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Assessment and identification of children with emotional and behavioral disorders (EBD) is complex and involves multiple techniques, levels, and participants. While federal law sets the general parameters for identification in school settings, these criteria are vague and may lead to inconsistencies in selection and interpretation of assessment measures. Assessment practice across school settings is greatly influenced by clinical guidelines such as the DSM-IV, which more specifically defines emotional and behavioral disorders and highlights the issue of co-morbidity. Before a student is assessed for special education eligibility under the IDEIA category of emotional disturbance, screening techniques and pre-referral interventions are needed. Positive Behavioral Supports and Response to Intervention models provide empirically supported frameworks for establishing the need for formal psychological assessment. Collaboration among members of the multidisciplinary team, including parents, helps to ensure that identification and intervention efforts have ecological validity. Tests and techniques vary considerably, but developmental histories, interviews, observations across settings, and behavioral checklists and rating scales are recommended, along with cognitive and achievement testing. While problems exist in the reliability and validity of projective techniques, they continue to be used in school-based assessment for EBD. Multitrait, multisetting, and multimethod approaches are essential for culturally fair assessment and reduction of bias in identification and placement.

Four reputed leaders for the coming years in the field of special education for individuals with emotional and behavioral disorders (EBD) each with a slightly different perspective on the field were asked to respond independently to a prompt asking what does special education mean for students with EBD and what is being done and how do we maintain tradition? The contributors' responses to the prompt are presented and then summarized across the essays. A remarkable consistency emerges across the independent essays. In addition to the tradition of providing a free and appropriate education in the least restrictive environment, the contributors identify needs to support teachers serving this population. Needs in teacher training and the expertise required to meet the needs of individuals with EBD are outlined as well as potential contributions of technology to carry out specific tasks. We conclude with a call for increased advocacy for use of the knowledge that we currently possess and that which will soon be discovered to support students with EBD as well as their teachers. We also note that the contributors' names are listed alphabetically to acknowledge the equality of each person to the final product.

Recently, a national priority has been set to improve mental health services for children and families. It has been identified in epidemiological literature that in the United States, an approximate 15% of youth meet diagnostic criteria for emotional or behavioral problems. Furthermore, less than one in every five children that present with such needs receive mental health services. Individual, family, and system barriers such as transportation, competing demands, and long waiting lists have negatively impacted access to mental health services. Therefore, the school system has become the “de facto” mental health system for children and adolescents, in part because of the significant time students spend at school. However, meeting the needs of students with behavioral or emotional problems within the school system poses its own challenges. Schools have reported being limited in their ability to deliver basic mental wellness to students due to the lack of available resources. Specifically, there is a shortage of school-employed mental health personnel and the ratio of student to mental health professional is two to three times larger than recommended. Expanded school mental health programs are partnered systems that utilize existing services and collaborate with community mental health (CMH) professionals at each level of the three-tiered system. This partnership enables CMH staff gain access to youth with emotional and behavioral problems, resulting in increased prevention and intervention services for students. Additionally, a coordinated effort such as student-transition services has an integral role of facilitating the process from the school system to postsecondary employment, training, and or additional education.

Borderline personality disorder (BPD) is a debilitating illness characterised by a pervasive pattern of emotional instability, interpersonal difficulties and impulsive behaviour in association with repeated self-injury and chronic suicidal ideation. People diagnosed with BPD also have high rates of co-occurring psychopathology, including disorders associated with disturbed impulse control, such as substance use disorder (SUD) and disordered eating behaviours. The co-occurrence of BPD and impulse control disorders contributes to the severity and complexity of clinical presentations and negatively impacts the course of treatment and recovery. This study qualitatively documents aspects of the lived experience and recovery journeys of people diagnosed with BPD and co-occurring SUD and/or disordered eating. This study aims to identify similarities with respect to themes reported at different stages of the recovery process, as well as highlight important factors that may hinder and/or foster recovery.

In-person, in-depth, semi-structured interviews were conducted with 12 specialist service consumers within a clinical setting. Ten women and two men (22–58 years; mean: 35.5 years) were recruited. Interview transcripts were analysed using thematic analysis principles.

As expected, participants with co-occurring disorders experienced severe forms of psychopathology. The lived experience descriptions aligned with the proposition that people with BPD engage in impulsive behaviours as a response to extreme emotional states. Key emergent themes and sub-themes relating to recovery comprised three domains: factors hindering adaptive change; factors assisting adaptive change and factors that constitute change. An inability to regulate negative affect appears to be an important underlying mechanism that links the three disorders.

This study highlights the potential shortcomings in the traditional approach of treating co-occurring disorders of BPD, SUD and eating disorders as separate diagnoses. The current findings strongly support the adoption of an integrative approach to treating complex mental health issues while concurrently emphasising social connection, support and general health and lifestyle changes.

The findings of this study contribute to the burgeoning BPD recovery literature. A feature of the current study was its use of in-depth face-to-face interviews, which provided rich, many layered, detailed and nuanced data, which is a major goal of qualitative research (Fusch and Ness, 2015). Furthermore, the interviews were conducted within a safe clinical setting with engagement facilitated by a clinically trained professional. There was also a genuine willingness among participants to share their stories in the belief that doing so would inform effective future clinical practice. Their willingness and engagement as participants may reflect their progress along the path to recovery in comparison to others with similar diagnoses. Finally, most of the interviewees were engaging in dialectical behavioural therapy (DBT)-style therapies; two were receiving mentalisation-based therapy treatment, and most had previously engaged in cognitive behavioural therapy or acceptance and commitment therapy-based approaches. The predominance of DBT-style therapy may have influenced the ways that themes were articulated. Future studies could supplement this area of research by interviewing participants receiving therapeutic interventions other than DBT for the treatment of BPD and heightened impulsivity.

The authors speculate only about relatively short-term advances in special education for students with emotional and behavioral disorders. Speculation is confined to the overlapping areas of core values, technologies, neuroscience, and law/policy. In core values, the authors hope to see a resurgence of commitment to special, effective instruction and to practice aligned with scientific evidence. It is hoped that technologies will advance practices in instruction, improve the uses of artificial intelligence in teacher training and teaching, and encourage the appropriate use of artificial reproduction to avoid disorders. Neuroscience, it is hoped, will yield more reliable and helpful classification of disorders, better and more useful imaging, and more effective treatment of a variety of emotional, behavioral, and academic problems. In law and policy, the authors hope the Supreme Court's Endrew case will result in greater focus on challenging, appropriate education. Law and policy should also encourage trauma sensitivity in education, make whole-school approaches to trauma sensitivity the priority, and avoid universal trauma screening. Students' and families' legitimate interests in confidentiality and data privacy should be protected in newly constructed information-sharing infrastructures.

In this chapter, we examine the current research on how technology is applied to benefit students with emotional and/or behavioral disorders (EBD). First, we describe the iterative yet unpredictable nature of technological innovation to suggest that incremental successes are qualified by the creation of often unforeseen consequences. We then identify commonly used nonelectronic technologies in education to emphasize that the hoped-for advances in electronic technology have failed to deliver on their decades-old promise of educational revolution. We continue with our review of the literature on empirical studies examining how technology is used to support students with EBD. These findings indicate that the research design primarily employed in this field is single-subject. Examples of specific findings include web-based graphic organizers for student writing, virtual self-modeling for targeting student behaviors, and virtual coaching for teachers of students with EBD. We conclude by reviewing how leaders in the field of special education predict the field will change in the future. Overall, with an increased emphasis on research accessibility and practitioner-validated knowledge, and advances in neuroscience and artificial technologies, practitioners may hold a more central role to the creation and dissemination of knowledge.

The purpose of this paper is to describe the mental and intellectual developmental status of children with combined intellectual disabilities, reactive attachment disorder (RAD), and/or disinhibited social engagement disorder (DSED), and to describe the presence of comorbid diagnoses.

The study included 55 children that were referred for psychiatric consultation due to low intellectual functioning (borderline or mild; IQ 50-84). Attachment diagnoses were based on the Clinical Observation of Attachment (COA) procedure. Development was measured with the Dutch version of the Vineland Adaptive Behaviour Scales. Psychopathology was measured with the DISC-IV and AUTI-R. Emotional and behavioural problems were measured with the Dutch version of the Developmental Behaviour Checklist.

Children with and without attachment diagnoses had similar IQs. However, children with disturbed attachment, RAD, and/or DSED had lower levels of adaptive behaviour than those without attachment diagnoses. No comorbidity was associated with autism or ADHD. However, 80 per cent of children with RAD and/or DSED were also diagnosed with ADHD. Parents of children with DSED often reported disruptive anti-social behaviour.

Children with RAD and/or DSED may have unused developmental potential. Disturbed attachment should be considered in some cases of ADHD.

Findings suggested that diagnostic expertise provided added value for distinguishing disordered attachment in young clients with intellectual disability.

Despite some advances in the assessment and treatment of autism spectrum disorder (ASD), there remains a paucity of intervention and research literature in treating adults with ASD. There is growing evidence supporting a relationship between the core features of ASD and emotion dysregulation. There is an overlap between ASD and borderline personality disorder (BPD) characteristics such as emotional dysregulation, sensory issues and social skills deficits. This paper aims to explore the applications of dialectical behaviour therapy (DBT) concepts and skills in treating ASD individuals who display challenging or offending behaviours. The similarities in characteristics between ASD and BPD and the core issue of emotion dysregulation hold promise in the utility of DBT with ASD.

This is a conceptual paper that includes a case vignette.

A DBT-informed treatment approach using the adaptations and reconceptualization, i.e. risky mind–wise mind outlined in this paper, can be considered promising in addressing issues for ASD individuals, particularly those with challenging and/or offending behaviours. DBT incorporates different elements of applied behaviour analysis, cognitive behavioural therapy, mindfulness skills, sensory-based treatments, psychosocial interventions and emotion regulation skills, which makes it a more cohesive and integrated approach to treatment. The authors assert that DBT can be considered a more integrated, strengths-based, habilitative and trauma-informed approach which can be promising in its application to address challenging behaviours or offending in ASD individuals.

It is recommended that research be carried out to evaluate the effectiveness of adapted DBT programs in treating ASD individuals presenting with challenging and/or offending behaviours. Future research can focus on evaluating the effectiveness of the different DBT concepts and skills and the different DBT modules to determine which components of the program are particularly useful for this client group.

Treatment manuals have already been developed for clients with intellectual disability and developmental disabilities who exhibit challenging and/or offending behaviour; hence, it is recommended that modifications be made to make it more applicable and appropriate for ASD individuals. Modifications should address ASD-specific issues (e.g. black and white thinking, cognitive rigidity, sensory issues, impaired theory of mind, emotion dysregulation issues, social skills deficits and anxiety issues). The use of DBT has much wider implications regarding addressing comorbid mental health conditions and personality issues in this client group.

There are limited psychological interventions that prove to be useful for individuals with ASD with complex presentations and challenging or offending behaviours. This paper discusses the application of adapted DBT concepts and skills that appear to be promising in the treatment of this client group.

There are few challenges as daunting as achieving positive outcomes for students with emotional disabilities. A major obstacle is the generally poor quality of classroom instruction. Too few general education teachers or special education teachers possess the knowledge and skills to adequately serve this population of learners. Various factors account for the inadequate level of teacher preparation, including licensure requirements that emphasize quantity over quality, the research-to-practice gap, a train-and-hope rather than a train-and-coach approach to teacher preparation, and the absence of an infrastructure to support sustained use of evidence-based practices. I discuss each of these factors and offer some recommendations for improving the quality of teacher preparation and, in turn, the potential for more positive student outcomes.

This chapter summarizes issues related to the accurate and timely identification of students with emotional and/or behavioral disorders (EBDs) as well as identifying need, planning interventions, and monitoring outcomes. First, we describe ongoing issues and concerns with accurate (e.g., minimization of false positives and false negatives) and timely (e.g., improved service delivery by being more responsive to students in need of special education) identification of students with emotional disturbance (ED). ¹ Next, we describe general assessment methods and considerations that may contribute to improved service delivery. We close this chapter with a discussion of the critical role that accurate and timely identification plays in the provision of opportunity and the attainment of free appropriate public education (FAPE) mandates.