DEFINITION OF SERIOUS EMOTIONAL DISTURBANCE  (SED)

 

Children and Adolescents (Birth -18)

 

Individuals from birth to eighteen years of age who meet the following criteria comprise the target population:

 

A.         A child who possesses a diagnosable, serious disorder under DSM-IV such as pervasive developmental disorder, childhood schizophrenia, schizophrenia of adult-type manifesting in adolescence, conduct disorder, affective disorder, other disruptive behaviors, or other disorders with serious medical implications such as eating disorders, or persistent involvement with alcohol or drugs;

and

B.        Who has a functioning level which includes:  (a) a moderate impairment in at least four, (b) severe impairment in two or (c) extreme impairment in one of the following areas:

1.         Feeling, Mood, and Affect: Uncontrolled emotion is clearly disruptive in its effects on other aspects of a child's life.  Frustration, anger, loneliness and boredom persist beyond the precipitating situation.  Symptoms of distress are pervasive and do not respond to encouragement or reassurance.

2.         Thinking: Disruption of daily life due to impaired thoughts and thinking process.  Inability to distinguish between fantasy and reality. Unusual thoughts or attachments to objects.

3.         Substance Use: Frequent difficulties due to substance use. Repeated use of substances causing difficulty at home or in school.

4.         Family:  Disruption of family relationships.  Family does not function as a unit and experiences frequent turbulence.  Relationships that exist are psychologically devastating.  Lacks family support.  Abused or neglected.

5.         Interpersonal:  Severe inability to establish or maintain a personal social support system.  Lacks close friends or group affiliations.  Socially isolated.  Lacks age appropriate social skills.

6.         Role Performance: Frequent disruption of role performance and individual is unable to meet usual expectations. Persistent behavior problems. Failure, suspension or expelled from school.

7.         Socio-legal:  Inability to maintain conduct within the limits prescribed by law, rules, and strong mores.  Shows little concern for consequences of actions. Delinquent acts and/or frequent contact with law enforcement.        

8.         Self Care/Basic Needs: The ability to care for self is considerably below expectation.

9.         Caregiver Resources: Caregiver has difficulties providing for the child's basic needs or developmental needs such that there is a negative impact on the child's level of functioning.

 

Or

 

C.        Who has a duration of illness for at least one year and has (a) functioning level of moderate impairment in at least two, or (b) severe impairment in one of the following areas:

1.         Feeling, Mood, and Affect: Uncontrolled emotion is clearly disruptive in its effects on other aspects of a child's life.  Frustration, anger, loneliness, and boredom persist beyond the precipitating situation.  Symptoms of distress are pervasive and do not respond to encouragement or reassurance.

2.         Thinking: Disruption of daily life due to impaired thoughts and thinking process.  Inability to distinguish between fantasy and reality.  Unusual thoughts or attachments to objects.

3.         Substance Use: Frequent difficulties due to substance use.  Repeated use of substances causing difficulty at home or in school.

4.         Family:  Disruption of family relationships.  Family does not function as a unit and experiences frequent turbulence.  Relationships that exist are psychologically devastating.  Lacks family support.  Abused or neglected.

5.         Interpersonal:  Severe inability to establish or maintain a personal social support system.  Lacks close friends or group affiliations.  Socially isolated.  Lacks age appropriate social skills.

6.         Role Performance: Frequent disruption of role performance and individual is unable to meet usual expectations. Persistent behavior problems.  Failure, suspension or expelled from school.

7.         Socio-legal:  Inability to maintain conduct within the limits prescribed by law, rules and strong mores.  Shows little concern for consequences of actions.  Delinquent acts and/or frequent contact with law enforcement.                       

8.         Self Care/Basic Needs: The ability to care for self is considerably below expectation.

9.         Caregiver Resources: Caregiver has difficulties in providing for the child's basic needs or developmental needs such that there is a negative impact on the child's level of functioning.

 

NOTE:  Children with a primary diagnosis of developmental disorders are excluded from this definition.

 

Individuals may show less impairment if they are on medications or involved in other treatment services that reduce the symptoms of the illness but moderate to severe impairment in functioning would result with discontinuation of the medications or current treatment.