Moving the Dial for Students With Emotional and Behavioral Disorders

Prevention of EBDs

Psychopathology typically contributes to the development of EBDs; however, we have long known that problem behavior in this population emerges early and often is strengthened by a number of environmental factors, including naturally occurring interactions within children’s environment (e.g., see Brownlee & Bakeman, 1981). We also know that if left untreated, the severity and magnitude of children’s problem behavior increases over time and has deleterious effects on their developmental and learning trajectory (Dunlap et al., 2006). Yet, we rarely intervene early enough, particularly for children and youth who require intensive behavioral supports. Often we wait until problem behavior has become well established in an individual’s functional repertoire, making it increasingly resistant to long-term change. In this issue, Lane and colleagues present findings from a descriptive study illustrating the magnitude of social and behavioral risk in middle and high school students and offer us a methodological approach for conducting systematic behavior screenings that is both psychometrically sound and feasible. Although a strength of the work presented by Lane and her colleagues is the focus on students in secondary settings, who are often overlooked, we as a field have failed if students in middle and high school continue to have significant and intensive behavioral needs that persist. We have a choice whether to intervene early, establish resilience in the face of risk conditions, and build protective factors that can set these children and youth on a better path, or wait to intervene until their behavioral needs have become extreme and resistant to long-term change (Kazdin, 1987). The timing of early learning experiences matters (National Research Council and Institute of Medicine, 2000), particularly when children are faced with risk factors that contribute to EBDs. In my view, it is vital that we work to prevent and treat EBDs early—long before children reach adolescence. As suggested by Hawkins and colleagues (2015), prevention is the best investment we can make, and we need to start now. This special issue confirms that we have the tools and technology to address the behavioral needs of children and youth with EBDs. What we are lacking is a seamless, comprehensive service delivery system that provides early screening and identification of children who are faced with risk conditions leading to the development of EBDs. Rather than waiting for problem behavior to become severe, a preventive approach beginning at birth, which identifies children who are biologically and/or environmentally at risk for EBDs and provides them and their families the social–emotional and behavioral skills and supports needed to succeed in school, is not only logical and cost-effective but also morally and ethically sound. This system should begin well before school begins, include family members, and span across age levels to ensure these children’s success in school and later life.

Scaling Up Intensive Interventions

In addition to early identification and prevention of EBDs, once identified, we need to make certain that scientifically informed interventions are in place to support the needs of children and their families. EBDs are complex, and as a result, effective interventions to address them are equally complex, which requires a highly skilled workforce as suggested by Farmer and colleagues (2016). As illustrated by the authors of articles in this special issue, when addressing the needs of students who require intensive supports, “one size does not fit all.” Rather than presenting research on packaged interventions, for the most part, the authors describe systematic processes informed by data that can be used to identify individuals who need the most intensive supports (i.e., Lane et al., 2016) or to address their academic, social, emotional, and behavioral needs (i.e., Farmer et al., 2016, Lloyd et al., 2016, and Maggin et al., 2016). Data-based, individualized interventions are not new to the field of EBDs—in fact, individualizing intervention is at the heart of special education law and practice. Why then when we know “what works for whom” and we have policies in place to guide our practice do we rarely see these data-informed, individualized interventions implemented by teachers in school settings with students who have intensive behavioral needs? I believe two factors contribute to the lack of translation from research to practice: (a) a top-down approach to research, and (b) a lack of a knowledgeable and skilled workforce.

As highlighted in the implementation science literature (Fixsen & Blasé, 2008), there are many barriers to widespread adoption of effective programs and practices. Much of the research on intensive supports and interventions, however, is implemented from a top-down perspective and has been conducted through the lens of researchers, rather than a collaborative approach involving those who work directly with these students on a daily basis. After all these years, research on intensive interventions, including the research presented in this special issue, is still mainly conducted by researchers under highly controlled circumstances and environments with limited evaluation and focus on the generalization and maintenance of behavior change over time and settings. Methodologically, our research is experimentally sound and we have repeatedly demonstrated that through manipulation of environmental events, we can positively change student behavior. From a social validity perspective, however, I believe we have a long way to go in understanding “what works for whom and under what conditions.” As suggested by Wolf (1978), “If the participants don’t like the treatment [intervention] then they may avoid it, run away, or complain loudly. And thus, society will be less likely to use our technology, no matter how potentially effective and efficient it might be” (p. 206). Because problem behavior is highly influenced by the environment in which it occurs, we need to ensure that our interventions are not only effective in changing student behavior but also are a good contextual fit for that environment. In other words, we need to ensure that intensive interventions can be feasibly implemented by teachers and other school staff, and when applied with fidelity, student outcomes improve and are maintained over time and across contexts.

In moving the dial forward, the instillation of scientifically informed practices and interventions in schools by teachers and school staff is an important next challenge for our field. Clearly, we need to continue to strengthen the science behind our programs and practices making them relevant and feasible; but, as we persist in our research efforts, we also need to examine the variables that influence the implementation and effectiveness of intensive interventions and ensure that we have teachers who are highly skilled and competent. As the authors of the papers included in this special issue continue their lines of research, I urge them to examine the contextual fit of their interventions by expanding research on implementation variables, such as change agents, generalized contexts, and maintenance over time.

Conclusion

In conclusion, the contributors to this special issue highlight innovative approaches for using intensive interventions to address the social–emotional learning and behavioral needs of children and youth with EBDs. Although each article makes its own a noteworthy contribution to the field by expanding our current knowledge and practice, I return to Knitzer’s (1993) challenge and encourage us as a field to take the next steps in reframing our approach toward the education of children and youth with EBDs by establishing cross-disciplinary mechanisms, including policies, services, and practices, that focus on a lifelong comprehensive approach toward prevention, identification, and intervention of EBDs. Over the past several decades, as a field we have expanded the science of “what works and for whom,” but ensuring that children and youth and their families in communities across our nation have access to high-quality, comprehensive services that can change their developmental trajectory continues to be lost in the abyss. We have a scientific and moral responsibility to reshape the way we support children and youth with EBDs, and we need to start now.