EDUCATING THE EDUCATORS

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1 EDUCATING THE EDUCATORS A Professional Development Program of NAMI Massachusetts Newburyport School District May 7, 2015 Copyrighted and Developed by NAMI NJ

2 GREAT Teachers are the Product of Nurture and Nature

3 OUR PRESENTERS: 1. Physician Clinical Aspects 2. Educator Classroom Strategies 3. Parent Family Experience

4 THIS PRESENTATION OF EDUCATING THE EDUCATORS IS DEDICATED TO THE MEMORY OF JAMES GAUTHIER

5 Part 1 PHYSICIAN WHAT IS MENTAL ILLNESS?

6 MENTAL ILLNESS is: Biologic disease which causes: Physical changes in the brain Changes in thinking, emotion and behavior.

7 RECOVERY Every child has an age/ developmentally appropriate responsibility for managing his/her own illness and pursuing recovery.

8 ACCENTUATE THE POSITIVE Build upon assets of Child Family Teacher(s) and school staff Improve communication Provide predictable environment

9 HOW MENTAL ILLNESS AFFECTS LEARNING Emotional Readiness Concentration Thinking Recall of Information Side Effects of Medication

10 MAJOR DEPRESSION

11 MAJOR DEPRESSION Depressed mood (or Irritable mood) or diminished interest in activities (BORED!) Changes in appetite, sleep, lack of energy, loss of self esteem or guilt, difficulty concentrating. Suicidal thoughts and ideas

12 CAUSES of DEPRESSION Strong family history, genetic predisposition (altered receptors for serotonin) Environmental and physical stressors Biologic changes in the brain with alteration of brain function.

13 BRAIN SCAN

14 MAJOR DEPRESSION In Children and Teens. IRRITABILITY is COMMON

15 DISRUPTIVE MOOD DYSREGULATION DISORDER New diagnosis added to DSM 5 because of concerns about over-diagnosis of Bipolar Disorder. Children up to age 12 with chronic, severe persistent irritability and angry mood who have frequent temper outbursts.

16 TREATMENT OF DEPRESSION UNDERSTAND THAT THESE STUDENTS HAVE DIFFICULTY GETTING UP IN THE MORNING, GETTING THEIR WORK DONE, ETC. IF WITHDRAWN, REACH OUT TO THEM COGNITIVE BEHAVIORAL THERAPY MEDICATION FRIENDS NEED TO TALK TO STAFF OR PARENT IF STUDENT MENTIONS SUICIDAL THOUGHTS

17 ATTENTION DEFICIT HYPERACTIVITY DISORDER

18 ADHD A Neurodevelopment Disorder characterized by impairing levels of: Inattention and disorganization Hyperactivity-impulsiveness more frequent and severe than normally seen in individuals at a comparable level of development.

19

20 ADHD MANAGEMENT STRATEGIES Psychological factors, learning ability, executive functions, social skills, self-control strategies. School and home support and behavioral management Medication

21 OPPOSITIONAL DEFIANT DISORDER Recurrent pattern of irritable mood, defiant behavior and being argumentative. Typically blames others for negative occurrences Less intense emotionality, frequency and chronicity than Disruptive Mood Dysregulation Disorder

22 HOW TO DIFFERENTIATE BIPOLAR DISORDER FROM ADHD

23 ANXIETY

24 ANXIETY DISORDERS Generalized Anxiety Disorder (GAD) Social Anxiety Disorder Panic Disorder Specific Phobias Post Traumatic Stress Disorder and Obsessive Compulsive Disorder are now classified separately

25 ANXIETY DISORDERS (cont.) Involve a physiological state of hyperarousal Tend to run in families More common than any other disorders discussed and exacerbate the other problems Can be addressed by a variety of behavioral methods eg deep breathing

26 POST TRAUMATIC STRESS DISORDER EXPOSURE TO ACTUAL OR THREATENED DEATH, SERIOUS INJURY OR SEXUAL VIOLENCE PRESENCE OF INTRUSIVE SYMPTOMS PERSISTENT AVOIDANCE OF STIMULI NEGATIVE ALTERATIONS IN COGNITIONS AND MOOD MARKED ALTERATIONS IN AROUSAL AND REACTIVITY ALL OF THESE ARE ASSOCIATED WITH THE TRAUMATIC EVENT

27 Let s Summarize Major Depression ADHD Anxiety Disorders

28 Mental Illness: Shared Concerns Physician/Educator/Parent/Family Downward trajectory of functioning Associated disorders and symptoms Aggression towards self or others Violent Behavior Suicidal ideation School and family stressors

29

30 Part 2 Teacher Perspective

31 1 in 5 1 in 5 persons will have mental illness at some time in their lives. They all are treatable!

32

33 Stigma + Bullying* Students who bully are: Easily Frustrated Lack Empathy * Affects 25% of all students either as bully or victim. Students who are bullied are at risk for: Depression Anxiety Disorders Other Consequences.

34

35 Keys to Successful Strategies Let students know that you care. Acknowledge their daily struggles. Try to focus on what they can & do accomplish.

36 Depression

37 SUGGESTED STRATEGIES* FOR TEACHING STUDENTS WITH DEPRESSION: Frequent, consistent feedback: Academic/social/behavioral Assist Student Goals: Daily/weekly/monthly Frequent Monitoring: Encouraging asking for help Develop Accommodations: Respond to fluctuations; mood and attitude Work with Team (Counselor): Coordinate interventions; monitor thoughts. *Refer to handout for specific situational strategies

38 Call the National Prevention Suicide Hotline TALK (8255) available 24/7 -IS PREVENTABLE More than 12,000 teens die each year by suicide More than 72,000 teens are treated in the ER each year for suicide attempts (CDC, 2003a) If you are thinking about suicide or you know someone who is, please talk to a trusted adult

39

40 Strategies* for Teaching Students with ADD/ADHD For inattention: Classroom physical arrangement (Spacing). Provide study outlines ahead of time (Notes for key concepts and review orally). Oral Directions: (Short, sequential [1 step]; repeat back, if confused. *Refer to handout for more specifics

41 Strategies* for Teaching Students with ADHD For Hyperactivity: Lessons Active (Charts, drawings, physical activity). Scheduled/Unscheduled Breaks Peer Buddy *Refer to handout for strategizing diverse challenges

42 Strategies* for Teaching Students with ADD/ADHD For Disorganization: Use Assignment Book; Check regularly Written Assignments on Board (Review) Consistent Classroom Routines Student explains assignments; What needs to be done *See Handout for Expanded Strategies

43 Strategies* for Teaching Students with ADD/ADHD For Impulsivity: Establish clear posted rules for classroom behavior; review frequently. Keep environment structured; Avoid 3 D s (Downtime, Distraction, Delay) Assist students in new transitions *See handout for expanded strategies

44

45 Activities Difficult for Students with Anxiety Unstructured Times Transitions Writing Demands Social Demands Novel Events Unexpected Changes in Routine Minahan/Rappaport, 2014

46 Strategies for Teaching Students with Anxiety Disorders (Vary by level: Elementary, Middle, High School) Visual Schedules: Assignments/Deadlines Preferential Seating: Placement Breaking Down: Long-range assignments into manageable steps requiring frequent check-ins Alternate Output/Portfolio: Independent study/problem-based learning, whenever possible (oral presentation) Pairing: Peer Buddy

47 Strategies for Teaching Students with Anxiety Disorders (Vary by level: Elementary, Middle, High School) Directions Oral/Written: Shorten; Sequential Homework Expectations: Time Class Participation: Signals; Opportunity to share knowledge Class Presentations: Alone; Small Group. Partner Extended Test Time: 50%; SAT Model Transition Prep: What s next/different?

48 See Page 6 of Handout for Situational Strategies for Teaching Students Who Live with Anxiety

49 RTI: Response to Intervention Utilization of Student Assistance Team (Child Study Team: Psychologist; Nurse; Counselor; Principal, etc.) 1. For students not yet identified as students in need: Teacher (s) shares observations (Data) from class and parent contact & input asking: What can I do as a classroom teacher if I suspect that a student is dealing with anxiety issues?

50 RTI 2. Academic availability: Is this child not available for learning because of anxiety? 3. How do I rule out learning disorder? Family issues or involvement? Trauma history? 4. Formal Assessments? BASC-2

51 Let s summarize Accentuate the Positive For inappropriate behavior For low frustration level For obsessive compulsive behavior/worry For fluctuations in mood and attitude

52

53 Part 3 Parent Perspective

54

55 THE KIDS WHO NEED THE MOST LOVE WILL OFTEN ASK FOR IT IN THE MOST UNLOVING OF WAYS.

56

57

58

59 I m sometimes asked

60

61 STAGES OF EMOTIONAL RESPONSE 1. Dealing with the Catastrophic Event Crisis/Chaos/Shock Denial Hoping-Against-Hope NEEDS: Support, Comfort, Empathy, Resources, Crisis intervention, Prognosis.

62 STAGES OF EMOTIONAL RESPONSE 2. Learning to Cope Anger/Guilt/Resentment Recognition Grief NEEDS: Vent feelings, Keep hope, Education, Self- care, Networking, Skill training, Letting go, Cooperation from systems.

63 STAGES OF EMOTIONAL RESPONSE 3. Moving toward Advocacy Understanding Acceptance Advocacy/Action NEEDS: Activism, Open-mindedness of others, Restoring balance in life, Responsiveness from system.

64 Here s my take-home message: The attributes of the teachers most effective with my son were: My son responded by:

65

66

67 Freedom from Stigma!

68

69 NAMI Mass Schrafft Center 529 Main Street Boston, MA namimass.org

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