George

Children with covert antisocial behavior often exhibit overt antisocial behavior as well. In fact, multiple problems are more the norm than are isolated problems. George is a case in point.

George's first grade teacher, Mrs. Anderson, came to the child study meeting concerned about his behavior, which was frightening her and her other students. George was highly noncompliant, aggressive, and abusive to himself and others. Some teachers thought George should have a full evaluation immediately, but an administrator demanded prereferral strategies in Mrs. Anderson's class. Mrs. Anderson was visibly upset, even though she was given a list of strategies recommended by "experts."

Mrs. Anderson faithfully followed the strategies and documented the results for two weeks. George was no better. She described George's daily fights with his classmates. She also told the child study committee how George had stolen a tooth from another child's backpack in an attempt to get a reward from the "tooth fairy." After he was told that if he lost one of his own teeth he would get the reward, but not if he stole someone else's tooth, George put a block in his mouth, chomped hard on it, broke his tooth, and demanded a reward. The school nurse corroborated the story.

The administrator who had demanded prereferral strategies maintained that the female teachers were over reacting, that George was just a normal, active little boy. However, George's fighting, cursing, and stealing increased in spite of the best efforts of the teachers. In fact, his behavior got worse. Mrs. Anderson refused to plead his case before the child study committee anymore. "What does it take to get you people to refer a student? Murder? Suicide?"

George stomped the innards out of a dead bird one day on the playground. He cackled and laughed while stomping. He hit a teacher who tried to stop him from throwing rocks at other kids on the playground. And his teacher told others that one day he stroked her breast and said, "This'll be our secret. Don't tell anyone, and we can do it again."

The final act that got George referred was hanging from a railing around open steps to the basement level of the school. Had he lost his grip, he likely would have been very seriously injured or killed. He was finally referred, found eligible for special education, and placed in a special class for students with emotional disturbance. The class was on the second floor of the school, and George made repeated attempts to jump out of the window. After being moved to another school with only one floor, he tried repeatedly to run away, and his violence escalated.

1. What might have been done to prevent George's increasingly troublesome behavior?

The teacher should have documented every incidence of problem behavior from the start. She could have also acted like she was not as bothered by the behavior as she was. If she was confronting George in front of the class, this may have escalated the problem behaviors.

2. If George were your student, what would be your primary objective? Why?

I would be concerned of the fact that George exhibits signs of conduct disorder such as aggression toward people and animals, theft, inappropriate sexual conduct, and running away. My concerns also include a lack of remorse shown by George. Therefore, my primary objective would be to ensure the welfare of George’s classmates. Then, I would determine why he is acting out, so that I can teach a new, more appropriate replacement behaviors.

3. What suggestions would you have given Mrs. Anderson for prereferral interventions?

I would have suggested proximity control, positive/negative reinforcement systems, and ask for additional support in the classroom. I would try to build a positive relationship with George and his family. I would communicate my concerns to the family in a way that is appropriate and non-threatening. I would also draw on George’s interests to keep him involved in the classroom. The busier George is kept, the less likely he will disrupt the class. Also George seems to be stressed when changes are made. It is possible that Mrs. Anderson’s classroom is not structured enough for George and that she may not have a set routine. If this is the case, I would definitely suggest her working on that to not only benefit George, but also benefit any other students that need a highly structured environment.