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Addressing Mental Health and Behavior

Notes from the April 23, 2020 Distance Learning Innovations for Special Education Webinar: Addressing Mental Health and Behavior.

Coronavirus (COVID-19) Main Web Page

Date: April 23, 2020
Opening/Welcome: Kristin Wright, Director of Special Education, California
Facilitators: Kristin Brooks, Executive Director and Kevin Schaefer, Director/Supporting Inclusive Practices (SIP)

Elizabeth Estes, Founder of Breaking Barriers

  1. Before Covid-19, exponential increase in identified social emotional and behavioral health needs for California’s children was noted
    1. Suicide, suicidal ideation, self-injury, anxiety and depression were on the rise
  2. With the addition of distance learning, due to Covid-19, there is an additional impact of:
    1. Increased anxiety
    2. Mass disruption of routines
    3. Social isolation
    4. Economic instability
    5. Additional family strain

All of these factors impact a student’s ability to access their education. Most students receive social emotional and behavioral health support through their schools – whether through a teacher just being a friend or through intensive special education services. It is critical to continue these supports as we move ahead with distance learning. No one person or agency can do this alone. It must be a united effort between teachers, schools, districts, Special Education Local Plan Areas (SELPA) and other agencies, such as the Department of Public Heath, Department of Behavioral Health, Social Services, Probation, and Rehabilitation.

Jeannine Topalian, California Association of School Psychologists (CASP), President-Elect

School psychologists support educators, parents, and students by utilizing a multi-tiered comprehensive approach that is trauma informed and leads to better outcomes for student achievement and collaborate with stakeholders to support the mental health needs of all students to increase academic functioning and overall resiliency.

  1. Keep students occupied, feeling safe, and attempting to keep up with schoolwork as best as possible.
  2. Teach students positive preventive measures, talking with them about their fears, and giving them a sense of some control over their risk of infection can help reduce anxiety.
  3. Role modeling for children problem-solving, flexibility, and compassion as we all work through adjusting daily schedules, balancing work and other activities, getting creative about how we spend time, processing new information from authorities, and connecting and supporting friends and family members in new ways.

These tasks are accomplished by implementing a multi-tiered system.

  1. Tier 1: Promoting a community of support: Making connections
    1. Academically
      1. Connections to teachers
      2. Providing educational resources
    2. Socially
      1. Connections to friends and family (peer aged cousins)
        1. Facetime, zoom, other social media
    3. Emotionally
      1. Connections to caregivers
  2. Tier 2: Providing psychological education
    1. To parents and educators about the signs and symptoms of trauma in students
      1. Changes in behavior
      2. Changes in patterns
      3. Excessive crying
      4. Irritation
      5. Regression
      6. Excessive worrying
      7. Unhealthy eating and sleeping habits
      8. Poor school performance
      9. Avoiding school
      10. Unexplained headaches or body pains
    2. Strategies for psychological first aide
      1. Listen
      2. Protect
      3. Connect
      4. Model
      5. Teach
    3. Supporting all students with the “check-in” model
      1. What a check-in is NOT
        1. Crisis hotline counseling
        2. Social call
        3. telehealth therapy session
        4. Weekly counseling session for an individual student or meant to replace previous counseling serviced provided by the LEA.
      2. What a check-in IS
        1. A short phone conversation with a student to check-in on how they are doing
        2. Within your Pupil Personnel Services scope of practice
        3. An opportunity to connect with the student and express empathy
        4. A method to monitor a student’s stress reaction
        5. Available to all students
  3. Tier 3: Offering psychological interventions
    1. Considering virtual service delivery resources (i.e., by telephone) when social support is lacking, and psychological education insufficient
    2. Providing more direct services (e.g., telehealth) via virtual meeting platforms
    3. Focusing on stabilization and grounding of persons with extreme stress reactions by providing adaptive coping mechanisms
    4. Collaborating with outside agencies for wrap-around services

While a district is in shelter in place, CASP recommends that the school psychologist consult with district/school administrators to determine assessment priority.

  1. Some possibilities to consider:
    1. Complete as much of any open signed initial and triennial assessments you are able, which may include background review, writing observations and interviews that have already been conducted, and completing reports of assessment results that have already been collected
    2. Complete triennial assessments that can be conducted as a record review per district policy and parent consent
    3. Conduct record reviews on any initial evaluation plans that were being developed (not signed) prior to the shelter in place in preparation for them being signed as soon as the policy is lifted
    4. Conduct as many initial, triennial Individualized Education Program (IEP) meetings as are possible until the end of the academic year per district policy on distance meetings to ensure confidentiality and informed consent

Looking forward, school psychologists can work collaboratively with all students, parents, and educators to promote psychological and physical safety as students return to school by maintaining an open communication between outside agencies, schools, teachers, and families.

Resources That May Be Helpful

National Association of School Psychologists (NASP) External link opens in new window or tab.

LAUSD Psychological First Aid External link opens in new window or tab. (PDF)

Wendi Aghily, SELPA Director from Mt Diablo, Jill Raslan, Teacher from Mt. Diablo Unified

A teacher’s perspective: The comfortable daily routine of a supply filled classroom and structure is not our current situation. Take a breath: take care of yourself, check in and find out what your students and families need. For students with emotional dysregulation and behavioral challenges, this disruption will create new anxieties and fears. It’s important to take an inventory before approaching the teaching aspect:

  1. What are the needs of each student and family?
    1. What supports are already in place?
      1. External
        1. Technology- do they have access and if not, how can we get it to them?
        2. Space- is there a place where they can safely access a Zoom meeting or study?
        3. Family support- are parents working from home? Can they take time to sit with students to help them?
        4. Staff support
      2. Internal
        1. Ability- overall learning levels
        2. Accommodations that are already in place
        3. Motivation- what motivates them?
        4. Resilience- how resilient are they?
        5. Tools used for learning
    2. What support can be provided?
      1. Classroom support
        1. Planning lessons-Maintaining similar lessons, activities, and supports as received in the classroom
          1. Synchronous
          2. Asynchronous
          3. Independent work vs. “class” work
          4. Multiple methods of learning and demonstrating learning
        2. Planning social support
          1. maintaining class expectations for social interactions
            1. raising hand
            2. listening when teacher is presenting
          2. integration of social skills activities and lessons in virtual setting
          3. availability of a variety of forums to collaborate, share, or chat
        3. Planning therapeutic support
          1. Individual
          2. Group
          3. Family
          4. Wraparound
          5. Therapeutic supports within the academic virtual lessons
      2. Engage in online activities
        1. Encourage students to meet with other students to study
      3. Continue to monitor IEP goals via calls and zoom meetings with student and parents
      4. The support of the school principal is important. The principal should receive information from teachers regarding what the needs of families are and if possible, assist in getting the supports in place for each family.
  2. Supporting the needs of staff:
    1. Collaboration, instruction, guidance and encouragement for distance learning methods
      1. Initially there was too much information and not everyone was familiar with the tools, which was overwhelming
    2. Grade level virtual collaboration
    3. Virtual “staff lounge”
      1. Each day teachers log into a chat room to socialize and share with each other.
      2. Support each other
        1. Helping with Google online instruction
        2. Providing technology instruction and trouble shooting
      3. If staff are not supported, they can’t teach the students

Jenae Holtz, Desert Mountain SELPA and CAHELP

Desert/Mountain Children’s Center (DMCC) provides services in across 2,200 square miles.

For this large territory it is necessary to have strong communication and collaboration with many other agencies, and has a blended funding source of AB114 and early periodic screening diagnosis treatment Medi-Cal dollars. DMCC serves children and families, birth to 22 years old, with mild to severe behavioral health concerns.

DMCC’s Timeline of the Covid-19 impact:

  • March 16- LEAs shut down
  • March 17- Began phone and virtual services for behavioral health:
    • Individual
    • Group
    • Sibling Set
    • Family

Engagement Types:

  1. Birth to 3-year-old
    1. Skills taught to parents
      1. Emotional regulation
    2. Infant massage
      1. Soothing and self-soothing
    3. Attachment therapy
    4. Parent child attunement therapy
      1. Therapist observes and coaches while parent is interacting and responding to the child’s behavior
  2. 3–6-year-old—This age group is very engaged, and therapists are reporting much more interaction with parents than during regular classroom instruction. Therapist engage via screen sharing:
    1. Feelings videos
    2. Games including talking about feelings
    3. Provide parents with information for visual schedules
    4. Yoga for kids
    5. PCIT
  3. Elementary —These students are showing a higher level of depression, grief, and anxiety.
    1. Anger Management Skills Cards
    2. Emotion Wheel
    3. Coping Skills
      1. Deep Breathing
      2. Progressive Muscle Relaxation
      3. Challenging – Discus Irrational Thoughts
      4. Imagery
    4. My Anxiety Workbook
    5. Grief and Loss Workbook
  4. Middle School—High School— These students are much better conversationalists, and with those who aren’t, therapists have become very creative via the virtual tools.
    1. Conversation through virtual platforms
      1. Play games together through virtual means
      2. Cards
      3. Board game if both have the board game
      4. Emotion speed game
        1. Each person says an emotion back and forth. When an emotion is repeated, that emotion is discussed more deeply.
      5. Sharing music
        1. Talking about emotions brought out by the students chosen songs
    2. Phone conversations

DMCC has a triage grant though the state of California. The triage group provides various resources to the students and families.

Triage Interventions:

  • Creating community resources
  • Collaborating with DMCC
  • Continued collaboration and support to Local Educational Agencies
  • Providing webinars throughout the state
  • Sharing behavior strategies virtually with parents/educators
  • Create a portal on the CAHELP website “Parents Plugged In”

Luke Anderson from Placer County Office of Education and the Positive Behavioral Intervention Supports (PBIS) Coalition and Lisa Phillips from Rocklin Unified School District

California PBIS Coalition is a collaborative organization using evidence-based, culturally relevant practices to build the capacity for all stakeholders in the implementation of PBIS as a multi-tiered system following the National PBIS Blueprints for professional development, implementation, and evaluation.

The PBIS has shifted focus to families and direct support. Because this work usually happens at the school site level, it is now shifted to focusing on the needs of the students in their homes to ensure that they have the tools needed for distance learning and that their families are equipped with information.

One of these resources is PBIS at home. They have created a Google Docs folder that can be accessed as a workbook for families and practitioners.

PBIS at Home:

  1. Basics for Distance Learning- tools for behavioral, social, and emotional success
    1. Routines & Schedules
    2. Home Behavior Expectations
      1. When students know what is expected, they are far more likely to be successful
    3. Behavior Matrix
    4. Teach-Remind-Reward
      1. Teach
      2. Remind
      3. Reward
    5. Respond
    6. Self-Care

The PBIS Coalition tries to encourage schools to adopt the PBIS methods. One strategy of encouraging schools to implement these effective methods has been to develop a recognition system for schools who do. The priory system has been adjusted to accommodate the changes caused by distance learning.

To participate, schools need only to provide a story or artifact (e.g., video, picture, document) that demonstrates their commitment to supporting their community, families, and/or students during the COVID-19 pandemic. Schools will be commended for innovative academic, mental health, and behavior supports during distance learning.

One of the more successful schools that has shared their story is Rocklin Elementary. Rocklin Elementary uses a tiered approach to assisting families in the distance learning process:

  1. Tier I
    1. Teachers conducting classroom circles through Google Meet or Google Classroom using prompts
      1. Beginning with low level questions, trying to engage and build community
      2. Deeper responses can be shifted to a platform called Flipgrid, so that replies come to the teacher directly, rather than the group.
    2. Teachers sending home newsletters with calming corner ideas and punch cards for at home behavior support
  2. Tier II
    1. Students continue to receive Check-In, Check-Out supports from mentors through emails, online video conferencing
  3. Tier III
    1. Continued partnership with Wellness Together to provide virtual individual school-based therapy sessions
    2. Updates are given to Behavior Intervention Team Lead and additional referrals can be made

Upcoming Webinar Schedule

April 30th: Related Services, Students with More Significant Disabilities, and Low Incidence Supports

Contacts and Resources (in the order of presentation)

Questions:   California Department of Education | COVID19@cde.ca.gov
Last Reviewed: Monday, February 5, 2024