The causes of emotional disturbance have not been adequately determined. Although various factors
such as heredity, brain disorder, diet, stress, and family functioning have been suggested as possible
causes, research has not shown any of these factors to be the direct cause of behavior problems.
Some of the characteristics and behaviors seen in children who have emotional disturbances include:

     Hyperactivity (short attention span, impulsiveness); 
     Aggression/self-injurious behavior (acting out, fighting); 
     Withdrawal (failure to initiate interaction with others; retreat from exchanges of social
     interaction, excessive fear or anxiety); 
     Immaturity (inappropriate crying, temper tantrums, poor coping skills); and 
     Learning difficulties (academically performing below grade level). 

Children with the most serious emotional disturbances may exhibit distorted thinking, excessive
anxiety, bizarre motor acts, and abnormal mood swings and are sometimes identified as children who
have a severe psychosis or schizophrenia. 

Many children who do not have emotional disturbances may display some of these same behaviors at
various times during their development. However, when children have serious emotional disturbances,
these behaviors continue over long periods of time. Their behavior thus signals that they are not
coping with their environment or peers. 

EDUCATIONAL IMPLICATIONS

The educational programs for students with a serious emotional disturbance need to include attention
to mastering academics, developing social skills, and increasing self-awareness, self-esteem, and
self-control. Career education (both academic and vocational programs) is also a major part of
secondary education and should be a part of every adolescent's transition plan in his or her
Individualized Education Program (IEP). 

Behavior modification is one of the most widely used approaches to helping children with a serious
emotional disturbance. However, there are many other techniques that are also successful and may
be used in combination with behavior modification. Life Space Intervention and Conflict Resolution
are two such techniques.

Students eligible for special education services under the category of serious emotional disturbance
may have IEPs that include psychological or counseling services as a related service. This is an
important related service which is available under the law and is to be provided by a qualified social
worker, psychologist, guidance counselor, or other qualified personnel.

There is growing recognition that families, as well as their children, need support, respite care,
intensive case management services, and multi-agency treatment plan. Many communities are
working toward providing these wrap-around services, and there are a growing number of agencies
and organizations actively involved in establishing support services in the community. Parent support
groups are also important, and organizations such as the Federation of Families for Children's Mental
Health and the National Alliance for the Mentally Ill (NAMI) have parent representatives and groups
in every state. Both of these organizations are listed under the resource section of this fact sheet.

OTHER CONSIDERATIONS

Families of children with emotional disturbances may need help in understanding their children's
condition and in learning how to work effectively with them. Help is available from psychiatrists,
psychologists or other mental health professionals in public or private mental health settings. Children
should be provided services based on their individual needs, and all persons who are involved with
these children should be aware of the care they are receiving. It is important to coordinate all
services between home, school, and therapeutic community with open communication.