. It

has been severely criticized as invalid and arbitrary (Forness

& Knitzer, 1990; Gresham et al., 2000). Recently, Walker,

Nishioka, Zeller, Bullis, and Sprague (2001) reported results

of a study in which no differences were detected between 15

ED-certified and 15 noncertified socially maladjusted (SM)

middle school boys on a series of measures that assessed both

positive and negative forms of adjustment within home and

school settings. The dimensions on which the two groups

were evaluated included demographics, school history, acad-

emic achievement, social competence, behavioral character-

istics, personal strengths, ADHD symptoms, and attitudes

toward aggression and violence using multiple measures and

informants across home and school settings (see Walker

et al., 2001, for details of these measures). Given these

results, it is difficult to see on what basis the judgment was

made in determining the ED or SM status of these students.

This is especially significant, given that 12 of the 15 socially

maladjusted students had previously been referred and certi-

fied as eligible for special education but were later decerti-

fied. However, all of the socially maladjusted boys in this

study had been placed on a waiting list for placement in an

alternative middle school program for students having severe

behavior problems. 

The observation has been made by some BD professionals

that students should not be screened and identified for ser-

vices that do not currently exist. However, it is difficult to

know how the true need for services for this population can

be determined unless systematic screening efforts are put in

place to document the extent of need. Without such careful

documentation, motivations to develop services and delivery

mechanisms will continue to be weak among school person-

nel. Standardized definitional criteria and screening proce-

dures would likely be required to accomplish this goal. 

We are convinced that a different approach is necessary to

meet the needs of the public school student population with

behavior disorders. In our view, an integrated approach or

model of the type proposed by Walker et al. (1996) will be re-

quired to address the needs of all students in a school setting.

This model provides for the seamless integration of differing

types of interventions for achieving primary, secondary, and

tertiary prevention goals and outcomes. In this integrated

Critical Issues Affecting the Field of Behavior Disorders

521

approach, universal interventions are used to achieve primary

prevention outcomes; small-group interventions are used to

address secondary prevention goals; and individualized inter-

ventions with wraparound services are used to address the

needs of tertiary level students and their families. A resis-

tance to intervention procedure determines which students

require secondary and tertiary prevention supports and ser-

vices following their exposure to the primary prevention in-

tervention. This integrated model is highly cost-effective and

is perhaps the only way that the mental health and adjustment

needs of all students in today’s schools can be addressed, at

some level, given the ongoing press on schooling dollars. A

more detailed illustration of this model is presented in the

section on evidence-based interventions.

BD Leadership in Developing a Prevention Agenda

In our view, there are two major opportunities or windows for

mounting prevention initiatives that have a chance to divert

behaviorally at-risk children from a destructive path. The two

developmental periods or windows are the age ranges of 0 to

5 years and 6 to 10 years. Because BD professionals are pri-

marily school based, they can have their greatest impact from

kindergarten through the primary and intermediate grades.

However, many behavioral specialists employed by school

districts have the opportunity to work collaboratively with

early childhood educators and Head Start personnel who deal

with 3- and 4-year-olds. In the past decade there have been

many anecdotal reports of very young children exhibiting

more mature forms of destructive behavior (e.g., wearing

gang colors, physically attacking teachers, plotting serious

harm toward peers, engaging in inappropriate sexual behav-

ior, etc.). Furthermore, larger numbers of children are coming

to school lacking in specific school-readiness skills, and they

are often very unprepared to cope with the normal demands

and routines of schooling. In a recent survey Rimm-Kaufman,

Pianta, and Cox (2000) documented the breadth and preva-

lence of school-readiness problems among kindergartners. In

their survey, up to 46% of surveyed teachers reported that

about half of their class entered kindergarten with problems in

one or more areas, as follows: difficulty following directions,

46%; difficulty working independently, 34%; difficulty work-

ing as part of a group, 30%; problems with social skills, 20%;

immaturity, 20%; and difficulty communicating/language

problems, 14%. Longitudinal research indicates that these im-

pairments in social competence and school readiness skills

can serve as harbingers of future adjustment problems in a

number of domains including interpersonal relations, em-

ployment, academic achievement, and mental health (Loeber

& Farrington, 1998; McEvoy & Welker, 2000).

As noted earlier, increasing numbers of children are bring-

ing antisocial, challenging behavior patterns with them to the

schooling process. Moffitt (1994) referred to these children

as early starters who are inadvertently socialized to an antiso-

cial behavior pattern by their families and caregivers.

Patterson et al. (1992) researched and illustrated the coercion

processes operating among family members that lead to this

unfortunate and destructive behavior pattern. In this family

context, early starters learn to aggress, escalate, and coerce

others to achieve their social goals. Most bring this behavior

pattern with them to the schooling process, and this leads to

social rejection by both teachers and peers within just a few

years (Eddy et al., 2002). Unfortunately, a majority of these

children will not access the school-based intervention sup-

ports and services that they need to succeed in school because

of the practices of related services, school personnel who typ-

ically classify them as socially maladjusted which has the

effect of denying them this access.

Thousands of our vulnerable children and youth are on a

destructive path. The longer one remains on this path, the

more serious are the outcomes the individual is likely to en-

counter. Longitudinal studies in Australia, New Zealand,

Canada, the United States, and Western Europe converge in

documenting this destructive pathway (Kellam, Brown,

Rubin, & Ensminger, 1983; Loeber & Farrington, 1998; Pat-

terson et al., 1992). Reid and his colleagues (Eddy, Reid, &

Fetrow, 2000; Reid, 1993) have long argued that the earlier

one addresses the problems of children who are on this path,

the more likely it is that they will be successfully diverted

from later destructive outcomes. Longitudinal follow-up

studies of the long-term effects of early intervention provide

clear evidence that this is indeed the case (see Barnett, 1985;

Hawkins, Catalano, Kosterman, Abbott, & Hill; 1999; Strain

& Timm, 2001). Further, in a randomized-control trial of

early versus later intervention, Hawkins et al. (1999) found

that a school-based early intervention that (a) targets and

teaches social skills to students, behavior-management skills

to teachers, and family-management skills to parents in a co-

ordinated fashion; (b) facilitates bonding, engagement, and

attachment to schooling; and (c) is delivered in the primary

grades leads to strong protections against a number of health-

risk behaviors at age 18, including delinquent acts, teenage

pregnancy, heavy drinking, multiple sex partners, behavioral

incidents requiring disciplinary action at school, low

achievement, and school failure. 

It is essential that BD professionals assume a more active

role, and a leadership one when possible, in making sure that

all behaviorally at-risk children are detected at the point of

school entry and provided with the supports, services, and

interventions that will help ensure a successful beginning to

522

School-Related Behavior Disorders

their school careers. Achieving this goal will require devel-

oping close working relationships with early childhood

educators, parents, and mental health professionals, where

appropriate. The school-based BD professional is ideally po-

sitioned to assume this role and to coordinate the universal

screening and intervention delivery strategies that can divert

many behaviorally at-risk students from this path. More

specifically, as argued elsewhere (Walker et al., 1999), we be-

lieve that the BD professional’s role should include the fol-

lowing functions at a minimum:

1. Promulgating best practices for students both with and

without behavior disorders that are research based and

cost efficient.

2. Advocating for educators’ adoption of proven evidence-

based approaches to intervention.

3. Forming true partnerships with general educators and pro-

fessionals from other disciplines that create the commit-

ment and breadth of knowledge necessary to address the

complex needs and problems of the behaviorally at-risk

school population.

4. Taking the lead in building multidisciplinary, interagency

team approaches to providing integrated interventions for

at-risk students and their families.

The BD field has a talented and knowledgeable cadre of pro-

fessionals who, in our estimation, could perform these func-

tions skillfully. However, at present they are not adequately

supported by school systems in performing these functions.

ADOPTION AND DELIVERY OF

EVIDENCE-BASED INTERVENTIONS 

In traditional practice schools have not been strongly moti-

vated to assume ownership and responsibility for solving the

behavior problems and disorders of school-age children and

youth. Rather than investing in proactive interventions to

teach skills and to develop behavioral solutions, school ad-

ministrators have relied primarily on a combination of sanc-

tions (suspensions, expulsions) and assignment of problem

students to self-contained settings in responding to the BD stu-

dent population. The basic strategy has been to punish or iso-

late students with challenging behavior rather than to solve

their problems and respond to their needs. Some educators

have referred to these students as the schools’ homeless street

people, and, in a very real sense, they have typically been

treated as such.

In addition, school systems historically have not been

motivated to search for and apply proven, cost-effective

interventions that can substantively affect the learning and

adjustment of the full range of K–12 students. Walker et al.

(1998) noted that in no field is there a more glaring lack of

connection between the availability of proven, research-based

methods and their effective application by consumers in edu-

cation. The analysis, commentary, and writings of Carnine

(1993, 1995) and Kauffman (1996) have been instrumental

in highlighting the gaps that exist in the field of education.

Kauffman (1996) observed that the education profession

is characterized by continuous change but little sustained im-

provement because the relationship between reliable, effec-

tive practices and their widespread adoption remains obscure.

This is the dominant educational context in which BD profes-

sionals have to work and advocate for the adoption of proven,

effective practices for the student population with behavior

disorders.

However, in the last few years the attitudes of school sys-

tems have shown signs of change in this regard probably as a

function of the twin pressures generated by the school reform

movement and the school-shooting tragedies of the 1990s.

Now schools are beginning to embrace the following prac-

tices, which had, in the past, been infrequently adopted:

(a) the universal screening of all students to detect those with

emerging behavior disorders; (b) investment in primary, sec-

ondary, and tertiary forms of prevention; (c) developing

proactive rather than reactive responses to child and youth

problems in school; and (d) searching for evidence-based in-

terventions and approaches that are proven to work. This may

be the front edge of a paradigm shift for the field of general

education. If so, the school-based BD professional is ideally

positioned to serve as a leader and resource in facilitating this

organizational change. 

In our view, the problems attendant on serving the full

range of K–12 students with behavior disorders do not stem

from a lack of available, evidence-based interventions.

Rather, it is much more a problem of knowing what works,

having the will to implement effective practices with good in-

tegrity, and finding the resources necessary to support this

effort. A number of reviews of best practices in the areas of

school-related behavior disorders, school safety, and violence

prevention have been developed recently. These reviews pro-

vide a valuable resource for school-based professionals and

administrators who often have difficulty locating and evalu-

ating the efficacy of differing intervention models and

approaches—all of which claim to be effective. 

One of the most valuable, thorough, and comprehensive

reviews of effective, school-based interventions addresses

the effectiveness of programs for preventing mental disorders

in school-age children and youth and that are designed for

use primarily in school settings (Greenberg, Domitrovich, &

Bumbarger, 1999). These investigators reviewed the broad

landscape of available programs numbering in the thousands.