Students with emotional and behavioral disorders (EBD) often pose formidable challenges to school-site personnel as well as society in general. These students represent a varied group of individuals, encompassing both major behavioral disorders of childhood: externalizing and internalizing behaviors (Achenbach, 1991; H. M. Walker, 2003). Students with externalizing behaviors (referred to as undercontrolled behaviors) are most easily recognized by teachers, even without systematic screening efforts, as these youth present with outward directed behaviors such as verbal and physical aggression as well as coercive tactics (e.g., arguing). Clearly, these behaviors tend to disrupt instruction by quickly capturing teachers' attention (Bradshaw, Buckley, & lalongo, 2008; Crick, Crotpeter, & Bigbee, 2002; Eisenberg et al., 2009). In contrast, students with internalizing behaviors (referred to as overcontrolled behaviors) often go unnoticed by teachers as their behaviors tend to be directed inward. Such behaviors include anxiety, depression, social withdrawal, and even self-inflicted pain (Kovacs & Devlin, 1998; Morris, Shah, & Morris, 2002).
Overall, prevalence estimates report between 2% and 20% of school-age youth evidencing some form of EBD, with conservative estimates suggesting 6% (Kauffman & Brigham, 2009). Recent figures suggest 20% of students have at least some mild manifestations of EBD (Forness, Freeman, Paparella, Kauffman, & Walker, 2012). Not surprisingly, these students with internalizing behaviors are less apt to receive supports and services relative to students with externalizing behaviors (Bradshaw et al., 2008). This reality is disturbing given prevalence estimates that suggest internalizing behaviors are more common than one might expect and are highly likely to persist into adulthood (Kessler, Berglund, Dernier, Jin, & Walkers, 2005). Approximately 5.8% to 17.5% of school-age youth have anxiety disorders (Breton et al., 1999). Childhood depression rates indicate that 2.8% of children younger than 1 3 years and 5.6% of youth 13 to 18 years of age experience this disorder (Costello, Erkanli, & Angold, 2006), with 15.9% of school-age students demonstrating comorbidity (Brady & Kendall, 1992). Furthermore, 28.4% of middle school youth manifest self-injurious behavior (Alfonso & Dedrick, 2010).
In the absence of effective interventions, these students struggle socially, behaviorally, and academically during the school years. For example, antisocial behaviors (McEvoy & Welker, 2000), limited social skills (Caprara, Barbaranelli, Pastorelli, Bandura, & Zimbardo, 2000; Malecki & Elliott, 2002), as well as anxiety and depression (Rapport, Denny, Chung, & Hustace, 2001) negatively affect students' academic performance and impede their ability to successfully negotiate student and adult interactions. Furthermore, students with EBD continue to struggle during postsecondary experiences, as demonstrated by unemployment, continued need for mental health supports, and strained interpersonal relationships (Masten et al., 2005; Siperstein, Wiley, & Forness, 2011; H. M. Walker, Ramsey, & Gresham, 2004).
It is essential to identify and support these students at the earliest possible juncture - at the first sign of behavioral concern and as early as possible in their educational careers (Lane et al., 2013) - when behaviors are most amenable to intervention efforts (Kazdin, 1 993). For the vast majority of students, supports will be provided by the general education community as less than 1% of school-age youth with EBD go on to manifest behavioral patterns severe enough to warrant special education services under the category of emotional disturbance (Individuals with Disabilities Education Improvement Act [IDEA], 2004). Even if students do qualify for special education services, the goal is inclusive programming, again indicating the need to empower the general education community to support students with behavioral challenges (Wagner, Newman, Cameto, Levine, & Garza, 2006). …