Suicide and Students With High-Incidence Disabilities: What Special Educators Need to Know

As we learned in Module 9, depression and suicidal thoughts or actions are serious issues that affect thousands of adolescents each year. As the article states, "Within a typical high school classroom, it is likely that three students (one boy and two girls) have made a suicide attempt in the past year," with suicide being the "third leading cause of death in individuals ages 10 to 24 (Wachter & Bouck, 2008, p.66). About "17% to 29% of secondary school students seriously consider suicide" while "8% attempt suicide" (Wachter, et al., 2008, p.66). While these statistics are already shockingly high, they only go up for adolescents with high incidence disabilities.  Adolescents with high incidence disabilities are more likely to have a lack of social support, due to fewer school supports and social isolation, and are statistically more susceptible to depression that their peers. In fact, the article states that approximately 50% of students who are eligible for special education services could also be diagnosed as depressed" (Wachter, et al., 2008, p.66). These risk factors mean that adolescents with high incidence disabilities tend to "think more about suicide and make more suicide attempts than their peers without a disability" (Wachter, et al., p.67). Due to these alarming correlations, it is extremely important for teachers working with students with high incidence disabilities to know the warning signs and how to properly intervene. The article suggests teachers implement preventive measures, such as school-wide programs or classroom presentations by school counselors, that can educate students on how to recognize when a peer is in trouble or can teach students "coping skills for anger, sadness, and anxiety" (Wachter, et al., p.68). However, these programs will not always be enough. The article goes on to list common signs of danger, or "indicators that a student may be going through personal difficulties and should be monitored," and imminent risk, which "indicate a need for immediate intervention" (Wachter, et al., p.68). Finally, the article lists many important and practical tips on how to address students who are considering suicide, most importantly, always "taking all threats or signs seriously, even if the student seems to be attention seeking" (Wachter, et al., p.70). 

After completing the textbook reading and watching the videos in module 9 about depression and bullying, I was deeply sadden by how prevalent suicide has become for adolescents. As the textbook states, adolescence is a time of "storm and stress," when students "tend to be sensitive to criticism  easily take offense at comments made by peers and family, and display inconsistent behaviors, moodiness, and often self-consciousness" (Smith, Gartin, & Murdick, 2012, p.4). For adolescents with disabilities, "these changes may be compounded by the characteristics of the individual disability" (Smith, et al., 2012, p.5). Many students with high-incidence disabilities have "social skill deficits" that can result in "difficulty in developing friendships and successful peer relationships," as well as "low self-esteem, imperfect self-awareness, and flawed self-perception" (Smith, et al., 2012, p. 12). These overwhelming social and emotional changes can often cause "anxiety, depression, or acting-out behaviors" (Smith, et al., 2012, p. 12). As shown in the article, due to all these compounding factors, adolescents with high incidence disabilities have a greater risk for depression and suicidal thoughts and actions. Because of these alarming statistics, I felt this article was a good choice for this week's blog post. Not only does the article connect closely to the reading, but also offers practical strategies and tips for handling these issues safely and effectively. 

I found this article to be very practical and would recommend it to all teachers, not only those working with the special education population. The tips and strategies listed in the article to help identify students in the danger or imminent risk stages are something all educators should be familiar with. While students with high incidence disabilities may be at a higher risk for suicidal thoughts and actions, as the statistics in the videos and this article show, depression and suicide can sadly be a major issue for all adolescents. The strategies listed for addressing students who are considering suicide may seem like common sense, however, when put in such a high-risk and dangerous situation, they are things that must be kept in mind, especially for a special education teacher who may be more likely to encounter a depressed or even suicidal student. With adolescent depression and suicide being such a prevalent and alarming issue in society today, I believe training, preventative and intervention, or at the very least, reading an article such as this one, should be made mandatory for all teachers. 

Smith, T.E.C., Gartin, B., & Murdick, N.L. (2012). Including Adolescents with Disabilities in General Education Classrooms. Upper Saddle River, NJ: Pearson. 

Wachter, C. A., & Bouck, E. C. (2008). Suicide and Students With High-Incidence Disabilities.Teaching Exceptional Children, 41(1), 66-72.

Different Service Delivery Models for Different Communication Disorders

The article I read this week, Different Service Delivery Models for Different Communication Disorders, focused on the impact communication disorders can have on a student and how important intensive speech and language services are on not only their education, but their social experiences and post-school opportunities. Nippold (2012) states that communication disorders, especially language disorders, can have a tremendous impact on a student's "academic, social, and vocational success" (p. 117). Nippold (2012) goes on to state that students who are diagnosed with language disorders in kindergarten "continue to lag behind their typically developing peers in spoken and written language development throughout the school-age years" causing "poorer academic outcomes, weaker social competence, and higher rates of rule-breaking behavior compared to their typically developing peers" (p. 117). Not only are these students less likely to graduate from high school with their peers, but also "less likely to attend college, and that when they do obtain employment, it is often at a substantially lower salary" (Nippold, 2012, p. 117). However, students with language disorders are not doomed to follow this path; Nippold offers possible solutions to these troubling finds. Instead of the commonly used "pull-out" model, in which students are pulled out of the room once or twice a week for usually 30 minute sessions with a speech-language pathologist, Nippold (2012) argues that effective intervention for language disorders must be "frequent and intense," promoting "children’s active attention; and that children receive corrective feedback on their responses and praise for their efforts and successes" (p. 118). Not only should intervention occur as early as possible, but should also closely include other school staff, especially the classroom teacher, a special education teacher, and a school counselor, to help with reducing the student's frustration and creating a supportive environment. Nippold states that while the "pull-out" model may be ideal for students with speech disorders, such as stuttering, it is not always the most effective option for students with language disorders. 

I found this article definitely connected with our reading this week on communication disorders. Nippold's startling facts about the impact a language disorder can have on a person's life are echoed in the textbook. The reading states that, because "communication skills are an essential part of social relations," the social behavior of a student is often affected by their communication disorder, often resulting in "withdrawn behavior" or "undesirable interactions such as aggression or disruption" (McLeskey, Rosenberg, & Westling, 2013, p. 131). Also, there is a strong correlation between communication disorders and behavioral and emotional disabilities, with "71% of students who were labeled with emotional and behavioral disabilities also having language deficits" and "57% of the students identified with language deficits also were classified as having emotional and behavioral disabilities" (McLeskey, et al., 2013, p. 131). In my classroom at Elim, all eight students use AAC devices to communicate due to a variety of language deficits. While not all of our students have behavior problems at school, those who do are often triggered by frustration due to not being understood or not being able to effectively communicate their thoughts. I believe the correlation between communication disorders and emotional or behavioral disabilities is a very evident in our room. To help remediate this issue, the students receive many of the services suggested by Nippold in the article, including speech services with our speech-language pathologist, taking part in a speech group as a class, receiving counseling services, and also receiving assistance in using their AAC devices effectively from the teacher and aides. 

I thought this article was very informative and the facts that Nippold shared about how important early language intervention is were extremely alarming. While I found her research and solutions very well done, I would have like some more concrete strategies for teachers to use in the classroom to help these students and be an effective piece of the intervention plan. Also, while I understand how important intense intervention is for students with language disorders, Nippold herself states that many speech-language pathologists in schools are already stretched thin, many working with over 60+ students, all with very different and demanding communication disorders. I agree with Nippold, that until school districts are able to fund multiple SLP's, maybe even those who focus solely on particular communication disorders, frequent and intense intervention such as she suggests may not always, unfortunately, be possible. 

McLeskey, J., Rosenberg, M.S., & Westling, D.L. (2013). Inclusion: Effective Practices for All Students. Upper Saddle River, NJ: Pearson.

Nippold, M. A. (2012). Different Service Delivery Models for Different Communication Disorders. Language, Speech & Hearing Services In Schools, 43(2), 117-120.

Mainstreaming v. Special School Placement for Students with ASD

This week, the article I read focused on a study completed by British psychologists on whether mainstreaming is truly the best practice for students with Autism Spectrum Disorder. As the article states, about 60 percent of students with ASD in the UK are placed in mainstreamed educational settings (Reed, Osborne, & Waddington, 2012, p.750). Many supporters of mainstreaming argue that ASD students should be placed in general education settings as frequently as possible particularly because of the social development benefits due to modeling by peers.  However, the authors of the study argue that, for students with ASD in particular, studies "have shown significant improvements in social skills for children placed in special placement" rather than general education placements and even that "several studies have shown particularly poor performance for children with ASD placed in mainstream schools" (Reed et al., 2012, p. 751). The authors of the article argue that, "for a population with ASD, it appears that social interactions may well be the domain that is most vulnerable to negative impact by mainstream placement" due to "problems with teacher training," "unrealistic teacher expectations," and "the impact of parent confidence and stress on their children’s performance" (Reed et al., 2012, p. 751). They believe that these issues, resulting from a mainstreamed placement, result in higher levels of stress and challenging behaviors for students with ASD. To test out their beliefs, the researchers administered questionnaires to students with ASD, attending both specialized and general education schools, and their parents in the beginning of the school year and then gave the same questionnaire nine months later. The questionnaire measured the students' strengths and weaknesses, as well as their adaptive behavior. The results showed that "children placed in special schools made greater improvements in their behaviour problems" and while "children with ASD can make progress in areas of adaptive behaviours when placed in mainstream schools, they do not make greater progress than children placed in special schools in socialisation" (Reed et al., 2012, p. 759). 

I found this article to be particularly interesting because of my current position as a paraeducator in a specialized school setting. At Elim Christian School, we have many students with Autism that, due to severe communication or behavior issues, cannot be mainstreamed into a general education setting. These students display many of the characteristics described in our textbook, such as "significant limitations in expressive and receptive language," "difficulties in social reciprocity," and " repetitive, stereotypical, and ritualistic behaviors," however many to an extreme degree (McLeskey, Rosenberg, & Westling, 2013, p. 113). Many of these students also exhibit the many of the challenging behaviors listed in the Autism Speaks toolkit, including aggressive and self-injurious behaviors. Due to my experience working with these students, I understand why the least-restrictive environment does not always mean a general education setting. Many school districts do not have the level of training, staff, or specific resources needed to educate and keep these students safe. As the Autism Speaks toolkit outlined, students with ASD can have episodes that escalate into emergency situations and it may take a team of staff to safely and successfully execute a crisis plan. Specialized school settings, such as Elim, can also adapt the environment specifically for students with ASD. At Elim Christian School, we have the ACE, or Autism Comprehensive Educational, Program that is housed in a special wing of the school where everything from the type of lightbulbs used to the playground outside are specifically tailored for students with ASD and their sensory needs. Accommodations like this are too extreme and not realistically expected in a mainstreamed setting.

While I work at a specialized school setting and think it can be a great place for some students with ASD, I believe the authors of this article are far too biased against mainstream settings. From the beginning of the article, it is evident that they do not believe students with ASD can function in a general education classroom. While they have some research to support their claim, I believe that their results, and those of similar studies, could have been caused by a variety of factors. How much training as each teacher had on working with students with ASD? What resources does the school have for students with ASD? Did the student's parents practice adaptive behavior skills at home? Do the students participate in any activities outside of school? Does the student have a supportive group of friends or family? Does the student have a history of behavior problems? Could their be other factors affecting their use of challenging behaviors? Every student with ASD is different, using behavior and language in their own way to serve a particular function. I believe the author's concept that it is merely their school placement, rather than the plethora of other possible factors, that is affecting their social and academic development is far too generalizing for all students with ASD. While I understand that a mainstreamed, general education setting may not be the best choice for every student with ASD, I do not believe it should be ruled out as viable option for all students with ASD. Instead, I believe it should be a decision made on an individual basis, taking into account all the determining factors. 

McLeskey, J., Rosenberg, M.S., & Westling, D.L. (2013). Inclusion: Effective Practices for All Students. Upper Saddle River, NJ: Pearson.

Reed, P., Osborne, L. A., & Waddington, E. M. (2012). A comparative study of the impact of mainstream and special school placement on the behaviour of children with Autism Spectrum Disorders. British Educational Research Journal, 38(5), 749-763.