Addressing Barriers to Learning: Helping Students Cope with Disruptive BehaviorsBipolar Disorder
Mental Health in the Schools Series
Suzanne RillingMili LalSusan Cole
OBJECTIVESOverview of Bipolar Disorder
Signs and Symptoms
Developing a Plan
Childhood Bipolar DisorderGeneral Information:Previously called manic depression Alternate between poles of excessive energy and hopelessness1% of populationUsually diagnosed late adolescence or early adulthoodRecognized in children since 1995
Diagnostic CriteriaSymptoms are at an inappropriate severity level for age and developmental stage.
Must cause SIGNIFICANT functional impairment to be considered a disorder.
Essential Clinical FeaturesMarked by EXTREME changes in mood, thought, and behavior
Disturbance must be severe enough to cause impairment in school/family/peer functioning or need hospitalization.
Etiology of Childhood Bipolar DisorderGenetic
Life stressors exacerbate illness
Signs and Symptoms of Childhood Bipolar DisorderPoor behavior regulationIrritabilityLabileDistractibility Switches topics rapidlySensation SeekingRacing thoughtsInflated Self-Esteem
IndecisiveChange in eating habitsSleep disturbanceFatigueDifficulty concentratingFeelings of helplessness and hopelessness
Symptoms Continued..Other possible symptoms:
Misinterpretation of social cues
Beliefs of special powers
ACTIVITYWHAT MIGHT CHILDHOOD BIPOLAR DISORDER LOOK LIKE IN YOUR CLASSROOM/SCHOOL ENVIRONMENT?
Observable/Measurable Behaviors of Bipolar Disorder in the ClassroomOff task/Inability to focusSleeping/Head on deskRagesCryingPoor InitiationFlat affect
Frequent school absencesPoor gradesPhysical complaints
Types of Treatment Psychotherapeutic TreatmentsCognitive Behavioral TherapyFamily TherapyOther Therapies
STRATEGY INFORMATION SHAREWHAT WORKS?WHAT DOESNT?
Helpful AccommodationsBack and Forth Notebook between home and schoolExtended time for tests/assignmentsLate start to school day or shortened dayUnlimited access to bathroom/waterExtra set of books at homeTool kit to manage emotions
Calculator for mathBreak long tasks into smaller segmentsPermission to have snacksAlternative/Modified assignmentsBooks on tapeNatural LightHard copy of notes
Developing A Good Intervention PlanSTEP I: Establish a team
STEP 2: Get Student Input
STEP 3: Teach Self-Monitoring Techniques
STEP 4: Design Classroom Exit Strategy for the student
CASE STUDYJESSICA- 9TH GRADE
AVAILABLE SCHOOL-BASED SUPPORT SERVICES
Introduce Elaborate on definition of excessive energy and hopelessness in regards to disorder and fluctuation.Comorbidity: Often associated with ADHD;ODD/CD; Substance Abuse; OCD; Panic Disorder; Social phobia, Tourettes, PDD Clarify developmental stage ie., temper tantrums in a 5 year old.Childhood characteristics may be more subtle.Genetic: one parent = 15-30%, both parents= 50-75% (4-6% - broad spectrum)Give example of life stressors: divorce, move, incarceration, death, new baby, poverty, etc.Give examplesNot as simple as one minute he is sad the next he is happy. Symptoms must be present for at least 6 months!Distorted thinking attributing false motives to others, blaming external conditions, delusional thinking, hallucinations (auditory most common), inaccurate or delusional self observation.Implusive thought, hyper focus, chronic procrastination, difficulty getting organized or started, extreme forgetfulness, need for high stimulationInvolve school based and community resources/agencies (Refer to handout)This is out of school staff control- can only educate parent and provide resources.What doesnt work:General classroom management systemsSuspensionDetentionPunishmentWhat works: Peer and Teacher education about disordersStrong Behavior Intervention Plan with student inputCommunication with parentSafe place in the school; adult mentorTeaching replacement behaviorsHANDOUTTeam: parent, teacher, mental health, case manager, student support team, nurse, counselor, social worker, school psychologist, behavioral support services, etc.Handout when I might need to leave the classroom and crisis management check listStudent Input: Teacher should meet 1:1 with studentSelf-Monitoring Techniques: gage anxiety/moodExit Strategy: determine when student needs a break, nonverbal cue, safe place designated by the team and work on something (puzzle, art, activities) as chosen by student.
Do a BIP Provide forms of NHCS BIP form for participants to fill out.