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UCLA School Mental Health Project
Center for Mental Health in Schools
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Continuing Education: Unit I

Addressing Barriers to Learning
New Directions for Mental Health in Schools

Section B: The Need to Enhance Healthy Development
and Address Barriers to Learning

Section B Contents

Objectives for Section B

After completing this section of the unit, your should be able to:

discuss why providing health and social services is an insufficient strategy for addressing barriers to student learning

identify at least five major areas of focus in enhancing healthy psychosocial development

differentiate between personal and systemic barriers to student learning and understand the bias toward personal rather than social causation

understand a range of family needs for social and emotional support and enumerate at least three characteristics of family-oriented interventions

A Few Focusing Questions

What are the major barriers that interfere with students learning and performing effectively at school?
How can school staff build alliances with families?
How do persons and environments interact to cause problems

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Contents of Section B

No one has to make the case that there are many factors interfering with students' learning and performance.

And the consensus is that there are many such barriers to learning in any school enrolling a high proportion of students who are poor or immigrants or both.

School policy makers also understand that poor health can be such a barrier and that healthy development is important to ongoing well-being.

At the same time, school policy makers are clear that health is not a school's primary mission. Education is.

Thus, the idea that schools should focus resources on physical and mental health must be advocated within the context of enabling schools to accomplish their primary mission.

The message that must be conveyed is that the mission of educating all students requires a comprehensive set of interventions that address barriers to learning in an integrated way.

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Contents of Section B

What are some major barriers you think must be addressed so that students will learn and perform appropriately at school?

Click Here to see some major barriers.
(a new page will open)

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Schools clearly are involved in dealing with barriers to learning.

They hire pupil service professionals and institute services and programs aimed at such concerns as drug abuse, teen pregnancy, dropout prevention, and on and on. In addition, efforts increasingly are made to link with community health and social services.

Unfortunately, the prevailing activity is not enough.

Even though poor health and other barriers to student learning are seen as directly related to poor educational outcomes, programs to address barriers to learning are treated as "add-ons." That is, in terms of policy and practice, they are not assigned top priority and often are among the first cut when budgets are tight.

As long as this is the case, many students will continue to encounter barriers that interfere with their benefiting from instructional reforms. And for schools serving large numbers of such students, this means continuation of the pattern of test score averages that do not rise substantially.

This is a central paradox of school reform. That is: school restructuring clearly is intended to enhance student achievement. To this end, reform efforts predominantly focus on improving instruction and school management, with little attention paid to restructuring and enhancing resources that address barriers to learning. Consequentially, too many students are unable to take advantage of improved teaching.

What is the solution to this paradox?

One strategy is to help policy makers understand that current efforts to restructure schools are missing a major component.

The missing component doesn't focus on health and social services per se, but it encompasses a strong emphasis on physical and mental health as one major facet of helping schools address barriers to student learning. Such a component is essential in any school committed to the success of all.

By themselves, health and social services are an insufficient strategy for addressing the biggest problems confronting schools. They are not, for example, designed to address a full range of factors that cause poor academic performance, dropouts, gang violence, teenage pregnancy, substance abuse, racial conflict, and so forth. This is not a criticism of the services per se. The point is that such services are only one facet of a comprehensive approach.

A broad perspective of what is needed emerges by conceiving the missing component for addressing barriers to learning as encompassing efforts to prevent and correct learning, behavior, emotional, and health problems. Such efforts include activity that fosters academic, social, emotional, and physical functioning.

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Contents of Section B

Promoting Healthy Development

Promoting healthy development is one of the keys to preventing mental health and psychosocial problems. For schools, the need is to maintain and enhance health and safety and hopefully do more.

This requires programs that:

Areas of Focus in Enhancing Healthy Psychosocial Development

Appreciation of the developmental demands at different age levels is helpful, and awareness of an individual's current levels of development is essential. Basic textbooks provide guides to understanding developmental tasks.

For illustrative purposes, listed here are some major developmental tasks.
What are others you encounter frequently?
What do the many developmental tasks suggest for what schools should be doing?

Click Here to see some major developmental tasks.
(a new page will open)

One way to think about all this is to remember that the normal trends are for school-age youngsters to strive toward feeling competent, self-determining, and connected with others. When youngsters experience the opposite of such feelings, the situation may arouse anxiety, fear, anger, alienation, a sense of losing control, a sense of impotence, hopelessness, powerlessness. In turn, this can lead to externalizing (aggressive, "acting out") or internalizing (withdrawal, self-punishing, delusional) behaviors.

While efforts to facilitate social and emotional development focus on enhancing knowledge, skills, and attitudes, from a mental health perspective the intent is to enhance an individual's feelings of competence, self-determination, and connectedness with others.

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Personal and Systemic Barriers to Student Learning

She's depressed.

That kid's got an attention deficit hyperactivity disorder.

He's learning disabled.

In discussing mental health, it is easy to fall into the trap of thinking only in terms of psychopathology. As the noted anthropologist Ruth Benedict wisely noted:

Normality and exceptionally (or deviance) are not absolutes; both are culturally defined by particular societies at particular times for particular purposes.

What's in a name?

Strong images are associated with diagnostic labels, and people act upon these images. Sometimes the images are useful generalizations; sometimes they are harmful stereotypes. Sometimes they guide practitioners toward good ways to help; sometimes they contribute to "blaming the victim" -- making young people the focus of intervention rather than pursuing system deficiencies that are causing the problem in the first place. In all cases, diagnostic labels can profoundly shape a person's future.

Youngsters manifesting emotional upset, misbehavior, and learning problems commonly are assigned psychiatric labels that were created to categorize internal disorders. Thus, there is increasing use of terms such as ADHD, depression, and LD. This happens despite the fact that the problems of most youngsters are not rooted in internal pathology. Indeed, many of their troubling symptoms would not have developed if their environmental circumstances had been appropriately different.

It is not surprising that debates about labeling young people are so heated. Differential diagnosis is difficult and fraught with complex issues (e.g., Adelman, 1995; Adelman & Taylor, 1994; Carnegie Council on Adolescent Development, 1989; Dryfoos, 1990).

The thinking of those who study behavioral, emotional, and learning problems is dominated by models stressing person pathology.

Because of this, diagnostic systems do not adequately account for psychosocial problems.

This is well-illustrated by the widely-used Diagnostic and Statistical Manual of Mental Disorders -- DSM IV (American Psychiatric Association, 1994).

As a result, formal systems for classifying problems in human functioning convey the impression that all behavioral, emotional, or learning problems are due to internal pathology.

Thus, most differential diagnoses of children's problems are made by focusing on identifying one or more disorders (e.g., oppositional defiant disorder, attention-deficit/hyperactivity disorder, or adjustment disorders), rather than first asking:

Is there a disorder?

Bias toward labeling problems in terms of personal rather than social causation is bolstered by factors such as

(a) attributional bias --a tendency for observers to perceive others' problems as rooted in stable personal dispositions (Miller & Porter, 1988)
(b) economic and political influences -- whereby society's current priorities and other extrinsic forces shape professional practice (Chase, 1977; Hobbs, 1975; Schact, 1985).
There is a substantial community-serving component in policies and procedures for classifying and labeling exceptional children and in the various kinds of institutional arrangements made to take care of them.

"To take care of them" can and should be read with two meanings: to give children help and to exclude them from the community.

Nicholas Hobbs

Overemphasis on pathology skews theory, research, practice, and public policy away from environmentally caused problems and psychosocial problems. There is considerable irony in all this because practitioners understand that most problems in human functioning result from the interplay of person and environment. That is, it is not nature versus nurture, but nature transacting with nurture that determines human behavior.

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Contents of Section B

To illustrate, let's look at something school staff encounter everyday -- students who clearly have learning problems and whose misbehavior and various physical complaints seem very much connected to their negative experiences related to academic learning difficulties.

Of the many students who come to see you with some problem, how many are doing poorly with their class work? Do you think some of their physical complaints are related to their learning problems?

As you know, not all learning problems stem from the same causes. How do you understand the range of factors that cause such problems?

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In the classroom, it is evident that some students learn easily, and some do not; some misbehave, some do not. Even a good student may appear distracted on a given day. Everyone who wants to help students who manifest problems needs some basic understanding of

Why the differences?

A common sense answer suggests that each student brings something different to the situation and therefore experiences it differently. And that's a pretty good answer -- as far as it goes. What gets lost in this simple explanation is the reciprocal impact student and situation have on each other -- resulting in continuous change in both.

To clarify the point: a student brings to a situation capacities and attitudes accumulated over time, as well as current states of being and behaving. These "person" variables transact with each other and also with the environment.

At the same time, any situation in which students are expected to function not only consists of instructional processes and content, but also the physical and social context in which instruction takes place. Each part of the environment also transacts with the others.

Obviously, transactions vary considerably and lead to a variety of outcomes. These outcomes may primarily reflect the impact of person variables, environmental variables, or both.

Not all outcomes are desirable. Undesirable outcomes include deviant, disrupted, and delayed functioning.

Undesirable outcomes may be due to a dysfunction within the student such a neurological dysfunction interfering with effective processing of letters and numbers (a true learning disability) or psychopathology that preoccupies the student at the expense of school learning.

However, as any school nurse will be quick to emphasize, the problem may also reflect any number of physical health problems.

It also may be related to a variety of psychosocial factors that are barriers to the student attending school regularly or functioning appropriately when at school (frequent school changes because of family mobility, factors related to poverty such as hunger, distractors such as gang affiliation and teen pregnancy, taking drugs, etc.).

Then, there are the many environmental stressors that can negatively affect learning and behavior -- dysfunctional families, physical and sexual abuse, excessive pressure to achieve, etc.

Finally, it is important to remember that in some cases there is nothing objectively wrong with the student or the environment, but for various reasons a student may not mesh well with a given teacher, school, group of peers, and so forth. Common examples of student-environment mismatches are seen in the many instances when a fine teacher and an able youngster find they rub each other the wrong way and thus have trouble working together.

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Family Needs for Social and Emotional Support

School Counselor:
Cara showed up today bruised and battered. We think her dad is abusing her.

A parent to a teacher:
I don't know what to do with Matt. He always seems angry and won't do any school work. I'm so depressed, I can hardly deal with him any more.

Parent involvement in schools is a prominent item on the education reform agenda. As Epstein (1987) notes, "the evidence is clear that parental encouragement, activities, and interest at home and participation in schools and classrooms affect children's achievements, attitudes, and aspirations, even after student ability and family socioeconomic status are taken into account."

Home involvement is especially important when students have problems. Clearly, families play a key role in causing and sometimes maintaining a student's problems. They also can play a major role in correcting or at least minimizing problems. And, any family that has a youngster with a problem is likely to pay a price economically, psychologically, and socially.

In all cases, besides whatever direct health and human services the family requires, there may also be a need for social and emotional support.

Think about the families of the students who are referred to you because of problems.

How does the school interact with them? Do they see school staff as allies? If not, why not?

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Parents and other caretakers find it difficult to attend to the needs of their children when their own pressing needs are not attended to. This may help account for why parents who are most receptive to efforts to involve them in schools and schooling are a relatively small group.

Parents and others in the home need to feel welcomed and appreciated by the school.

Parents and others in the home often need to have an opportunity to share concerns.

Parents and others in the home need good information when there are problems -- information about the problem and presentation of such information in a context that also recognizes assets.

Parents and others in the home need information and ready access to resources.

In situations where there are large numbers of students who are having problems, the need is for healthy families, healthy schools, and healthy communities.

It seems likely that efforts to involve increasing numbers of parents in improving the well-being of their children must include a focus on improving the well-being of the many parents who are struggling to meet their own basic personal and interpersonal needs.

Thus, schools must be prepared to add programs and services that address such basic needs and staff must reach out to parents with interventions that are welcoming and encourage use of such programs. At the same time, schools must resist the temptation to scold such parents (Adelman, 1994).

Prevailing agendas for parent involvement emphasize meeting societal and school needs. It is not surprising, therefore, that little attention is paid to schools helping parents and caretakers meet their own needs. Schools do offer some activities, such as parent support groups and classes to teach them English as a second language, that may help parents and contribute to their well-being (e.g., by improving parenting or literacy skills). However, the rationale for expending resources on these activities usually is that they enhance parents' ability to play a greater role in improving schooling.

Another reason for involving parents is to support their efforts to improve the quality of their lives. This includes the notion of the school providing a social setting for parents and, in the process, fostering a psychological sense of community (Sarason, 1996; also see Haynes, Comer, & Hamilton-Lee, 1989).

If a school wants home involvement, it must create a setting where parents, others in the home, school staff, and students want to and are able to interact with each other in mutually beneficial ways that lead to a special feeling of connection. This encompasses finding ways to account for and celebrate cultural and individual diversity in the school community.

To these ends, ways must be found to minimize transactions that make parents feel incompetent, blamed, or coerced. At the same time, procedures and settings must be designed to foster informal encounters, provide information and learning opportunities, enable social interactions, facilitate access to sources of social support (including linkage to local social services), encourage participation in decision making, and so forth.


the primary intent is to improve the quality of life for the participants.

Although any impact on schooling is a secondary gain, it is encouraging to note that fostering such a climate is consistent with the school reform literature's focus on the importance of a school's climate/ethos/culture.

Barriers to Involving Parents/Home in Schools and Schooling; (a new page will open)
Forms of Barriers vs Types of Barriers

Approaching the topic from a special education orientation, Dunst et al. (1991) differentiate family-oriented intervention policies and practices as

They categorize the characteristics of family-oriented interventions in terms of those that focus on

(1) enhancing a sense of community (i.e., "promoting the coming together of people around shared values and common needs in ways that create mutually beneficial interdependencies"),

(2) mobilizing resources and supports (i.e., "building support systems that enhance the flow of resources in ways that assist families with parenting responsibilities),

(3) shared responsibility and collaboration (i.e., "sharing ideas and skills by parents and professionals in ways that build and strengthen collaborative arrangements"),

(4) protecting family integrity (i.e., "respecting the family beliefs and values and protecting the family from intrusion upon its beliefs by outsiders"),

(5) strengthening family functioning (i.e., "promoting the capabilities and competencies of families necessary to mobilize resources and perform parenting responsibilities in ways that have empowering consequences"), and

(6) proactive human service practices (i.e., "adoption of consumer-driven human service-delivery models and practices that support and strengthen family functioning").

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