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INTERVENSI PSYCHOEDUCATIONAL Miller, Bagnato, Dunst, and Mangis (2006) summarized seven principles of psychoeducational interventions. They should include functional interven-tion goals, developmental perspective on change, linkages between func-tional assessment and interventions, functional instructional strategies, attention to functional contexts and settings, integrated support services, and collaborative teamwork. In addition, Miller and colleagues pointed out that family-centered care is critical. Connell and Dishion (2008) supported this position in a three-year longitudinal study of family-centered therapy of middle school youth where they found that inclusion of family therapy prevented an increase in depressive symptoms in a high-riskgroup corn-pared to a control group. More specific to the classroom setting and educational environment, educa-tional modifications and accommodations can be put into place to help children with internalizing disorders succeed in the classroom. Recommendations include providing extra time on homework assignments and tests that can give the child time to calm down and concentrate. The school canprovide weekly counseling and as needed trips to the counselor when the child feels overwhelmed. A designated person can be assigned to check to make sure the child is bringing all homework home and documenting assignments in a day planner. The child can have the ability to retake tests or turn in homework a little late for days when symptoms are had. The teachers can also send emails to the parents notifying them of the cliiklis progress.if the child is taking medication, someone in the school can be decignated to make sure the child gets his or her medication. Other things such as increasing the light, putting up bright-colored posters, or having the teachers speak more Positively about assignments can help the child feel more comfortable in the classroom. With these modifications, students with inter-nalizing disorders can be helped to achieve higher levels of academic success.
SUMMARY
Internalizing disorders are characterized as having symptoms that are typi-cally internal, cognitive-emotional experiences. Internalizing disorders in-clude depression and anxiety and are associated with significant impairment of psychosocial and academic functioning. The school neuropsychologist should be concerned with internalizing disorders for at least two reasons. First, internalizing disorders may emerge as a result of either the direct or indirect effects of acquired or developmental brain dysfunction. Second, in the absence of evidence of brain dysfunction, internalizing disorders are associated with a number of neuropsychological deficits that are amenable to intervention or accommodation. Depression can have a global impact on neuropsychological functioning. Involvement of the frontal lobes in youth with depression is related to executive function deficits, general cognitive deficits, psychomotor retarda-tion, inattention, and memory deficits. Anxiety involves complex brain systems because of the adaptive and phylogentically old nature of the fear response. Youth with anxiety may have comorbid language deficits, memory and learning problems, executive function deficits, slower speed of informa-tion processing, and general cognitive deficits. Also, internalizing disorders have been shown to be highly comorbid with each other and with other classes of disorders. Thus, it is important to conduct a comprehensive neuropsychological evaluation of children presenting with internalizing disorders as well as to assess for internalizing disorders in those who have experienced brain injury. Cognitive-behavioral interventions have been shown as one of the most effective treatments for children with internalizing disorders. In addition, pharmacotherapy and adjustments to the educational milli u are Indic deed forms of treatment.
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