12 / 64
126
JCPSLP
Volume 19, Number 3 2017
Journal of Clinical Practice in Speech-Language Pathology
Students with SEBD are a heterogeneous group, but are
consistently found to have a combination of risk factors that
outweigh the protective factors that are present within the
student, their family, and/or their environment. Protective
factors against SEBD include, but are not limited to, relatively
strong academic and social skills, a stable (undisrupted)
home environment, a history of strong parental attachment,
and having prosocial friends (Ttofi, Bowes, Farrington, &
Lösel, 2014). While this population has been of interest to
researchers for many years, an understanding of the
causes and contributors to social, emotional and
behavioural difficulties, including communication skills, have
not translated into a strong understanding that underpins
classroom practices (Graham et al., 2010; Law & Stringer,
2014; Van Bergen et al., 2015). A common theme in the
literature, also played out in classrooms across Australia, is
that students who present with challenging behaviours that
are disruptive, distracting, and affect teachers’ and allied
professionals’ capacity to complete tasks, are the students
who are most likely to receive attention (Armstrong et al.,
2016; Cohen, Davine, Horodezky, Lipsett, & Isaacson,
1993; Cole et al., 2012). This attention may be aimed at
addressing an underlying problem, or may be punitive in
nature. Further to this, Garner (2012) argued that
mainstream teachers’ approaches to behaviour
management are most influenced by their colleagues and
the culture of the school in which they work, rather than
policy or pre-service training, and as such can be variable
and in some contexts, overly reliant on punitive responses.
Oral language, literacy and SEBD
For nearly three decades, oral language and literacy
difficulties have been known to be unrecognised or
under-recognised in students with SEBD (Hollo et al., 2014;
Law & Stringer, 2014; Prizant et al., 1990; Ripley & Yuill,
2005; Stringer & Lozano, 2007). As discussed by Law,
Plunkett and Stringer (2012), the frequent co-occurrence of
language difficulties and SEBD does not mean that there is
a definitively causal relationship, but rather, a multifaceted
relationship between these two areas of functioning is
evident. Chow and Wehby (2016) theorise that language
influences both academic skills and behaviour, and
academic skills and behaviour, in turn, influence each other,
as well as later life outcomes. The meta-analysis by these
authors identified a significant negative concurrent and
predictive association between language and problematic
behaviour (Chow & Wehby, 2016).
To date, research investigating the association between
language delay and disorder and SEBD has taken two
approaches. The leading approach has been to measure
the prevalence of social, emotional or behavioural difficulties
in children who present with primary communication
impairments (Botting & Conti-Ramsden, 2000; Durkin
& Conti-Ramsden, 2010; Van Daal, Verhoeven, & Van
Balkom, 2007). An example of this approach is the work
of Botting and Conti-Ramsden (2000), who, in a study
of students who were 11 years of age and attending
a specialist unit for students with specific language
impairments, found that the students’ average behaviour
scores were within the normal range. However, the
students with language impairments in both receptive and
expressive modalities were more likely to present with
behavioural difficulties in the clinical range when compared
to students with expressive language impairments only
(Botting & Conti-Ramsden, 2000).
The secondary methodological approach is measuring
communicative competence in children and adolescents
include distractibility, verbal or physical joking, causing
others to lose concentration, and ignoring reasonable
requests and instructions (Armstrong et al., 2016). The term
challenging behaviour
is often used to refer to more serious,
violent, or aggressive behaviour directed towards staff,
other students, or the student themselves (Armstrong et al.,
2016; Cross, 2011).
Social, emotional and behavioural
difficulties
Students with SEBD present with maladaptive social and
behavioural responses that are severe, chronic, and pervasive
(Gresham, 2005; Hollo et al., 2014), rather than behaviours
that are episodic and transitory. These prolonged emotional
and behavioural responses can limit participation in the
classroom, which may result in school disengagement,
academic failure, and/or social isolation (Beitchman et al.,
2001; Snow, 2014; Tommerdahl & Semingson, 2013).
SEBD encompasses a broad range of presentations and
disorders, which may or may not meet the criteria for the
diagnosis of a neurodevelopmental disorder as specified in
the
Diagnostic and Statistical Manual of Mental Disorders 5
(DSM-5) (American Psychiatric Association, 2013). The
representation of students with SEBD has increased in both
mainstream and specialist schools in Australia (Graham et
al., 2010; Van Bergen et al., 2015) and overseas (Hollo et
al., 2014; Stringer & Lozano, 2007) in the past decade. This
is reflected, for example, in the doubling of the number of
students funded under the severe behaviour category of the
Program for Students with Disabilities (PSD) in Victoria (see
Table 2) between 2006 and 2013. The number of students
who receive this form of funding rose from 706 to 1560
(Victorian Department of Education and Training, 2016), a
120% increase, compared to a 2.84% increase in total
student enrolments.
A
Student displays disturbed behaviour to a point where special
support in a withdrawal group or special class/unit is required;
AND
B
Student displays behaviour so deviant and with such frequency
and severity that they require regular psychological or psychiatric
treatment;
AND
C
The severe behaviour cannot be accounted for by: intellectual
disability, sensory (vision, hearing), physical and/or health issues,
autism spectrum disorder or severe language disorder;
AND
D
A history and evidence of an ongoing problem with an expectation
of continuation during the school years.
Source: Victorian Department of Education and Training, 2016
Table 2. Criteria for severe behaviour disorder
Risk factors for SEBD
The known risk factors for SEBD are consistent with many
of the risk factors for communication impairment (Cross,
2011). These include male gender (Graham et al., 2010;
Hollo et al., 2014), low SES (Bretherton et al., 2014), a
history of maltreatment (Cross, 2011; Lum, Powell, Timms,
& Snow, 2015), indigenous heritage (Bretherton et al.,
2014), being placed in out of home care (Cross, 2011;
Snow & Powell, 2011), and having a neurodevelopmental
disorder, such as autism spectrum disorder (Cole, Daniels,
& Visser, 2012). While the co-occurrence of multiple
neurodevelopmental disorders in children with SEBD is
beyond the scope of this discussion, it must be noted that
many students are diagnosed with more than one
neurodevelopmental disorder (Cole et al., 2012).