Remedial and Special Education

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Critical Educational Program Components for Students With Emotional and Behavioral Disorders: Science, Policy, and Practice Richard L. Simpson, Reece L. Peterson and Carl R. Smith Remedial and Special Education 2011 32: 230 originally published online 9 March 2010 DOI: 10.1177/0741932510361269 The online version of this article can be found at: http://rse.sagepub.com/content/32/3/230

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Critical Educational Program Components for Students With Emotional and Behavioral Disorders: Science, Policy, and Practice

Remedial and Special Education 32(3) 230–242 © 2011 Hammill Institute on Disabilities Reprints and permission: http://www. sagepub.com/journalsPermissions.nav DOI: 10.1177/0741932510361269 http://rase.sagepub.com

Richard L. Simpson1, Reece L. Peterson2, and Carl R. Smith3

Abstract In spite of recent education reform and reorganization efforts requiring the use of research-based methods, the fundamental elements of an effective program for children and youth with emotional and behavioral disorders (EBD) have not been succinctly identified. This article presents the essential features of programs for students with EBD. Program elements include (a) qualified and committed professionals, (b) utilitarian environmental supports, (c) effective behavior management plans, (d) valid social skill and social interpretation training and social interaction programs, (e) proven academic support systems, (f) strong parent- and family-involvement programs, (g) coordinated community support mechanisms, and (h) ongoing evaluation of essential program components and student outcomes and progress. A justification for the program and a comparison of the proposed program with existing models is included in the discussion. Keywords emotional and behavioral disorders, effective practices Students with emotional and behavioral disorders (EBD) are well known for their challenging, demanding, unpredictable, and difficult to manage behaviors. These characteristics affect performance in fundamental areas of functioning including behavior, social interactions, social skill fluency, and academic achievement (Kauffman & Landrum, 2009; H. M. Walker, Ramsey & Gresham, 2004). Problems characteristic of EBD, such as developing and maintaining appropriate interpersonal relationships, adhering to basic rules of conduct, and acquiring and performing age-appropriate academic skills, often begin early in life and all too often negatively affect individuals and their families throughout their lives (Briggs-Gowan, Carter, Bosson-Heenan, Guyer, & Horwitz, 2006; Gresham, Lane & Lambros, 2000; Kauffman, 2005; Neel, Cessna, Borock & Bechard, 2003). Significant mental health problems and pernicious school and postschool outcomes are common among children and youth identified as having EBD, including failure to complete school, incarceration, unemployment and underemployment, and significant interpersonal difficulties (Chen & Weikart, 2008; Kauffman, 2005; H. M. Walker et al., 2004). That prevalence estimates of childhood emotional and behavior problems are typically at least five times higher than the number of students identified and served

further intensifies problems of EBD (Costello, Egger, & Angold, 2005; Costello, Foley, & Angold, 2006; Kauffman & Landrum, 2009). Commenting on the problem of underserving students with emotional and behavioral problems, Dunlap et al. (2006) observed, “When the challenging behavior of young children is not addressed in an appropriate and timely way, the future likelihood increases for poor academic outcomes, peer rejection, adult mental health concerns, and adverse effects on their families, their service providers, and their communities” (p. 33). Just as surely as there is evidence that EBD is a harmful, insidious, and underserved disability is certitude that effective educational programming is a successful route to EBD prevention and amelioration (Kennedy & Jolivette, 2008; Lewis & Wehby, 2007; Montague, Enders & Castro, 2005). Learners with EBD unquestionably require individualized 1

University of Kansas, Lawrence University of Nebraska–Lincoln 3 Iowa State University, Ames 2

Corresponding Author: Richard L. Simpson, University of Kansas, JR Pearson Hall, 1122 W. Campus Road, Lawrence, KS 66045 Email: [email protected]


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Simpson et al. programming based on effective methods implemented by well-trained professionals (Algozzine, Serna & Patton, 2001; Kostewicz & Kubina, 2008; Nelson, Leone, & Rutherford, 2004). This article discusses issues related to identification and implementation of effective methods for students with EBD. We provide a model that identifies basic components of an effective program for students with EBD and compare and contrast the proposed structure with existing models that outline services and programs for learners with EBD.

Effective Practice: What It Is and How It Is Achieved Authorities in the field of EBD agree that positive educational outcomes come as a result of appropriate use of effective methods and related strategies; well-trained and disciplined professionals; and carefully orchestrated community, home, and school support systems (Algozzine et al., 2001; Kauffman & Landrum, 2009; Nelson et al., 2004). In spite of this agreement, numerous questions and few points of accord can be found related to choosing and implementing evidencebased methods with children and youth diagnosed with EBD. The very meaning and essential elements of evidencebased methods; strategies for ensuring that teachers have access to utilitarian, evidence-based methods; and mechanisms for confirming that teachers and other practitioners have the necessary training and resources to correctly use appropriate effective strategies, materials, and methods are undecided (Cook & Schirmer, 2006). Linked to these significant fundamental issues is the clear reality that identifying and rigorously ensuring use of effective practice methods with students with EBD is no easy task. There is little reason to believe that most students identified with EBD are currently receiving an education based on effective methods and that all educators who work with these learners are well prepared to use strategies, curricula, and procedures that are associated with the best outcomes (Downing, 2007; Firestone & Riehl, 2005; Nelson, 2000). Significant lack of agreement on what constitutes effective practices for students with EBD and well-documented personnel shortages suggest that this pattern is unlikely going to change any time soon (Hemsley-Brown & Sharp, 2003; Kauffman, 2007). Additionally, Lewis, Hudson, Richter, and Johnson (2004) poignantly observed that “policy and position papers expressing concern that special education services may be ineffective, that special education teachers do not serve students adequately, and that special education is not equipped to meet the demands of current federal initiatives are all grounded squarely in our fractured knowledge base” (pp. 247–248). Of course, use of research-based methods extends beyond children and youth diagnosed with EBD and other disabilities

(Simpson, 2008). In large measure, this is a function of federal mandates, in particular the No Child Left Behind Act of 2001 (NCLB, 2002) and the Individuals with Disabilities Education Act reauthorization of 2004. The NCLB language related to effective education practices requires educators to use scientifically based research methods, defined as techniques that have met rigorous peer review and other traditional and conservative research standards. The NCLB interpretation of scientifically based research is narrowly defined; it primarily refers to practices, products, and materials that have been validated via use of random samples and control and experimental group research designs. This interpretation of effective practice and scientifically based research has been widely discussed and criticized (Algozzine, 2003; Allbritten, Mainzer & Ziegler, 2004; Bateman, 2007; Odom et al., 2005; Thompson, Diamond, McWilliam, Snyder, & Snyder, 2005). However, there is little opposition to the general notion that educators need to be more adept at identifying and consistently using practices that have proven benefit (Horner et al., 2005; Shavelson & Towne, 2002; Sutherland, Lewis-Palmer, Stichter & Morgan, 2008). Relative to learners with EBD, there is widespread and clear recognition of the importance of making effective strategy use a central component of educational reform. Clearly students’ needs and best interests demand that teachers and other practitioners base their professional practices on efficacious methods and strategies. Nearly two decades ago, the Peacock Hill Working Group (1991) identified fundamental elements needed for an effective EBD program: systematic and data-based interventions, continuous assessment and monitoring of progress, provision for practice of new skills, a systematic intervention selection process wherein treatment methods are matched to problems, use of multicomponent treatment, programming for transfer and maintenance, and commitment to sustained intervention. This early-stage foundational model outlines salient elements of high-quality programs for students with EBD yet fails to identify key curricular and other essential and indispensable program features, such as instructional domains and intervention targets. In the area of violence prevention, Milhalic, Irwin, Elliott, Fagan, and Hansen (2001) offered a program model that was based on intervention strategies with proven empirical success, including positive outcome sustainability and multiple site replications. Although it is composed of basically sound building blocks, the Milhalic et al. plan is not primarily designed to be an educational model. Thus, it falls short of clearly describing fundamental features needed to successfully address the variable and challenging needs of students with EBD in schools. Others have argued for the calibrated use of evidence-based interventions based on clinical dimensions of EBD such as depression, attention-deficit/hyperactivity disorder, anxiety,


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and disruptive behavior (Hoagwood, 2001; Marsenich, 2002). The Hoagwood (2001) model is logical and generally suited for children and youth with mental illness; however, its clinical orientation makes it less than ideal for day-to-day classroom use. Others in the field of EBD have also called for educators to use effective methods and have offered general descriptions of elemental program building blocks for students with EBD, albeit without the specificity needed for orchestrated action (Cheney & Barringer, 1999; Jones, Dohrn, & Dunn, 2004). A variety of researchbased resources and models for addressing students’ needs within narrowly defined domains, chiefly behavior management (Maag, 2004), can also be found. Yet comprehensive and systematic models for advancing the use of maximally effective methods with learners with EBD are unavailable. There is clear consensus that an agreed-upon framework for effectively meeting the educational needs of students with EBD and for creating organizational structures that encourage and guide educators in more consistently using research-based methods is needed. Lewis et al. (2004) called for the adoption of a consistent set of universal standards for determining research-based practices. Their vetting system led to the identification of four research based practices: (a) teacher praise, (b) instructional opportunities to respond, (c) direct instruction and other sound instructional methods, and (d) positive behavior supports. These methods are clearly essential for positive outcomes for students with EBD. However, they fall short of providing an overall and global framework and organization for educators of students with EBD relative to targeting salient domains for interventions based on scientifically proven methods. In spite of calls for adoption of effective practices with students with EBD, the clear reality is that teachers, related service personnel, and other practitioners currently base much of their teaching on methods that fall outside the boundaries of effective educational practice and that this longstanding custom will in all likelihood continue, at least to some extent, into the foreseeable future (Cook & Schirmer, 2006; Hemsley-Brown & Sharp, 2003). Such a declaration in no way detracts from nor undercuts the need for wide-scale identification and use of effective practices. Instead, this acknowledgment opens the way to recognition that the path to special education’s improving its professional image and advancing the integrity and reliability of its professional practices will be tied to its ability to clearly identify and use methods that are scientifically and technically sound and unambiguously connected to desired outcomes. This fundamental step is needed to advance the profession and, more importantly, to improve outcomes for children and youth with EBD.

A Fundamental Model for EBD Effective Practice Candidly and unapologetically acknowledging the blemished and inconsistent state of affairs relative to educating students with EBD carries with it a willingness to improve conditions by beginning the challenging process of identifying and consistently implementing sound basic educational programs based on effective practice. Such reform is in no way an easy task, yet it is achievable and realistic if undertaken in an incremental and logical fashion. Success in such a process requires several basic steps. First there is a need for professionals in the field to identify agreed-upon indispensable and fundamental elements and features of effective programs for children and youth with EBD. These vital and rudimentary factors and features form the foundation of programs for students with EBD. The Peacock Hill Working Group (1991) and others (e.g., see Jones et al., 2004; Kauffman, 2007; Lewis et al., 2004) have taken initial steps toward contributing to such a structure. However, further expansion and clarification are needed to create a basic practitioner model that broadly and flexibly describes essential elements of an effective and scientifically based educational program for learners with EBD. Effective practice reform is also contingent on recognition and acceptance that effectual and successful programs for students with EBD are based on human relationships that transcend and interact with the methodologies that are used (Morse, 1994). Programs and interventions for students with EBD are only as effective as the individuals who apply them and are inextricably aligned with relationships between teachers and learners. Although this principle applies to any instructional relationship, it is particularly important in educating children and youth with EBD. As Jensen (2003) so aptly put it, In all of this research activity, we rarely step back to carefully examine the extent to which the elements of scientific “proof” have been woven together to provide the necessary empirical fabric with clear linkages between the overarching theory, postulated mechanisms for change, and therapeutic outcomes. Pausing for such reflection is necessary, however, since in many instances a number of competing explanations might equally be invoked to explain change. In particular, the notion of “nonspecific therapeutic factors”—the effects of attention, positive regard, and a therapeutic alliance—are usually not sufficiently addressed or ruled out as causal explanations in most studies. (p. 37) This factor thus recognizes, appreciates, and builds on the notion that educators who work with children and youth with EBD make their most significant and enduring positive


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Simpson et al. progress when they are able to forge trusting and positive relationships with their students and suggests interlinking these affirmative interpersonal relationships with effective methods. It would be difficult to find a teacher of students with EBD who will not only concede this point but who will eagerly and convincingly offer examples that illustrate that it is only through constructive relationship formation that a method or curricula, independent of how allegedly effective it is, will have the potential to work most effectively. Finally, successful and pragmatic reform recognizes and legitimizes that educators and others who directly work with students with EBD will of necessity base their instructional, management, and other decisions on a variety of approaches and styles, including scientific thinking, logical judgment, common sense, personal experiences and attitudes, and so forth. Such recognition neither challenges nor competes with the need to have those who teach students with EBD adopt a more scientific persona. It does, however, recognize and validate that professionals who successfully educate students with EBD must possess and appropriately apply a variety of skills and strategies, at least some of which fall beyond the scope and boundaries of traditional empirical science. This knowledge and these skills complement and interact with the professed effective practice curricula, strategies, and methodologies that educators apply in their professional work. In this context, calls for adoption of a purely scientifically based educational model that fails to consider these other factors—particularly one that requires exclusive use of a narrow and restrictive interpretation of science (and arguably requires that teachers take on the role of a detached technician)—bodes poorly for students with EBD. In no way does this view denigrate or defame the value and importance of the profession’s adopting a more scientific character or the significance of choosing and appropriately using effective methods. Instead it places the role of science in teaching students with EBD within an overall skill and knowledge context. A colleague related an example of this opinion. She shared that she was contacted by a parent of a severely disabled 17-year-old female student whose longtime female teaching assistant resigned from her school district position because her family was moving to another state. This individual’s school-related responsibilities included assisting the 17-year-old female student with classroom activities as well as personal hygiene and independent living. School district personnel notified the parents that they had decided to hire a 25-year-old male to be their daughter’s personal attendant replacement. Because the assistant would need to assume responsibility for their daughter’s toileting and other personal needs, the parents objected to the hiring choice, arguing that a female attendant would be more appropriate. School district personnel indicated that they were flexible on their hiring choice, albeit only if the parents

were able to produce “empirical scientific evidence” that a female teaching assistant would be more suitable than a male. Whereas one might argue that a male attendant in this case would be just as appropriate as a female, it would be highly unlikely that a definitively defined “correct decision” would be purely based on scientific evidence. This also illustrates an interesting challenge regarding who should have the burden of proof in such cases! That is, as is the state of affairs with so many issues that confront special education personnel and families of students with EBD, scientific evidence in and of itself cannot be expected to fully direct every decision. Common sense, professionals’ experience-based opinions, policy decisions based on consideration of myriad matter-of-fact variables that fit with individual cases and circumstances, and similar factors are legitimate considerations that we respectfully contend must not be overlooked.

Effective Practice: Fundamental Components for Building Successful Programs We offer recommended elements that we consider essential for every educational program for children and youth with EBD. The model, shown in Figure 1, is a broad-spectrum template that identifies fundamental program components that we propose be clearly identifiable in all classrooms and individual programs for student with EBD. The elements are basic building blocks of an effective program, and they recognize and build on the work of others such as the Peacock Hill Working Group (1991) and Lewis et al. (2004). Because they are frequently absent from programs and because the field lacks a succinct and straightforward current description of essential program features, we offer this blueprint as an important foundational step that we hope will result in development of more consistent effectivepractice programs for children and youth with EBD. Our recommendations are based on pragmatic and realistic interpretations of broad-spectrum effective practices. Thus we deem our recommendations to encompass basic support, treatment, and intervention methods that have the potential to significantly improve educational programs for students with EBD. For that reason we use the term effective practice to refer to strategies and methods that have been shown to be objectively utilitarian based on respected and well-founded research, albeit not exclusively rooted in unreasonably rigid and antiquated interpretations of research methodology. For these strategies and tactics to confer significant benefit, they must be individualized and systematically used with fidelity. As a result, these supports and practices will only be effective when properly tailored to fit individual student needs and when applied consistently and reliably. The ultimate benefit of these recommendations will accordingly be tied to their


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Coordinated Community Support Mechanisms Effectual Parent & Family Involvement Programs

Utilitarian Environmental Supports

Qualified & Committed Professionals

Effective Behavior Management Systems

Proven Academic Support Systems Valid Social Skill, Interpretation, & Interaction Programs

Figure 1. Fundamental effective practice components for programs for students with emotional and behavioral disorders

alignment with the needs of individual children and youth and to the extent to which they are used in an approved fashion by knowledgeable and suitably trained personnel. The central and key building block of this model is qualified and committed professionals. As shown in Figure 1, every element of the model connects to an appropriately trained and committed professional. Other effective practice elemental components include (a) environmental supports, (b) behavior management systems, (c) social skill and social interpretation training and social interaction programs, (d) learning and academic support methods, (e) parent and family involvement programs, and (f) community supports. We recognize that ongoing evaluation of essential program components and student outcomes and progress is also an important model element. Thus, although it is not discussed as an independent component in this article, this significant factor is considered within every facet of the model.

Qualified and Committed Professionals. The single most salient consideration in this model is welltrained and qualified teachers and program managers for students with EBD. These indispensable professionals, independent of delivery models, particular intervention and treatment strategies, and similar considerations, are the crucial leaders who direct and coordinate students’ learning

and program administration. Hence, above and beyond all else, these individuals will primarily determine the outcomes of students. The effective practice literature clearly supports that well-trained and qualified teachers and support personnel are the predominant ingredient in successful programs for students with EBD (Blood & Neel, 2007; Downing, 2007; Jones & Jones, 2004; Morse, 1994; Walker, Shea, & Bauer, 2004). Without a doubt there is an undeniable connection between educational outcomes of students and the quality of their teachers (Darling-Hammond, 1999; DarlingHammond & Youngs, 2002; Ehrenberg & Brewer, 1994; Sutherland et al., 2008). Wayne and Youngs’s (2003) observation that “both intuition and empirical research tell us that the achievement of school children depends substantially on the teachers they are assigned” (p. 89) is a pithy acknowledgement of this clear fact. In spite of mandates and overwhelming evidence that teachers are the key element in successful programs, many classrooms, including those for students with EBD, are being taught by personnel who have not demonstrated competencies in areas of special education (Downing, 2007; Egnor, 2003). Our purpose in identifying teachers as program linchpins and our comments relating to the poor state of personnel in many programs is not to unnecessarily dwell on the patently obvious. Yet bluntly stated, effective practice implementation and aggregate program improvement for children and youth with EBD will occur only as a result of having an adequate supply of competent and skilled teachers and other personnel. Hence, based on indisputable evidence that there is a shortage of teachers and other professionals who are qualified to serve the needs of students with EBD and that this trend will continue for at least the short term, we remind readers that teachers and other appropriately trained and qualified personnel form the core of our effective practice model. Discussion of the specific knowledge and skills we judge teachers of students with EBD to need is well beyond the scope of this article. Briefly and generally, however, they include a foundation of basic general and special education skills and knowledge along with specialty skills connected to an understanding of the characteristics of students with EBD. EBD-specific knowledge and skills in assessment and evaluation, curricula, instructional methods, management and social skill instruction, parent and family involvement, and collaboration with other professionals are minimal requirements as well.

Environmental Supports The importance of highly structured educational models has been recognized for decades (Strauss & Lehtinen, 1947). Haring and Phillips (1962), for instance, observed the powerful impact of creating a predictable and consistent


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Simpson et al. classroom environment for students with EBD. Following this legacy, teachers of students with EBD have documented that planned, organized, and orderly classrooms are essential. Indeed, clearly identified and enforced rules, unambiguous and reasonable expectations, and carefully monitored and appropriately supported performance are essential for children and youth with emotional and behavioral problems (Cipani, 2008). Brophy (1988) reminded professionals that a positive and effective classroom environment does more than simply minimize misconduct; it also maximizes students’ learning and socially appropriate and productive classroom and community activities. Thus, he and others have advocated for programs that recognize and support student’s personal needs, create and maintain positive relationships between faculty and students, understand and address students’ academic needs, use a variety of appropriate management methods, and are based on predictable routines and organization. Building on recognition by researchers and successful teachers of the benefits of a structured and orderly classroom and school environment, Maag (2004) observed that “a disorganized classroom environment is a major antecedent for student disruptions. Conversely, a well-organized classroom environment can exert a powerful influence on students’ behavior and lead to high levels of academic engagement” (p. 223). In recognition of this importance we recommend, at a minimum, the following environmental supports and conditions for students with EBD: 1. clearly stated rules and behavioral expectations; 2. consistent rule monitoring; 3. immediate and uniform feedback and positive corrective actions for rule infractions; 4. consistent and predictable schedules and routines; 5. appropriate and supportive learning environments including lighting, sounds, heating and cooling, storage, and so forth; 6. sufficient and suitably designed and identifiable space for learning, social, and other activities; 7. developmentally appropriate schedules and transition opportunities; 8. developmentally appropriate and organized classroom materials; 9. elimination of high-traffic classroom and school areas that are prime areas for disruption and behavior problems; and 10. seating arrangements that are based on unique and individual student needs and tendencies and predispositions.

Behavior Management Supports It should come as no surprise that we identify an effective behavior support system as an essential program feature.

The majority of school-age students identified with EBD have conduct disorders and antisocial behavior patterns. As a result, these learners have a long history of exposure to punishment-based strategies (Sugai, Horner, & Gresham, 2002). To be sure, there is strong evidence that students with conduct problems and antisocial tendencies are most commonly dealt with through use of punishment and related behavior-reduction strategies (Walker, Ramsey et al., 2004). There is ever-increasing evidence, however, that punishment-based methods are generally ineffective, especially if they are the primary or exclusive intervention strategy (Sugai et al., 2000). Moreover, evidence accumulates that management systems for students with EBD that are exclusively based on punishment strategies increase aggression and other problems, including early school exit (Gershoff, 2002; Kennedy & Jolivette, 2008; Mayer & Sulzer-Azaroff, 2002). It is significant to note that there is little evidence to support traditional “office-bound” psychotherapy as a primary intervention leading to meaningful and long-term behavioral changes for most students with EBD (Eddy, Reid, & Curry, 2002). J. Walker et al. (2004) provided a terse appraisal of the value of psychotherapy in their assessment that “regrettably, counseling is among the least effective options available to us if the goal is to produce reliable, meaningful changes in student behavior” (p. 159). We, of course, recognize that school personnel routinely integrate counseling and counseling-related activities as a part of their programs and that these program elements and components are often viewed as both indispensable and effective. Nevertheless, when used independent of other effective program elements, counseling and psychotherapy will often be relatively ineffective. The situation confronting educators who work with students with EBD, wherein two widely used and purportedly utilitarian intervention tools (i.e., punishment-based strategies and traditional counseling and psychotherapy) are declared to be generally ineffective, leads logically to the question of what then to do about management. There is no simple answer; however, there are logical and multifaceted support systems that have been shown to be effective when used in a consistent and coordinated fashion. First, teachers and other staff who strive to create a positive, encouraging, and supportive classroom and school atmosphere and environment tend to get better results (e.g., see Kennedy & Jolivette, 2008). This simple rule (that is not always simple to consistently implement) is an acknowledgement of the vital role that a positive social ecology and culture plays in affecting desirable student behavior. Wehlage, Rutter, Smith, Lesko, and Fernandez (1989) contended that “there are four teacher beliefs and/or values, accompanied by corresponding sets of behaviors, that together constitute a positive teacher culture facilitating membership and engagement for students” (p. 135): personal


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teacher responsibility for student success, an optimistic and comprehensive teacher and mentor role, teacher persistence with all students, and an optimism that all students can learn. Others have been equally persuasive in observing that the quality of teacher–student relationships, the atmosphere and tone of classrooms and the overall impact of positive classroom environments is an essential feature of an effective management program (Darling-Hammond, 1997; Koegel, Koegel & Dunlap, 1996; Skiba & Rausch, 2006). Berliner (1985) observed that positively and clearly communicating academic work expectations, programming for student success, and developing a hospitable and welcoming atmosphere bode well for all students and thus should be used to positively influence school and classroom climate. However, he sagely noted that although such conditions are essential they are not sufficiently powerful to eliminate the need for other management programs. As previously noted, an organized and structured environment based on effective methods that consider both group and individualized management needs is a fundamental and essential feature of an effective program for children and youth with EBD. Such programs should be crafted individually in accordance with functional behavior analysis findings and geared to consider multifaceted approaches that mirror the unique and complex needs of students with EBD. Applied behavior analysis and behavior modification are pivotal and essential tools for understanding, managing, and evaluating the behavior of students identified with EBD. An understanding of observable behavior relative to antecedent variables and consequences is, thus, essential. Accordingly, knowledge and skill in designing, implementing, and evaluating reinforcement-oriented programs that can be used to increase behavior, extinction strategies, differential reinforcement methods, appropriate behavior reduction options, and self-management and cognitive-behavior modification strategies are indispensable. We also recognize the potential benefit of medically based interventions and treatments and interventions that are connected to intrapsychic approaches. In particular we are of the opinion that individualized programs based on certain types of psychoeducational methodology may be effective tools. In spite of their face validity and decades of use by countless practitioners, such methods have in many cases not been empirically validated. Nevertheless, when based on functional behavior analysis findings and objectively and empirically evaluated with individual students, we think they deserve consideration. For instance, longrelied-upon methods such as planned ignoring, signal interference, and proximity control—when individually crafted, based on functional behavior analysis findings, and systematically and objectively evaluated—may be effective. For example, a functional behavior analysis based on systematic direct observation and empirically designed hypothesis testing revealed that an adolescent with EBD was prone to

initiate confrontations with his teachers and peers when given novel academic assignments. Based on this information his school team designed and implemented an intervention program based on the psychoeducational tool hurdle help (Wood, Long, & Fecser, 2001). This program involved his teacher’s individually assisting the student when presented with unfamiliar assignments. Whereas it is not typically considered to be an empirically and scientifically valid method, in this instance the hurdle help method was found to be an effective tool. Over the course of several weeks, the students’ teachers were able to increasingly shape the student’s willingness to independently attempt new assignments, thus reducing his persistent need for individual hurdle help, making the method even more appealing. Although we support consideration of intervention options that lack clear and convincing effective practice validation under specified conditions (i.e., when dictated by functional behavior analyses and when the strategies are systematically and objectively evaluated), we are not recommending that the field continue its long-standing tradition of broad-spectrum tolerance and tacit acceptance of any and all purported and unproven interventions and treatment methods. We think it is painfully evident that unrestricted use and reliance on untested methods, especially those that lack theoretical, clinical, and anecdotal promise, have been detrimental to the EBD field. Uncritical acceptance of unproven interventions and strategies, especially those that are used to supplant proven methods, have undermined identification, implementation, and objective evaluation of methods that bode best for students with EBD. At the same time, adoption of narrowly construed, scientifically based methods and protocol are no less unappealing. Hence, at least for the present, we advocate for consideration of a variety of options, albeit with the aforementioned caveats.

Social Skill and Social Interaction Supports In a fashion parallel to having an effective behavior management and behavior support system, we consider ongoing social skill and social interaction training to be an essential feature of an effective EBD program. Children and youth with EBD have an irrefutable need for social skill instruction and support (Downing, 2007; Gresham, 2002). This assessment is given with recognition that current meta-analyses of social skills training efforts suggest at best an overall modest impact on behavioral change (Forness & Kavale, 1996). In reviewing such results, we would suggest at least three explanations for such gains. First, there is the need that social interventions be carefully crafted to match desired social outcomes and individual circumstances. Second, interventions must be appropriately calibrated according to the severity and complexity of the behaviors being targeted for change. Finally, significant


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Simpson et al. time and effort must be devoted to social skill instruction, including opportunities for practice in natural settings. Children and youth with EBD are often remarkably resistant to social training and related interventions. To be sure, a number of authorities have offered testament to the intractable nature of social problems (Kauffman, 2005). Authorities assert that well-established patterns of antisocial behavior should be viewed in a manner similar to chronic and incurable childhood medical diseases such as diabetes, whereby the problem can be effectively managed but not necessarily cured (Patterson, DeNarushe, & Ramsey, 1989; Walker et al., 2004). Our belief that programs for students with EBD should include social instruction and support is also made with recognition that the utility and efficacy of social skill training has been questioned (Gresham, 1998; Rosenberg, Wilson, Maheady, & Sindelar, 2004; Quinn, Kavale, Mathur, Rutherford, & Forness, 1999). Nevertheless, based on the obvious need for social skill instruction and support among students with EBD and evidence that effective programs are available, we advocate strongly for clear specification and inclusion of intervention strategies that address social problems of children and youth with EBD. According to Gresham (1998), students with EBD can be expected to have the three types of social skill problems: Social skill acquisition deficits (lack of knowledge needed to execute a social skill or inability to discriminate the appropriateness of particular social behaviors), social performance deficits (failure to perform social skills or social behaviors at suitable levels and in needed situations in spite of possessing the social skill), and fluency deficits (lack of ease and skill in demonstrating and performing a social skill at appropriate times). The persistent and pervasive nature of these challenges along with recognition that peer rejection of students with EBD is a predictable norm (Reid, Patterson, & Snyder, 2002) calls for comprehensive social competence training and support that targets socially valid behaviors. Identification of classes and groupings of suitable social targets for intervention is also important (Rivera & Smith, 1997). Caldarella and Merrell (1997), for instance, identified five general classes of social behavior that require attention: (a) relationships with peers (e.g., pro-social social interaction skills), (b) self-control and self-management (e.g., personal responsibility), (c) academically related social skills (e.g., respect for school social rules), (d) social compliance (e.g., cooperation with others), and (e) social assertiveness (e.g., social initiation with peers). The diverse nature of these general targets necessitates the use of a range of social instruction and support tools including direct skill instruction; consistent and ongoing coaching, peer development, and support programs; inclusion and integration of cognitive-based and problem-solvingoriented methods; and generalization training. Instruction of

social skills using these strategies appears to be most effective when individually crafted and when socially valid behaviors are taught in naturalistic settings and situations. Instruction also appears most apt to result in desired outcomes when it addresses acquisition, performance, and fluency deficits; is based on suitable and realistic models; is supported by realistic behavioral rehearsal opportunities, performance feedback, and appropriate reinforcement; considers contextual variables (i.e., environments and particular circumstances); and involves identifying and implementing generalization plans in all stages of training and support.

Learning and Academic Supports By definition, learners with EBD experience academic problems and poor scholastic achievement (Bos & Vaughn, 2006; Kauffman, 2005). Nevertheless, academic instruction has received relatively limited attention and has clearly been secondary to behavior management (Bos, Coleman, & Vaughn, 2002; Downing, 2007). As a consequence, just as observed by Knitzer, Steinberg, and Fliesch (1990) years ago, programs for students with EBD continue to accentuate behavior control and give far too little attention to pupils’ academic needs (Hodge, Riccomini, Buford, & Herbst, 2006; Reid, Gonzalez, Nordness, Trout & Epstein, 2004) despite researchers’ realization of the importance of well-planned and stimulating academic programs. In spite of its relative lack of attention, it is clear that scholastic skills are essential for students with EBD and are central elements of an appropriate program and positive outcomes (Gunter & Denny, 1998; Kostewicz & Kubina, 2008). Accordingly, clearly designed and structured instructional methods appear to bode best for positive academic outcomes (Mooney, Epstein, Reid, & Nelson, 2003; D. Rivera & Smith, 1997). Rosenberg et al. (2004) surmised that such strategies were “structured methods of instruction” (p. 361) and included efficient and carefully orchestrated use of instructional time; individualized instruction and curricula, including use of a variety of group sizes that were matched to student needs and learning activities; precise and clear-cut pursuit of specific and essential instructional targets, including ongoing use of curriculum-based assessment methods, task analysis, and subsequent sequential and structured instruction; regular and systematic evaluation; and attention to creating a positive and reinforcing learning environment characterized by appropriate academic expectations and high rates of academic success. Rosenberg and his colleagues also recommended effective practice instructional techniques that incorporate lesson overviews and reviews (advance organizers, classroom rules, skill reviews); structured presentation of novel materials based on demonstrations, prompts, and guided and independent practice; ongoing review and


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employment of previously learned subject matter; and instruction in and applied use of critical learning strategies. Specific to acquiring reading skills, phonemic awareness, phonics, vocabulary, fluency, and comprehension have been identified as essential targets of instruction (M. Rivera, Al-Otaiba, & Koorland, 2006). There is no question that children and youth with EBD experience significant educational problems and that they will challenge the instructional skills and perseverance of educators. At the same time, there is strong evidence that these students are able to acquire academic skills and knowledge when systematically and meticulously exposed to effective practice curricula and instructional methods such as direct instruction and tutoring (Coleman & Vaughn, 2000; Griffith, Trout, Hagaman, & Harper, 2008; Lane, 2004). Kerr and Nelson (2002) correctly and fittingly observed that “behavior problems and academic difficulties often are functionally related” (p. 25). Accordingly, it is essential that academic goals be given the same import and consideration as social and behavioral targets are given. We strongly concur with M. Rivera et al. (2006) in their conclusion that the poor academic skills of students with EBD “will continue to hold them behind until effective practices take place” (p. 336).

Parent and Family Support Parents and families have an enormous impact on the development of children and youth, including students with EBD (Fiedler, Simpson, & Clark, 2007). In recognition of the influence of families on children and youth (and of course children’s influence on families) and because parents and families are a primary source of support for students with EBD and other disabilities, there is clear logic and need to support families in their care-giving responsibilities. Without a doubt, school personnel can enhance the development and progress of learners with EBD by working with and supporting parents and families. Accordingly, we include this element as one of the basic components of a successful EBD program. That effective communication and support programs for parents and families have traditionally been weak or absent from many programs that serve students with EBD makes this program building block particularly significant. Review of research literature and practitioner reports clearly confirms the need for and the benefits of partnerships between schools and parents and families (Berry, 1995; Christenson & Cleary, 1990). Academic and social benefits for children and reduction in family strain and tension are often directly connected with well-orchestrated and designed communication, support, and training programs (Bauer & Shea, 2003; Carpenter, 2000; Fiedler et al., 2007). At a minimum, we recommend that components

within this often-neglected area include emotional support and coping and stress support resources for parents and families, sibling information and support programs, homebased tutoring and educational support opportunities and options, positive behavioral support training and related resources, and programs that assist parents and families in transition planning and programming.

Coordinated Community Support There is progressively increased recognition of the need for integrated and comprehensive support services for children and youth with EBD and their parents and families (Fiedler et al., 2007; Morse, 1994). These collaborative and comprehensive relationships and program options show recognition of the significant challenges that confront individuals with EBD and their families and the need for community support programs that augment and complement schoolbased services. Nelson (2000) wisely reminded people that “with the most challenging students and the most challenged families, schools cannot be expected to do the job alone” (p. 212). In spite of overwhelming evidence that children and youth diagnosed with EBD generally require community supports and non-school-based services, many families and professionals report that they are either unaware of programs or are unable to access them (Fiedler et al., 2007; Neel et al., 2003; Odom & Wolery, 2003). Of course needs will vary from individual to individual, families will have different wants and needs, and communities will vary in the resources and programs they provide. Nevertheless, the need for basic community support resources is obvious and we consider it essential that such programs be recognized as foundational and indispensable elements of programs for students with EBD. At a minimum, children and youth with EBD and their families require community-based education and information resources for parents and families; affordable support, counseling, and crisis-intervention services; protection and advocacy agencies that understand the needs of students with EBD and their families; community recreation resources and programs that have the personnel and willingness to successfully accommodate students with behavioral and emotional problems (e.g., summer camps, libraries, museums); respite care and child care services for children with special needs; economic and social support agencies and programs that have personnel and other resources suitable for the needs of persons with EBD and mental illness (e.g., public assistance, Social Security Administration, Medicaid, vocational rehabilitation agencies); reasonably priced medical and therapeutic programs that are geared to serve children and youth with EBD; and transition, job support, and job coaching resources appropriate for individuals with a diagnosis of EBD.


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Summary Thoughts There is unquestionable need for identification and use of scientifically based and effective practice methods with students with EBD. Initial steps have been taken to advance and orchestrate the field’s use of effective methods. We particularly praise the work of the Peacock Hill Working Group (1991) and Lewis and his colleagues (2004). These initial efforts to promote use of methods that have proven utility and to bring attention to the need for universal standards for programs for learners with EBD form the foundation for ensuing models that further clarify how to improve student outcomes. We offer the model discussed in this article as an additional step toward outlining the essential elements that underpin utilitarian programs for students with behavioral and emotional challenges. We close with themes that have resonated throughout our article. Effective and research-based practices are of great significance; however, attainment of positive outcomes by students with EBD will occur only when these methods are used appropriately by knowledgeable, skilled, and committed professionals and support staff. Without treatment fidelity, wherein procedures are properly chosen and consistently and correctly implemented and evaluated by knowledgeable and sensitive educators, students will not fully benefit from even the most efficacious and robust methods. We also think it important to remind stakeholders that there are no universally effective strategies and no one-size-fits-all alternatives for students with emotional and behavioral challenges. Positive outcomes necessitate that intervention and treatment methods are appropriately matched and individualized to fit unique students’ needs. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Financial Disclosure/Funding We gratefully acknowledge the support of our respective institutions. Iowa State University, the University of Kansas, and the University of Nebraska–Lincoln each contributed to this work through the Big 12 Faculty Fellowship Program.

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About the Authors Richard L. Simpson, EdD, is professor of Special Education at the University of Kansas. His research interests include learners with emotional and/or behavioral disorders and children and youth with autism spectrum disorders. Reece L. Peterson, PhD, is professor of Special Education at the University of Nebraska–Lincoln. He has worked extensively with schools to develop and improve effective behavior management and school discipline policies, policies on physical restraint and seclusion, and to address school violence and student aggression. Carl R. Smith, PhD, is professor and chair of the Department of Curriculum and Instruction at Iowa State University. His research interests include policy and advocacy issues impacting student with emotional and/or behavioral disorders.
