What Parents Need to Know when Disability Impacts Behavior and Discipline at School

A Brief Overview

  • Discussion about school-based discipline was pretty quiet during the pandemic. The topic is resurfacing as schools begin to reopen for in-person instruction. Read on for information about student rights in Washington and what families need to know when behavior impedes learning and disability may be a factor.
  • Schools are required to provide education and support before resorting to discipline. This article includes resources and information to help families ensure that students receive best-practice services and that disciplinary actions are non-discriminatory.
  • If the school calls to send a child home due to behavior, parents can ask whether the student is being suspended. If the school is not taking formal disciplinary action, parents are not required to take a child home. If the action is a suspension, specific rules apply. Read on for more detail. PAVE also provides a video with information about what to do if the school wants to send a child home due to behavior.
  • Families can seek individualized assistance by clicking Get Help from PAVE’s website, wapave.org.
  • Read on for information about Procedural Safeguards, which are downloadable through the Office of Superintendent of Public Instruction (OSPI), Washington’s lead educational agency.

Full Article

Behavior is a form of communication, and children often try to express their needs and wants more through behavior than words. When a young person has a disability or has experienced trauma or other distress, adults and authorities may need to put in extra effort to understand. Missed cues and unmet needs can result in unexpected and sometimes explosive behaviors, which may lead schools to suspend or expel students. Best practice is to meet behavioral health needs and support students before disciplinary action is necessary.

Unfortunately, not all students are adequately supported. Before the COVID-19 pandemic, state data indicated that students with disabilities were disciplined at least 2.5 times more often than non-disabled peers (See WA State Report Card). For students with disabilities who are Black, Indigenous, or People of Color (BIPOC), the numbers are consistently higher.

Although no one can predict what will happen as schools reopen for in-person services, research clearly indicates that children’s behavioral health has worsened during the pandemic. Governor Jay Inslee on March 14, 2021, issued an emergency proclamation declaring children’s mental health to be in crisis.

The governor’s order requires schools to provide in-person learning options at least part of the week and directs the Health Care Authority and Department of Health to “immediately begin work on recommendations on how to support the behavioral health needs of our children and youth over the next 6 to 12 months and to address and triage the full spectrum of rising pediatric behavioral health needs.”

As schools reopen, the topic of how to support expected behavior and avoid disciplinary removal from the classroom is resurfacing. Read on for foundational information about student and family rights in Washington.

What is exclusionary discipline?

Any school disciplinary action that takes a student away from their regularly scheduled placement at school is called exclusionary discipline. Out-of-school suspensions, expulsions, and in-school suspensions count. Another element is isolation/restraint, which is an emergency response to imminent danger and not disciplinary. See below for more detail.

Families can empower themselves to advocate for their students by learning the federal framework for school-based services. Students who receive accommodations and supports through a Section 504 Plan have anti-discrimination protections from the Rehabilitation Act of 1973. Students with an Individualized Education Program (IEP) have Section 504 protections and specific rights and protections from the Individuals with Disabilities Education Act (IDEA).

Exclusionary discipline may violate FAPE

A student with an identified disability may be suspended for a behavioral violation that is outlined in district policy. State guidance is for schools to suspend students only if there are significant safety concerns. Schools are limited in their ability to exclude students from school because of behaviors that “manifest” (arise or express) from disability.

Students with identified disabilities supported through either an IEP or a 504 Plan are afforded access to a Free Appropriate Public Education (FAPE). Disciplinary actions that deny access to FAPE may be discriminatory. In other words, if a student with disabilities has unmet needs and is consistently sent home instead of helped, the school may be held accountable.

Read on for information about Procedural Safeguards, which are downloadable through the Office of Superintendent of Public Instruction (OSPI), Washington’s lead educational agency.

Unexpected behavior may indicate a disability and need for services

School districts have a duty to evaluate students to determine eligibility for special education if they have learning challenges or exhibit behavior that may indicate a disability. Under IDEA, this responsibility is called Child Find.

The Office for Civil Rights within the U.S. Department of Education in December 2016 issued a two-page Fact Sheet that includes this statement: “A student’s behavioral challenges, such as those that lead to an emergency situation in which a school believes restraint or seclusion is a justified response could be a sign that the student actually has a disability and needs special education or related aids and services in order to receive FAPE.”

Manifestation Determination

To avoid FAPE violations, schools are required to document missed educational time and meet with family to review the student’s circumstances if the time a student has been suspended or otherwise removed from their academic placement for discipline adds up to 10 days. That meeting is called a Manifestation Determination. Manifestation Determination is a distinct process for students with known or suspected disabilities and is separate from general education disciplinary hearings or procedures.

Under Section 504, schools are bound to consider disability-related factors through Manifestation Determination if the disciplinary removal is for more than 10 consecutive school days or when the child is sub­jected to a series of removals that constitute a pattern. OSPI provides a guidance form for Section 504 circumstances.

For a student with an IEP, removal from regularly scheduled classes for more than 10 days per school year constitutes a “change of placement” and a Manifestation Determination meeting is held to determine whether the disciplinary removals resulted from the school’s failure to implement the IEP. OSPI provides a guidance form for IEP circumstances.

During a Manifestation Determination meeting, a student’s circumstances and services are reviewed. An IEP can be amended to provide additional support. For students not yet identified for special education services, this meeting can initiate or expedite an evaluation if the school district knew or should have known that the student needed special education services. 

Family members are included in this process. According to WAC 392-172A-05146, “If the school district, the parent, and relevant members of the student’s IEP team determine the conduct was a manifestation of the student’s disability, the school district must take immediate steps to remedy those deficiencies.”

If the conduct is determined to be unrelated to disability, then school personnel may use general education discipline procedures. The school must still provide any special education services that the student has already been found to need. The IEP team decides the appropriate alternative setting and special education services to meet the student’s needs while suspended.

Note: With the exception of a firearm violation under federal law, school districts are not required to suspend or expel students for any behavioral violation. State law explicitly encourages school districts to consider alternative actions before administering suspension or expulsion. If a student’s conduct involves weapons, illegal drugs, or serious bodily injury, a student may be removed for up to 45 school days regardless of whether the student’s behavior was a manifestation of disability. However, a manifestation determination meeting still is required within the first 10 days of removal from school and educational services are provided.

Schools are required to support behavior and work with families

Schools are required to provide education and support before resorting to discipline for children who struggle with behavior because of their impairments. Under the IDEA, when behavior impedes the child’s learning or that of others, the IEP Team is required to consider the use of positive behavioral interventions and supports, and other strategies, to address that behavior. When necessary (for FAPE), the team must include those supports in the IEP.

These requirements are described in a federal Dear Colleague letter from August 1, 2016: “We are issuing this guidance to clarify that the failure to consider and provide for needed behavioral supports through the IEP process is likely to result in a child not receiving a meaningful educational benefit or FAPE.”

The letter, provided by the U.S. Department of Education, recommends specific alternatives to disciplinary removal and includes detail about the rights of families when there are behavioral concerns: “In general, IEP Team meetings provide parents (who are required members of the team) critical opportunities to participate in the decision-making process, raise questions and concerns regarding their child’s behavior, and provide input on the types of behavioral supports their children may need.”

When a student is suspended, the school is required to submit a report to the family and the state. That report must include an explanation of how school staff attempted to de-escalate a situation before resorting to disciplinary removal. OSPI provides information for schools and families related to state guidance and requirements. A one-page introductory handout for parents is a place to begin.

As a local control state, individual school districts determine their specific policies related to disciplinary criteria and actions. According to OSPI, school districts are required to engage with community members and families when updating their discipline policies, which must align with state and federal regulations.

In general, Washington rules:

  • Encourage schools to minimize the use of suspensions and expulsions and focus instead on evidence-based, best-practice educational strategies
  • Prohibit schools from excluding students due to absences or tardiness
  • Limit use of exclusionary discipline for behaviors that do not present a safety threat
  • Prohibit expulsion for students in kindergarten through grade four (children in that age range cannot be excluded from their classroom placements/suspended for more than 10 cumulative days per academic term)
  • Require schools to provide educational access while a student is suspended or expelled

Schools must provide educational services during a suspension

State law requires that all suspended and expelled students have an opportunity to receive educational services (RCW 28A.600.015). According to the Washington Administrative Codes (WAC 392-400-610) educational services provided in an alternative setting must enable the student to:

  • Continue to participate in the general education curriculum
  • Meet the educational standards established within the district
  • Complete subject, grade-level, and graduation requirements

The American Civil Liberties Union of Washington provides a free, downloadable Parents’ Guide to Public School Discipline in Washington. Part III includes information about laws and procedures that are specific to students in special education. The ACLU guidebook encourages parents to gather as much information as possible when a student is disciplined:

“It is important to fully understand the type of proposed discipline, the underlying behavior, how the behavior relates to the student’s disability, and what additional supports may be available in order to fully advocate for your student.”

Schools can assess the behavior (FBA) to make a plan (BIP)

Regardless of whether the student has qualified for services, best practice is for the school to conduct a Functional Behavioral Assessment (FBA) following a significant disciplinary action. An FBA can be done for students with or without IEPs or Section 504 Plans.

The FBA is used to develop a Behavior Intervention Plan (BIP), which helps a child learn expected behaviors and prevent escalations. The BIP identifies target behaviors that disrupt learning and calls out “antecedents,” conditions or events that occur first—before the targeted behavior. A BIP supports “replacement” behavior so a student can develop skills for expected learning behaviors.  

In addition to a BIP, a student receiving special education services whose behavior impedes their learning may need Specially Designed Instruction (SDI) to support skill-development in an area of education called Social Emotional Learning (SEL). If targeted SEL instruction is needed, the student will have specific IEP goals to support the learning.

Another way that an IEP can support students with behavioral disabilities is through related services. Counseling can be written into an IEP as a related service. When included in a student’s IEP as educationally necessary for FAPE, a school district is responsible to provide and fund those services. School districts can receive reimbursement for 70 percent of the cost of behavioral health services for students who are covered by Medicaid and on an IEP.

All students access behavioral supports when schools use Multi-Tiered Systems of Support (MTSS). Families can ask school staff to describe their MTSS structure and how students receive support through Tier 1 (all students), Tier 2 (targeted groups), and Tier 3 (individualized support). An element of MTSS is Positive Behavioral Interventions and Supports (PBIS), which also supports students across levels of need.

PAVE provides an article with more information about MTSS/PBIS and how to support expected behaviors at school.

Do you need to pick up your student if the school calls?

In its guidance booklet, ACLU addresses the question, “Do you need to pick up your student every time the school calls?” A parent can ask whether the student is being suspended.  “If your student has not been officially suspended,” ACLU advises, “The school cannot force you to pick up the student.

“If you choose to pick up your student when he or she has not been suspended, the school may not record the removal from class and may not trigger additional protections (such as Manifestation Determination Hearings) that apply when students with disabilities are removed from school for 10 days or more.”

The ACLU guidebook includes a list of supports parents can ask for: “The law requires behavior supports to be based on evidence, and so you can ask for additional expert evaluation to determine whether the behavior supports offered to your student are appropriate.”

PAVE provides additional information about what to do if the school calls in a video.

Guidance related to isolation and restraint

The state has specific rules related to the use of isolation and restraint, which are implemented only when a student’s behavior poses an imminent likelihood of serious bodily harm and are discontinued when the likelihood of serious harm has passed. Isolation and restraint are not used as a form of standard discipline or aversive intervention.

The Washington State Governor’s Office of the Education Ombuds (OEO) offers an online resource page that details state guidance related to isolation and restraint. Included is this statement:

“Schools in Washington State are not allowed to use restraint or isolation as a form of discipline or punishment, or as a way to try to correct a child’s behavior. Restraint and isolation are only allowed as emergency measures, to be used if necessary, to keep a student or others safe from serious harm. They can continue only as long as the emergency continues.”

School districts are required to collect and report data on the use of restraint and isolation. That data is posted on OSPI’s website as part of the School Safety Resource Library. 

Emergency Response Protocol (ERP)

If emergency responses and/or severe disciplinary actions become frequent, schools might ask the parent/guardian to sign an Emergency Response Protocol (ERP) for an individual student. Families are not required to sign this.

The ERP explains what the school’s policies are related to isolation and restraint and what the training requirements are for staff authorized to conduct isolation and restraint. Parents can request a copy of the district’s general education policies on this topic. The ERP can include a statement about how parents are contacted if the school uses isolation or restraint.

Reporting requirements

Schools are required to provide a report to the parent/guardian and to the state any time formal disciplinary or emergency actions are taken. Following are statements from the Revised Code of Washington (RCW 28A.600.485):

“Any school employee, resource officer, or school security officer who uses isolation or restraint on a student during school-sponsored instruction or activities must inform the building administrator or building administrator’s designee as soon as possible, and within two business days submit a written report of the incident to the district office. The written report must include, at a minimum, the following information:

  • The date and time of the incident
  • The name and job title of the individual who administered the restraint or isolation
  • A description of the activity that led to the restraint or isolation
  • The type of restraint or isolation used on the student, including the duration
  • Whether the student or staff was physically injured during the restraint or isolation incident and any medical care provided
  • Any recommendations for changing the nature or amount of resources available to the student and staff members in order to avoid similar incidents”

The RCW also states that school staff “must make a reasonable effort to verbally inform the student’s parent or guardian within 24 hours of the incident and must send written notification as soon as practical but postmarked no later than five business days after the restraint or isolation occurred. If the school or school district customarily provides the parent or guardian with school-related information in a language other than English, the written report under this section must be provided to the parent or guardian in that language.”

Equity work in student discipline is ongoing

A graph that shows disparity in discipline is provided on OSPI’s website, which includes training and materials for schools to support improvements. “Like other states, Washington has experienced significant and persistent disparities in the discipline of students based upon race/ethnicity, disability status, language, sex and other factors,” OSPI’s website states. “While overall rates of exclusionary discipline (suspension and expulsion) have declined over the last decade, significant disparities persist. These trends warrant serious attention from school districts, as well as OSPI, to work toward equitable opportunities and outcomes for each and every student.”

Isolation and Restraint Practices Attract Media Attention

Disability Rights Washington (DRW) has published a video about school use of isolation and restraint. The video, which is posted to YouTube, was produced by DRW’s media program called Rooted in Rights. DRW is a private non-profit organization with a mission to advance the dignity, equality, and self-determination of people with disabilities. The agency is staffed with attorneys who pursue justice on matters related to human and legal rights.

In Washington State, isolation and restraint may be used if “reasonably necessary to control spontaneous behavior that poses an imminent likelihood of serious harm,” as defined in the Revised Code of Washington (RCW 70.96B.010). The isolation/restraint ends when the imminent likelihood of harm has passed. These practices are considered emergency responses and not disciplinary actions.

The Office of Superintendent of Public Instruction (OSPI) describes specific reporting requirements for schools to inform parents and the state about isolation and restraint incidents.

PAVE’s website, wapave.org, provides several articles that include information about isolation and restraint practices. Articles also describe ways to incorporate positive behavior supports into school programs to reduce the need for emergency response. An article titled, Ideas and Resources to Support Your Child’s Behavior at School, is a place to start.

Another option to research information on the topic is to type the word “Behavior” into the search bar at wapave.org to find additional articles. A comprehensive article about policies related to discipline is titled, What Parents Need to Know when Disability Impacts Behavior and Discipline at School.

Educators and policy makers generally agree that an evidence-based method to keep everyone safe and learning at school is to incorporate Positive Behavior Interventions and Supports (PBIS) into a school-wide program that focuses on a healthy school climate. PBIS is described in several of PAVE’s articles, including one contributed by University of Washington researcher Kelcey Schmitz: Positive Behavioral Interventions & Supports (PBIS) in Schools.

Implementation of PBIS varies widely across the state. Parents can ask their school district administrators about whether a PBIS framework is being used within the district.

 

 

Ideas and Resources to Support Your Child’s Behavior at School

A Brief Overview

  • Behavior specialists generally agree that difficult behaviors arise from unmet needs. How adults respond is critical if a child is going to learn new ways to communicate.
  • Humans spend about 80 percent of their brain energy trying to belong. This can explain a lot when a child with a disability feels isolated or unwanted and starts to act out.
  • Positive Behavior Interventions and Supports (PBIS) is a framework that a growing number of schools nationwide are using to improve school climate, which refers to the way a school feels to students and staff.
  • Members of the U.S. Congress discussed PBIS on February 27, 2019, when a committee heard public testimony regarding a bill that would regulate use of isolation and restraint in public schools. Positive behavior interventions are considered “protective” by behavior experts, and there is evidence that isolation and restraint cause trauma.
  • Read on for questions families can consider when they are trying to understand what’s happening with a child and how to intervene for the best outcomes.

Full Article

Families and teachers often struggle to figure out what to do when a child’s behavior at school is getting in the way of learning.  How adults respond to unexpected behavior can impact whether an incident leads down a path of worsening problems or toward improved learning. Parents can help by understanding as much as possible about what the child might be trying to communicate or overcome.

“Difficult behaviors result from unmet needs,” says David Pitonyak, PhD, an educational consultant, author and public speaker who specializes in behavior supports for children with disabilities. Pitonyak speaks nationally and provides a variety of online tools to help families and educators.

One example is a free, online presentation, “All Behavior is Meaning-full.” In it, Pitonyak includes a list of what might be missing when an unmet need leads to a behavior incident:

  • Meaningful relationships
  • A sense of safety and well-being
  • Power
  • Things to look forward to
  • A sense of value and self-worth
  • Relevant skills and knowledge

“Supporting a person requires us to get to know the person as a complicated human being influenced by a complex personal history,” Pitonyak says. “While it is tempting to look for a quick fix, which usually means attacking the person and his or her behavior, suppressing behavior without understanding something about the life the person is living is disrespectful and counterproductive….

“Our challenge is to find out what the person needs so that we can be more supportive.”

A running theme in Pitonyak’s work is that adults need to strengthen their own social and emotional skills in order to effectively help children. He often quotes another specialist in the field, Jean Clark: “A person’s needs are best met by people whose needs are met.” In other words, parents and teachers need to practice self-care and regulate their own behaviors and emotions to provide the best examples to children. Read on for a check-list that adults can use to develop their own skills while they help children.

A brain’s biggest job is to belong

Pitonyak is among specialists who believe that children act out because they feel misunderstood, devalued, lonely or powerless. Other growing themes are the importance of belonging and the human need to contribute meaningfully to a social group. Neuroscientists have found that humans spend about 80 percent of their brain energy trying to belong. This can explain a lot when a child with a disability feels isolated or unwanted and starts to act out.

Parents can use these concepts in a variety of ways to participate in their child’s educational program. Here are examples of questions to ask in any meeting with a school:

  • Who are the adults at school that my child trusts?
  • Does my child have special jobs or responsibilities, so he/she feels important at school?
  • Is someone regularly checking in with my child to see what’s going on?
  • How are positive behavior skills being taught and reinforced?

Positive Behavior Interventions and Supports (PBIS) is a framework that a growing number of schools nationwide are using to improve “school climate,” which refers to the way a school feels to its students and staff.

Schools that embrace PBIS generally create programs to help all students participate in well-being and then offer more targeted social, emotional and behavioral help to students who struggle the most. These different levels of intervention are called Multi-Tiered Systems of Support (MTSS). According to the federal PBIS website, “PBIS improves social, emotional and academic outcomes for all students, including students with disabilities and students from underrepresented groups.”

Information about federal guidelines and programs related to PBIS and MTSS are available online from the U.S. Department of Education’s Office of Special Education Programs (OSEP) and the Office of Elementary and Secondary Education (OESE). PAVE provides an article about PBIS, with parenting tips by Kelcey Schmitz, a longtime MTSS expert who previously worked for OSPI and now is part of the University of Washington’s School of Medicine and the School Mental Health Assessment, Research, & Training (SMART) Center.

PBIS is a protective strategy

The United States Congressional Committee on Education and Labor received training about PBIS on February 27, 2019, when they heard public testimony (YouTube video): Classrooms in Crisis: Examining the Inappropriate Use of Seclusion and Restraint Practices. Congress is considering legislation that would create a federal standard on accepted practice, accountability and training for teachers who might use isolation or restraint in an emergency.

National Public Radio reported about isolation and restraint in a June 5, 2019, broadcast that included personal comments from two families in Vancouver, Washington.

The State of Washington allows isolation and restraint by trained school staff if a student’s behavior poses an imminent threat of serious bodily harm. PAVE’s comprehensive article about discipline at school includes more information and resources about isolation and restraint, which is described by state law as an emergency response and not a form of disciplinary action.

Among those who provided public testimony for the U.S. Congress was George Sugai, PhD, professor of special education at the University of Connecticut who was a key developer of the PBIS framework. At the public hearing, Sugai spoke about the reduction in trauma among schools who embrace PBIS. He said teachers report more positive feelings toward their work and that students show more progress toward specific educational goals. “PBIS is a protective strategy,” he said.

The behavior itself holds the clues about what to do next

Sugai, who holds a Master of Arts and a PhD in special education from the University of Washington, spoke about understanding a child’s unmet needs. “We have to understand what children are communicating through their behavior,” he said. “The behavior itself holds the clues about what to do next.”

Washington’s Office of Superintendent of Public Instruction (OSPI), which oversees the state’s school districts, has a variety of programs underway to address school climate and improve staff training in Social Emotional Learning, equity in student discipline and development of Compassionate Schools. The state encourages use of a Behavior Intervention Plan (BIP), which promotes positive support and skill-building for expected school behavior. The plan is to prevent the need for disciplinary action or emergency response. A BIP is developed with data collected through a Functional Behavior Analysis (FBA), which is a best-practice tool for schools to figure out what help a student with challenging behavior might need. OSPI’s website includes examples of the FBA and BIP in its Model Forms.

OSPI’s family and community liaison, Scott Raub, partnered with a special services director from the Puget Sound’s Educational Service District 121 to create a slide presentation about isolation and restraint that is available as a free, downloadable PDF. The document is titled, Stop Using Restraint and Isolation: An Evolution or a REVOLUTION? The presentation includes specific guidance for school staff to use a Behavior Intervention Plan (BIP) as a strategy for managing behavior. A flow chart shows how early intervention might diffuse a situation to allow a student to remain in a more regulated state and stay in class. The document also provides detail about recent OSPI rulings about isolation and restraint raised through the Citizen’s Complaint process.

In accordance with the Revised Code of Washington (RCW 28A.600.485), “Restraint or isolation of any student is permitted only when reasonably necessary to control spontaneous behavior that poses an imminent likelihood of serious harm. Restraint or isolation must be closely monitored to prevent harm to the student, and must be discontinued as soon as the likelihood of serious harm has dissipated. Each school district shall adopt a policy providing for the least amount of restraint or isolation appropriate to protect the safety of students and staff under such circumstances.”

In the slide presentation, designed for schools and publicly available, OSPI provides detail about what “imminent likelihood of serious harm” can look like and provides direct guidance to staff, including these statements:

  • Emergency Response Protocols are NOT a substitute for BIPs.
  • BIPs must be updated as part of student’s annual IEP [review].
  • The time to end isolation and restraint is as soon as the likelihood of serious harm has dissipated; this is not equivalent to waiting until the student has calmed.

A state workgroup to study Social Emotional Learning (SEL) in October 2016 proposed a set of Standards and Benchmarks to help school staff identify how best to help children who struggle with their behavior, social skills and emotional regulation. The group established six standards with specific benchmarks. A report from that workgroup includes a chart of the standards (Page 3). Families can share this information with schools when trying to identify what’s happening with a child and what interventions might help.

Below is a brief overview of those SEL standards and a few questions parents can bring to the table. In each target area, parents can ask what school staff are doing to help. This check-list also can be a good starting-point for adults who want to work on their own emotional regulation and coping strategies.

1. Self-Awareness

  • Can the student identify and understand emotions?
  • What is the student good at or interested in?
  • How are family, school and community agencies helping as a team?

2.Self-Management

  • Can the student express emotions and manage stress constructively?
  • What problem-solving skills are in place or need to be learned?

3. Self-Efficacy (self-motivated/seeing self as capable)

  • Can the student understand and work toward a goal?
  • Can the student show problem-solving skills?
  • Can the student request what he/she needs?

4. Social Awareness

  • Can the student recognize another person’s emotions?
  • Can the student show respect for others who are different?
  • Can the student accept another cultural perspective?

5. Social Management

  • Does the student have ways to communicate?
  • Can the student take steps to resolve conflicts with other people?
  • Does the student have constructive relationships with a variety of people?

6. Social Engagement

  • Does the student feel responsibility as part of a community?
  • Can the student work with others to achieve a goal?
  • Does the student contribute productively and recognize his/her contribution?

Additional Resources

PAVE provides a series of three articles with more information and resources about Social Emotional Learning (SEL).

Many parents struggle in their communications with the school when a child’s specific disability and its impact on behavior is not well understood. A place to research specific disabilities related to mental health, such as Oppositional Defiance Disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD) or Disruptive Mood Dysregulation Disorder (DMDD) is the Child Mind Institute.

A resource for better understanding how children might behave in response to trauma or Adverse Childhood Experiences (ACEs) is the Children’s Health Foundation.

An agency called GoZen offers an online article about Eight Ways a Child’s Anxiety Shows up at Something Else. Included in the list: difficulty sleeping, anger, defiance, lack of focus, avoidance, negativity, over-planning and “chandeliering,” which refers to a full-blown tantrum that seemingly comes out of nowhere. In addition to its free online articles, GoZen provides fee-based programs on resilience.