JCPSLP November 2017

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 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). Table 2. Criteria for severe behaviour disorder

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

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JCPSLP Volume 19, Number 3 2017

Journal of Clinical Practice in Speech-Language Pathology

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