The Open Family Studies Journal




(Discontinued)

ISSN: 1874-9224 ― Volume 12, 2020
REVIEW ARTICLE

Explorations of Family-school Relationships Regarding Children with RAD and/or EBD: A Review of Relevant Literature from 1995-2016



Christa Wenger*, Sara Lyn Crump, Jessica LaFollette, Megan Kurtz
University of Missouri-Kansas City, Missouri, USA

Abstract

Background:

School and family interactions that include a focus on students from all backgrounds and ability levels are crucial for promoting students’ social, academic, and behavioral success. Specifically, it is important that educators and other stakeholders focus on developing effective interactions with the families of students who have Emotional and Behavioral Disorders (EBD) or Reactive Attachment Disorder (RAD).

Objective:

The aim of this study is to gain an understanding of the relationships between schools and the families of students with EBD or RAD as represented in published research. Another goal of this study is to understand whether these relationships have changed over time (1995-present).

Method:

This investigation sought to find empirical studies concerning relationships between schools and the families of students with EBD or RAD. The researchers divided the 1995-2016 time period into five- to-six-year increments and then searched for qualitative articles using agreed upon search terms. The authors used mainly the ERIC database from which to conduct their initial search.

Results:

There were 11 qualitative studies reviewed for this article. The articles were summarized and discussed according to two categories: “Families of Children with RAD” and “Families of Children with EBD.” Among these studies, three themes emerged in response to the research question: “The Importance of Caregivers,” “Family and School Communication,” and “Support Systems and Interventions.” These themes revealed critical ideologies regarding persons diagnosed with RAD or EBD and their family-school partnerships. Further, this review of literature indicates qualitative studies involving students with RAD or EBD in connection with family-school ties are limited, although a significant amount of literature exists regarding school-family ties.

Conclusion:

More qualitative studies are needed involving students with RAD and/or EBD and the connection to family-school relationships. The reviewed articles indicated that family-school partnerships depend on the landscape of the school system. Communication from the families to the schools and vice versa is important for persons with RAD or EBD diagnoses, as well as interventions and support systems. While this review does help to better understand these family–school partnerships, educators would benefit from additional studies during this time of the Common Core State Standards, increased accountability, inclusion, and high–stakes testing.

Keywords: Reactive attachment disorder, Emotional behavioral disorder/s, Parental involvement, Families, Schools, Family-school relationships/partnerships.


Article Information


Identifiers and Pagination:

Year: 2017
Volume: 9
Issue: Suppl-1, M4
First Page: 111
Last Page: 121
Publisher Id: TOFAMSJ-9-111
DOI: 10.2174/1874922401709010111

Article History:

Received Date: 30/06/2017
Revision Received Date: 14/08/2017
Acceptance Date: 14/09/2017
Electronic publication date: 10/10/2017
Collection year: 2017

© 2017 Wenger et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the University of Missouri-Kansas City, Missouri, USA, Tel: 417-224-2179; Emails: wengerch@umkc.edu; crumpsl@umkc.edu





1. INTRODUCTION

There is a growing impetus in contemporary schools to include all students with disabilities in the general education classroom, such as children with behavioral issues. Increasingly, it is expected that students with behavior challenges learn and interact with their peers in mainstream educational settings [1Yell ML, Meadows NB, Drasgow E, Shriner JG. Evidence-based practices for educating students with emotional and behavioral disorders 2009.]. These children may often be diagnosed with a behavior disorder, which might include Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), or, if defined as a disability under IDEA, Emotional Behavioral Disorder (EBD). Furthermore, a subset of students with attachment issues or diagnosed with Reactive Attachment Disorder (RAD) is also being included in the general education classroom. According to some researchers, students with RAD may present some of the most challenging behaviors in schools. Unfortunately, school professionals may be ill-prepared to deal with these children [2Schwartz E, Davis AS. Reactive Attachment Disorder: Implications for school readiness and school functioning. Psychol Sch 2006; 43(4): 471-9.
[http://dx.doi.org/10.1002/pits.20161]
].

Moreover, in the age of standardization and accountability, there is an increasing need to examine the ways in which families and schools interact to support and educate particular groups of students [3Blue-Banning M, Summers JA, Frankland HC, Nelson LL, Beegle G. Dimensions of family and professional partnerships: Constructive guidelines for collaboration. Except Child 2004; 70(2): 167-84.
[http://dx.doi.org/10.1177/001440290407000203]
, 4Turnbull AA, Turnbull HR, Erwin EJ, Soodak LC, Shogren KA. Families, professionals, and exceptionality: Positive outcomes through partnerships and trust 2015.]. School and family interactions that include a focus on students’ backgrounds and ability levels are crucial for promoting students’ social, academic, and behavioral success. Specifically, it is important that educators focus on developing effective interactions with the families of persons who have EBD or RAD [11Chapman S. Focus on practice: Reactive Attachment Disorder. Br J Spec Educ 2002; 29(2): 91-5.
[http://dx.doi.org/10.1111/1467-8527.00246]
]. Taft, Schlein and Ramsay [5Taft RJ, Schlein C, Ramsay CM. Experiences of school and family communications and interactions among parents of children with Reactive Attachment Disorder. Int J Educ Res 2016; 15(1): 66-78.] found that it is important for educators to be responsive and sensitive to the specific needs of students with special emotional needs, such as those with EBD or RAD, and their families. This sensitivity and awareness includes an understanding of how these students might form relationships at home and how their cultural backgrounds might affect their daily lives at school. As Habel, Bloom, Ray and Bacon [6Habel J, Bloom LA, Ray MS, Bacon E. Consumer reports: What students with behavior disorders say about school. Remedial Spec Educ 1999; 20(2): 93-105.
[http://dx.doi.org/10.1177/074193259902000206]
] argued, “classrooms and schools are social places situated within particular cultures and contexts” (p. 93), and social contexts shape and create how students perceive, interact, and learn [6Habel J, Bloom LA, Ray MS, Bacon E. Consumer reports: What students with behavior disorders say about school. Remedial Spec Educ 1999; 20(2): 93-105.
[http://dx.doi.org/10.1177/074193259902000206]
].

There is a substantial existing research base on individuals with EBD and school performance, but there is less work on families of students with EBD and schools. There is a seeming lack of research on the relationships between schools and families regarding students with RAD. Less information exists on how families of children with EBD or RAD navigate the complexities of home-school collaborations. For example, Coleman [7Coleman PK. Reactive Attachment Disorder in the context of the family: A review and call for further research. Emot Behav Difficulties 2003; 8(3): 205-16.] suggested that children with RAD need to be parented differently from children without RAD. While Coleman’s review of literature did not extend beyond the family landscape to include school or educational interactions, the findings about families might easily be applied within the context of school for teachers and other involved stakeholders. Coleman concluded that further research was needed in order to understand how to best help family members to successfully navigate the complexities RAD presents regarding home-school interactions.

An example of the literature involving persons with EBD involves their successes and/or failures in school, but it does not necessarily focus on family-school interactions for persons with EBD. Trout, Nordness, Pierce, and Epstein [8Trout AL, Nordness PD, Pierce CD, Epstein MH. Research on the academic status of children with emotional and behavioral disorders: A review of the literature from 1961 to 2000. J Emot Behav Disord 2003; 11(4): 198-210.
[http://dx.doi.org/10.1177/10634266030110040201]
] reported that the literature shows that students with EBD are often academic underachievers, and it was common for these students to be one or more grade levels behind in multiple academic domains. An important implication of their review is that interventions that focused only on behaviors and ignored students' academic deficits may have harmful effects on student academic achievement. That may contribute to further lifelong problems.

Research on relationships between schools and families with students diagnosed with EBD or RAD is scant. This demonstrates an investigative gap concerning the school-family relationship as it relates to individuals with RAD and EBD. Specifically, there is a paucity of research on the quality of relationships between families with children with RAD or EBD and the schools that serve these students. The purpose of this review is to examine the existing research regarding the relationship between schools and families of children diagnosed with RAD or EBD that have been published in peer-reviewed journals from 1995-2017. A categorical exploration of the literature will situate the research within its educational context, which is important for understanding the relationships between schools, families, and students with RAD or EBD.

2. METHOD

2.1. Selection Criteria

Included articles in this literature review needed to meet the following criteria: (a) targeted school age children diagnosed with emotional behavior disorders (EBD), Reactive Attachment Disorder (RAD), or significant attachment issues; (b) were qualitative studies with defined outcomes; and (c) appeared in refereed journals. There were no age limits on subjects. All settings (i.e., residential treatment facility, home, school, alternate education placement, or vocational) were acceptable.

2.2. Search Procedures

A comprehensive search was conducted for journal articles that investigated the relationships between schools and families of children with EBD, RAD, or attachment issues. Search parameters included articles from 1995-2017. The search focused on research studies that utilized a qualitative research methodology. First, an electronic search of The Education Resource Information Center (ERIC), Psych–INFO, Google Scholar, and Ebscohost databases was conducted for articles that met the abovementioned criteria. Keywords used to identify appropriate journal articles included: Reactive Attachment Disorder, Emotional Behavioral Disorder; parental involvement; families; schools; family-school relationships and/or partnerships. The keywords were used alone and in combinations. Ancestral searches were performed by checking citations of acceptable articles. Additionally, references from prior literature reviews on EBD and RAD were checked for relevant articles [3Blue-Banning M, Summers JA, Frankland HC, Nelson LL, Beegle G. Dimensions of family and professional partnerships: Constructive guidelines for collaboration. Except Child 2004; 70(2): 167-84.
[http://dx.doi.org/10.1177/001440290407000203]
, 7Coleman PK. Reactive Attachment Disorder in the context of the family: A review and call for further research. Emot Behav Difficulties 2003; 8(3): 205-16.-10Floyd KK, Hester P, Griffin HC, Golden J, Canter LL. Reactive Attachment Disorder: Challenges for early identification and intervention within the schools. Int J Spec Educ 2008; 23(2): 47-55.]. Authors of published studies targeting students with RAD and/or EBD and family-school relationships were also approached via e-mail regarding availability of any studies currently submitted for publication or in press with peer-reviewed journals.

Database searches found 11 articles that met selection criteria. Four articles addressed EBD and school-family relationships and seven articles focused on RAD in relation to family-school relationships. The review of these articles is organized under two broad sections; (a) Families of Children with RAD and (b) Families of Children with EBD. A discussion of the studies of a particular section summarizes the findings of those articles reviewed in that section. We discuss, within those two discrete sections a series of crucial questions: What is the state of home school interactions for families of children with EBD and RAD? Are there common themes across studies? If so, what are they? This literature review concludes with a discussion of the limitations of the existing research and suggestions for future directions of research.

3. RESULTS

In this section we discuss the findings of our literature review search in accordance with two overarching categories; (1) Families of Children with RAD and (2) Families of Children with EBD. We highlight below the themed findings of our literature review study across these two categories.

3.1. Families of Children with RAD

Search procedures found seven qualitative articles that met the stated inclusion criteria and that investigated families of students with RAD and their relationships with the schools that served their students. These studies all employed a qualitative research methodology.

Chapman [11Chapman S. Focus on practice: Reactive Attachment Disorder. Br J Spec Educ 2002; 29(2): 91-5.
[http://dx.doi.org/10.1111/1467-8527.00246]
] conducted a single case study that described the experiences of an adoptive parent of a child with RAD. In her study, Chapman, a teacher and the adoptive parent, articulated the difficulties involving her interactions with the school and its inability to utilize effective behavior management strategies for her child, 12-year-old Anna, whom Chapman adopted at 20 months old. The author noted that typical behavior strategies, such as behavior charts, rewards, or sanctions proved to be ineffective and that “conventional behavior management strategies exacerbated the problem” (11: p. 91). She also noted there was a struggle to find support for herself in her parenting role and in understanding the difficulties presented by Anna.

Instead, Chapman found the re-nurturing process, a form of re-parenting, proved to be more effective in filling in the gaps for her daughter with RAD. She reported significant positive gains for her child after adopting re-nurturing therapy. Chapman suggested that schools could help to re-nurture students with RAD by providing specific accommodations, such as the use of break rooms for a brief escape and/or altering school schedules to assist children with RAD in finding a balance between spending time at school and with their primary caregiver/s. Finally, the researcher concluded that teachers need realistic strategies when dealing with students with attachment disorders, even though such strategies may conflict with administrators’ or districts’ policies regarding generally acceptable forms of behavior management. The author stated that such non-traditional strategies are most effective when both the home and school communicate to implement similar approaches to behavior management.

A longitudinal study conducted by Rijk, Hoksbergen, and Laak [12Rijk CH, Hoksbergen RA, ter Laak J. Education after early-life deprivation: Teachers’ experiences with a clinical group of deprived Romanian adopted children. Adoption Q 2008; 11(4): 255-77.
[http://dx.doi.org/10.1080/10926750802569806]
] investigated the experiences of family-school partnerships of families who had adopted Romanian children who had experienced severe deprivation prior to adoption. The study consisted of three phases using mixed methods. The third phase was mainly qualitative in nature [12Rijk CH, Hoksbergen RA, ter Laak J. Education after early-life deprivation: Teachers’ experiences with a clinical group of deprived Romanian adopted children. Adoption Q 2008; 11(4): 255-77.
[http://dx.doi.org/10.1080/10926750802569806]
] and included 17 adopted Romanian children, their adoptive parents, and 17 teachers who had one Romanian adoptee in their classroom. The children, who were 10 years 8 months old, had been adopted at 2-years 11 months old. All children demonstrated significant behavioral problems at school that hindered their school performance. According to their teachers, problem behaviors were due to the severe deprivation that the children had experienced prior to adoption. The researchers detailed how family and school partnerships provided support for Romanian students who had experienced extreme early-life deprivation and struggled with school behaviors after their adoption in the Netherlands.

Among several successful strategies described by teachers, parent involvement and communication were noted as very important. These researchers indicated that parents played an essential role in providing information to teachers, and in turn, the researchers stated that teachers could help parents when problems arose. One teacher reported good contacts with parents, and when given suggestions on dealing with behavior problems, the teacher found parental input to be very helpful. However, conflicts between these key partners also occurred. Families and teachers described six occurrences of conflict. All of these problems centered on differences in opinion of the child’s potential, where parents felt “the school was underestimating their child” and the teachers felt “parents had trouble accepting their child’s limitations” (12: p. 274). These conflicts and different perspectives of a child's abilities may be one reason why it is difficult to build effective school-family relationships.

Vasquez and Stensland [13Vasquez M, Stensland M. Adopted children with Reactive Attachment Disorder: A qualitative study on family processes. Clin Soc Work J 2015; 44(3): 319-32.
[http://dx.doi.org/10.1007/s10615-015-0560-3]
] conducted a grounded-theory qualitative study examining the effects of RAD on adopted children, their parents, and their siblings. Participants included five families that contained at least one biological child and one adopted child who had been diagnosed with RAD. The researchers conducted multi–stage interviews over a six–month period, consisting of individual and group interviews. The study found that parents, in particular, experienced significant difficulties and stresses related to their child’s RAD diagnosis. One stated finding is that parents often struggled to get schools to take their child’s diagnosis seriously. Participants in this study described a struggle to educate others about RAD, with a constant fight to obtain services and supports for their children with RAD [13Vasquez M, Stensland M. Adopted children with Reactive Attachment Disorder: A qualitative study on family processes. Clin Soc Work J 2015; 44(3): 319-32.
[http://dx.doi.org/10.1007/s10615-015-0560-3]
].

Parents reported that their interactions with their child’s school were often combative or adversarial. Two parents, who were both practicing teachers [13Vasquez M, Stensland M. Adopted children with Reactive Attachment Disorder: A qualitative study on family processes. Clin Soc Work J 2015; 44(3): 319-32.
[http://dx.doi.org/10.1007/s10615-015-0560-3]
], indicated that they were often ignored when it came to their daughter’s behaviors. Their daughter did not act out in class, but she did exhibit intense behaviors at home. This resulted in difficulties in obtaining individual educational plans (IEPs) and appropriate services for their child. It took over a year to obtain an IEP for the student [13Vasquez M, Stensland M. Adopted children with Reactive Attachment Disorder: A qualitative study on family processes. Clin Soc Work J 2015; 44(3): 319-32.
[http://dx.doi.org/10.1007/s10615-015-0560-3]
]. Still, other parents told stories about how their children would manipulate school professionals and use behaviors to get what they wanted or to escape from something (e.g. suspension gets the student out of school). Parents also commented on the fact that not understanding RAD resulted in difficulties not only with educators, but with other service professionals who could help their children [13Vasquez M, Stensland M. Adopted children with Reactive Attachment Disorder: A qualitative study on family processes. Clin Soc Work J 2015; 44(3): 319-32.
[http://dx.doi.org/10.1007/s10615-015-0560-3]
]. Finally, lack of support from the schools had unforeseen negative consequences on the parents and families.

Taft, Ramsay, and Schlein [14Taft RJ, Ramsay CM, Schlein C. Home and school experiences of caring for children with Reactive Attachment Disorder. J Ethnogr Qual Res 2015; 9(3): 237-46.] described the findings of a narrative inquiry into the stories of caregivers of children with RAD. The researchers investigated the experiences that caregivers of children with RAD faced on a daily basis both at home and in interactions with their children’s schools. Data were collected over the course of one year through informal, semi–structured interviews and during group support meetings. Many of the participants described the unpredictable, inappropriate, or, in some cases, threatening behaviors exhibited by their children with RAD. Essentially, all of the parents included in this inquiry described how they “battle daily to find help for themselves and for their children” (14: p. 242).

Participants voiced concerns similar to those mentioned by parents in studies previously discussed. Parents stated a lack of behavior at school made it difficult for them to obtain supports from the schools that would help their children succeed in the school environment. They also stated that behaviors at home were extreme. They conceded that from the perspective of the school, the children were “perfect.” This article gives a good example of a possible disconnect in communication between school and family that could easily impact the quality of the school-family relationship. Overall, this article sought to elevate the voices of these caregivers, since they are largely underrepresented in the research involving this topic.

In another article, Taft, Schlein, and Ramsay [5Taft RJ, Schlein C, Ramsay CM. Experiences of school and family communications and interactions among parents of children with Reactive Attachment Disorder. Int J Educ Res 2016; 15(1): 66-78.] discussed the experiences of parents of children with RAD with a particular focus on home and school communication. Using a narrative inquiry approach, data gathered found that most parents did not view the child’s school to be supportive and willing to collaborate with them. Parents reported that educators did not respect their knowledge and perspectives, but, instead, often blamed them for their child’s behavior. They also shared that, rather than helping them, schools seemed to erect roadblocks that made it challenging to get necessary services for their child. In addition, school–to–home communication was perceived to be mostly negative, with teachers often communicating with parents solely to report the child’s bad behavior. These researchers [5Taft RJ, Schlein C, Ramsay CM. Experiences of school and family communications and interactions among parents of children with Reactive Attachment Disorder. Int J Educ Res 2016; 15(1): 66-78.] concluded that when it came to school-family collaborations, families were seemingly not included as equal team members in their child's educational process, and school professionals might not have been proactive or positive when it came to working with the families or children with RAD [5Taft RJ, Schlein C, Ramsay CM. Experiences of school and family communications and interactions among parents of children with Reactive Attachment Disorder. Int J Educ Res 2016; 15(1): 66-78.].

We communicated with this set of authors to request additional published or unpublished work. In a provided unpublished work, Schlein and Taft [15Schlein C, Taft RJ. Educational accountability and critical voices of silenced students on school landscapes. Manuscript submitted for publication 2017.] discussed a narrative investigation involving the experiences of adoptive and foster families with their children with RAD to better understand how they engage in curricular interactions in school. Participants stated that children with RAD experience increased anxiety regarding their academic success in school. They also highlighted that students with RAD experienced problems with social success as well. Parents further discussed how their children often did not see school as a safe place, nor did they feel welcomed in their educational environments. Finally, participant stories revealed that while many children with RAD are intelligent, their behaviors often result in their removal from mainstream classrooms. This may result in a potential placement that is a mismatch between student goals, ability, and academic placement.

Schlein, Taft, and Ramsay [16Schlein C, Taft RJ, Ramsay CM. The intersection of culture and behavior: Intercultural competence, transnational adoptees, and social studies classrooms. Journal of International Social Studies 2016; 6(1): 128-42.] highlighted the experiences of families of children with RAD who were transnational adoptees within the context of the social studies classroom. This article focused on the narratives of experiences of a subset of parent participants from a larger group of 10 parents of children with RAD, those who had adopted children transnationally. Within this subset, the authors described the experiences of the parents of Maya and Aidan, two children with RAD who were adopted from Eastern Europe. Both Maya and Aidan exhibited extreme behaviors that made success in school difficult. Participant stories highlighted the need for teachers to understand how RAD can impact the student, especially if other cultural variables were considered. The article specifically discusses the importance of creating culturally competent teachers who are able to meet the needs of all students in their classrooms. Teachers who are not culturally competent might inadvertently trigger behaviors in the student with RAD, especially those who are transnational adoptees. Conversely, educators with cultural competence “might be positioned well for considering multiple cultural vantages, especially educators in social studies classrooms, where issues of culture and identity are studied” (16: p. 138).

3.2. Families of Children with EBD

Search procedures found four qualitative articles that met inclusion criteria and investigated families of students with EBD and their relationships with the schools that served their students. These studies employed a qualitative research methodology.

Crawford and Simonoff [17Crawford T, Simonoff E. Parental views about services for children attending schools for the emotionally and behaviourally disturbed (EBD): a qualitative analysis. Child Care Health Dev 2003; 29(6): 481-91.
[http://dx.doi.org/10.1046/j.1365-2214.2003.00368.x] [PMID: 14616906]
] conducted a qualitative study in which they examined the views of parents of children attending schools for emotionally and behaviorally challenged students. The study investigated how students felt about their journeys through the educational system. Five focus group discussions with 30 parents of 25 children were used to collect data. The study took place at five EBD schools and one school for children with mixed needs in three London boroughs. An analysis of transcripts from each of the five focus groups indicated that children with EBD and their families often face social exclusion or feel as though they receive inadequate education services. Other parents voiced that their children are inappropriately placed in EBD programs, causing their children to be passed from one educational program to another. Parents also expressed that they felt that a lack of experience and training in how to deal with emotional and behavioral problems was a particular issue for school staff, especially among mainstream teachers and other staff who supervise after-school programs.

Some parents did, however, describe positive feelings toward schools for students with EBD and felt there were many “positive effects of this environment on their child’s behavior, and development (17: p. 486).” Parents stated that EBD schools appeared to be less likely to exclude children, and they had a greater understanding and tolerance for EBD problems. In contrast, the parents in this study criticized mainstream schools, citing that often their children were segregated within these environments and isolated from their peers. Furthermore, parents described frustrations in waiting for services from these schools. In particular, the parents in this study stressed the importance of effective collaboration between home and school in order to promote a better understanding of emotional and behavioral disorders and in setting goals for children with EBD. Data from the study suggested that schools might need to improve communication and collaboration with parents to better serve this population.

Rosenzweig, Brennan, and Ogilvie [18Rosenzweig JM, Brennan EM, Ogilvie AM. Work-family fit: voices of parents of children with emotional and behavioral disorders. Soc Work 2002; 47(4): 415-24.
[http://dx.doi.org/10.1093/sw/47.4.415] [PMID: 12450012]
] examined five focus groups with 41 employed parents of children with EBD. The purpose of this study was to gain insight about how parents of children with EBD overcome challenges to fulfill their daily work and family responsibilities. While the primary purpose of this study was to describe the strategies used by parents and their perceptions about caring for persons with EBD, the parents interviewed in this study and their difficult relationships with schools emerged as a major theme. Many parents in the study expressed strong opinions that the school system “was not set up to meet the needs of children with serious emotional problems” (18: p. 419). In particular, parents felt that schools forced family members to solve problems regarding their children with EBD that parents felt were school-related problems, rather than home-related problems. Many participants described challenges in finding supervision and adequate care for children with EBD outside of the regular school day, and they indicated that they were unable to use school-related care services since most programs were ill-equipped to handle students with EBD. Parents even voiced problems in finding transportation for their children, because the transportation services offered by schools often excluded their children due to behavior problems. Overall results from this study indicated that many parents believed the school system was not set up to meet the needs of children with serious emotional and/or behavioral disorders.

Rosenzweig et al. [18Rosenzweig JM, Brennan EM, Ogilvie AM. Work-family fit: voices of parents of children with emotional and behavioral disorders. Soc Work 2002; 47(4): 415-24.
[http://dx.doi.org/10.1093/sw/47.4.415] [PMID: 12450012]
] suggested that schools need to do a better job in communicating with families of children with EBD by seeking out “information about the specifics of children’s mental health disorders and work-family fit issues” (p. 422). Moreover, stakeholders such as social workers and school administrators need to work with these families to develop crisis management strategies that do not regularly remove parents from their other life responsibilities. Finally, the authors argued that better education for primary and secondary educators might help to improve the relationship between schools and families of children with EBD.

Trainor [19Trainor AA. Diverse approaches to parent advocacy during special education home-school interactions identification and use of cultural and social capital. Remedial Spec Educ 2010; 31(1): 34-47.
[http://dx.doi.org/10.1177/0741932508324401]
] inquired into parental experiences of advocacy during special education home-school interactions. Interviews were conducted with focus groups and with individual participants. Participants included 33 adults from 27 families from a large urban district. These families represented 36 children with special needs. Disability categories varied, with nine students categorized with EBD. Data gathered from the interviews indicated that intercultural and intracultural differences existed among parents and their styles of advocacy. Trainor delineated four approaches to advocacy that emerged from the qualitative data: the intuitive advocate, the disability expert, the strategist, and the change agent. Findings underscored that although no single approach was always effective, the intuitive advocacy approach, where the parent uses perceptive insights of their child, was used more often by families who qualified for free and reduced lunch. This approach was also less likely to result in the parents’ desired outcomes.

Trainor [19Trainor AA. Diverse approaches to parent advocacy during special education home-school interactions identification and use of cultural and social capital. Remedial Spec Educ 2010; 31(1): 34-47.
[http://dx.doi.org/10.1177/0741932508324401]
] further noted that “parents of youth with emotional or behavioral disabilities were more likely to discuss advocacy efforts that were thwarted by teachers’ responses to behavior problems” (p. 45). These findings underlined that multiple complex factors affect family-school partnerships for students with EBD. In addition to cultural differences, family styles of advocacy vary by social class, and teachers may be less responsive to the types of advocacy used more often by parents from working class backgrounds across all racial groups. Student behavior problems were also seen as functioning to disconnect parents and teachers from ultimately working together to develop successful education strategies.

Schlein, Taft, and Tucker-Blackwell [20Schlein C, Taft RJ, Tucker-Blackwell V. Teachers experiences with classroom management and children diagnosed with emotional behavioral disorder. Curriculum and Teaching Dialogue 2013; 15(1): 133-46.] examined the experiences of general education teachers of students who have been diagnosed with EBD in a diverse urban core school. Participants included three general education teachers at an elementary school in a large urban Midwestern city. The authors conducted semi-structured interviews that included 15 open-ended questions. Participants described their experiences working with children with EBD. They cited acknowledgement of students’ home lives and a concentration on fostering positive relationships as crucial for effective classroom management among students with EBD. Furthermore, the study underlined how cultural backgrounds and cultural experiences might play a role in effective classroom management among students with EBD.

4. DISCUSSION

In this section we outline the themes found from among the literature reviewed in accordance with three main themes. One theme found across the literature reviewed is “Caregiver Voice,” which highlights the need to empower parents and their children through voicing their concerns and attending to their suggestions as significant resources to improve services to their children with EBD or RAD. “Home-School Communication” is the second theme, which underlines how a possible lack of strong communication can be problematic and a potential source for building barriers between school personnel and the families of children diagnosed with EBD or RAD. The other salient theme across this literature review is “School Support Systems and Interventions.” This theme concentrates on intervention strategies for these families and the children with EBD and RAD through school-family relationships. These themes were represented across all of the reviewed studies (See Table (1).

Table 1
Explorations of Family-School Relationships: RAD and EBD.


4.1. Caregiver Voice

One of the themes that emerged from the literature was the importance of voicing the experiences of the caregivers of persons with RAD and EBD, since the roles of these persons often seemed to be overlooked [15Schlein C, Taft RJ. Educational accountability and critical voices of silenced students on school landscapes. Manuscript submitted for publication 2017., 16Schlein C, Taft RJ, Ramsay CM. The intersection of culture and behavior: Intercultural competence, transnational adoptees, and social studies classrooms. Journal of International Social Studies 2016; 6(1): 128-42.]. In fact, the importance of voicing the experiences of this aforementioned population is perhaps why narrative inquiry, with its attention to experience and the collection of stories of experience, was used as a methodology in at least 60% of the articles reviewed (See Table 1). Several of the reviewed articles indicated that caregivers often struggled to meet the needs of their children with RAD and EBD [14Taft RJ, Ramsay CM, Schlein C. Home and school experiences of caring for children with Reactive Attachment Disorder. J Ethnogr Qual Res 2015; 9(3): 237-46., 15Schlein C, Taft RJ. Educational accountability and critical voices of silenced students on school landscapes. Manuscript submitted for publication 2017., 17Crawford T, Simonoff E. Parental views about services for children attending schools for the emotionally and behaviourally disturbed (EBD): a qualitative analysis. Child Care Health Dev 2003; 29(6): 481-91.
[http://dx.doi.org/10.1046/j.1365-2214.2003.00368.x] [PMID: 14616906]
]. Moreover, many of the caregivers in the reviewed literature often felt misunderstood or silenced regarding their children [15Schlein C, Taft RJ. Educational accountability and critical voices of silenced students on school landscapes. Manuscript submitted for publication 2017., 16Schlein C, Taft RJ, Ramsay CM. The intersection of culture and behavior: Intercultural competence, transnational adoptees, and social studies classrooms. Journal of International Social Studies 2016; 6(1): 128-42.]. The reviewed body of qualitative research, however, allowed for caregiver participants to not only explain the behaviors and frustrations involving their children with RAD or EBD, but the studies allowed their voices to be heard.

In addition, attending to the voices of caregivers displayed that many of the caregivers acknowledged the difficulties in maintaining a work-life balance. This was because the demands for caregiving increase significantly when families have children with RAD or EBD that require special care or attention [14Taft RJ, Ramsay CM, Schlein C. Home and school experiences of caring for children with Reactive Attachment Disorder. J Ethnogr Qual Res 2015; 9(3): 237-46., 18Rosenzweig JM, Brennan EM, Ogilvie AM. Work-family fit: voices of parents of children with emotional and behavioral disorders. Soc Work 2002; 47(4): 415-24.
[http://dx.doi.org/10.1093/sw/47.4.415] [PMID: 12450012]
]. Another important aspect of caregivers involved the context of adoptive and foster families. Many of the studies in this review included participants who had fostered and/or adopted children with RAD or EBD. Studies reviewed here hint that there might be an added layer of complexity involved in voicing the experiences of foster and/or adoptive parents, especially when a lack of knowledge about birth family medical and school history might limit their understanding of early childhood circumstances of their children and adoptive and foster parents might be overlooked as sources of knowledge about the children in their care.

4.2. Home-School Communication

Research shows that effective collaboration and partnerships between schools and families and the inclusion of parents as equal members in educational decision-making teams promotes more positive student outcomes [1Yell ML, Meadows NB, Drasgow E, Shriner JG. Evidence-based practices for educating students with emotional and behavioral disorders 2009., 3Blue-Banning M, Summers JA, Frankland HC, Nelson LL, Beegle G. Dimensions of family and professional partnerships: Constructive guidelines for collaboration. Except Child 2004; 70(2): 167-84.
[http://dx.doi.org/10.1177/001440290407000203]
, 4Turnbull AA, Turnbull HR, Erwin EJ, Soodak LC, Shogren KA. Families, professionals, and exceptionality: Positive outcomes through partnerships and trust 2015.]. In this review, a second major theme that emerged concerned communication between homes and schools involving persons with RAD or EBD. Several qualitative studies focused on parent and teacher perceptions of involvement and/or communication with their child’s schools [19Trainor AA. Diverse approaches to parent advocacy during special education home-school interactions identification and use of cultural and social capital. Remedial Spec Educ 2010; 31(1): 34-47.
[http://dx.doi.org/10.1177/0741932508324401]
, 20Schlein C, Taft RJ, Tucker-Blackwell V. Teachers experiences with classroom management and children diagnosed with emotional behavioral disorder. Curriculum and Teaching Dialogue 2013; 15(1): 133-46.], suggesting that the relationship between home and school is imperative for student success. Researchers in psychology and special education have continued to document the efficacy of strong partnerships between parents and schools [21Anderson KJ, Minke KM. Parent involvement in education: Toward an understanding of parents’ decision making. J Educ Res 2007; 100(5): 311-23.
[http://dx.doi.org/10.3200/JOER.100.5.311-323]
, 22Flores de Apodaca R, Gentling DG, Steinhaus JK, Rosenberg EA. Parental involvement as a mediator of academic performance among special education middle school students. Sch Community J 2015; 25(2): 35-54.], while many teachers and administrators feel compelled to toughen their stance on behaviors that might detract from learning in the general classroom setting [23Quinn KP, Lee V. The wraparound approach for students with emotional and behavioral disorders: Opportunities for school psychologists. Psychol Sch 2007; 44(1): 101-11.
[http://dx.doi.org/10.1002/pits.20209]
]. The available peer–reviewed research comprises a multitude of articles around the relationship between home and school, but with a particular focus on improving test scores of students in the general population [24Sitlington PL, Neubert DA. Preparing youths with emotional or behavioral disorders for transition to adult life: Can it be done within the standards-based reform movement? Behav Disord 2004; 29(3): 279-88.].

While communication and family–school ties are solidified as important within a large body of research, results from the qualitative studies reviewed here indicate that many families of students diagnosed with RAD or EBD described negative communication between home and school [5Taft RJ, Schlein C, Ramsay CM. Experiences of school and family communications and interactions among parents of children with Reactive Attachment Disorder. Int J Educ Res 2016; 15(1): 66-78., 13Vasquez M, Stensland M. Adopted children with Reactive Attachment Disorder: A qualitative study on family processes. Clin Soc Work J 2015; 44(3): 319-32.
[http://dx.doi.org/10.1007/s10615-015-0560-3]
-19Trainor AA. Diverse approaches to parent advocacy during special education home-school interactions identification and use of cultural and social capital. Remedial Spec Educ 2010; 31(1): 34-47.
[http://dx.doi.org/10.1177/0741932508324401]
]. Moreover, several works indicated that parents often felt under–represented in educational settings or that their children were misdiagnosed, placed inappropriately, or removed from mainstream classrooms because of behaviors rather than academic skills [17Crawford T, Simonoff E. Parental views about services for children attending schools for the emotionally and behaviourally disturbed (EBD): a qualitative analysis. Child Care Health Dev 2003; 29(6): 481-91.
[http://dx.doi.org/10.1046/j.1365-2214.2003.00368.x] [PMID: 14616906]
, 18Rosenzweig JM, Brennan EM, Ogilvie AM. Work-family fit: voices of parents of children with emotional and behavioral disorders. Soc Work 2002; 47(4): 415-24.
[http://dx.doi.org/10.1093/sw/47.4.415] [PMID: 12450012]
]. This perceived lack of understanding on the part of schools led to frustration on the part of many caregivers. In fact, almost all of the literature reviewed, even articles not falling directly under the topic of home-school communication, revealed feelings of frustration, concern, and voicelessness. Thus, the qualitative literature reveals another potential gap between empirically based beliefs and practices about the importance of communication between home and school and actual classroom practices, especially for persons with RAD or EBD. The findings of this review suggest that home-school relationships for these two student populations and their families might not be effective and schools may need to make a concerted effort positively address this issue.

4.3. Support Systems and Interventions

There is an established body of research that discusses how schools can best work with parents and caregivers to build collaborative partnerships that support and provide adequate services for children with RAD or EBD [3Blue-Banning M, Summers JA, Frankland HC, Nelson LL, Beegle G. Dimensions of family and professional partnerships: Constructive guidelines for collaboration. Except Child 2004; 70(2): 167-84.
[http://dx.doi.org/10.1177/001440290407000203]
, 4Turnbull AA, Turnbull HR, Erwin EJ, Soodak LC, Shogren KA. Families, professionals, and exceptionality: Positive outcomes through partnerships and trust 2015., 24Sitlington PL, Neubert DA. Preparing youths with emotional or behavioral disorders for transition to adult life: Can it be done within the standards-based reform movement? Behav Disord 2004; 29(3): 279-88.-26Landrum TJ, Tankersley M, Kauffman JM. What is special about special education for students with emotional or behavioral disorders? J Spec Educ 2003; 37(3): 148-56.
[http://dx.doi.org/10.1177/00224669030370030401]
]. However, the majority of research regarding schools and parental involvement among students with EBD employs quantitative methodologies or is theoretical in nature but qualitative studies on schools’ interactions with families of students with RAD is scarce. In fact, this review found only 11 total qualitative articles examining interactions between schools and families of students with EBD or RAD, and out of those, only six seemed to focus on support systems and interventions. Data from the qualitative research reviewed in this paper indicated that parents often felt that support systems and interventions were inconsistent or not present at all, which suggests a research-to-practice gap between the theoretical literature and the actual experiences of families and students with RAD and EBD. Further, participants felt that school personnel were ill-prepared to work with their children and that they were not trained sufficiently to deal with behaviors expressed by some of the students, especially students with RAD.

Essentially, there is literature about how to support these families and their children [27Lechtenberger D, Mullins FE. Promoting better family-school-community partnerships for all of America’s children. Beyond Behav 2004; 14(1): 17-22.], but many of the participants in the articles in this review indicated that they rarely felt supported, nor did they feel that schools understood how to best meet the needs of their children. This feeling was consistent in seven of the articles falling under this theme [11Chapman S. Focus on practice: Reactive Attachment Disorder. Br J Spec Educ 2002; 29(2): 91-5.
[http://dx.doi.org/10.1111/1467-8527.00246]
, 13Vasquez M, Stensland M. Adopted children with Reactive Attachment Disorder: A qualitative study on family processes. Clin Soc Work J 2015; 44(3): 319-32.
[http://dx.doi.org/10.1007/s10615-015-0560-3]
-20Schlein C, Taft RJ, Tucker-Blackwell V. Teachers experiences with classroom management and children diagnosed with emotional behavioral disorder. Curriculum and Teaching Dialogue 2013; 15(1): 133-46.]. The data also suggested that in order to better understand and meet the needs of students from these populations, more qualitative research that captures the experiences of teachers, students, and parents is needed. Specifically, one work indicated that teachers must be given practical, real-world strategies to best meet the needs of these students [11Chapman S. Focus on practice: Reactive Attachment Disorder. Br J Spec Educ 2002; 29(2): 91-5.
[http://dx.doi.org/10.1111/1467-8527.00246]
], while another argued that teachers need to truly understand the environments and experiences of their students in order to effectively manage students with behavioral disorders [20Schlein C, Taft RJ, Tucker-Blackwell V. Teachers experiences with classroom management and children diagnosed with emotional behavioral disorder. Curriculum and Teaching Dialogue 2013; 15(1): 133-46.]. In addition, Schlein, Taft, and Ramsay [16Schlein C, Taft RJ, Ramsay CM. The intersection of culture and behavior: Intercultural competence, transnational adoptees, and social studies classrooms. Journal of International Social Studies 2016; 6(1): 128-42.] indicated that families of persons with EBD and RAD might have more nuanced behavioral and cultural needs and, therefore, they would benefit from interacting with teachers who employ culturally responsive pedagogy. The findings from the qualitative articles in this literature review highlight that hearing the actual stories from involved stakeholders might be essential to developing adequate support systems and interventions for persons affected by RAD or EBD.

Few studies have examined the home-school relationships of persons with RAD or EBD, making it challenging to detect patterns in the qualitative research included in this review. However, based on the publication dates of several of the articles, it does appear that in recent years researchers have become more aware of this population group and are more willing to listen to these families’ stories and how they deal with the dramatic effects of EBD and RAD. In addition, the focus of the research in this review shifted from the need of the schools to increase the grades and test scores of students with EBD or RAD to the difficulties parents of children with EBD or RAD face. Moreover, much of this research was conducted with families who had adopted children with EBD or RAD, since it was increasingly becoming recognized within the body of research on this topic that traumatic childhood events, such as abusive/neglectful parenting or removal from birth families, were likely to be increase the risk of EBD and was most likely a causal variable for development of RAD. The articles discussed above are representative of these shifts in focus and methods regarding persons with EBD or RAD.

CONCLUSION

The literature from the past 22 years concerning school-family ties and children with RAD and EBD reveals the progression of this particular relationship and how this population of students has come to be understood over time and across contexts. However, qualitative information regarding school-family relationships for these two student populations appears to be limited, especially with students with RAD and their families. Heading into the 21st century, federal legislation, such as NCLB and the Common Core State Standards, required schools to be held accountable for all students, including students with EBD [28United States Department of Education. A blueprint for reform: The reauthorization of the Elementary and Secondary Education Act [Available from http://www2.ed.gov/policy/elsec/leg/blueprint/ 2010.http://www2.ed.gov/policy/elsec/leg/blueprint/, 29Common Core State Standards Initiative. Common Core State Standards for English language arts & literacy in history/social studies, science, and technical subjects [Available from https://dese.mo.gov/sites/ default/files/CCSSI_ELA%20Standards.pdf 2016.]. Even though RAD is not recognized as a disability category under IDEA, given the concerns presented by students with RAD across all school and home domains, it would seem redundant to state that these students should receive support from our schools under one of several appropriate disability categories (i.e. Other Health Impaired).

Simply because legislation is intended to hold schools accountable for some of these student groups does not mean that schools or teachers are well-equipped to meet the needs of students with EBD or RAD. The literature asserts that achievement is important for all students and that parental involvement through effective collaborative efforts with school professionals is essential for promoting positive outcomes for all students, including students with disabilities. Much of the research that has been conducted in this area investigated the achievement levels of general education students. In the era of high stakes testing and accountability it would make sense that quantitative research would be the focus, since numbers and data sets are how educational stakeholders currently attempt to make sense of students, progress, and achievement. Recently, however, qualitative researchers have begun investigating parent-school interactions that aimed to capture the experiences and voices of families and children with these disorders.

The existing research demonstrates that students and their parents remain underrepresented and sometimes overlooked by school personnel. In fact, data from research from the included 22-year time span of this literature review indicated that many parents continue to feel underrepresented, negatively perceived, or misunderstood regarding their children with RAD or EBD. This lack of understanding and feeling of voicelessness might demonstrate the necessity of more qualitative research in this area so school professionals can better understand the needs of families of children with RAD or EBD and their relationships with the school.

The seemingly tenuous relationship between schools and families of children with RAD or EBD sheds light on the need for more qualitative research to capture the stories and experiences of this population. Actualizing the voices of both parents and children might help educators to better understand the experiences of the students for which they are required to provide services. Recognizing and accounting for the experiences and perspectives of families of persons with RAD or EBD is essential in order to foster a more positive relationship between these families and the schools that serve them. Using qualitative research to tell these stories might be especially effective, because students bring with them to the classroom a variety of cultures and backgrounds that might be used to individualize effective pedagogy for all students. Moreover, capturing the experiences of families of children with RAD or EBD through qualitative research can be an effective tool for providing information on strategies that might be used to improve home-school relationships and promote more positive interactions between the families, schools, administrators, and teachers, ultimately leading to increased student success in academic, behavioral, and social terms.

ETHICS APPROVAL AND CONSENT TO PARTICIPATE

The study was approved by the Institutional Review Board (IRB).

CONSENT FOR PUBLICATION

Not applicable.

CONFLICT OF INTEREST

The authors declare no conflict of interest, financial or otherwise.

ACKNOWLEDGEMENTS

Declared none.

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