Depression among exceptional children

Fifty percent of the children under 15 who committed suicide within a 3-year period in Los Angeles County were identified as students with learning disabilities.

Teenage suicide rates have continued to increase steadily over the past several decades; suicide is the third leading cause of death in U.S. youths between the ages of 15 and 24. Depression, a contributing factor in 60 percent of suicides, has become a life-threatening problem among our children and youth.

The relationship between suicide and depression makes it important for educators to be knowledgeable about symptoms of depression. Carol Wright-Strawderman, Special Education Administrator, and Joseph R. Flippo, Psychologist, Las Lunas, New Mexico, Public Schools; Pam Lindsey, Texas Tech University; and Lori Navarette, Kansas State University, describe the role educators can play in identifying students with depressive symptoms. They also suggest effective intervention practices for schools.

Elementary children with depression often display physical symptoms such as chronic headaches or stomach aches. Depressed children sometimes have difficulty concentrating on schoolwork, describe themselves as unlikable or without friends, and become sluggish or inactive. Gifted children and students with disabilities — in particular, learning problems and conduct disorders — appear to be at a greater risk for depression.

Several characteristics have been identified as typical of children and adolescents with depression including: low self-esteem, hopelessness, suicidal thoughts and behavior, changes in appetite or sleep patterns, poor concentration, and negative expressions about the future.

The inability to form or maintain friendships, poor social problem-solving skills or a problem controlling impulses are also common in youngsters with depression. Significant changes in a student’s behavior or appearance should alert school personnel to potential problems.

Self-reporting scales helpful

Teachers are in a unique position to detect signs of depression in students, and research has shown them to be accurate observers of these symptoms. Assessment by a mental health professional should be encouraged when school personnel become concerned. Self-reporting scales are very helpful in identifying feelings of sadness, worthlessness, or loss of interest in enjoyable activities. The Children’s Depression Inventory, the most widely used, is designed for children aged 7 to 17 years. It contains 27 items, each made up of three statements each from which the student herself chooses the one that best describes her during the past two weeks.

Specific risk factors for suicide include depression, decreased inhibition due to drug use, talk of or previous attempts at suicide, access to lethal means, and severe stress or crisis.

A crisis in a child’s life, such as a recent death or divorce in the family, chronic illness or public humiliation, is an important warning sign of potential suicide. It is important to remember that it is not the type of loss that is critical, but rather how much the loss means to the student. Certain personality traits have also been associated with people who commit suicide, including impulsivity, aggressiveness, cognitive rigidity, excessive perfectionism and hopelessness.

Intervening to help these youngsters is a team effort between school, home and clinic. An important contribution from teachers is the tracking of the student’s behavior and mood. Depressed students often need encouragement to participate in classroom activities. Feelings of hopelessness and helplessness often cause them to exhibit “learned helplessness.”

They believe that their behavior does not influence events in their lives and that they are unable to make substantial changes in life situations. A failed exam is attributed to their innate stupidity and a good grade to luck. Setting excessively stringent, unattainable standards for performance can also result in depression. These attitudes need to be made apparent to the student, who needs guidance to evaluate and change them. Teaching children to give themselves a “pat on the back” has proved an effective component of academic and behavioral strategy training with learning-disabled students.

Teachers play an important role in identifying and supporting students with depression. These researchers urge teachers to take immediate action when a student’s behavior suggests depression. They recommend that one person on the school team be responsible for maintaining communication between all those involved in the student’s life. Policies and procedures, as well as referrals and parent notifications, should be carefully documented.

“Depression in Students with Disabilities: Recognition and Intervention Strategies” Intervention in School and Clinic Volume 31, Number 5, May 1996 pp. 261-273.

Published in ERN September/October 1996 Volume 9 Number 4

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